Feeding difficulties in older patients who are suffering from dementia present problems with balancing conflicting ethical principles. They have been considered by several writers in recent years, and the views of nursing and care staff have been studied in different contexts. The present study used focus groups to explore the way in which nursing and care staff in a National Health Service trust deal with conflict between ethical principles in this area. Three focus groups were convened, one each from the (...) staff of three wards caring for patients with dementia. Case histories were discussed and transcripts analysed. It emerged that staff were aware of making fine judgements of utility concerning the spectrum of feeding methods available. Informants gave some weight to the principle of autonomy, but sought to balance that against their commitment to care. In explaining their perspectives, informants gave more weight to personal attitudes and trust culture than to professional ethics. (shrink)

This article reflects on childhood times based on the words chrónos, kairós and aión, which the Greeks use to conceptualize time, in dialogue with different authors, such as Kohan, Pohlmann, Skliar, Kohan and Fernandes. In the pedagogical field, we explore how Pedagogy of Childhood has focused on the importance of childhood temporality and children’s agency, with contributions from Hoyuelos, Parrini, Aguilera et al., Barbosa, Oliveira-Formosinho e Araújo, Oliveira-Formosinho, Pinazza and Gobbi. We reflect on what forms of organizing time are possible (...) when we think about children and their childhoods. Would it be a continuous and chronological time, a time of opportunity for the instant or the timeless intensity of the aiónic? Would it be possible to open spaces in school for other temporalities, given its immersion in chronological time, and its extreme emphasis on routine? We seek a relationship between forms of temporality, philosophy, and early education in order to explore alternative possibilities in the relationship between child and the school context, and conclude that, since the child’s is the aiónic time of intense experience, it is in the heightened dynamic immediacy and the multiple symbolic languages of play that it may be possible to create pedagogical structures that provide a dwelling for childhood temporality. (shrink)

A major problem for interpersonal aggregation is how to compare utility across individuals; a major problem for decision-making under normative uncertainty is the formally analogous problem of how to compare choice-worthiness across theories. We introduce and study a class of methods, which we call statistical normalization methods, for making interpersonal comparisons of utility and intertheoretic comparisons of choice-worthiness. We argue against the statistical normalization methods that have been proposed in the literature. We argue, instead, in favor of normalization of variance: (...) we claim that this is the account that most plausibly gives all individuals or theories ‘equal say’. To this end, we provide two proofs that variance normalization has desirable properties that all other normalization methods lack, though we also show how different assumptions could lead one to axiomatize alternative statistical normalization methods. (shrink)

Nick Bostrom and others have suggested treating decision-making under moral uncertainty as analogous to parliamentary decision-making. The core suggestion of this “parliamentary approach” is that the competing moral theories function like delegates to the parliament, and that these delegates then make decisions by some combination of bargaining and voting. There seems some reason to hope that such an approach might avoid standard objections to existing approaches (for example, the “maximise expected choiceworthiness” (MEC) and “my favourite theory” approaches). However, the parliamentary (...) approach is so far extremely underspecified, making it largely indeterminate how such a model will in fact behave in the respects that those concerned with moral uncertainty care about. This paper explores one way of making it precise. We treat predicaments of moral uncertainty as analogous to bargaining situations alone (setting aside voting), and apply a version of the Nash solution that is standard in bargaining theory. The resulting model does indeed perform in many of the hoped-for ways. However, so also does a version of MEC that employs a structural approach to intertheoretic comparisons. It seems to us an open question which, regarding this version of MEC and the bargaining-theoretic approach, is superior to the other. We identify the key points on which the two differ. (shrink)

This provocative book paved the way for nursing research informed by f eminist scholarship, critical theory, and post-modern thought. Controv ersial then, relevant today.

