Tocqueville's contradictory writings on imperialism have produced interpretations that range from unrepentant realism to lapsed universalism. This essay considers the moral psychology that underlies his position. It argues that Tocqueville's writings on colonialism exemplify his resort to apologia when his deepest apprehensions are aroused and offers a typology of Tocquevillean rhetorical evasions: the mechanisms by which he attempts to quell perceptions of moral dissonance. It also argues that Tocqueville's evasion of the challenge of Algeria illustrates a particular kind of liberal (...) failure and a peculiar liberal temptation. By avoiding rather than confronting the conflicting intuitions underlying his moral judgments, Tocqueville betrays the promise of his liberalism by failing to explore the tensions implicit in the practice of liberal democracy. These strategies to deaden awareness of complicity in colonial violence appear disturbingly familiar in a world in which national interests and universally acknowledged "human maxims" increasingly collide in the liberal conscience. (shrink)

Alexis de Tocqueville is one of the most renowned and debated figures in contemporary political and social theory. This clear new introduction to de Tocqueville's thought examines in detail his classic works and their major themes. Beginning with an analysis of de Tocqueville's philosophy against the historical background and intellectual context of his time, Welch traces the development of his philosophy on democracy, revolution, history, slavery, religion, and gender--including chapters on de Tocqueville's writings on France and the United States. (...) This volume also explores de Tocqueville's historical legacy as well as his contemporary significance, illuminating the reasons why this displaced nineteenth century aristocrat has become one of the most popular figures in current political and social thought. (shrink)

The Cambridge Companion to Tocqueville contains a set of critical interpretive essays by internationally renowned scholars on the work of Alexis de Tocqueville. The essays cover Tocqueville's major themes (liberty, equality, democracy, despotism, civil society, religion) and texts (Democracy in America, Recollections, Old Regime and the Revolution, other important reports, speeches and letters). The authors analyze both Tocqueville's contributions as a theorist of modern democracy and his craft as a writer. Collections of secondary work on Tocqueville have tended to fall (...) into camps, either bringing together only scholars from one point of view or discipline, or treating only one major text. This Companion transcends national, ideological, disciplinary, and textual boundaries to bring together the best in recent Tocqueville scholarship. The essays not only introduce Tocqueville's major themes and texts, but also put forward provocative arguments that advance the field of Tocqueville studies. (shrink)

This essay examines Tocqueville's conception of the “social” against the background of debates over the relationship between the social and the political in France from the Revolution to mid-century. It focuses on three groups: those associated with the social philosophy of industrialisme, those concerned with the evils of pauperism from the standpoint of Catholic social reform, and those allied with the new Doctrinaire view of society and politics. It argues that Tocqueville consistently resisted the primacy of the “social” as articulated (...) by these thinkers, even in the seductive form offered by François Guizot, whose influence on Tocqueville is examined in light of recent debates over this issue. (shrink)

Moral distress (MD) is well-documented within the nursing literature and occurs when constraints prevent a correct course of action from being implemented. The measured frequency of MD has increased among nurses over recent years, especially since the COVID-19 Pandemic. MD is less understood among nurse leaders than other populations of nurses. A qualitative systematic review was conducted with the aim to synthesize the experiences of MD among nurse leaders. This review involved a search of three databases (Medline, CINAHL, and APA (...) PsychINFO) which resulted in the retrieval of 303 articles. PRISMA review criteria guided authors during the article review and selection process. Following the review, six articles were identified meeting review criteria and quality was assessed using the Critical Appraisal Skills Programme (CASP) Checklist for qualitative studies. No ethical review was required for this systematic review. The six studies included in this review originated from the United States, Brazil, Turkey, and Iran. Leadership roles ranged from unit-based leadership to executive leadership. Assigned quality scores based upon CASP criteria ranged from 6 to 9 (moderate to high quality). Three analytical themes emerged from the synthesis: (1) moral distress is consuming; (2) constrained by the system; and (3) adapt to overcome. The unique contributors of MD among nurse leaders include the leadership role itself and challenges navigating moral situations as they arise. The nurse leader perspective should be considered in the development of future MD interventions. (shrink)

This paper reframes the futility debate, moving away from the question “Who decides when to end what is considered to be a medically inappropriate or futile treatment?” and toward the question “How can society make policy that will best account for the multitude of values and conflicts involved in such decision-making?” It offers a pragmatist moral epistemology that provides us with a clear justification of why it is important to take best standards, norms, and physician judgment seriously and a clear (...) justification of why ample opportunity must be made for patients, families, and society to challenge those standards and norms. (shrink)

