Background/ObjectiveSeveral studies have examined the impact of Parkinson’s disease on the quality of couples’ relationships. To date, few studies have explored how couples experience their relationship dynamic by taking into account the disease stage. The objectives of this study were to understand the experience of each partner and to study the mechanisms that underlie their couple organization in the advanced stage of PD.MethodsSemistructured individual interviews conducted with fifteen patients and their partners were the subject of a dyadic interpretative phenomenological analysis.ResultsThree (...) themes were identified from the analysis: the first, “A Closeness That Separates,” allows the identification of different patterns of interactions that lead to emotional distancing between the partners; the second, “The Adversity Is Not Unbearable, But Going It Alone Would Be,” emphasizes the importance of how the assisting partner provides support; and the third, “Be Prepared for Anything and Facing an Uncertain Future,” reveals the extent and modes of the dyadic regulation of the emotions linked to what the future may hold.ConclusionPsychological support is important to help couples express both their feelings and their respective needs in the evolving context of PD. (shrink)

Interdisciplinary research needs innovation. As an action-oriented intervention, this Manifesto begins from the authors’ experiences as social scientists working within interdisciplinary science and technology collaborations in agriculture and food. We draw from these experiences to: 1) explain what social scientists contribute to interdisciplinary agri-food tech collaborations; (2) describe barriers to substantive and meaningful collaboration; and (3) propose ways to overcome these barriers. We encourage funding bodies to develop mechanisms that ensure funded projects respect the integrity of social science expertise and (...) incorporate its insights. We also call for the integration of social scientific questions and methods in interdisciplinary projects from the outset, and for a genuine curiosity on the part of STEM and social science researchers alike about the knowledge and skills each of us has to offer. We contend that cultivating such integration and curiosity within interdisciplinary collaborations will make them more enriching for all researchers involved, and more likely to generate socially beneficial outcomes. (shrink)

BackgroundCountries are increasingly devoting significant resources to creating or strengthening research ethics committees, but there has been insufficient attention to assessing whether these committees are actually improving the protection of human research participants.DiscussionResearch ethics committees face numerous obstacles to achieving their goal of improving research participant protection. These include the inherently amorphous nature of ethics review, the tendency of regulatory systems to encourage a focus on form over substance, financial and resource constraints, and conflicts of interest. Auditing and accreditation programs (...) can improve the quality of ethics review by encouraging the development of standardized policies and procedures, promoting a common base of knowledge, and enhancing the status of research ethics committees within their own institutions. However, these mechanisms focus largely on questions of structure and process and are therefore incapable of answering many critical questions about ethics committees' actual impact on research practices.The first step in determining whether research ethics committees are achieving their intended function is to identify what prospective research participants and their communities hope to get out of the ethics review process. Answers to this question can help guide the development of effective outcomes assessment measures. It is also important to determine whether research ethics committees' guidance to investigators is actually being followed. Finally, the information developed through outcomes assessment must be disseminated to key decision-makers and incorporated into practice. This article offers concrete suggestions for achieving these goals.ConclusionOutcomes assessment of research ethics committees should address the following questions: First, does research ethics committee review improve participants' understanding of the risks and potential benefits of studies? Second, does the process affect prospective participants' decisions about whether to participate in research? Third, does it change participants' subjective experiences in studies or their attitudes about research? Fourth, does it reduce the riskiness of research? Fifth, does it result in more research responsive to the local community's self-identified needs? Sixth, is research ethics committees' guidance to researchers actually being followed? (shrink)

Clinical ethics support services are experiencing a phase of flourishing and of growing recognition. At the same time, however, the expectations regarding the acceptance and the integration of traditional CES services into clinical processes are not met. Ethics rounds as an additional instrument or as an alternative to traditional clinical ethics support strategies might have the potential to address both deficits. By implementing ethics rounds, we were able to better address the needs of the clinical sections and to develop a (...) more comprehensive account of ethics quality in our hospital, which covers the level of decisions and actions, and also the level of systems and processes and aspects of ethical leadership. (shrink)