We draw on three illustrative vignettes to examine how REBs manage participants’ agency in the context of qualitative research. We ask: Who owns a participant’s consent? Central to informed consent is the principle of Respect for Persons, which privileges the autonomy of individuals to make decisions about what happens (or not) to them. Yet, REBs sometimes require researchers to get permission from organizations to conduct research on their current and former members, even when the research is not about those organizations. (...) Our aim is to raise awareness about the inherent contradictions of this practice and to consider guidelines for determining the appropriateness of involving organizations that may be tangentially connected to the research objectives or potential participants. (shrink)

What considerations place genuine constraints on an adequate semantics for normative and evaluative expressions? Linguists recognize facts about ordinary uses of such expressions and competent speakers’ judgments about which uses are appropriate. The contemporary literature reflects the widespread assumption that linguists don’t rely upon an additional source of data—competent speakers’ judgments about possible disagreement with hypothetical speech communities. We have several good reasons to think that such judgments are not probative for semantic theorizing. Therefore, we should accord these judgments no (...) probative value for the development of a semantics for our moral terms. Such judgments can no longer be presumed to put pressure on theories according to which our moral expressions share a semantics with ordinary, descriptive terms. Many rivals to pure, Descriptivist theories count among their advantages the ability to accommodate these judgments. If these judgments have no probative value, such theories lose an important source of support. (shrink)

Many UK public companies invest considerable resources in charitable donations and community involvement. Using semi‐structured interviews with public company officers, the author sought to investigate the motivations behind this activity. Was it undertaken because of an expectation of commercial benefit, out of a sense of obligation, or for other reasons? It appeared that public companies were increasingly anxious to make connections between corporate activity in the community and business activities. Public companies linked with local communities clearly felt a sense of (...) connection with them. Corporate officers were constantly dealing with the management of reputation, which was seen as a valuable business asset, and community links made this task easier. (shrink)

The purpose of this article is to assess Rosabeth Moss Kanter's work on tokenism in light of more than a decade of research and discussion. While Kanter argued that performance pressures, social isolation, and role encapsulation were the consequences of disproportionate numbers of women and men in a workplace, a review of empirical data concludes that these outcomes occur only for token women in gender-inappropriate occupations. Furthermore, Kanter's emphasis on number balancing as a social-change strategy failed to anticipate backlash from (...) dominants. Blalock's theory of intrusiveness suggests that surges in the number of lower-status members threaten dominants, thereby increasing gender discrimination in the forms of sexual harassment, wage inequities, and limited opportunities for promotion. Although Kanter's analysis of the individual consequences of tokenism was compelling to researchers and organizational change agents, continued reliance on numbers as the theoretical cause of, and as the solution to, gender discrimination in the workplace neglects the complexities of gender integration. (shrink)

The aim of this workshop was to ask potential end-users of the citizens’ information pack on legal and ethical issues around ICTs the following questions: What is your knowledge of the EU’s General Data Protection Regulation, and what actions have you taken in response to these regulations? What challenges are you experiencing in ensuring the protection and security of your project data, and compliance with the GDPR, within existing data management processes/systems? What information/tools/resources do you need to overcome these challenges? (...) What are the best formats/channels for receiving, sharing and acting upon this information? What is the most appropriate structure/format for the citizens’ information pack? (shrink)

The phenomenon of industrial melanism became widely acknowledged as a well-documented example of natural selection largely as a result of H.B.D. Kettlewell’s pioneering research on the subject in the early 1950s. It was quickly picked up by American biology textbooks starting in the early 1960s and became ubiquitous throughout the 1970s, 1980s and 1990s. While recent research on the phenomenon broadly supports Kettlewell’s explanation of IM in the peppered moth, which in turn has strengthened this example of natural selection, textbook (...) IM entries have actually declined in recent years in favor of other examples. In a previous paper, we drew attention to the pivotal role visual aspects played in the introduction of IM into textbook accounts. The present article continues this investigation by analyzing textual passages on industrial melanism within a stratified random sample of textbooks from the 1960s to the 2000s. The fact that this example of natural selection was included by multiple publishers independently, in a short period of time, makes it uniquely qualified for a textbook study of this kind. The purpose of the present project was to determine whether these textbooks contain what has come to be known as the standard peppered moth story. Three complete series were also inspected for change across time. Our analysis focused on the amount of text devoted to industrial melanism; what specific science content elements were present; and what, if any, nature of science aspects were included. The study documents an increase in the amount of text devoted to industrial melanism over the decades. In spite of this increase, only modest changes in science content and NOS aspects were found. (shrink)

