As health systems around the world turn towards highly distributed, specialized and cooperative structures to increase quality and safety of care as well as efficiency and efficacy of delivery processes, there is a growing need for supporting communication and collaboration of all parties involved with advanced ICT solutions. The Electronic Health Record (EHR) provides the information platform which is maturing towards the eHealth core application. To meet the requirements for sustainable, semantically interoperable, and trustworthy EHR solutions, different standards and different (...) national strategies have been established. The workshop summarizes the requirements for such advanced EHR systems and their underlying architecture, presents different strategies and solutions advocated by corresponding protagonists, discusses pros and cons as well as harmonization and migration strategies for those approaches. It particularly highlights a turn towards ontology-driven architectures. (shrink)

This collection of essays fairly exhibits the diversity of opinions about and approaches to the study of Nietzsche within the contemporary academy’s influential and far flung Nietzsche establishment. Notwithstanding the absence of feminist interpretations of Nietzsche and despite the omission of chapters that take seriously Nietzsche’s debt to the ancients, critique of the spirit of democracy, defense of a rank order of desires and souls, recurring articulations of an aristocratic politics, attack on the morally and politically debilitating effects of professional (...) scholarship, and persistent celebration of the philosopher as the highest human type, this book will prove useful to amateurs and professionals alike. (shrink)

IntroductionLittle is known about risk factors for both Long COVID and somatic symptoms that develop in individuals without a history of COVID-19 in response to the pandemic. There is reason to assume an interplay between pathophysiological mechanisms and psychosocial factors in the etiology of symptom persistence.ObjectiveTherefore, this study investigates specific risk factors for somatic symptom deterioration in a cohort of German adults with and without prior SARS-CoV-2 infection.MethodsGerman healthcare professionals underwent SARS-CoV-2 IgG antibody testing and completed self-rating questionnaires at baseline (...) and 21 months later between April 2020 and February 2022. Differences in variables between the time points were analyzed and a regression analysis was performed to predict somatic symptom deterioration at follow-up.ResultsSeven hundred fifty-one adults completed both assessments. Until follow-up, n = 58 had contracted SARS-CoV-2 confirmed by serology. Between baseline and follow-up, signs of mental and physical strain increased significantly in the sample. Symptom expectations associated with COVID-19 and a self-reported history of COVID-19, but not serologically confirmed SARS-CoV-2 infection, significantly predicted somatic symptom deterioration at follow-up. A further predictor was baseline psychological symptom burden.ConclusionsThis study supports a disease-overarching biopsychosocial model for the development of burdensome somatic symptoms during the COVID-19 pandemic and supports research findings that symptom burden may be more related to the psychosocial effects of the pandemic than to infection itself. Future studies on Long COVID should include SARS-CoV-2 negative control groups and consider symptom burden prior to infection in order to avoid an overestimation of prevalence rates. (shrink)

This paper throws some light on the nature of argumentation, its use and advantages, within the setting of doctor–patient interaction. It claims that argumentation can be used by doctors to offer patients reasons that work as ontological conditions for enhancing the decision making process, as well as to preserve the institutional nature of their relationship with patients. In support of these claims, selected arguments from real-life interactions are presented in the second part of the paper, and analysed by means of (...) a model of argumentation borrowed from classical rhetoric, and refined according to the modern orientation of the pragma-dialectic approach. (shrink)

General practice consultation has often been characterized by pragma-dialecticians as an argumentative activity type. These characterizations are typically derived from theoretical insights and qualitative analyses. Yet, descriptions that are based on quantitative data are thus far lacking. This paper provides a detailed account of the development of an instrument to guide the quantitative analysis of argumentation in doctor–patient consultation. It describes the implementation and preliminary results of a content analysis of seventy videotaped medical consultations of which the extent and type (...) of doctors’ argumentative support for medical opinions and advice are analyzed. Based on the study results, this paper addresses the merits of observational studies using content analysis as a method for the analysis of argumentative discourse in context as well as some of its key challenges and limitations, laying bare the opportunities for future research. (shrink)

