Background: Undergraduate nursing students have been documented to experience ethical distress during their clinical training and felt poorly supported in discussing the ethical issues they encountered. Research aims: This study was aimed at exploring nursing students’ perceived opportunity to discuss ethical issues that emerged during their clinical learning experience and associated factors. Research design: An Italian national cross-sectional study design was performed in 2015–2016. Participants were invited to answer a questionnaire composed of four sections regarding: (1) socio-demographic data, (2) previous (...) clinical learning experiences, (3) current clinical learning experience quality and outcomes, and (4) the opportunity to discuss ethical issues with nurses in the last clinical learning experience (from 0 – ‘never’ to 3 – ‘very much’). Participants and research context: Participants were 9607 undergraduate nursing students who were attending 95 different three-year Italian baccalaureate nursing programmes, located at 27 universities in 15 Italian regions. Ethical considerations: This study was conducted in accordance with the Human Subject Research Ethics Committee guidelines after the research protocol was approved by an ethics committee. Findings: Overall, 4707 (49%) perceived to have discussed ethical issues ‘much’ or ‘very much’; among the remaining, 3683 (38.3%) and 1217 (12.7%) students reported the perception of having discussed, respectively, ‘enough’ or ‘never’ ethical issues emerged in the clinical practice. At the multivariate logistic regression analysis explaining 38.1% of the overall variance, the factors promoting ethical discussion were mainly set at the clinical learning environment levels (i.e. increased learning opportunities, self-directed learning, safety and nursing care quality, quality of the tutorial strategies, competences learned and supervision by a clinical nurse). In contrast, being male was associated with a perception of less opportunity to discuss ethical issues. Conclusion: Nursing faculties should assess the clinical environment prerequisites of the settings as a context of student experience before deciding on their accreditation. Moreover, the nursing faculty and nurse managers should also enhance competence with regard to discussing ethical issues with students among clinical nurses by identifying factors that hinder this learning opportunity in daily practice. (shrink)

Happiness is typically reported as an important reason for participating in challenging activities like extreme sport. While in the middle of the activity, however, participants do not seem particularly happy. So where does the happiness come from? The article proposes some answers from a study of facially expressed emotions measured moment-by-moment during a backcountry skiing event. Self-reported emotions were also assessed immediately after the skiing. Participants expressed lower levels of happiness while skiing, compared to when stopping for a break. Moment-to-moment (...) and self-reported measures of emotions were largely unrelated. These findings are explained with reference to the Functional Wellbeing Approach ( Vittersø, 2013 ), which argues that some moment-to-moment feelings are non-evaluative in the sense of being generated directly by the difficulty of an activity. By contrast, retrospective emotional feelings are more complex as they include an evaluation of the overall goals and values associated with the activity as a whole. (shrink)

In this article, we explore the institutional negotiation of public engagement in matters of science and technology. We take the example of the Science in Society dialogue program initiated by the UK’s Royal Society, but set this case within the wider experience of the public engagement activities of a range of charities, corporations, governmental departments, and scientific institutions. The novelty of the analysis lies in the linking of an account of the dialogue event and its outcomes to the values, practices, (...) and imperatives—the institutional rationality—of the commissioning organization. We argue that the often tacit institutional construction of scientific citizenship is a critical, and relatively undeveloped, element of analysis—one that offers considerable insight into the practice and democratic implications of engaging publics in science and science policy. We also present evidence indicating that over time the expanding ‘‘capacities’’ associated with dialogue can act in subtle ways to enroll other elements of institutional architectures into more reflexive modes of thinking and acting. In the concluding section of the article, we consider the ways in which research and practice could engage more squarely with facets of institutional context and culture. (shrink)

The aim of this study was to understand how mothers experienced midwives' uncaring behaviour and actions during birth. Sixty-seven first-time mothers took part in the study, in which data were collected through interview. The interview text was analysed using hermeneutic text analysis. Nearly half of the mothers interviewed (n = 32) said that midwives did not care for them. The findings show that midwives' behaviour was humiliating when they ignored mothers and held them in contempt. The mothers felt further humiliated (...) when the midwives did not believe them, treated their bodies in a careless manner and tended to put blame on them. Through their behaviour and actions, some midwives have shown that they no longer have a caring attitude as an element of their professional practice and that they have ignored ethics by offending mothers' sense of dignity. (shrink)

