This discussion paper aims to explore potential ethical and moral implications of (patient) centredness in nursing and healthcare. Healthcare is experiencing a philosophical shift from a perspective where the health professional is positioned as the expert to one that re‐centres care and service provision central to the needs and desires of the persons served. This centred approach to healthcare delivery has gained a moral authority as the right thing to do. However, little attention has been given to its moral and (...) ethical theoretical grounding and potential implications for nurses, persons served and the healthcare system. Based upon a review of academic and grey literature, centredness is proposed as a value‐laden concept in nursing inquiry. Potential moral and ethical implications of centredness on nurses/healthcare providers, persons served and the healthcare system are discussed. These challenges are then considered within the context of normative and relational ethical theories. These perspectives may offer guidance relative to how one should act in those circumstances as well as an understanding as to how interdependency and engagement with the other person(s) can help navigate the challenges of a centred care approach. Viewing centredness through an ethical theoretical lens provides a valuable discourse to nursing in efforts to expand the knowledge base and integrate centred approaches into practice and policy. (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 book updates and adds to the classic Social Movements of the Sixties and Seventies, showing how social movement theory has grown and changed.

This study investigated potential risk factors (coping, perfectionism and self-regulation) for substantial injuries in contemporary dance students using a prospective cohort design, as high-quality studies focusing on mental risk factors for dance injuries are lacking. Student characteristics (age, sex, BMI, educational program and history of injury) and psychological constructs (coping, perfectionism and self-regulation) were assessed using the Performing artist and Athlete Health Monitor (PAHM), a web-based system. Substantial injuries were measured with the Oslo Sports Trauma Research Center (OSTRC) Questionnaire on (...) Health Problems and recorded on a monthly basis as part of the PAHM system. Univariate and multivariate logistic regression analyses were conducted to test the associations between potential risk factors (i.e. student characteristics and psychological constructs) and substantial injuries. 99 students were included in the analyses. During the academic year 2016-2017, 48 students (48.5%) reported at least one substantial injury. Of all factors included, coping skills (OR: 0.91; 95% CI: 0.84–0.98), age (OR: 0.67; 95% CI: 0.46–0.98) and BMI (OR: 1.38; 95% CI: 1.05–1.80) were identified as significant risk factors in the multivariate analysis. The model explained 24% of the variance in the substantial injury group. Further prospective research into mental risk factors for dance injuries with larger samples sizes is needed to develop preventive strategies. Yet, dance schools could consider including coping skills training as part of injury prevention programs and, perhaps, providing special attention to younger dancers and those with a higher BMI through transitional programs to assist them in managing the stress they experience throughout their (academic) career. (shrink)

This paper explores the relationship between individual work values and unethical decision-making and actual behavior at work through two complementary studies. Specifically, we use a robust and comprehensive model of individual work values to predict unethical decision-making in a sample of working professionals and accounting students enrolled in ethics courses, and IT employees working in sales and customer service. Study 1 demonstrates that young professionals who rate power as a relatively important value (i.e., those reporting high levels of the self-enhancement (...) value) are more likely to violate professional conduct guidelines despite receiving training regarding ethical professional principles. Study 2, which examines a group of employees from an IT firm, demonstrates that those rating power as an important value are more likely to engage in non-work-related computing (i.e., cyberloafing) even when they are aware of a monitoring software that tracks their computer usage and an explicit policy prohibiting the use of these computers for personal reasons. (shrink)

The acquisition and evolution of speech production, discourse and communication can be negatively impacted by brain malformations. We describe, for the first time, a case of developmental dynamic dysphasia (DDD) in a right-handed adolescent boy (subject D) with cortical malformations involving language-eloquent regions (inferior frontal gyrus) in both the left and the right hemispheres. Language evaluation revealed a markedly reduced verbal output affecting phonemic and semantic fluency, phrase and sentence generation and verbal communication in everyday life. Auditory comprehension, repetition, naming, (...) reading and spelling were relatively preserved, but executive function was impaired. Multimodal neuroimaging showed a malformed cerebral cortex with atypical configuration and placement of white matter tracts bilaterally and abnormal callosal fibers. Dichotic listening showed right hemisphere dominance for language and functional magnetic resonance imaging (fMRI) additionally revealed dissociated hemispheric language representation with right frontal activation for phonology and bilateral dominance for semantic processing. Moreover, subject D also had congenital mirror movements (CMM), defined as involuntary movements of one side of the body that mirror intentional movements of the other side. Transcranial magnetic stimulation and fMRI during voluntary unimanual (left and right) hand movements showed bilateral motor cortex recruitment and tractography revealed a lack of decussation of bilateral corticospinal tracts. Genetic testing aimed to detect mutations that disrupt the development of commissural tracts correlating with CMM (e.g., Germline DCC mutations) was negative. Overall, our findings suggest that DDD in subject D resulted from the underdevelopment of the left inferior frontal gyrus with limited capacity for plastic reorganization by its homologous counterpart in the right hemisphere. Corpus callosum anomalies probably contributed to hinder interhemispheric connectivity necessary to compensate language and communication deficits after left frontal involvement. (shrink)

How could the self be a substance? There are various ways in which it could be, some familiar from the history of philosophy. I shall be rejecting these more familiar substantivalist approaches, but also the non-substantival theories traditionally opposed to them. I believe that the self is indeed a substance—in fact, that it is a simple or noncomposite substance—and, perhaps more remarkably still, that selves are, in a sense, self-creating substances. Of course, if one thinks of the notion of substance (...) as an outmoded relic of prescientific metaphysics—as the notion of some kind of basic and perhaps ineffablestuff—then the suggestion that the self is a substance may appear derisory. Even what we ordinarilycall‘stuffs’—gold and water and butter and the like—are, it seems, more properly conceived of as aggregates of molecules or atoms, while the latter are not appropriately to be thought of as being ‘made’ of any kind of ‘stuff’ at all. But this only goes to show that we need to think in terms of a more sophisticated notion of substance—one which may ultimately be traced back to Aristotle's conception of a ‘primary substance’ in theCategories, and whose heir in modern times is W. E. Johnson's notion of the ‘continuant’. It is the notion, that is, of a concrete individual capable of persisting identically through qualitative change, a subject of alterable predicates that is not itself predicable of any further subject. (shrink)

For the good that I would, I do not; but the evil which I would not, that I do. Now if I do that I would not, it is no more I that do it, but sin that dwelleth in me. Romans 7.19-20.

Academia bases reputation and standing on the number of published articles. As a result, the abilities and potential of researchers are also being judged by the number of articles they write, as well as on the impact factor of the journals in which their articles are being published. In itself this is not a problem, although one could of course question the assumption that the quantity of the output reflects the competence of individual researchers. As Altman has stated: “The length (...) of a list of publications is a dubious indicator of ability to do good research.”1 However, if senior faculty decide that the career progress of junior researchers in academia should be based on these criteria, academic medicine is bound to fail in fulfilling its role, namely maximising the quality of medical research and doing research for the right reasons. And to some extent it already has.1 …. (shrink)

Soon after receiving Bouvet's interpretation of the hexagrams of the I ching as binary numbers, Leibniz communicated this application of his binary arithmetic to Hans Sloane in a letter published here for the first time. The letter also included a report on the observations of the variable star in the neck of the Swan by Gottfried Kirch. Sloane sent a copy of the scientific parts of the letter to Flamsteed.