This work has been selected by scholars as being culturally important, and is part of the knowledge base of civilization as we know it. This work was reproduced from the original artifact, and remains as true to the original work as possible. Therefore, you will see the original copyright references, library stamps (as most of these works have been housed in our most important libraries around the world), and other notations in the work.This work is in the public domain in (...) the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work.As a reproduction of a historical artifact, this work may contain missing or blurred pages, poor pictures, errant marks, etc. Scholars believe, and we concur, that this work is important enough to be preserved, reproduced, and made generally available to the public. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)

In the context of long waiting time to access rehabilitation services, a large majority of settings use referral prioritization to help manage waiting lists. Prioritization practices vary greatly between settings and there is little consensus on how best to prioritize referrals. This paper describes the prioritization processes for physiotherapy services in Québec and its potential implications in terms of equity in access to services. This is a secondary analysis of a survey of outpatient physiotherapy departments (n=98; proportion of participation was (...) 99%) conducted in 2015 across publicly funded hospitals in Québec. In many settings, persons with acute orthopaedic conditions were prioritized while chronic conditions were given a lower priority. There were 72 different combinations of prioritization criteria used in outpatient physiotherapy departments. Variability was also observed in the type of personnel involved in the prioritization process, the number of priority levels used to rank the referrals and the source of information used to prioritize referrals. These results highlight potential issues regarding equity in access to physiotherapy services: the prioritization of persons with acute conditions to the detriment of those with chronic conditions, the lack of consensus on a fair prioritization process and the importance to adequately assess patients’ needs for treatment. Further research and interventions on prioritization criteria and processes are needed to ensure equitable access to physiotherapy services, especially in the public sector. (shrink)

In the context of long waiting time to access rehabilitation services, a large majority of settings use referral prioritization to help manage waiting lists. Prioritization practices vary greatly between settings and there is little consensus on how best to prioritize referrals. This paper describes the prioritization processes for physiotherapy services in Québec and its potential implications in terms of equity in access to services. This is a secondary analysis of a survey of outpatient physiotherapy departments conducted in 2015 across publicly (...) funded hospitals in Québec. In many settings, persons with acute orthopaedic conditions were prioritized while chronic conditions were given a lower priority. There were 72 different combinations of prioritization criteria used in outpatient physiotherapy departments. Variability was also observed in the type of personnel involved in the prioritization process, the number of priority levels used to rank the referrals and the source of information used to prioritize referrals. These results highlight potential issues regarding equity in access to physiotherapy services: the prioritization of persons with acute conditions to the detriment of those with chronic conditions, the lack of consensus on a fair prioritization process and the importance to adequately assess patients’ needs for treatment. Further research and interventions on prioritization criteria and processes are needed to ensure equitable access to physiotherapy services, especially in the public sector. (shrink)

Photographs are commonly taken of children in medical and research contexts. With the increased availability of photographs through the internet, it is increasingly important to consider their potential for negative consequences and the nature of any consent obtained. In this research we explore the issues around photography in low-resource settings, in particular concentrating on the challenges in gaining informed consent.

Why should the work of the ancient and the medievals, so far as it relates to nature, still be of interest and an inspiration to us now? The contributions to this enlightening volume explore and uncover contemporary scholarship's debt to the classical and medieval past. Thinking About the Environment synthesizes religious thought and environmental theory to trace a trajectory from Mesopotamian mythology and classical and Hellenistic Greek, through classical Latin writers, to medieval Christian views of the natural world and our (...) relationship with it. The work also offers medieval Arabic and Jewish views on humanity's inseparability from nature. The volume concludes with a study of the breakdown between science and value in contemporary ecological thought. Thinking About the Environment will be a invaluable source book for those seeking to address environmental ethics from a historical perspective. (shrink)

