Background: Coercion can cause harm to both the patient and the patient’s family. Few studies have examined how the coercive treatment of a close relative might affect young next-of-kin. Research questions: We aimed to investigate the views and experiences of health professionals being responsible for supporting young next-of-kin to patients in mental health care in relation to the needs of these young next-of-kin in coercive situations and to identify ethical challenges. Research design: We conducted a qualitative study based on semistructured, (...) focus group interviews and an individual interview. Participants and research context: We held three focus group interviews with six to seven children-responsible staff in each group and one individual interview with a family therapist. The participants were recruited from three hospital trusts in the eastern part of Norway. Ethical considerations: The study was approved by the National Data Protection Official for Research and based on informed consent and confidentiality. Findings: Coercion was not a theme among the participants in relation to their work with young next-of-kin, and there was much uncertainty related to whether these young people need special support to deal with the coercive treatment of their close relative. Despite the uncertainty, the study indicated a need for more information and emotional support among the youth. Discussion: Few studies have addressed the potential impact of coercive treatment of a close family member on young next-of-kin. The findings were consistent with existing research but highlighted disagreement and uncertainty among the children-responsible staff about to what extent the young next-of-kin should visit and whether they should enter the ward unit or not. We identified ethical challenges for the children-responsible staff related to the principle of not inflicting harm. Conclusion: From the perspective of children-responsible staff, it appears that the coercive treatment of a close family member entails a need for extra support of young relatives both in relation to information and the facilitation of visits, but more systematic knowledge about these issues is needed. (shrink)

The present paper explores patients’ experience of lived space at the hospital and at home. To expand the understanding of the existential meaning of lived space the study revisited two empirical studies and a study of a meta-synthesis on health and caring. Phenomenological philosophy was chosen as a theoretical framework for an excursive analysis. The paper demonstrates that existential dimensions of lived space at the hospital and at home differ significantly. For the patients, the hospital space means alien territory as (...) opposed to the familiar territory of home. To some extent the experienced differences are due to the physical environment; however, as our analysis shows, other and more significant meanings are also involved. For patients, lived space at the hospital primarily concerns the influence of complex institutional power structures and specific cultural and social conventions, e.g. the role of the good patient and the ambiance of hospitals. Home, on the other hand, offers familiar lived space in which patients feel protected and safe. Further, the paper relates patients’ experience of lived space to a phenomenological view of lived space in order to illustrate the radical influence of illness on patients’ lifeworld and experience of lived space. The combination of illness and general discomfort may influence patients’ experience of home negatively; the former experience of home as a sanctuary changes into feelings of being left on one’s own and burdened by too much responsibility. Consequently, in the light of the increasing focus on patients’ self-monitoring at home, it is important for healthcare professionals to recognize the influence of spatial aspects on patients’ well-being both at the hospital and at home. (shrink)

Drawing on previous empirical research, we provide an exemplary narrative to illustrate how patients have experienced hospital care organized according to evidence‐based fast‐track programmes. The aim of this paper was to analyse and discuss if and how it is possible to include patients’ individual perspectives in an evidence‐based practice as seen from the point of view of nursing theory. The paper highlights two conflicting courses of development. One is a course of standardization founded on evidence‐based recommendations, which specify a set (...) of rules that the patient must follow rigorously. The other is a course of democratization based on patients’ involvement in care. Referring to the analysis of the narrative, we argue that, in the current implementation of evidence‐based practice, the proposed involvement of patients resembles empty rhetoric. We argue that the principles and values from evidence‐based medicine are being lost in the transformation into the current evidence‐based hospital culture which potentially leads to a McDonaldization of nursing practice reflected as ‘one best way’. We argue for reviving ethics of care perspectives in today's evidence practice as the fundamental values of nursing may potentially bridge conflicts between evidence‐based practice and the ideals of patient participation thus preventing a practice of ‘McNursing’. (shrink)

The aim of this article is to investigate the concept of care in contemporary medical practice and medical ethics. Although care has been hailed throughout the centuries as a crucial ideal in medical practice and as an honourable virtue to be observed in codes of medical ethics, I argue that contemporary medicine and medical ethics suffer from the lack of a theoretically sustainable concept of care and then discuss possible reasons that may help to explain this absence. I draw on (...) the empirical studies of Carol Gilligan on care and connectedness as ontologically situated realities in human life. Based on a philosophical elaboration of her findings on the ethics of care emphasizing relationality, I try to show how the notion of ‘relational ontology’ originating from this stream of thought may be of help in developing a medical ethics that acknowledges care as a perspective to be observed in all interactions between physicians and patients. (shrink)