Advances in genetic research have created the need to inform consumers. Yet, the communication of hereditary risk and of the options for how to deal with it is a difficult task. Due to the abstract nature of genetics, people tend to overestimate or underestimate their risk. This paper addresses the issue of how to communicate risk information on hereditary breast and ovarian cancer through an online application. The core of the paper illustrates the design of OPERA, a risk assessment instrument (...) that applies the UK National Institute of Health and Clinical Excellence's guidelines on the basis of (i) the number of relatives on the same side of the family with the same cancer or cancers that are known to run together; (ii) the ages of these relatives at diagnosis and (iii) the closeness of the family relationship with the person who is doing the assessment. By relying on the argumentation theory, we explain how the communication strategy that OPERA implements is essentially based on Perelman and Olbrechts-Tyteca's deductive argumentation by association. By using as premises “facts” (propositions about reality that can be assumed without further justification) and “truths” (propositions that make connections about facts), OPERA delivers its claims with an ex auctoritate causal link aimed at transferring the audience's acceptance of the cause to the effect. Overall, the design of OPERA rests on its capacity to induce users' active processing of risk information through an appeal to their reasoning faculty. In the conclusion, we present some results from a pilot evaluation of users' acceptance of OPERA. (shrink)

The linguistic complexity of words has largely been studied on the behavioral level and in experimental settings. Only little is known about the neural processes underlying it in uninstructed, spontaneous conversations. We built up a multimodal neurolinguistic corpus composed of synchronized audio, video, and electrocorticographic (ECoG) recordings from the fronto-temporo-parietal cortex to address this phenomenon based on uninstructed, spontaneous speech production. We performed extensive linguistic annotations of the language material and calculated word complexity using several numeric parameters. We orthogonalized the (...) parameters with the help of a linear regression model. Then, we correlated the spectral components of neural activity with the individual linguistic parameters and with the residuals of the linear regression model, and compared the results. The proportional relation between the number of consonants and vowels, which was the most informative parameter with regard to the neural representation of word complexity, showed effects in two areas: the frontal one was at the junction of the premotor cortex, the prefrontal cortex, and Brodmann area 44. The postcentral one lay directly above the lateral sulcus and comprised the ventral central sulcus, the parietal operculum and the adjacent inferior parietal cortex. Beyond the physiological findings summarized here, our methods may be useful for those interested in ways of studying neural effects related to natural language production and in surmounting the intrinsic problem of collinearity between multiple features of spontaneously spoken material. (shrink)

In the original publication of the article, the commentary of mine to Christopher Tindale’s article ‘Constrained Maneuvering: Rhetoric as a Rational Enterprise’, English translations of phrasings regarding several distinctions in the concept of rationality were taken from Stefan Gosepath’s book Aufgeklärtes Eigeninteresse: Eine Theorie theoretischer und praktischer Rationalität, Frankfurt: Suhrkamp 1992, without providing reference to his publication.

This article is concerned with the reasons why sometimes good arguments in health communication leaflets fail to convince the targeted audience. As an illustrative example it uses the age-dependent eligibility of women in the Netherlands to receive routine breast cancer screening examinations: according to Dutch regulations women under 50 are ineligible for them. The present qualitative study rests on and complements three experimental studies on the persuasiveness of mammography information leaflets; it uses interviews to elucidate reasons why the arguments in (...) the health communication leaflets for the exclusion of women under 50 from routine mammographic screenings do not work. (shrink)