Whipple disease is a rare, infectious, disease first described from a single case by Whipple in 1907. As well as characterising the clinical and pathological features of the condition, Whipple made two suggestions regarding its aetiology. These were either than the disease was caused by an infectious agent, or that it was of metabolic origin. As the disease is now thought to be caused by infection with the bacterium Tropheryma whipplei, historical reviews of the history of the disease typically mention (...) only the first of these suggestions. In this paper, we therefore revisit Whipple’s other theory. We argue that a diverse and often successful research programme was developed around this mechanism of disease causation which gave rise to many useful findings on the condition. In the later parts of this article, we then turn to discuss the surprising neglect of this period of Whipple disease research in the current literature, and conclude by offering a brief reconstruction of this early history suitable for use in a technical context. (shrink)

Contains the author's responses to comments by the three named authors on her book, 'A Metaphysics for Freedom'.

The nature of poetic truth, and of the belief claimed by poetry, has become for many thinkers a question of keener interest through the discussions of Dr. I. A. Richards. In a recent article in this Journal,1 Dr. Helen Wodehouse has expressed her own view, elicited in relation to that of Dr. Richards, concerning truth in poetry. She urges that “a great poem seems sometimes centrally to be showing us the full measure and nature of some aspect of the (...) actual world.” Our response involves essentially an element of belief in something revealed as rooted in reality, laying necessity upon the poet; even though that belief may not attach to all that the poet accepted as fact, and though we may be unable to formulate in reflective terms the nature of the truth discerned. (shrink)

Humans and other animals have an evolved ability to detect discrete magnitudes in their environment. Does this observation support evolutionary debunking arguments against mathematical realism, as has been recently argued by Clarke-Doane, or does it bolster mathematical realism, as authors such as Joyce and Sinnott-Armstrong have assumed? To find out, we need to pay closer attention to the features of evolved numerical cognition. I provide a detailed examination of the functional properties of evolved numerical cognition, and propose that they (...) prima facie favor a realist account of numbers. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Arrows of Apollo BROOKE CLARK To Aachchi If thou beest he; But O how fallen, how changed From him who in the happy realms of light Clothed with transcendent brightness didst outshine Myriads though bright— —Milton, Paradise Lost i. Today, slumped at my desk, I glimpsed the sun. I wasn’t certain how long I had sat facing my own face’s dim reflection in my computer screen—chin ringed with (...) fat, the sharp-lined contours of my youth long gone, my cheekbones hidden, my bright gaze gone flat— and then—there—on the left side of my face a glow my slightest movement would erase. How that stippling brought me back to life: I felt like I was walking once again through woods where sunlight touched the trees in leaf. I felt warmth prickle up beneath my skin as though the flesh responded to the brief caress of light which brought hope rushing in, as though Apollo had reached down and laid his brilliant fingertips on what he’d made. A sharp, metallic rattle cut the air; Helen had stood up to close the blinds— Helen, too devoid of soul to care that some of us might greet the sun as friends. Her only comment was, “Jeez, what a glare!” arion 27.2 fall 2019 Sweet moments often come to such harsh ends: some people are too coarse for fragile joys, and spoil light with darkness, peace with noise. Helen was such a woman: lumpy, heavy, seemingly formed exclusively of fat, barely mobile yet constantly sweaty, like some malevolent Buddha, she sat and meditated acts of petty cruelty; each time she closed the blinds I heard, “Take that!” in their harsh snap, and felt as if she knew I longed for light, so wouldn’t let it through. Another bitter, desk-bound endomorph (although she would have seemed an Aphrodite to those who carved the Venus of Willendorf), and fated by her own obesity to be struck down and swiftly carried off by a sudden, massive coronary, in line at some all-you-can-eat buffet— she wasn’t worth my notice anyway, although she kept impinging on my sight, but then I caught the slight trace of a smirk when I turned back towards the vanished light (instead of going quietly back to work) and said, “The blinds were fine—it’s not too bright for me—without a window, it feels dark.” Helen snorted: “No thanks—too hot out there. I’m roastin’ like a turkey over here.” Who would not hate the court from which there lies no avenue or hope for an appeal? Her desk was on the coveted window side while mine sat boxed against an inside wall, and that gave Helen power over blinds and sunlight—that was office protocol. 64 the arrows of apollo I longed to feel Apollo’s fingertips but this slug-goddess ruled in grim eclipse. I felt like Milton’s Satan when he fell, plumbing so great a depth from such a height and measuring the lowest pits of Hell, prostrate, near dead—I sat, deprived of light, walled in by my grey-sided cubicle, and sank beneath my own despair’s dead weight. But why should Helen have the power to plunge me into darkness? I deserved revenge— revenge for all the time I’d wasted here, revenge for every hope that slowly died, revenge for every minute of every year, revenge for every bold attempt untried, revenge for every lonely, bitter tear I’d swallowed, choked back, or held in, uncried. Helen became, in that one poisoned moment, the symbol and the source of all my torment. Brooke Clark 65 ii. Boredom was my soul mate; the days slid by unused and empty; I sat and watched them go, hardly recalling that once even I had clung to aspirations—but it was so uncomfortably easy to let them die. I’d turned into a man I didn’t know: in youth, I’d never compromise or settle— so it seemed now—but memory gilds the nettle. Instead of working, I listened to the flies that mobbed the windows, struggling to get out; freedom stretched away... (shrink)