In 2012, a U.S. Institute of Medicine report called for a different approach to health care: “Left unchanged, health care will continue to underperform; cause unnecessary harm; and strain national, state, and family budgets.” The answer, they suggested, would be a “continuously learning” health system. Ethicists and researchers urged the creation of “learning health organizations” that would integrate knowledge from patient‐care data to continuously improve the quality of care. Our experience with an ongoing research study on atrial fibrillation—a trial known (...) as IMPACT‐AFib—gave us some insight into one of the challenges that will have to be dealt with in creating these organizations. Although the proposed educational intervention study placed no restrictions on what providers and health plans could do, the oversight team argued that the ethical principle of beneficence did not allow the researchers to be “bystanders” in relation to a control group receiving suboptimal care. In response, the researchers designed a “workaround” that allowed the project to go forward. We believe the experience suggests that what we call “bystander ethics” will create challenges for the kinds of quality improvement research that LHOs are designed to do. (shrink)

In 2012, a U.S. Institute of Medicine report called for a different approach to health care: “Left unchanged, health care will continue to underperform; cause unnecessary harm; and strain national, state, and family budgets.” The answer, they suggested, would be a “continuously learning” health system. Ethicists and researchers urged the creation of “learning health organizations” that would integrate knowledge from patient‐care data to continuously improve the quality of care. Our experience with an ongoing research study on atrial fibrillation—a trial known (...) as IMPACT‐AFib—gave us some insight into one of the challenges that will have to be dealt with in creating these organizations. Although the proposed educational intervention study placed no restrictions on what providers and health plans could do, the oversight team argued that the ethical principle of beneficence did not allow the researchers to be “bystanders” in relation to a control group receiving suboptimal care. In response, the researchers designed a “workaround” that allowed the project to go forward. We believe the experience suggests that what we call “bystander ethics” will create challenges for the kinds of quality improvement research that LHOs are designed to do. (shrink)

This article provides current Schwartz Values Survey (SVS) data from samples of business managers and professionals across 50 societies that are culturally and socioeconomically diverse. We report the society scores for SVS values dimensions for both individual- and societal-level analyses. At the individual-level, we report on the ten circumplex values sub-dimensions and two sets of values dimensions (collectivism and individualism; openness to change, conservation, self-enhancement, and self-transcendence). At the societal-level, we report on the values dimensions of embeddedness, hierarchy, mastery, affective (...) autonomy, intellectual autonomy, egalitarianism, and harmony. For each society, we report the Cronbach’s α statistics for each values dimension scale to assess their internal consistency (reliability) as well as report interrater agreement (IRA) analyses to assess the acceptability of using aggregated individual level values scores to represent country values. We also examined whether societal development level is related to systematic variation in the measurement and importance of values. Thus, the contributions of our evaluation of the SVS values dimensions are two-fold. First, we identify the SVS dimensions that have cross-culturally internally reliable structures and within-society agreement for business professionals. Second, we report the society cultural values scores developed from the twenty-first century data that can be used as macro-level predictors in multilevel and single-level international business research. (shrink)

_341_ _Objectives: _In patients with multivessel disease both the detection of the culprit lesion and the exact allocation are important preconditions for sufficient treatment and improved outcome. In a vessel based approach the combination of quantitative coronary angiography and fractional flow reserve measured by a pressure wire should be advantageous compared to myocardial SPECT, as morphological and functional information is delivered simultaneously. Therefore our aim was to evaluate MS in the detection and allocation of hemodynamically significant stenoses obtained by the (...) combined gold standard QCA plus FFR in patients with multivessel disease. _Methods: _FFR and QCA of 95 vessels in 80 patients have been evaluated. Hemodynamically significant target lesions were defined as intermediate stenoses between 50 and 75% with an FFR. (shrink)

This article provides current Schwartz Values Survey data from samples of business managers and professionals across 50 societies that are culturally and socioeconomically diverse. We report the society scores for SVS values dimensions for both individual- and societallevel analyses. At the individual- level, we report on the ten circumplex values sub- dimensions and two sets of values dimensions. At the societal- level, we report on the values dimensions of embeddedness, hierarchy, mastery, affective autonomy, intellectual autonomy, egalitarianism, and harmony. For each (...) society, we report the Cronbach' s? statistics for each values dimension scale to assess their internal consistency as well as report interrater agreement analyses to assess the acceptability of using aggregated individual level values scores to represent country span sp. (shrink)