Background: SNOMED CT is a large terminology system designed to represent all aspects of healthcare. Its current form and content result from decades of bottom-up evolution. Due to SNOMED CT’s formal descriptions, it can be considered an ontology. The Basic Formal Ontology (BFO) is a foundational ontology that proposes a small set of disjoint, hierarchically ordered classes, supported by relations and axioms. In contrast, as a typical top-down endeavor, BFO was designed as a foundational framework for domain ontologies in the (...) natural sciences and related disciplines. Whereas it is mostly assumed that domain ontologies should be created as extensions of foundational ontologies, a post-hoc harmonization of consolidated domain ontologies in use, such as SNOMED CT, is known to be challenging. Methods: We explored the feasibility of harmonizing SNOMED CT with BFO, with a focus on the SNOMED CT Clinical Finding hierarchy. With more than 100,000 classes, it accounts for about one third of SNOMED CT’s content. In particular, we represented typical SNOMED CT finding/disorder concepts using description logics under BFO. Three representational patterns were created and the logical entailments analyzed. Results: Under a first scrutiny, the clinical intuition that diseases, disorders, signs and symptoms form a homogeneous ontological upper-level class appeared incompatible with BFO’s upper-level distinction into continuants and occurrents. The Clinical finding class seemed to be an umbrella for all kinds of entities of clinical interest, such as material entities, processes, states, dispositions, and qualities. This suggests the conclusion that Clinical finding would not be a suitable upper-level class from an BFO perspective. On closer inspection of the taxonomic links within this hierarchy and the implicit meaning derived thereof, it became clear that Clinical finding classes do not characterize the entity (e.g. a fracture, allergy, tumor, pain, hemorrhage, seizure, fever) in a literal sense but rather the condition of a patient having that fracture, allergy, pain etc. This gives sense to the current characteristic of the Clinical Finding hierarchy, in which complex classes are modeled as subclasses of their constituents. Most of these taxonomic links are inferred, as the consequence of the ‘role group’ design pattern, which is ubiquitous in SNOMED CT and has often been subject of controversy regarding its semantics. Conclusion: Our analyses resulted in the proposal of (i) equating SNOMED CT’s ‘role group’ property with the reflexive and transitive BFO relation ‘has occurrent part’; and (ii) reinterpreting Clinical Findings as Clinical Occurrents, i.e. temporally extended entities in an organism, having one or more occurrents as temporal parts that occur in continuants. This re-interpretation was corroborated by a manual analysis of classes under Clinical Finding, as well as the identification of similar modeling patterns in other ontologies. As a result, SNOMED CT does not require any content redesign to establish compatibility with BFO, apart from this re-interpretation, and a suggested re-labeling. Regarding the feasibility of harmonizing terminologies with principled foundational ontologies post-hoc, our results provide support to the assumption that this does not necessarily require major redesign efforts, but rather a careful analysis of the implicit assumptions of terminology curators and users. (shrink)

The Anthropology of Sport and Human Movement represents a collection of work that reveals and explores the often times dramatic relationship of our biology and culture that is inextricably woven into a tapestry of movement patterns. It explores the underpinning of human movement, reflected in play, sport, games and human culture from an evolutionary perspective and contemporary expression of sport and human movement.

From its beginning, Critical Theory aimed to explore the laws governing social life as a formational totality and the forces shaping and driving its historical evolution. So the attempt to develop a comprehensive conception of ‘society’ encompassing both its structural as well as its cultural components can be considered one of the defining hallmarks of Critical Theory through all its theoretical and generational variations. But what, then, is Critical Theory’s conception of society? To answer this question, the authors make use (...) of a three-tiered heuristic model distinguishing synthesis (what is society?), dynamis (what are the driving forces of social change?) and praxis ((how) can social change be motivated or influenced by social actors?). In this way, they are able to reconstruct not only the divergences and controversies between the different versions and approaches in Critical Theory across the four generations of authors writing in this tradition, but also four core points of convergence which can serve to differentiate between Critical Theory in the Frankfurt School tradition and other critical theories. These four points, we suggest, should be seen to form the backbone of any valid conception of society in contemporary Critical Theory. (shrink)

As a way to advance integration between traditional readings of the medical encounter and argumentation theory, this article conceptualizes the doctor–patient interaction as a form of info-suasive dialogue. Firstly, the article explores the relevance of argumentation in the medical encounter in connection with the process of informed consent. Secondly, it discloses the risks inherent to a lack of reconciliation of the dialectical and rhetorical components in the delivery of the doctor’s advice, as especially resulting from the less-than-ideal conditions of the (...) internal states of the doctor and the patient, and the lack of symmetry in their status. (shrink)