IntroductionThe National Institute for Health and Care Excellence guidelines acknowledge the importance of the parent–infant relationship for child development but highlight the need for further research to establish reliable tools for assessment, particularly for parents of children under 1 year. This study explores the acceptability and psychometric properties of a co-developed tool, ‘Me and My Baby’.Study designA cross-sectional design was applied. The MaMB was administered universally with mothers during routine 6–8-week Health Visitor contacts. The sample comprised 467 mothers. Dimensionality of (...) instrument responses were evaluated via exploratory and confirmatory ordinal factor analyses. Item response modeling was conducted via a Rasch calibration to evaluate how the tool conformed to principles of ‘fundamental measurement’. Tool acceptability was evaluated via completion rates and comparing ‘completers’ and ‘non-completers’ demographic differences on age, parity, ethnicity, and English as an additional language. Free-text comments were summarized. Data sharing agreements and data management were compliant with the General Data Protection Regulation, and University of York data management policies.ResultsHigh completion rates suggested the MaMB was acceptable. Psychometric analyses showed the response data to be an excellent fit to a unidimensional confirmatory factor analytic model. All items loaded statistically significantly and substantially on a single underlying factor. The item response modeling showed that most MaMB items fitted the Rasch model. item reliability was high yet the test yielded little information on each respondent, as highlighted by the relatively low ‘person separation index’ of 0.1.Conclusion and next stepsMaMB reliably measures a single construct, likely to be infant bonding. However, further validation work is needed, preferably with ‘enriched population samples’ to include higher-need/risk families. The MaMB tool may benefit from reduced response categories and some modest item wording amendments. Following further validation and reliability appraisal the MaMB may ultimately be used with fathers/other primary caregivers and be potentially useful in research, universal health settings as part of a referral pathway, and clinical practice, to identify dyads in need of additional support/interventions. (shrink)

Previous research suggests that exposure to nature may reduce delay discounting and thereby facilitate healthier dietary intake. This pre-registered study examined the impact of online exposure to images of natural scenes on delay discounting and food preferences. It was predicted that exposure to images of natural scenes would be associated with: lower delay discounting; higher desirability for fruits and vegetables ; and delay discounting would mediate the effect of nature-image exposure on food desirability. Adult participants were recruited to an online (...) between-subjects experiment in which they viewed a timed sequence of six images either showing natural landscape scenes or urban scenes. They then completed measures of mood, delay discounting and rated their momentary desire to eat four fruits and vegetables, and four energy-dense foods. There was no statistically significant effect of experimental condition on delay discounting or food desirability. Bayes factors supported the null hypothesis for discounting, and energy-dense food desirability, but provided no strong evidence for either hypothesis for F&V desirability. These findings indicate that brief online exposure to images of nature does not affect momentary impulsivity or energy-dense food preference, whereas for preference for less-energy dense foods, the evidence was inconclusive. (shrink)

The provision of informed consent is a prerequisite for inclusion of a patient in a clinical research project. In some countries, the legislation on clinical research authorizes a third person to provide informed consent if the patient is unable to do so directly . This is the case during acute stroke, when the symptoms may prevent the patient from providing informed consent and thus require a third party to be approached. Identification of factors associated with the medical team’s decision to (...) resort to surrogate consent may help the care team during the inclusion process and enable the patient’s family circle to be better informed about providing surrogate consent. (shrink)

Background The first COVID-19 wave started in February 2020 in France. The influx of patients requiring emergency care and high-level technicity led healthcare professionals to fear saturation of available care. In that context, the multidisciplinary Ethics- Support Cell (EST) was created to help medical teams consider the decisions that could potentially be sources of ethical dilemmas. Objectives The primary objective was to prospectively collect information on requests for EST assistance from 23 March to 9 May 2020. The secondary aim was (...) to describe the Cell’s functions during that period. Research design This observational, real-time study of requests for Cell consultations concerned ethical dilemmas arising during a public health crisis. The EST created a grid to collect relevant information (clinical, patient’s/designated representative’s preferences and ethical principles strained by the situation), thereby assuring that each EST asked the same questions, in the same order. Participants and research context Only our university hospital’s clinicians could request EST intervention. Ethical considerations The hospital Research Ethics Committee approved this study (no. CER-2020-107). The patient, his/her family, or designated representative was informed of this ethics consultation and most met with EST members, which enabled them to express their preferences and/or opposition. Findings/results 33 requests (patients’ mean age: 80.8 years; 29 had COVID-19: 24 with dyspnea, 30 with comorbidities). 17 Emergency Department solicitations concerned ICU admission, without reference to resource constraints; others addressed therapeutic proportionality dilemmas. Discussion Intervention-request motives concerned limited resources and treatment intensity. Management revolved around three axes: the treatment option most appropriate for the patient, the feasibility of implementation, and dignified care for the patient. Conclusions COVID-19 crisis forced hospitals to envisage prioritization of ICU access. Established decision-making criteria and protocols do not enable healthcare professionals to escape ethical dilemmas. That acknowledgement highlights ethical risks, enhances the added-value of nursing and encourages all players to be vigilant to pursue collective deliberations to achieve clear and transparent decisions. (shrink)

This article is an edited transcript of the roundtable entitled “What is Philo-Performance?” that took place in Paris on 28 June 2014, within the framework of the “Theatre, Performance, Philosophy International Conference: Crossings and Transfers in Anglo-American Thought”. The conference was organized by Julien Alliot, Flore Garcin-Marrou, Liza Kharoubi and Anna Street from the LAPS, a French research group on performance philosophy.