Making Social Science Matter presents an exciting new approach to the social and behavioral sciences including theoretical argument, methodological guidelines, and examples of practical application. Why has social science failed in attempts to emulate natural science and produce normal theory? Bent Flyvbjerg argues that the strength of social sciences lies in its rich, reflexive analysis of values and power, essential to the social and economic development of any society. Richly informed, powerfully argued, and clearly written, this book opens up a (...) new future for the social sciences. Its empowering message will make it required reading for students and academics across the social and behavioral sciences. (shrink)

Der Sammelband nimmt seinen Ausgang in einer der prominentesten und lebendigsten Debatten inner-halb der neueren Politischen Theorie, die seit uber einer Dekade intensiv auch in der deutschsprachigen Politischen Theorie gefuhrt wird. Im Zentrum der Diskussion steht die Unterscheidung von Politik und Politischem, in deren Licht die Beitrage des Bandes Fragen der radikalen Demokratie, dem Widerstandigen des Politischen und den Rezeptionslinien dieser wichtigen Debatte nachspuren. Mit Beitragen von Werner Friedrichs, Mareike Gebhardt, Anastasoiya Kasko, Oliver Marchart, Martin Nonhoff, Hagen Scholzel, Karsten Schubert, (...) Manon Westphal und Markus Wolf. (shrink)

This article is about nursing theories, the development of nursing knowledge and the underlying, hidden epistemology. The current technical–economical rationality in society and health care calls for a specific kind of knowledge based on a traditional Western, Socratic view of science. This has an immense influence on the development of nursing knowledge. The purpose of the article was therefore to discuss the hidden epistemology of nursing knowledge and theories seen in a broad historical context and point to an alternative epistemology (...) for a future context. It is a question about which nursing theories and what nursing knowledge should be developed in order to benefit patients and relatives of the future. We suggest that future knowledge development in nursing be developed in an interchange between theory and practice and guided by philosophy like a kind of pendulum where all three elements are treated as equals. We suggest a framework for the development of nursing knowledge based on a caring‐ethical practice, a theory on life phenomena in suffering and relationship‐based nursing, and thereby, we may be able to help patients to be cured, to recover, to be alleviated or comforted when suffering. (shrink)

A theory of learning for the future advocates the teaching of a preparedness to respond in a creative way to difference and otherness. This includes an ability to act imaginatively in situations of uncertainties. John Dewey’s pragmatism holds the key to such a learning theory his view of the continuous meetings of individuals and environments as experimental and playful. That pragmatism has not yet been acknowledged as a relevant learning theory for the future may be due to the immediate connotation (...) and the many interpretations associated with the term ‘experience’, which is at the heart of Dewey’s educational thinking. Dewey defi ned experience in a way that is not well understood within educational research, and in a way that is easily confused with the term ‘experiential learning’. The latter refers to the importance of participants’ ‘experiences’ derived from bodily actions and stored in memory as more or less tacit knowledge. (shrink)

In this paper I introduce a theoretical framework on care developed by the Norwegian nurse and philosopher Kari Martinsen, and I argue that this approach has relevance not only within nursing, but also within clinical medicine. I try to substantiate this claim by analysing some of the key concepts in this approach, and I illustrate the potential clinical relevance of this approach by applying it in relation to two care scenarios. Finally, I discuss some of the concerns that have (...) been raised in relation to the aim of highlighting care in medicine. (shrink)

Real Social Science presents a new, hands-on approach to social inquiry. The theoretical and methodological ideas behind the book, inspired by Aristotelian phronesis, represent an original perspective within the social sciences, and this volume gives readers for the first time a set of studies exemplifying what applied phronesis looks like in practice. The reflexive analysis of values and power gives new meaning to the impact of research on policy and practice. Real Social Science is a major step forward in a (...) novel and thriving field of research. This book will benefit scholars, researchers and students who want to make a difference in practice, not just in the academy. Its message will make it essential reading for students and academics across the social sciences. (shrink)

Das Buch entwirft mithilfe von Befragungen des Politischen eine radikale und kritische politische Theorie. Hierfür ist zum einen wichtig, die derzeit vorherrschende politische Theorie und Philosophie, die auf umfassende normative Begründungsprogramme setzt, einer eingehenden Kritik zu unterziehen. Das geschieht in dieser Studie, indem die Konturen einer gesellschaftstheoretischen, kritischen und skeptischen politischen Theorie in Auseinandersetzung mit u.a. Hegel, Marx, Nietzsche, Foucault, Derrida, Lefort, Butler und Rancière ausgeleuchtet werden. Zum anderen wird das Potential dieser anderen kritischen politischen Theorie an drei grundlegenden Gegenstandsbereichen (...) erprobt: Subjektkonstitution, Gesellschaftsordnung und radikale Demokratie. (shrink)