Driven by the increasing availability and deployment of ubiquitous computing technologies across our private and professional lives, implementations of automatically processable regulation (APR) have evolved over the past decade from academic projects to real-world implementations by states and companies. There are now pressing issues that such encoded regulation brings about for citizens and society, and strategies to mitigate these issues are required. However, _comprehensive yet practically operationalizable_ frameworks to navigate the complex interactions and evaluate the risks of projects that implement (...) APR are not available today. In this paper, and based on related work as well as our own experiences, we propose a framework to support the conceptualization, implementation, and application of _responsible_ APR. Our contribution is twofold: we provide a holistic characterization of what responsible APR means; and we provide support to operationalize this in concrete projects, in the form of leading questions, examples, and mitigation strategies. We thereby provide a scientifically backed yet practically applicable way to guide researchers, sponsors, implementers, and regulators toward better outcomes of APR for users and society. (shrink)

In diesem Beitrag wird das Verhalten des Papstes im europäischen Dialog der Religionen und Weltanschauungen kritisch erörtert. Am Anfang steht eine kurze Analyse der Sprache der Religionen bzw. Weltanschauungen, die in Anlehnung an Joseph Maria Bochenski durchgeführt ist. Es wird dabei die Auffassung vertreten, dass Religionen und manche Weltanschauungen Behauptungen über die Wirklichkeit aufstellen, Sprache in einer deskriptiv-kognitiven Funktion verwenden, dass ein solcher Sprachgebrauch eine epistemische Verpflichtung auf Bescheidenheit mit sich bringt und dass eine solche Verpflichtung wiederum eine Basis für (...) einen ernstgemeinten europäischen Dialog bieten könnte. Danach werden von einem theologischen Standpunkt ausgehend Bedingungen dafür untersucht, dass ein europäischer Dialog stattfinden kann. Anhand konkreter Beispiele, im Speziellen anhand der "Regensburger Rede" und der "Neuformulierung der Karfreitagsfürbitte für die Juden", wird gezeigt, wie sich der Papst im europäischen Dialog tatsächlich verhält und wie von Seiten der jeweiligen Religion auf dieses Verhalten eingegangen wird. Da er vor allem in der menschlichen Vernunft eine Brücke für einen europäischen Dialog sieht, wird anschließend auf seine Argumentation für eine Ausweitung der Vernunft und seinen Gebrauch der Wörter "Vernunft" und "Glauben" eingegangen. Dabei wird hauptsächlich auf Schriften, in denen der Papst seine Überzeugung ausdrückt, dass Religion und Vernunft sich gegenseitig korrigieren, begrenzen und unterstützen müssen, Bezug genommen. Abschließend wird ein bestimmtes Argument des Papstes für diese Überzeugung expliziert und bewertet. (shrink)

The gene regulation function (GRF) provides an operational description of a promoter behavior as a function of the concentration of one of its transcriptional regulators. Behind this apparently trivial definition lies a central concept in biological control: the GRF provides the input/output relationship of each edge in a transcriptional network, independently from the molecular interactions involved. Here we discuss how existing methods allow direct measurement of the GRF, and how several trade‐offs between scalability and accuracy have hindered its application to (...) relatively large networks. We discuss the theoretical and technical requirements for obtaining the GRF. Based on these requirements, we introduce a simplified and easily scalable method that is able to capture the significant parameters of the GRF. The GRF is able to predict the behavior of a simple genetic circuit, illustrating how addressing the quantitative nature of gene regulation substantially increases our comprehension on the mechanisms of gene control. (shrink)

Progressive supranuclear palsy is a movement disorder with prominent tau neuropathology. Brain diseases with abnormal tau deposits are called tauopathies, the most common of which is Alzheimer's disease. Environmental causes of tauopathies include repetitive head trauma associated with some sports. To identify common genetic variation contributing to risk for tauopathies, we carried out a genome-wide association study of 1,114 individuals with PSP and 3,247 controls followed by a second stage in which we genotyped 1,051 cases and 3,560 controls for the (...) stage 1 SNPs that yielded P ≤ 10-3. We found significant previously unidentified signals associated with PSP risk at STX6, EIF2AK3 and MOBP. We confirmed two independent variants in MAPT affecting risk for PSP, one of which influences MAPT brain expression. The genes implicated encode proteins for vesicle-membrane fusion at the Golgi-endosomal interface, for the endoplasmic reticulum unfolded protein response and for a myelin structural component. © 2011 Nature America, Inc. All rights reserved. (shrink)