Previous studies examining EEG and LORETA in patients with chronic pain discovered an overactivation of high theta and low beta power in central regions. MEG studies with healthy subjects correlating evoked nociception ratings and source localization described delta and gamma changes according to two music interventions. Using similar music conditions with chronic pain patients, we examined EEG in response to two different music interventions for pain. To study this process in-depth we conducted a mixed-methods case study approach, based on three (...) clinical cases. Effectiveness of personalized music therapy improvisations versus preferred music on chronic pain was examined with 16 participants. Three patients were randomly selected for follow-up EEG sessions three months post-intervention, where they listened to recordings of the music from the interventions provided during the research. To test the difference of EM versus preferred music, recordings were presented in a block design: silence, their own composed EM, preferred music, and a non-participant’s EM as a control. Participants rated their pain before and after the EEG on a 1–10 scale. We conducted a detailed single case analysis to compare all conditions, as well as a group comparison of entrainment-healing condition versus preferred music condition. Power spectrum and according LORETA distributions focused on expected changes in delta, theta, beta, and gamma frequencies, particularly in sensory-motor and central regions. Intentional moment-by-moment attention on the sounds/music rather than on pain and decreased awareness of pain was experienced from one participant. Corresponding EEG analysis showed accompanying power changes in sensory-motor regions and LORETA projection pointed to insula-related changes during entrainment-pain music. LORETA also indicated involvement of visual-spatial, motor, and language/music improvisation processing in response to his personalized EM which may reflect active recollection of creating the EM. Group-wide analysis showed common brain responses to personalized entrainment-healing music in theta and low beta range in right pre- and post-central gyrus. We observed somatosensory changes consistent with processing pain during entrainment-healing music that were not seen during preferred music. These results may depict top–down neural processes associated with active coping for pain. (shrink)

BackgroundAccurate reporting on sex and gender in health research is integral to ensuring that health interventions are safe and effective. In Canada and internationally, governments, research organizations, journal editors, and health agencies have called for more inclusive research, provision of sex-disaggregated data, and the integration of sex and gender analysis throughout the research process. Sex and gender analysis is generally defined as an approach for considering how and why different subpopulations (e.g., of diverse genders, ages, and social locations) may experience (...) health conditions and interventions in different or similar ways.The objective of this study was to assess the extent and nature of reporting about sex and/or gender, including whether sex and gender analysis (SGA) was carried out in a sample of Canadian randomized controlled trials (RCTs) with human participants.MethodsWe searched MEDLINE from 01 January 2013 to 23 July 2014 using a validated filter for identification of RCTs, combined with terms related to Canada. Two reviewers screened the search results to identify the first 100 RCTs that were either identified in the trial publication as funded by a Canadian organization or which had a first or last author based in Canada. Data were independently extracted by two people from 10% of the RCTs during an initial training period; once agreement was reached on this sample, the remainder of the data extraction was completed by one person and verified by a second.ResultsThe search yielded 1433 records. We screened 256 records to identify 100 RCTs which met our eligibility criteria. The median sample size of the RCTs was 107 participants (range 12–6085). While 98% of studies described the demographic composition of their participants by sex, only 6% conducted a subgroup analysis across sex and 4% reported sex-disaggregated data. No article defined “sex” and/or “gender.” No publication carried out a comprehensive sex and gender analysis.ConclusionsFindings highlight poor uptake of sex and gender considerations in the Canadian RCT context and underscore the need for better articulated guidance on sex and gender analysis to improve reporting of evidence, inform policy development, and guide future research. (shrink)

Primary progressive aphasia is a clinical syndrome in which patients progressively lose speech and language abilities. Three variants are recognized: logopenic, associated with phonology and/or short-term verbal memory deficits accompanied by left temporo-parietal atrophy; semantic, associated with semantic deficits and anterior temporal lobe atrophy; non-fluent associated with grammar and/or speech-motor deficits and inferior frontal gyrus atrophy. Here, we set out to investigate whether the three variants of PPA can be dissociated based on error patterns in a single language task. We (...) recruited 21 lvPPA, 28 svPPA, and 24 nfvPPA patients, together with 31 healthy controls, and analyzed their performance on an auditory noun-to-verb generation task, which requires auditory analysis of the input, access to and selection of relevant lexical and semantic knowledge, as well as preparation and execution of speech. Task accuracy differed across the three variants and controls, with lvPPA and nfvPPA having the lowest and highest accuracy, respectively. Critically, machine learning analysis of the different error types yielded above-chance classification of patients into their corresponding group. An analysis of the error types revealed clear variant-specific effects: lvPPA patients produced the highest percentage of “not-a-verb” responses and the highest number of semantically related nouns ; in contrast, svPPA patients produced the highest percentage of “unrelated verb” responses and the highest number of light verbs. Taken together, our findings indicate that error patterns in an auditory verb generation task are associated with the breakdown of different neurocognitive mechanisms across PPA variants. Specifically, they corroborate the link between temporo-parietal regions with lexical processing, as well as ATL with semantic processes. These findings illustrate how the analysis of pattern of responses can help PPA phenotyping and heighten diagnostic sensitivity, while providing insights on the neural correlates of different components of language. (shrink)