Researchers from diverse disciplines, including organismal and cellular physiology, sports science, human nutrition, evolution and ecology, have sought to understand the causes and consequences of the surprising variation in metabolic rate found among and within individual animals of the same species. Research in this area has been hampered by differences in approach, terminology and methodology, and the context in which measurements are made. Recent advances provide important opportunities to identify and address the key questions in the field. By bringing together (...) researchers from different areas of biology and biomedicine, we describe and evaluate these developments and the insights they could yield, highlighting the need for more standardisation across disciplines. We conclude with a list of important questions that can now be addressed by developing a common conceptual and methodological toolkit for studies on metabolic variation in animals. (shrink)

We explore physiological linkage among 34 same-sex male couples. Interbeat interval, an indicator of cardiovascular arousal, was collected across four conversational contexts in the lab: a baseline period that did not involve conversation, a conversation about body image, a conversation about health goals, and a recovery period that allowed for unstructured conversation. We used a newly developed R statistical package that simplifies the use of dynamic models for investigating interpersonal emotional processes. We identified two different PL patterns: a simple one (...) that was characterized by stable synchronization and low frequency of oscillation; and a complex one that was characterized by drifting synchronization, high frequency of oscillation, and eventual damping. Guided by social baseline theory and the reactive flexibility perspective, we explored the interactions between couple relationship functioning and conversational context as predictors of the PL patterns. The results suggest that partners in well-functioning relationships and emotionally challenging situations may be especially likely to show complex PL patterns that may reflect coregulatory processes. (shrink)

Medical educators recognize the value of reflection for medical students and the role creative writing can play in fostering this. However, direct creative writing tasks can be challenging for many students, particularly those with limited experience in the arts and humanities. An alternative strategy is to utilize an indirect approach, engaging students with structured tasks that obliquely encourage reflection. This paper reports one such approach. We refer to this approach as in-verse reflection, playing on both the structure of the writing (...) and its novel approach to reflection. Students were invited to write, in verse-like structures, about their personal and clinical experiences as medical students. Thematic analysis of their creative outputs and reactions identified four principal themes: the challenges of life as a medical student, the emotional demands of the medical course, a sense of connectedness and solidarity with fellow students, and a sense of marginality within the hospital system. Students generally found the tasks highly engaging and conducive to reflection, producing texts representing significant insights into their experiences as medical students. The reported method offers a relatively simple, structured, and guided approach to reflective writing, adding to the repertoire of methods available to educators in the medical humanities. (shrink)

Charlotte Wolff was born in Riesenburg, West Prussia into a middle-class Jewish family. She studied philosophy and then medicine at several German universities, completing her doctorate in Berlin in 1926. Working in various institutions over the next few years, she was also interested in psychotherapy and had a small private medical and psychotherapeutic practice. In 1933 she was forced to leave Germany because of the Nazi regime, and settled for a few years in Paris. As a German refugee she (...) was unable to practice medicine, so she began her research into the correlation between hand traits and personality. In 1936 she went to London to continue her research work and lived there until her death. An active lesbian from an early age, her later research turned to sexology and her writing on lesbianism and bisexuality were influential early works in the field. This is a great opportunity to rediscover her early work, including her first autobiography. (shrink)

Comment traduire le mot « Dieu » ? La question de la traduction dans les langues indigènes des désignations comme des concepts chrétiens a été un des premiers soucis des évangélisateurs. L'exemple des mission­naires du Pérou aux XVI° et XVII° siècles présente un cas particulièrement significatif de cette question avec des réponses variées selon les enjeux perçus par les traducteurs: de l'ignorance du problème par les premiers témoins de l'évangélisation, à la volonté de la « troisième génération » d'éradiquer tout (...) ce qui appartient à l'ancienne religion et parait absolument incompatible avec le Christianisme. Cela ira pourtant de pair avec une certaine étude des croyances antérieures de façon à mieux les réduire, au risque d'un certain syncrétisme dans la mesure où le mot à mot s'avérant insuffisant, des expressions complémentaires pour une plus grande précision et compréhension véhiculeraient d'anciennes résonances religieuses.How does one translate the word « God » ? The question of translation into indigenous languages to signify Christian concepts was one of the first concerns of the evangelizers. The missionaries to Peru in the 1 6th and 1 7th centuries present a particularly significant example of this question, with varied answers according to the situation perceived by the translators : from ignorance of the problem by the first witnesses of evangelization, to the desire of the « third generation » to wipe out everything that belonged to the old religion which seemed absolutely incompatible with Christianity. That goes along on a par, nevertheless, with a study of former beliefs, in such a way as to better reduce some complementary expressions for a greater precision and understanding that will transmit ancient religious resonan­ces. There will be the risk of a certain syncretism, in so far as the word for word translation would turn out to be insufficient. (shrink)