While psychotherapists are trained to improve their clients’ quality of life, little work has examined the quality of life experienced by psychotherapist trainees themselves. Yet their life satisfactions and stresses would plausibly affect both their ability to learn new skills and conduct psychotherapy. Therefore, in the Society for Psychotherapy Research Interest Section on Psychotherapist Development and Training study, we investigated the patterns of self-reported life quality and their correlates in a multinational sample of 1,214 psychotherapist trainees. A comprehensive questionnaire was (...) used at the outset of trainings to assess trainees’ professional background, current life situation, personal characteristics, family background, and social and national origin. The findings indicated 54.3% of trainees’ lives could be characterized as fortunate or happy, whereas 14.3% could be characterized as clearly distressed or troubled. The strongest correlates of high life stress, a contributor to poor life quality, were economic insecurity, self-protectiveness, and attachment-related anxiety in relationships, and economic or psychological hardship in childhood. In turn, greater wellbeing was most strongly associated with a warm and open interpersonal style, being married, having sufficient economic means, and material and emotional security in childhood. While the results indicate the majority of therapists experience a relatively good quality of life, the findings also suggest potential targets for increasing trainees’ life quality when it may be deficient, such as those on a societal level, training program level, and individual level, in order to promote effective learning and therapy practice. (shrink)

Written by two of the leading figures in the field, this is a lucid and systematic introduction to semantics as applied to transformational grammars of the ...

Aging is characterized by the decline and deterioration of functional cells and results in a wide variety of molecular damages and reduced physical and mental capacity. The knowledge on aging process is important because life expectancy is expected to rise until 2050. Aging cannot be considered a homogeneous process and includes different trajectories characterized by states of fitness, frailty, and disability. Frailty is a dynamic condition put between a normal functional state and disability, with reduced capacity to cope with stressors. (...) This geriatric syndrome affects physical, neuropsychological, and social domains and is driven by emotional and spiritual components. Sarcopenia is considered one of the determinants and the biological substrates of physical frailty. Physical and cognitive frailty are separately approached during daily clinical practice. The concept of motoric cognitive syndrome has partially changed this scenario, opening interesting windows toward future approaches. Thus, the purpose of this manuscript is to provide an excursus on current clinical practice, enforced by aneddoctical cases. The analysis of the current state of the art seems to support the urgent need of comprehensive organizational model incorporating physical and cognitive spheres in the same umbrella. (shrink)

This article uses a conversation analytic framework to describe a type of wh-question used to challenge a prior utterance, specifically to challenge the basis for or right to do an action done by the prior utterance. These wh-questions are able to do challenging because, rather than asking for new information, they are used to convey a strong epistemic stance of the questioner, a negative assertion. The utterances are designed as requests for an account for a prior claim or action, but (...) by conveying a negative assertion, they suggest that there is no adequate account available and, thus, that there are no grounds for the prior claim or action. The use of these questions in institutional settings can display participants' orientation to institutional goals, norms and roles, showing that institutional roles can thus be enacted, and goals accomplished, by means of practices of talk which are not, themselves, institutionally specific. (shrink)

With the turning of wilderness areas into wildlife parks and the returning of developed areas of land to the forces of nature, intermediate hybrid realms surface in which wild and managed nature become increasingly entangled. A partitioning of environmental philosophy into ecoethics and animal welfare ethics leaves these mixed territories relatively uncharted—the first dealing with wild (animals), the second with the welfare of captive or domestic animals. In this article, we explore an environmental philosophy that considers explicitly these mixed situations. (...) We examine a recent Dutch policy of introducing domesticated and semi-wild large herbivores in newly developed nature areas. Larger issues are at stake, such as the intertwinement of nature and culture, the dynamic character of de-domestication processes, and the relation between concepts of authenticity and the wild. We sketch a pluralistic, dynamic, and pragmatic environmental philosophy that is capable of dealing with the complicated ethicalproblems concerning creatures and land caught between domestication and the wild. (shrink)

This article adds to the conversation analytic literature on repair and on preference structure by examining a previously-undescribed otherinitiated repair practice, using the form of an alternative question, and the various actions that this practice is used to accomplish. Alternative question repair initiations can present alternate hearings or understandings of a prior utterance for clarification. They can also be used to initiate error correction by targeting a trouble source in a prior utterance with the first alternative and providing a candidate (...) correction with the second. In the latter case, rejection of the candidate preference can be done as a dispreferred response. Recipients can make use of both turn design and context to interpret the actions being done through this form of repair. (shrink)