BackgroundIn this article, the sources and features of moral distress as experienced by acute psychiatric care nurses are explored.Research designA qualitative design with 16 individual in-depth interviews was chosen. Braun and Clarke’s six analytic phases were used.Ethical considerationsApproval was obtained from the Norwegian Social Science Data Services. Participation was confidential and voluntary.FindingsBased on findings, a somewhat wider definition of moral distress is introduced where nurses experiencing being morally constrained, facing moral dilemmas or moral doubt are included. Coercive administration of (...) medicines, coercion that might be avoided and resistance to the use of coercion are all morally stressful situations. Insufficient resources, mentally poorer patients and quicker discharges lead to superficial treatment. Few staff on evening shifts/weekends make nurses worry when follow-up of the most ill patients, often suicidal, in need of seclusion or with heightened risk of violence, must be done by untrained personnel. Provision of good care when exposed to violence is morally challenging. Feelings of inadequacy, being squeezed between ideals and clinical reality, and failing the patients create moral distress. Moral distress causes bad conscience and feelings of guilt, frustration, anger, sadness, inadequacy, mental tiredness, emotional numbness and being fragmented. Others feel emotionally ‘flat’, cold and empty, and develop high blood pressure and problems sleeping. Even so, some nurses find that moral stress hones their ethical awareness.ConclusionMoral distress in acute psychiatric care may be caused by multiple reasons and cause a variety of reactions. Multifaceted ethical dilemmas, incompatible demands and proximity to patients’ suffering make nurses exposed to moral distress. Moral distress may lead to reduced quality care, which again may lead to bad conscience and cause moral distress. It is particularly problematic if moral distress results in nurses distancing and disconnecting themselves from the patients and their inner selves. (shrink)

This paper is part of a symposium discussing Helen Steward's A METAPHYSICS FOR FREEDOM. Steward argues for what she calls Agency Incompatibilism: agency itself is incompatible with determinism. This paper examines what Steward presents as her main argument for Agency Incompatibilism and finds it wanting.

The multifaceted work of the late Susan Leigh Star is explored through a selection of her writings and essays by friends and colleagues. Susan Leigh Star (1954–2010) was one of the most influential science studies scholars of the last several decades. In her work, Star highlighted the messy practices of discovering science, asking hard questions about the marginalizing as well as the liberating powers of science and technology. In the landmark work Sorting Things Out, Star and Geoffrey Bowker revealed the (...) social and ethical histories that are deeply embedded in classification systems. Star's most celebrated concept was the notion of boundary objects: representational forms—things or theories—that can be shared between different communities, with each holding its own understanding of the representation. Unfortunately, Leigh was unable to complete a work on the poetics of infrastructure that further developed the full range of her work. This volume collects articles by Star that set out some of her thinking on boundary objects, marginality, and infrastructure, together with essays by friends and colleagues from a range of disciplines—from philosophy of science to organization science—that testify to the wide-ranging influence of Star's work. Contributors Ellen Balka, Eevi E. Beck, Dick Boland, Geoffrey C. Bowker, Janet Ceja Alcalá, Adele E. Clarke, Les Gasser, James R. Griesemer, Gail Hornstein, John Leslie King, Cheris Kramarae, Maria Puig de la Bellacasa, Karen Ruhleder, Kjeld Schmidt, Brian Cantwell Smith, Susan Leigh Star, Anselm L. Strauss, Jane Summerton, Stefan Timmermans, Helen Verran, Nina Wakeford, Jutta Weber. (shrink)