Background No previous study has provided evidence for the scope and frequency of ethical dilemmas for paediatric nurses. It is essential to understand this to optimise patient care and tailor ethics support for nurses. Research aim The aim of this study was to explore the scope of nurses’ ethical dilemmas in a paediatric hospital and their engagement with the hospital clinical ethics service. Research design This study used a cross-sectional survey design. Participants and research context Paediatric nursing staff in a (...) tertiary paediatric centre in Australia completed an online survey asking about their exposure to a range of ethical dilemmas and their knowledge of the clinical ethics service. Analysis used descriptive and inferential statistics. Ethical considerations Ethical approval was granted from the hospital research committee. The survey was anonymous, and no identifying details of participants were collected. Results Paediatric nurses experienced a wide range of ethical dilemmas frequently, both in the intensive care and general areas. Knowledge and use of the clinical ethics service was poor and the most frequent challenge for nurses in managing dilemmas was feeling powerless. Conclusion There is a need to recognise the moral burden of ethical dilemmas for paediatric nurses in order to foster ethical sensitivity, and to provide adequate support to improve care and mitigate nursing moral distress. (shrink)

This article holds that ability to support one’s opinions with arguments, awareness of the arguments for other opinions, and insight into the superiority of some arguments are basic requirements for rational discourse. Based on a content analysis of Swiss Italian newspaper coverage of a controversy over a smoke-free law introduced and finally implemented in the canton of Ticino in 2007 and on a five-wave panel survey of public opinion on the issue, the article describes elements of the argumentative structure of (...) news coverage of this issue and relates them to rationality requirements. It finds that the newspapers offered a wide variety of arguments to readers (articulation function) when political activity to introduce a ban intensified, and especially when arguments mattered as a referendum approached. Papers displayed a reasonable and differentiated picture of arguments, contributing to a unique pattern of weighting and evaluating them. Neither newspaper coverage nor public opinion showed much sign of change, which speaks against a reaction to superior arguments. Finally, the newspaper bias towards arguments for the ban and their inclination to publish objections to arguments against may have contributed to a widespread lack of awareness of arguments against the ban among people favouring it. Thus, evidence of the rationality of argumentative structures is mixed, and further enquiry into this subject is encouraged. (shrink)

Humans discount rewards as a function of the delay to their receipt. This tendency is referred to as delay discounting and has been extensively researched in the last decades. The magnitude effect and the trait effect are two phenomena which have been consistently observed for a variety of reward types. Here, we wanted to investigate if these effects also occur in the context of the novel but widespread reward types of Instagram followers and likes and if delay discounting of these (...) outcomes is related to self-control and Instagram screen time. In a within-subject online experiment, 214 Instagram users chose between smaller, immediate and larger, delayed amounts of hypothetical money, Instagram followers and likes. First, we found that the magnitude effect also applies to Instagram followers and likes. Second, delay discounting of all three reward types was correlated, providing further evidence for a trait influence of delay discounting. Third, no relationships were found between delay discounting and self-control as well as Instagram screen time, respectively. However, a user’s average like count was related to delay discounting of Instagram likes. (shrink)

Dass unser Geschichtsbewusstseins Gründe hat, die im Nicht-Bewussten wurzeln, wird heutzutage niemand mehr prinzipiell bestreiten. Die bisher nur zögerlich erörterte Frage ist aber, ob und wie man dieses Nicht-Bewusste ans Tageslicht befördern kann. Das Buch beschäftigt sich mit der Psychoanalyse des Geschichtsbewusstseins, aber auch mit dem Geschichtsbewusstsein der Psychoanalyse. Es setzt sich mit Ängsten und Traumatisierungen auseinander, die - klinisch nachweisbar - im historisch-politischen Bewusstsein ihre Wirkungen ausüben. Es thematisiert aber auch die unbewussten An- und Auftriebskräfte, die uns vor der (...) Übermacht des historisch-destruktiven „Zuviel“ schützen und Möglichkeiten der Selbstbestimmung eröffnen. Besondere Beachtung findet ein durch den Holocaust bewirkter „Riss“ im Geschichtsbewusstsein, der kaum auszuhalten war und daher eilfertig überdeckt und verdrängt wurde. Das wird in einer Fallstudie über den deutschen Historiker Hermann Heimpel ausführlich dargelegt und gedeutet. Das lebensgeschichtliche Involviertsein des 1939 geborenen Autors wird dabei als Gefahr einer nicht durchschauten „Übertragung“ methodologisch berücksichtigt. Ein Anhang mit 16 kleinen Texten sowie 13 Abbildungen ergänzen die psychohistorisch-geschichtsanalytischen Recherchen und Reflexionen. (shrink)

Name der Zeitschrift: Zeitschrift für kritische Sozialtheorie und Philosophie Jahrgang: 2 Heft: 1 Seiten: 101-117.