In recent years, there have been many attempts at defining learning as a social phenomenon as opposed to an individual and primarily psychological matter. The move towards understanding learning as social processes has also altered the concept of knowledge as a well-defined element stored in books, brains, CD-Roms, disks, videos or on the Internet. Instead, knowledge has been perceived as a social and context related construction. The roots of the social angle within theories on learning and knowledge are much older (...) than the current literature suggests. This paper illustrates how these theories can be traced back to pragmatism as a philosophy and foundation for an educational approach introduced by the American, John Dewey, more than one hundred years ago. The paper also suggests that Dewey avoids some pitfalls that have come with the new theories, particularly the strong division between individual vs. social and school vs. everyday life learning. (shrink)

BackgroundBefore participation in medical research an informed consent must be obtained. This study investigates whether the readability of patient information and consent documents corresponds to the average educational level of participants in rheumatological studies in the Netherlands, Denmark, and Norway.Methods24 PICDs from studies were collected and readability was assessed independently using the Gunning’s Fog Index and Simple Measure of Gobbledygook grading.ResultsThe mean score for the FOG and SMOG grades were 14.2 and 14.2 respectively. The mean FOG and SMOG grades were (...) 12.7 and 13.3 in the Dutch studies, 15.0 and 14.9 in the Danish studies, and 14.6 and 14.3 in the Norwegian studies, respectively. Out of the 2865 participants, more than 57 % had a lower educational level than the highest readability score calculated in the individual study.ConclusionsAs the readability level of the PICDs did not match the participants’ educational level, consent may not have been valid, as the participants may have had a limited understanding of what they agreed to participate in. There should be more focus on the readability of PICDs. National guidelines for how to write clear and unambiguous PICDs in simple and easily understandable language could increase the focus on the readability of PICD. (shrink)

This narrative case study, created from several qualitative sources, portrays a young woman’s life experiences and an eight yearlong therapy process with Norwegian Psychomotor Physiotherapy. It is analyzed retrospectively from an analytical angle, where NPMP theory is expanded with Løgstrup’s phenomenology of sensation and Ricoeur’s narrative philosophy. Understanding Rita’s narrative through this window displayed some foundational phenomena in a singular way, illuminating embodied experiences in inter-subjective relationships in movement, sensation and time entwined. It illustrates how traumatic life experiences may cause (...) pain, suffering and ruptured narratives with fragmented physical and sensuous reactions, chaos and loss of temporal coherence with consequences for a person’s sense of identity. Rita’s narrative also illuminates how intersubjective interaction has healing potentials when there is time and space for trust to emerge and to support new bodily-based experiences. Embodied sensuous experiences in present time may help clarify past and present and support chronology in narration and the sense of identity. With this exemplary case study, we argue that Løgstrup’s and Ricoeur’s thinking may add valuable perspectives to understanding suffering and healing processes in the field of embodied therapies like NPMP. (shrink)

The recent debate about justice and responsibility increasingly tries to accommodate a new type of agentive situation in which local short-term actions have global long-term consequences due to the action’s embedding in complex interactional networks. Currently the debate is shifting focus from the spatial to the temporal dimension of such wide-scope results of individual actions. This shift from “global ethics” to “intergenerational ethics” and, in particular, “climate ethics” requires some new analytical concepts, however. A definition of wide-scope responsibility aimed at (...) articulating our moral concerns about emergent effects in complex systems, such as climate change, is needed. Working from Iris Marion Young’s “social connection model of responsibility,” a notion of shared ecological responsibility with global and intergenerational scope can be developed. This account is not affected by the so-called non-identity objection to intergenerational ethics. From an action-theoretic rather than normative perspective, the account is “ethically parametrized” in the sense that it can be combined with different conceptions of structural and intergenerational justice. The account can be used to support a concrete climate policy proposal: the “Greenhouse Development Rights Framework.”. (shrink)