SCHOFIELD I, TOLSON D and FLEMING V. Nursing Inquiry 2012; 19: 165–176 [Epub ahead of print]How nurses understand and care for older people with delirium in the acute hospital: a Critical Discourse AnalysisDelirium is a common presentation of deteriorating health in older people. It is potentially deleterious in terms of patient experience and clinical outcomes. Much of what is known about delirium is through positivist research, which forms the evidence base for disease‐based classification systems and clinical guidelines. There is little (...) systematic study of nurses’ day‐to‐day practice of nursing patients with delirium. The aim was to uncover the kinds of knowledge that informs nurses’ care and to explicate the basis of that knowledge. Critical Discourse Analysis is underpinned by the premise that powerful interests within society mediate how social practices are constructed. Links were made between the grammatical and lexical features of nurses’ language about care in interviews and naturalistic settings, and the healthcare context. Care focused on the continuous surveillance of patients with delirium by nurses themselves or vicariously through other patients, and containment. Nurses influenced by major discourses of risk reduction and safety, constructed patients with delirium as risk objects. The philosophy of person‐centred and dignified care advocated in nursing literature and government policy is an emerging discourse, though little evident in the data. The current dominant discourses on safety must give space to discourses of dignity and compassion. (shrink)

The “nature” of an artifact is often equated with its function. Clearly, an artifactual function must be an extrinsic property. This feature of functions has important implications on the semantics of artifactual kind terms: it enables us to vindicate that artifactual kind terms have an externalist semantics. Any alleged externalist theory, indeed, must show that the referents of the considered terms share a common nature (i.e., an extrinsic property), whether we know or could possibly ever know what that nature is. (...) However, the state of the art shows that function is not enough to represent such “nature”: function does not exhaustively account for important phenomena that characterize artifacts and artifactual kinds, nor does it thoroughly define what they are. Thus, extending the scope of externalism to artifactual kind terms seems doomed to fail. Pace opposite views, it could even be argued that artifacts are a sub-class of social kinds. If so, not only social but also artifactual kind terms cannot refer externalistically, since their referents constitutively depend on human intentions and norms. Either way, externalism fails to apply to those kinds of terms. (shrink)

RESUMO O ensaio revê a análise crítica de V. N. Volóchinov a respeito dos processos de transmissão discursiva, questionando estudos consagrados das categorias estilísticas e impressionistas. Ao descobrir formas em que o discurso citado tensiona a citação fazendo emergir um discurso quase direto, que tanto pode ser do narrador como da personagem, Volóchinov entende ter encontrado uma outra história do discurso, muito mais favorável à manifestação da bivocalidade como reação ativa ao discurso de outrem e como plena manifestação do ideologema. (...) Inferimos, por conseguinte, que o problema examinado pelo teórico se coloca como uma nova episteme discursiva nos estudos dialógicos. ABSTRACT This essay reviews the critical analysis of V.N. Voloshinov with respect to the process of discursive transmission, questioning consecrated studies of stylistic and impressionistic categories. Voloshinov, on discovering ways in which reported speech creates tension in the citation, causing a quasi-direct discourse to emerge, which can be attributed to both the narrator as well as the character, understands he has found another history of discourse that is much more favorable to the manifestation of bivocality as active reaction to the discourse of the other, and as a full manifestation of the ideologeme. We infer, thus, that the problem examined by the theorist establishes a new discursive episteme in dialogic studies. (shrink)

Le regard ethnologique, porté par l'auteur sur les pratiques de circulation entre la France et le Portugal de jeunes d'ascendance portugaise et de jeunes Portugais de France, révèle l'agencement de ressources matérielles et symboliques plurielles. Au-delà de la dimension économique et politique dans lesquelles s'insèrent ces pratiques, le processus identitaire dans lequel elles s'intègrent pose des questions, notamment dans le contexte de l'Union européenne. L'auteur montre ici comment, en puisant des éléments de l'histoire migratoire familiale, de l'histoire nationale et de (...) la culture portugaise, des descendants de migrants économiques européens tentent de dépasser le dilemme identitaire que représente la « double culture », ainsi que les contraintes sociales et culturelles imposées par leurs aînés. (shrink)