The human being is an important subject in Edith Stein's work, not only in her first writings but also in her later work. Edith Stein's own contribution comes about as a result of the particular way she relates the classical metaphysics of being to the phenomenological philosophy of consciousness.

Edith Stein’s work revolves around one central question, namely, the identity of the person. Discussions of this topic are already present in Stein’s dissertation. Iexamine her theory of identity, developed throughout her work and maturing in her magnum opus, Finite and Eternal Being, in three stages, each of which is historically relevant and original. First, Stein’s development of the question is examined phenomenologically, focusing on Stein’s early work. Second, I will show how Stein takes her early phenomenological positions concerning the (...) nature of the human person and combines them with Greek and medieval insights into ontology. Here I focus on Finite and Eternal Being. Finally, I concentrate on the meaning and value of Stein’s theory of identity as it contributes to a theory of the person in connection with Greek and medieval metaphysics, and a phenomenological philosophy of consciousness. Together, the three stages of the essay will demonstrate Stein’s systematic contribution toward a theory of personal identity, one of the most difficult problems of philosophy. (shrink)

Edith Stein’s work revolves around one central question, namely, the identity of the person. Discussions of this topic are already present in Stein’s dissertation. Iexamine her theory of identity, developed throughout her work and maturing in her magnum opus, Finite and Eternal Being, in three stages, each of which is historically relevant and original. First, Stein’s development of the question is examined phenomenologically, focusing on Stein’s early work. Second, I will show how Stein takes her early phenomenological positions concerning the (...) nature of the human person and combines them with Greek and medieval insights into ontology. Here I focus on Finite and Eternal Being. Finally, I concentrate on the meaning and value of Stein’s theory of identity as it contributes to a theory of the person in connection with Greek and medieval metaphysics, and a phenomenological philosophy of consciousness. Together, the three stages of the essay will demonstrate Stein’s systematic contribution toward a theory of personal identity, one of the most difficult problems of philosophy. (shrink)

As a way to advance integration between traditional readings of the medical encounter and argumentation theory, this article conceptualizes the doctor–patient interaction as a form of info-suasive dialogue. Firstly, the article explores the relevance of argumentation in the medical encounter in connection with the process of informed consent. Secondly, it discloses the risks inherent to a lack of reconciliation of the dialectical and rhetorical components in the delivery of the doctor’s advice, as especially resulting from the less than ideal conditions (...) of the internal states of the doctor and the patient, and the lack of symmetry in their status. (shrink)

Was es heiSSt, ein Subjekt oder eine Person zu sein, hat unweigerlich soziale, rechtliche und politische Folgen. DIe Frage nach der Subjektivitat impliziert damit immer auch die Frage nach dem rechten Leben. Die hier versammelten Beitrage lassen den historischen ProzeSS sowohl als Entwicklungs- wie als Auflosungsgeschichte verstehen, wobei sich am Ende, die fur unsere Zukunft entscheidende Frage nach dem Bleibenden stellt.

This roundtable discussion is based on an online symposium – The Promise of Photography: Scale, Measure and Proportion in a Conflicted Visual Milieu – which took place on 17 September 2021. Since its inception, photography has promised to set things to scale, to grant them measure and proportion, a series of promises that have also entailed moments of irrationality or conflict that persist in and continue to shape the era of global networked digital imaging technologies. The symposium started out from (...) the diagnosis that, whilst photography continues to promise an ordered, proportionate and measured world in which things can be set to their proper scale, it also acts in many ways as an agent of dismeasure, disproportion and the unscalable. In light of this, the roundtable discussion presented here examines a range of different meanings that scale, measure and proportion have accrued in the photographic context and sets out to explore conceptual frameworks and research methodologies through which the current situation might be understood. (shrink)

This article discusses the 2019 Event Horizon Telescope image of a black hole as an ontological question for photography, contrasting its spatially distributed operations as a planetary apparatus against its temporal inscriptions of successive histories of scientific realisms following Lorraine Daston and Peter Galison. The 'becoming photographic' of this image, this text argues, hinges on the distance it traverses from its scientific milieu to its vernacular reception, making visible the cultural calibrations that produce a consensually legible image.