As A. B. Lloyd points out, the passage from Herodotus which includes this sentence is the most important non-Egyptian commentary on Ancient Egyptian shipbuilding. In the years following the discovery of the Dynasty IV ships buried beside Khufu's pyramid at Giza , J. S. Morrison suggested a change in the translation of the word επκτωσαν. Traditionally, and in Lloyd's commentary, the verb μπακτω has been interpreted as meaning ‘to caulk’. Morrison, however, believes that επκτωσαν ought to refer to reinforcement of (...) a ship's fastenings with papyrus ropes. He bases this interpretation on the evidence of the Khufu boats, which are sewn through v-shaped mortises across the hull's width , and on the argument that caulking is better done from the outside. Lloyd has challenged this translation, but we would like to support it with some further evidence, in particular evidence of Egyptian shipbuilding practice. (shrink)

A small large cardinal upper bound in V for proving when certain subsets of ω 1 (including the universally Baire subsets) are precisely those constructible from a real is given. In the core model we find an exact equivalence in terms of the length of the mouse order; we show that $\forall B \subseteq \omega_1 \lbrack B$ is universally Baire $\Leftrightarrow B \in L\lbrack r \rbrack$ for some real r] is preserved under set-sized forcing extensions if and only if there (...) are arbitrarily large "admissibly measurable" cardinals. (shrink)

A small large cardinal upper bound in $V$ for proving when certain subsets of $\omega_1$ are precisely those constructible from a real is given. In the core model we find an exact equivalence in terms of the length of the mouse order; we show that $\forall B \subseteq \omega_1 \lbrack B$ is universally Baire $\Leftrightarrow B \in L\lbrack r \rbrack$ for some real $r\rbrack$ is preserved under set-sized forcing extensions if and only if there are arbitrarily large "admissibly measurable" cardinals.

Although Saghai primarily focuses on distinguishing nudges from other forms of influence, ‘Salvaging the Concept of Nudge’ offers a definition of nudges that could blunt much of the moral criticism of nudging and clarify debates about specific policies.1 The definition he offers, however, restricts the class of nudges to include only those influences that counter an individual's preferences; thus, contrary to what Thaler and Sunstein say, nudges cannot be instances of libertarian paternalism.1 ,2According to Saghai, ‘A nudges B when A (...) makes it more likely that B will ϕ, primarily by triggering B's shallow cognitive processes, while A's influence preserves B's choice-set and is substantially non-controlling ’. Because the second condition—the substantial non-control condition—is supposed to ensure that nudges preserve freedom in a robust sense, this condition warrants careful attention.According to Saghai, A's influence is substantially non-controlling ‘when B could easily not ϕ if she did not want to ϕ’. To determine whether a particular influence constitutes a nudge, we must ask whether from B's perspective that influence is easily resistible. …. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Democratic Hope: Pragmatism and the Politics of TruthCheryl MisakRobert B. Westbrook Democratic Hope: Pragmatism and the Politics of Truth Ithaca and London: Cornell University Press, 2005. xvi + 246 pp.Robert Westbrook, who in my view is our best intellectual historian of pragmatism, has written what is sure to be a major contribution to the study of pragmatist political theory, a branch of political theory which has recently seen (...) a salutary surge of interest. Democratic Hope: Pragmatism and the Politics of Truth is beautifully written, with a steady eye on the non-philosopher, yet it is sophisticated and nuanced so as to engage the most careful philosophers in the field and to genuinely advance current debates.It is interesting to see just what benefits come from having such an excellent intellectual historian take the long and wide view on pragmatism. For instance, Westbrook doesn't merely look at the classical pragmatist he thinks has the most important things to say about politics. Dewey is usually is taken to be the pragmatist of choice in political theory, although I myself have been rather single-minded about Peirce's implied account of politics. Westbrook gives us excellent accounts of Dewey and Peirce, but he also looks at James, at Mead, at how pragmatism and Marxism have had an off-again, on-again relationship, etc. That is, he gives us a panoramic view of how the pragmatists—classical and contemporary—line up in political theory. This is not only extremely useful to any student of pragmatism, but it is fascinating as well.Westbrook's abilities as an intellectual historian also have him making bang-on points about the debate within pragmatism for the heart and soul of pragmatism. Pragmatism, he says, has always been less a coherent philosophical school than a contentious family of thinkers holding distinct but related positions on the "workmanlike" nature of knowledge, meaning, and truth (p.1).The central debate within pragmatism is between those who take pragmatism to be akin to post-modern views, where there is no truth and objectivity to be had anywhere, and those who take pragmatism to promise a less absolutist account of truth—an account of truth on which we can make sense of aiming at the truth. On the one side of the debate we have Rorty and his [End Page 279] predecessors saying that there is no truth at which we might aim—only solidarity or agreement within a community. In some moods he goes as far as claiming that truth and objectivity are nothing more than what our peers will let us get away with saying. On the other side of the divide, we have those who think of pragmatism as rejecting an ahistorical, transcendental, or metaphysical theory of truth, but nonetheless being committed to doing justice to the objective dimension of human inquiry—to the fact that those engaged in deliberation and investigation take themselves to be aiming at getting things right, avoiding mistakes, and improving their beliefs and theories. On this more objective kind of pragmatism, the fact that our inquiries are historically situated does not entail that they lack objectivity. And the fact that standards of objectivity themselves come into being and evolve does not strip them of their worth. In James' well-known words, the trail of the human serpent is over everything, but (as James himself may or may not have seen) this does not toss us into a sea of arbitrariness, where there is no truth or where truth varies from person to person and culture to culture. Westbrook puts the issue nicely: "Post-modernist skeptics and their few neopragmatist admirers turn to the old pragmatists because they (correctly) see them as potential partners in a struggle against 'strong', that is, absolutist and 'totalizing', conceptions of truth. But what they neglect is the old pragmatists' conviction (shared by many neopragmatists) that once they had overcome absolutism, they could then resume traveling down the road of inquiry in a more fuel-efficient vehicle than Reason toward a more modest destination than Truth" (p. 7).Westbrook aligns himself with the kind of pragmatism that aims to take account of our human cognitive aspirations... (shrink)