To prevent and reduce the transmission of the coronavirus to vulnerable populations, the World Health Organization recommended the restriction of visitors to nursing homes. It was recognised that such restrictions could have profound impact on residents and their families. Nonetheless, these measures were strictly imposed over a prolonged period in many countries; impeding families from remaining involved in their relatives’ care and diluting the meaningful connections for residents with society. It is timely to explore the impact of public health measures (...) on people living in nursing homes from an ethical perspective. In order to foreground the ethical dimensions of the implications of visitor restrictions in nursing homes, we compiled an ethical case that reflects some recent experiences of nursing homes residents and their families, in the Irish Republic. We describe a series of events encountered by a woman and her family during the first wave of the pandemic in 2020 and we deploy an ethical decision-making tool to guide and structure our analysis. Our case analysis draws attention to ethical principles that are relevant to explicating the ethical duties and obligations that arise in relation to the interests, well-being, and safety of residents and their families, as well as nursing home staff and the wider community during a pandemic. These include the right of autonomy, trust, minimising harm, and proportionality. We conclude that a number of different strategies should be adopted by nursing homes and relevant regulatory bodies. This includes honest, regular communication between the nursing home staff, the resident and their family. Central to communications is the resident’s wishes, their current clinical status and the all-important wider public health obligations. National strategies include mass vaccination, the timely provision of guidance documents and interventions from regulatory bodies that are patient-centred, adaptable, and cost effective. (shrink)

This study investigates the performance measurement systems adopted by companies to manage their social responsibility activities, a theme that remains under-researched despite the important role that these mechanisms may play in helping firms control and improve their social performance. An integrative model is developed to examine how the three fundamental drivers of corporate social strategies, i.e., business motivations, perceived stakeholder pressures, and top management’s social commitment, influence the use of social performance indicators for internal decision-making and control and how such (...) use impacts companies’ social and economic performance. The results from a survey of 97 Italian companies suggest that economic motivations and top management’s commitment are associated with a more intensive use of social performance indicators for decision-making and control, whereas perceived pressures from stakeholders do not represent a significant determinant of such use. The use of social performance indicators, in turn, is found to directly influence a firm’s social performance and, indirectly, its bottom line. (shrink)

This article presents an artistic and political experiment as an effort to advance democratic transactions in the life sciences. Artists built a ‘gender democratic labyrinth’ in Maastricht, in which scientists, women’s groups, people in general, artists, philosophers, politicians, journalists, clinical geneticists and many others interacted and negotiated on the creation of human embryos for medical-scientific research. By taking a gender perspective on the process of democratizing science, we aimed to create a space in which alterity and difference are constitutive elements (...) in the public exchanges on science and technology. The idea to build a labyrinth was theoretically based on the notion of agonistic democracy - in which pluralism is the result of contestations and divisions - and on a notion of science and technology as being contextualized and socialized. (shrink)

The favored economic position that Venice enjoyed in the eastern Mediterranean and the Black Sea following the Fourth Crusade lasted only until the fall of the Latin Empire of Constantinople in 1261. During the next century the republic sought to reinstate its hegemony over the waterways and engaged in a prolonged struggle for maritime supremacy with its Ligurian rival, Genoa. The two cities were unable to resolve their debates over commercial privileges in key ports until 1381, following the conclusion of (...) the War of Chioggia. One of the features of this contest was a sharp rise in the instances of piracy and warfare between corsairs, particularly along the critical routes of Levantine trade. Genoa, however, was not the only power to challenge Venetian trade and domination. Robbery on the seas increased markedly as new adversaries edged their way onto the naval stage with greater intensity after 1300. The fourteenth century may have been a watershed in the history of naval plundering, marking a transitional phase during which the difference between pirates and corsairs crystallized. Moreover the years preceding the War of Chioggia reveal how Venice responded to the growing instability, how the commune implemented measures to deal effectively with multiplying threats, and, above all, how the republic's naval affairs reflected both remarkable elasticity and cohesion within the scope of state policies. (shrink)

Communication Studies currently undergoes a crisis of paradigms that requires an ontological review that must begin with a debate about the conditions of possibility of every communicational phenomena. In this article we argue that semiosis offers a conceptual framework that allows for the study of communication as qualitative action. Semiosis, or the action of the sign, is here defined as a fundamental process based on perception that models the world of species, creating cognition and culture. At the core of semiosis (...) are dynamic structures that the authors have defined as ‘ontological diagrams’. The first purpose of Semiotics of Communication is to understand how these modeling systems evolve ontologically and phylogenically, producing, in the case of human culture, means of communication ever more varied and technologically advanced. (shrink)