The current study analyzes trans-cultural universalities and specificities in the recognition of status roles, dominance perception and social evaluation based on nonverbal cues. Using a novel methodology, which allowed to mask clues to ethnicity and cultural background of the agents, we compared impression of Germans, Americans and Arabs observing computer-animated interactions from the three countries. Only in the German stimulus sample the status roles could be recognized above chance level. However we found significant correlations in dominance perception across all countries. (...) Significant correlations were only found for evaluation between German observers and observers from the other two countries. Perceived dominance uniformly predicted the assignment of status-roles in all cultures. Microanalysis of movement behavior further revealed predictive value of specific nonverbal cues for dominance ratings. Results support the hypothesis of universalities in the processing of dominance cues and point to cultural specificities in evaluative responses to nonverbal behavior. (shrink)

There is limited knowledge about sleep in adolescents with elevated levels of anxiety treated within primary health care settings, potentially resulting in sleep problems not being sufficiently addressed by primary health care workers. In the current study self-reported anxiety, insomnia, sleep onset latency, sleep duration, and depressive symptoms were assessed in 313 adolescents referred to treatment for anxiety within primary health care. Results showed that 38.1% of the adolescents met criteria for insomnia, 34.8% reported short sleep duration, and 83.1% reported (...) long sleep onset latency. Total anxiety symptoms were related to all sleep variables after controlling for age and sex. Furthermore, all anxiety symptom sub-types were associated with insomnia and sleep onset latency, whereas most anxiety subtypes were associated with sleep duration. Adolescents’ depressive symptoms accounted for most of the anxiety-sleep associations, emphasizing the importance of depressive symptoms for sleep. However, anxiety was associated with insomnia and sleep onset latency also among youth with low levels of depressive symptoms. The findings suggests that primary health care workers should assess sleep duration, sleep onset latency, and insomnia in help-seeking adolescents with anxiety. (shrink)

The human genome contains about 30,000 genes, each creating several transcripts per gene. Transcript structures and expression are studied by high‐throughput transcriptomic techniques using microarrays. Generally, transcripts are not directly operating molecules, but are translated into functional proteins, post‐translationally modified by proteolysis, glycosylation, phosphorylation, etc., sometimes with great functional impact. Proteins need to be analyzed by proteomic techniques, less suited for high‐throughput. Two‐dimensional polyacrylamide gel electrophoresis (2D‐PAGE), separating thousands of proteins has developed slowly over the past quarter of a century. (...) This technique is now quite reproducible and suitable for differential proteomics, comparing normal and diseased cells/tissues revealing differentially regulated proteins. 2D‐PAGE is combined with protein‐identification methods, currently mass spectrometry (MS), which has been significantly improved over the last decade. Other proteomic techniques studying protein–protein interactions are now either established or still being developed, such as peptide or protein arrays, phage display, and the yeast two‐hybrid system. The strengths and weaknesses of these techniques are discussed. BioEssays 26:901–915, 2004. © 2004 Wiley Periodicals, Inc. (shrink)

Although many aspects of the physiological and pathophysiological mechanisms remain unknown, recent advances in our knowledge suggest that the CREC proteins are promising disease biomarkers or targets for therapeutic intervention in a variety of diseases. The CREC family of low affinity, Ca2+‐binding, multiple EF‐hand proteins are encoded by five genes,RCN1,RCN2,RCN3,SDF4, andCALU, resulting in reticulocalbin, ER Ca2+‐binding protein of 55 kDa (ERC‐55), reticulocalbin‐3, Ca2+‐binding protein of 45 kDa (Cab45), and calumenin. Alternative splicing increases the number of gene products. The proteins are (...) localized in the cytosol, in various parts of the secretory pathway, secreted to the extracellular space or localized on the cell surface. The emerging functions appear to be highly diverse. The proteins interact with several different ligands. Rather well‐described functions are attached to calumenin with the inhibition of several proteins in the endoplasmic or sarcoplasmic reticulum membrane, the vitamin K12,3‐epoxide reductase, the γ‐carboxylase, the ryanodine receptor, and the Ca2+‐transporting ATPase. Other functions concern participation in the secretory process, chaperone activity, signal transduction as well as participation in a large variety of disease processes. (shrink)

_A Conversation with Cardiologist and Professor Dr. Jens Flensted Lassen._ The essay is a conversation with cardiologist Jens Flensted Lassen about the cultural history of the heart, the connections between the humanities and the hard sciences.