This is an important book precisely because there is none other quite like it.

In Supersizing the Mind, Andy Clark argues that the human mind is not bound inside the head but extends into body and environment.

Clinical trials emerged in rapid succession as the COVID-19 pandemic created an unprecedented need for life-saving therapies. Fair and equitable subject selection in clinical trials offering investigational therapies ought to be an urgent moral concern. Subject selection determines the distribution of risks and benefits, and impacts the applicability of the study results for the larger population. While Research Ethics Committees monitor fair subject selection within each trial, no standard oversight exists for subject selection across multiple trials for the same disease. (...) Drawing on the experience of multiple clinical trials at a single academic medical centre in the USA, we posit that concurrent COVID-19 trials are liable to unfair and inequitable subject selection on account of scientific uncertainty, lack of transparency, scarcity and, lastly, structural barriers to equity compounded by implicit bias. To address the critical gap in the current literature and international regulation, we propose new ethical guidelines for research design and conduct that bolsters fair and equitable subject selection. Although the proposed guidelines are tailored to the research design and protocol of concurrent trials in the COVID-19 pandemic, they may have broader relevance to single COVID-19 trials. (shrink)

This article aims to develop new conceptions of the psychosocial dynamics that drive the re-romanticization of domestic femininity in current financialized capitalism. Feminist scholars have described this heightened cultivation of mothering as a reparative move in response to irreconcilable tensions between cultural ideals of the ‘balancing mother’ and ‘lean-in femininity’. This article adds a materialist-psychosocial lens to these conceptions, to enhance understanding of what drives this craving for domestic femininity. Drawing on a free-association narrative interview study with couples in the (...) financial elite in the comparatively gender-egalitarian Norwegian context, I describe a specific emotional mechanism that resists democratization of gender in this specific group. The interviews reveal a felt need to cultivate ‘the human side of things’ at safe distance from the competitiveness of ‘hard-core finance’. The Nordic earner–carer model with its entwinement of care and professional pursuits, cultivated by the more self-fulfilment-oriented parts of the professional middle-class appears not only unwanted but threatening. In my analysis, I retrieve and develop a psychoanalytically inspired historical-materialist feminism, one that perceives of the gendered division of work as a split in modes of focusing human energy. I suggest that the resurgent cultivation of domestic femininity is nurtured by a self-energizing antagonism between competitive and relational practices. I further argue that the cultivation of domestic femininity in these financial couples points to a potential antagonism between the democratization of love and the specific anxiety-driven competitiveness to which this financial-elite group may be particularly susceptible. (shrink)

The term “value of life” can refer to life’s intrinsic dignity: something nonincremental and time-unaffected in contrast to the fluctuating, incremental “value” of our lives, as they are longer or shorter and more or less flourishing. Human beings are equal in their basic moral importance: the moral indignities we condemn in the treatment of e.g. those with dementia reflect the ongoing human dignity that is being violated. Indignities licensed by the person in advance remain indignities, as when people might volunteer (...) their living, unconscious bodies for surrogacy or training in amputation techniques. Respect for someone’s dignity is significantly impacted by a failure to value that person’s very existence, whatever genuine respect and good will is shown by wanting the person’s life to go well. Valuing and respecting life is not, however, vitalism: there can be good and compelling reasons for eschewing some means of prolonging life. (shrink)