We give limits defined in terms of abstract pointclasses of the amount of determinacy available in certain canonical inner models involving strong cardinals. We show for example: Theorem A. $\mathrm{D}\mathrm{e}\mathrm{t}\text{\hspace{0.17em}}({\mathrm{\Pi }}_{1}^{1}-\mathrm{I}\mathrm{N}\mathrm{D})$ ⇒ there exists an inner model with a strong cardinal. Theorem B. Det(AQI) ⇒ there exist type-1 mice and hence inner models with proper classes of strong cardinals. where ${\mathrm{\Pi }}_{1}^{1}-\mathrm{I}\mathrm{N}\mathrm{D}\phantom{\rule{0ex}{0ex}}$ (AQI) is the pointclass of boldface ${\mathrm{\Pi }}_{1}^{1}$ -inductive (respectively arithmetically quasi-inductive) sets of reals.

Broadening participation in early science, technology, engineering and math learning outside of school is important for families experiencing poverty. We evaluated variations of the Teaching Together STEM pre-kindergarten program for increasing parent involvement in STEM learning. This informal STEM, family engagement program was offered in 20 schools where 92% of students received free/reduced lunch. The core treatment included a series of family education workshops, text messages, and family museum passes. The workshops were delivered at school sites by museum outreach educators. (...) We randomly assigned schools to business-as-usual control or one of three additive treatment groups. Using an additive treatment design, we provided the core program in Treatment A, we added take-home STEM materials in Treatment B, and added materials + parent monetary rewards in Treatment C. The primary outcome was parent involvement in STEM. There were no significant impacts of any treatment on parent involvement; however, the groups that added take-home materials had larger effect sizes on parent involvement at posttest and later, kindergarten follow-up. Adding parent monetary rewards only produced short-term improvements in parent involvement that faded at follow-up. We discuss implications for other community-sponsored family engagement programs focused on informal STEM learning, including considering characteristics of families who were more versus less likely to attend. These null findings suggest that alternatives to in-person family education workshops should be considered when parents are experiencing poverty and have competing demands on their time. (shrink)

In recent work, Cheryl Misak has developed a novel justification of deliberative democracy rooted in Peircean epistemology. In this article, the author expands Misak's arguments to show that not only does Peircean pragmatism provide a justification for deliberative democracy that is more compelling than the justifications offered by competing liberal and discursivist views, but also fixes a specific conception of deliberative politics that is perfectionist rather than neutralist. The article concludes with a discussion of whether the `epistemic perfectionism' implied (...) by the pragmatist argument could be endorsed by liberal democrats. Key Words: deliberative democracy • epistemology • liberalism • Cheryl Misak • Charles Peirce • perfectionism • pragmatism • truth. (shrink)