In his historical novel from 1835, Prince Otto of Denmark and his Time, the poet Bernhard Severin Ingemann (1789-1862) established the unknown, yet historical character, Prince Otto of Denmark (1310-1346) as the hero of the novel. This choice has puzzled critics ever since, due to the fact that Prince Otto seems less a potential king than his brother Valdemar IV (1320-1372) who actually became a king of Denmark. Georg Brandes (1842-1927) claimed that Otto mirrored Ingemann’s persona as weak and feminine, (...) a “monk” not suited for kingship. In his ridicule of Prince Otto and Ingemann, Brandes reveals his ideas about gender, masculinity and femininity, but as this article seeks to show, such ideas are tied to time and place. Read from the distance of 2019, Ingemann’s feminine medieval hero might seem more modern and progressive than Brandes would have him. In this sense, the article is a piece of “queer medievalism”. (shrink)

Gegenstand dieser politikwissenschaftlichen Arbeit ist weder die >Textur des Gewissens von Politikern, noch das sozialöffentliche Gewissen, also die Untersuchung von Wohlfahrts-sytemen. Es geht vielmehr um Konzeptionen des moralisch-individuellen Gewissens und der darin konturierten Beziehung zum politischen System. Zentrales Thema ist mithin die Frage nach dem Verhältnis von individueller Freiheit und politischer Ordnung. Dabei wird das semantische Feld im Kontext der Termini Gewissen, Moral und Ethik neu formuliert. Mittels einer Analyse der Gewissensdiskurse in der Frühmoderne sowie in der Spätmoderne läßt sich (...) die These entfalten, daß die Erkenntnis der neuartigen normativen Prob-lemstrukturen im technischen Zeitalter eine politologische Aufklärung erfordern, welche die zu-nehmend erkennbar werdenden Grenzen des Wissens in die Theoriebildung einbezieht. Die Poli-tik- und Sozialwissenschaften befinden sich gegenwärtig in einer Schwellenphase, in der die herkömmlichen normativen Erklärungsmuster, die in der Tradition des ethischen Humanismus verwurzelt sind, zu erodieren beginnen - doch werden die weitreichenden Konsequenzen des gegenwärtig sich vollziehenden sozio-technischen Umbruchs für die politische Ethik allenfalls halbherzig gezogen. Anstelle des populären Rufs nach einer Ethiksteuerung, die via wissenschaft-licher Begründungskonstruktionen und Regelwerken die politische Emanzipation der Individuen verbindlich anleiten soll, wird in diesem Buch für einen Perspektivenwechsel durch die Ver-schiebung der gewissensrelevanten Leitfragen votiert. Dabei erweist sich - kontraintuitiv -, daß dem Subjekt. (shrink)

This article investigates the original Chinese sources for two circular trigram arrangements that have played a crucial role in numerology associated with the Book of Changes since the Song dynasty. While attempting to clarify the nature and the origins of these and related diagrams, recent secondary literature on topic is reviewed, especially the influential articles by Schuyler Cammann.

In the article, we propose to frame organizational learning as inquiry into and resolving tensions arising from the performance of different commitments to work and its organizing. We expand learning as participation with its focus upon identity and membership to the development of work and the experiences and knowledge of its participants. The proposal is inspired by pragmatist philosophy both through its emphasis on learning as ascribing meaning to experience and its sociological version, symbolic interactionism with its emphasis on work (...) and its organizing in social arenas/worlds. We show that a pragmatist learning theory, founded on principles of non-dualistic, non-hierarchy, and a non-linear view on relations, thinking and practice aligns well with the proposed refurbished learning approach via complexity theory in this special issue. Further, we propose that Dewey’s pragmatism adds an important feature to a refurbished theory of learning in organizations by emphasizing the tensional and uncertain aspects of situations as contextual wholes that for a pragmatist learning theory constitute the analytical point of departure. (shrink)

This study elaborates on narrative resources emerging in the treatment of longlasting musculoskeletal and psychosomatic disorders in Norwegian psychomotor physiotherapy. Patients’ experiences produced in focus group interviews were analyzed from a narrative perspective, combining common themes across groups with in depth analysis of selected particular stories. NPMP theory expanded by Løgstrup’s and Ricoeur’s philosophy, and Mattingly’s and Frank’s narrative approach provided the theoretical perspective. Patients had discovered meaning imbued in muscular tension. Control shifted from inhibiting discipline and cognitive strategies, towards (...) more contingence with gravity and sensation, and increased freedom to be what and who they were. Trust, time, open speech, and being respectfully listened to were described as therapeutic pre-conditions. The body was experienced as the source of their voice as their own. As tension patterns transformed, novel experience in sensation appeared to feed narrative imagination, reshaping past plots, embodied identity and future prospects. NPMP was disclosed as a treatment integrating detection, battle and repair as narrative subplots, but the core narrative was the journey of transformation. Novel embodied narrative resources nourished the quest for a life and identity in tune with the body as one’s own. (shrink)