This study focuses on how moral aspects of purpose shape collaborative processes. It does so by analyzing the unfolding of 21 relationships between four nonprofits and their funders using a framework based on French pragmatist sociology to help uncover the deeply held, ideological and moral beliefs that underscore assumptions about what the overarching purpose of a collaborative effort is or should be. This study contributes to the literature on single and cross-sectoral collaboration by showing that the way partners handle and (...) reconcile differences about purpose is related to the forms of agreement likely to be achieved. It also suggests that certain forms of agreement are inherently more enduring than others. Taken as a whole, this study provides some plausible explanations as to why so many collaborations fail despite their seeming benefits for all the parties involved. (shrink)

The aim of the article is to illustrate concrete problems in the asymmetrical nurse–patient power relationship. It is an ethical demand that the nurse is faced with the challenges that the power in the relation is administered so that the patient's room for action is expanded and trust maintained. It is an essential message in care philosophy, but in clinical practice, success is not always achievable. A hidden and more or less unconscious restriction of the patient's room for action may (...) result in the excesses of care. Three selected aspects: dependence, trust, and power described by the Danish philosopher K.E. Løgstrup and the Norwegian nursing philosopher Kari Martinsen's care philosophy has inspired this empirically based examination of some current barriers in the asymmetrical nurse–patient relationship. On the basis of qualitative interviews with six patients and six nurses, the research thus provides an identifying and problem‐exploratory examination of some current obstacles in which the handling of trust and power reflects the excesses of care. The findings develop three themes. ‘Being a burden’ acknowledges that the balance of power will always tip to the nurse's advantage. The second theme, ‘Doing only what's absolutely necessary’, shows how a fixation with ‘technicalism’ creates a distance between people that may constrain the patient's room for action. The last theme is concerning the nurse's ability to navigate between closeness and distance is essential in avoiding ‘the excesses of care’, paternalism, and overprotectiveness. A situation in which distance takes the upper hand and care turns into paternalism. A different situation would arise if the nurse's emotions became sentimental or intimate with the result that closeness gets the upper hand. To avoid a harmful exercise of power and the excesses of care, the findings have demonstrated that a relationship‐based caring is a demand for situation‐specific sensitive attention skills. (shrink)

The central question of this paper is: are deterministic and indeterministic descriptions observationally equivalent in the sense that they give the same predictions? I tackle this question for measure-theoretic deterministic systems and stochastic processes, both of which are ubiquitous in science. I first show that for many measure-theoretic deterministic systems there is a stochastic process which is observationally equivalent to the deterministic system. Conversely, I show that for all stochastic processes there is a measure-theoretic deterministic system which is observationally equivalent (...) to the stochastic process. Still, one might guess that the measure-theoretic deterministic systems which are observationally equivalent to stochastic processes used in science do not include any deterministic systems used in science. I argue that this is not so because deterministic systems used in science even give rise to Bernoulli processes. Despite this, one might guess that measure-theoretic deterministic systems used in science cannot give the same predictions at every observation level as stochastic processes used in science. By proving results in ergodic theory, I show that also this guess is misguided: there are several deterministic systems used in science which give the same predictions at every observation level as Markov processes. All these results show that measure-theoretic deterministic systems and stochastic processes are observationally equivalent more often than one might perhaps expect. Furthermore, I criticise the claims of the previous philosophy papers Suppes (1993, 1999), Suppes and de Barros (1996) and Winnie (1998) on observational equivalence. (shrink)

In cases of complicity in one’s own unfreedom and in structural injustice, it initially appears that agents are only vicariously responsible for their complicity because of the roles circumstantial and constitutive luck play in bringing about their complicity. By drawing on work from the phenomenological tradition, this paper rejects this conclusion and argues for a new responsive sense of agency and responsibility in cases of complicity. Highlighting the explanatory role of stubbornness in cases of complicity, it is argued that although (...) agents may only be vicariously responsible for becoming complicit, they can be held more directly responsible for entrenching their complicity. The complicit agent is responsible for their complicity to the extent that they fail to take responsibility for it. (shrink)