From the Disney 'Teacher of the Year' and New York Times bestselling author comes a road map to enrich students' learning experiences, revised and updated for today's teachers and parents. After publishing the New York Times bestseller The Essential 55 (over 1 million copies sold), award-winning teacher Ron Clark took his rules on the road and traveled to schools and districts in 50 states. He met amazing teachers, administrators, students, parents, and all kinds of people involved in bringing up great (...) kids. These are the eleven qualities he describes in The Excellent 11: Enthusiasm, Adventure, Creativity, Reflection, Balance, Compassion, Confidence, Humor, Common Sense, Appreciation, and Resilience. Ron has filled this book with hundreds of suggestions, stories, and wonderfully funny anecdotes. You'll be smiling as you read--and finding the inspiration to change lives, one student at a time"--Back cover. (shrink)

This chapter considers the ways in which whiteness as a skin color and ideology becomes a dominant level that sets the background against which all things, people and relations appear. Drawing on Merleau-Ponty's phenomenology, it takes up a series of films by Bruce Nauman and Marlon Riggs to consider ways in which this level is phenomenally challenged providing insights into the embodiment of racialization.

In his précis of a recent book, Richard Joyce writes, “My contention…is that…any epistemological benefit-of-the-doubt that might have been extended to moral beliefs…will be neutralized by the availability of an empirically confirmed moral genealogy that nowhere…presupposes their truth.” Such reasoning – falling under the heading “Genealogical Debunking Arguments” – is now commonplace. But how might “the availability of an empirically confirmed moral genealogy that nowhere… presupposes” the truth of our moral beliefs “neutralize” whatever “epistemological benefit-of-the-doubt that might have been extended (...) to” them? In this article, I argue that there appears to be no satisfactory answer to this question. The problem is quite general, applying to all arguments with the structure of Genealogical Debunking Arguments aimed at realism about a domain meeting two conditions. The Benacerraf-Field Challenge for mathematical realism affords an important special case. (shrink)

Maud Boyer Arnaud Destrebecqz Axel Cleeremans.

¿Es posible un decálogo del agua en la era de la globalización y la liberalización de todos los mercados y recursos naturales? Maude Barlow así lo cree y nos propone 10 principios básicos para mantener un equilibrio del agua entre las necesidades humanas y el mundo natural. El agua no puede concebirse simplemente como un recurso explotable, sino como un patrimonio del planeta y para las próximas generaciones. Los 10 principios de Barlow, más que un código, representan una invitación (...) a pensar la sustentabilidad a partir de lo local. (shrink)

« Il y a 9 mois, pour que les choses changent et après avoir travaillé sur mon sujet depuis plus de 15 ans, je fais le choix d'abandonner mon confort en devenant (bénévolement) la nouvelle déléguée nationale à l'Environnement chez Les Républicains. Je l'ai accepté dans le but unique de porter mes convictions. J'y ai proposé un programme précis, destiné à être appliqué. Puis je suis partie en campagne pour les régionales et j'ai été élue vice-présidente au développement durable, à (...) l'énergie et à la mer en PACA. J'ai la volonté de transformer ma région en un laboratoire d'idées. Je suis déterminée pour qu'elle devienne le porte-drapeau d'une écologie qui rime avec économie. Je veux agir dans ma région sans langue de bois, faire progresser l'écologie en étant réaliste et cohérente. Il est temps de dire la vérité. Je veux donner les vrais chiffres, arrêter le catastrophisme, « l'écologiquement correct », ne pas faire de calcul populiste. On est en 2016, il serait temps de secouer les choses et de changer de modèle. Je suis prête à en payer le prix, ma cause en vaut la peine : des tempêtes j'en ai vu d'autres. Je veux aussi parler de la place des femmes en politique, du sexisme. De l'intérieur, je vais vous raconter ce basculement d'une vie de sportive ayant été nommée personnalité de l'année par le Times magazine, à un milieu d'hommes auxquels seule la loi impose la mixité. Je veux agir pour la qualité de notre environnement et sur nos choix énergétiques comme on monte une entreprise, avec sérieux mais sans oublier qui je suis. Osons! J'ai décidé de remettre en jeu tout ce que j'avais construit/acquis ces dernières années pour faire avancer mes convictions pour l'environnement. L'avenir me dira si le jeu en valait la chandelle. » Maud Fontenoy. (shrink)

En comparant sur plusieurs scènes la réception de mes recherches sur le travail bénévole – désenchantement pour les un.es, truisme pour les autres – et en prenant au sérieux le processus de politisation par l’enquête qui a été le mien, cet article propose une analyse située à la fois socialement et politiquement du désenchantement que produirait la sociologie catégorisée comme critique. Il met en lumière deux défenses de l’autonomie de l’engagement, au cœur de la critique de la critique : celui (...) de l’autonomie de « l’engagement citoyen » des acteur.trices et de leur rapport au travail, et celui de l’autonomie du travail du chercheur.se et de ses « engagements », généralement présenté sous le topos de la « neutralité » de la recherche. Ce retour réflexif sur les effets de l’enquête sur les autres, mais aussi sur moi-même, vient questionner in fine la portée sociale et politique de cette « conception des mondes antagonistes » inscrite dans une « doctrine de la séparation des sphères » du travail et de l’engagement qui concerne ici tant l’objet que la pratique de recherche. (shrink)

It is widely agreed that the intelligibility of modal metaphysics has been vindicated. Quine's arguments to the contrary supposedly confused analyticity with metaphysical necessity, and rigid with non-rigid designators.2 But even if modal metaphysics is intelligible, it could be misconceived. It could be that metaphysical necessity is not absolute necessity – the strictest real notion of necessity – and that no proposition of traditional metaphysical interest is necessary in every real sense. If there were nothing otherwise “uniquely metaphysically significant” about (...) metaphysical necessity, then paradigmatic metaphysical necessities would be necessary in one sense of “necessary”, not necessary in another, and that would be it. The question of whether they were necessary simpliciter would be like the question of whether the Parallel Postulate is true simpliciter – understood as a pure mathematical conjecture, rather than as a hypothesis about physical spacetime. In a sense, the latter question has no objective answer. In this article, I argue that paradigmatic questions of modal metaphysics are like the Parallel Postulate question. I then discuss the deflationary ramifications of this argument. I conclude with an alternative conception of the space of possibility. According to this conception, there is no objective boundary between possibility and impossibility. Along the way, I sketch an analogy between modal metaphysics and set theory. (shrink)

In recent years, calls have been made to address the relative dearth of qualitative sociological investigation into the sensory dimensions of embodiment, including within physical cultures. This article contributes to a small, innovative and developing literature utilizing sociological phenomenology to examine sensuous embodiment. Drawing upon data from three research projects, here we explore some of the ‘sensuousities’ of ‘intense embodiment’ experiences as a distance-running-woman and a boxing-woman, respectively. Our analysis addresses the relatively unexplored haptic senses, particularly the ‘touch’ of heat. (...) Heat has been argued to constitute a specific sensory mode, a trans-boundary sense. Our findings suggest that ‘lived’ heat, in our own physical-cultural experiences, has highly proprioceptive elements and is experienced as both a form of touch and as a distinct perceptual mode, dependent upon context. Our analysis coheres around two key themes that emerged as salient: (1) warming up, and (2) thermoregulation, which in lived experience were encountered as strongly interwoven. (shrink)

The distinction between perception and cognition frames countless debates in philosophy and cognitive science. But what, if anything, does this distinction actually amount to? In this introductory article, we summarize recent work on this question. We first briefly consider the possibility that a perception-cognition border should be eliminated from our scientific ontology, and then introduce and critically examine five positive approaches to marking a perception–cognition border, framed in terms of phenomenology, revisability, modularity, format, and stimulus-dependence.

This paper examines three views of what an omission or an instance of refraining is. The view advanced is that in many cases, an omission is simply an absence of an action of some type. However, generally one’s not doing a certain thing counts as an omission only if there is some norm, standard, or ideal that calls for one’s doing that thing.