ABSTRACT:This paper explores how corporations, through their Corporate Social Responsibility (CSR) activities, can help to effect positive developmental change. We use research on institutional change, deinstitutionalization, and institutional work to develop our central theoretical framework. This framework allows us to suggest more explicitly how CSR can potentially be mobilized as a purposive form of institutional work aimed at disrupting existing institutions in favor of positive change. We take the gender institution in the Arab Middle East as a case in point. (...) Our suggestion is that the current context of the Arab Spring, which combined with increasingly obvious endogenous institutional contradictions, has created a fertile ground for shaping change processes within the gender institution. Finally, we provide concrete examples of CSR initiatives that regional corporate actors can engage in for positive developmental change supporting women. (shrink)

ABSTRACT When does a state of affairs constitute a harm to someone? Comparative accounts say that being worse off constitutes harm. The temporal version of the comparative account is seldom taken seriously, due to apparently fatal counterexamples. I defend the temporal version against these counterexamples, and show that it is in fact more plausible than the prominent counterfactual version of the account. Non-comparative accounts say that being badly off constitutes harm. However, neither the temporal comparative account nor the non-comparative account (...) can correctly classify all harms. I argue that we should combine them into a hybrid account of harm. The hybrid account is extensionally adequate and presents a unified view on the nature of harm. (shrink)

Feminist Metaphysics is the first collection of articles addressing metaphysical issues from a feminist perspective.

ABSTRACT Testimony from victims of gendered violence is often wrongly disbelieved. This paper explores a way to address this problem by developing a phenomenological approach to testimony. Guided by the concept of ‘disclosedness’, a tripartite analysis of testimony as an affective, embodied, communicative act is developed. Affect indicates how scepticism may arise through the social moods that often attune agents to victims’ testimony. The embodiment of meaning suggests testimony should not be approached as an assertion, but as a process of (...) ‘articulating an understanding’. This account is deepened in the discussion of testimony as a communicative act. It is argued that testimony must be considered as a relational whole, and thus our aim in receiving victims’ testimony should be to honour the relational conditions under which the truth of testimony can be heard. Approaching testimony as the collaborative process of enabling an understanding to be articulated can enhance our conception of gendered violence, whilst also better serving the victims of gendered violence by helping to overcome the lack of trust and excessive scepticism with which victims’ testimony is often met. (shrink)

Nunn's critique of the placebo concept is a radical and refreshing contribution to the debate. While there is much that can be contested in his analysis, his use of empirical and theoretical arguments to defend his conclusion - that the time has come to abandon the placebo construct altogether - presents an important challenge.

InThe Second Sex, Simone de Beauvoir argues that women are often complicit in reinforcing their own unfreedom. But why women become complicit remains an open question. The aim of this article is to offer a systematic analysis of complicity by focusing on the Heideggerian strands of Beauvoir's account. I begin by evaluating Susan James's interpretation of complicity qua republican freedom, which emphasizes the dependent situation of women as the primary cause of their complicity. I argue that James's analysis is compelling (...) as far as it goes, but that it implies complicity is the inevitable outcome of women's current existence and fails to adequately account for Beauvoir's claim that women actively embrace their own unfreedom. I then draw out the Heideggerian strands of Beauvoir's analysis, demonstrating how this enables us to systematize Beauvoir's account of women's oppressive situation with her claims regarding the active role women can play in reinforcing their own unfreedom. I argue that this approach preserves the strengths of the republican interpretation, but provides a better account of cases where complicity may not be inevitable and yet some women still act to reinforce rather than resist their own unfreedom. (shrink)

Charlotte Sabourin | : Cet article se penche sur la contribution de Gabrielle Suchon à la célèbre « querelle des femmes ». J’y démontre que, quoique Suchon défende l’égalité des deux sexes en ce qui a trait à leurs capacités à la liberté, à la science et à l’autorité, elle vise ultimement à montrer que les femmes peuvent se rendre supérieures aux hommes. Je montrerai que son projet d’élévation des femmes ne peut être accompli qu’en soustrayant les femmes à (...) l’influence des hommes, les relations entre les deux sexes étant foncièrement préjudiciables aux premières. | : This paper examines Gabrielle Suchon’s contribution to the famous “querelle des femmes”. I argue that although Suchon is a proponent of the equality of the sexes with respect to their capacities for freedom, science and authority, she ultimately suggests that there is a way in which women can make themselves superior to men. I will show that her project for the elevation of women can be accomplished only by isolating women from men, given that the relationships between the sexes will always be detrimental to women. (shrink)

The Metaphysics of Gender is a book about gender essentialism: what it is and why it might be true.

Charlotte Witt extracts from this text a coherent and provocative view about sensible substance by focusing on Aristotle's account of form or essence.