This chapter discusses three puzzles about practical conditionals and inferences and shows how the flexible, contextualist semantic framework for “ought”. The chapter develops elsewhere resolves all three puzzles more satisfactorily than any of its three most prominent rivals, the relativist account of Niko Kolodny and John MacFarlane, the wide-scoping account of John Broome, and the “trying on” account of James Dreier. The chapter first introduces the puzzle cases and six desiderata for their solutions, and then shows how only flexible contextualism (...) about “ought” is able to resolve each while satisfying all six desiderata. (shrink)

Attentional capture by schematic emotional faces was investigated in two experiments using the flanker task devised by Eriksen and Eriksen (1974). In Experiment 1, participants were presented with a central target (a schematic face that was either positive or negative) flanked by two identical distractors, one on either side (schematic faces that were positive, negative, or neutral). The objective was to identify the central target as quickly as possible. The impact of the flankers depended on their emotional expression. Consistent with (...) a threat advantage hypothesis (negative faces are processed faster and attract more processing resources), responses to positive faces were slower when these were flanked by (response incompatible) negative faces as compared with positive or neutral faces, whereas responses to negative faces were unaffected by the identity of the flankers. Experiment 2 was a standard flanker task with letter stimuli except that the task-neutral flankers were schematic faces that were either positive, negative, or emotionally neutral. In this case, in which faces and emotional expressions were to be ignored, performance seemed entirely unaffected by the faces. This result suggests that attentional capture by emotional faces is contingent on attentional control settings. (shrink)

Perhaps more controversial than whether physicalism is true is what exactly would have to be true for physicalism to be true. Everyone agrees that, intuitively at least, physicalism is the thesis that there is nothing over and above the physical. The disagreements arise in how to get beyond this intuitive formulation. Until about ten years ago, participants in this debate were concerned primarily with answering two questions. First, what is it for a property, kind, relation, or individual to be a (...) physical one? (shrink)

The aim of this study was interpret the existential construct of family caring following Acute Coronary Syndrome. Family support is known to have a positive impact on recovery and adjustment after cardiac events. Few studies provide philosophically-based, interpretative explorations of carer experience following a spouse’s ischaemic event. As carer experiences, behaviours and meaning-making may impact on the quality of the support they provide to patients, further understanding could improve both patient outcomes and family experience. Fourteen spouses of people experiencing Acute (...) Coronary Syndrome in Sydney, Australia were engaged in a single, semi-structured interview. Interviews were audio-recorded and transcribed verbatim. Data were analysed using hermeneutic interpretation within a Heideggerian phenomenological framework. Acute Coronary Syndrome disrupts lived temporality, and the projected potential for carers’ being-alongside. Carers experienced an existential uncertainty that arose from difficulty in diagnosis, and situated fear as an attuned, being-towards-death. They constructed protective strategies to insulate their partner and themselves from further stress and risk, however, unclear boundaries for protection heightened carer anxiety. The existential structure of care included one of two possible Heideggerian modes: leaping-in care was a dominating mode that required a high level of carer vigilance; leaping-ahead care was a metaphorical walking alongside, as carers gave back control, freeing opportunities for the person to ‘own’ care. Supporting carers through the intensive phase of leaping-in care, and equipping them for informed leaping-ahead care should be a focus in both the acute and post-discharge care phases. (shrink)

This article analyzes organizational mechanisms, and their contexts, leading to gender inequality among stockbrokers in two large brokerages. Inequality is the result of gender differences in sales, as both firms use performance-based pay, paying entirely by commissions. This article develops and tests whether performance-support bias, whereby women receive inferior sales support and sales assignments, causes the commissions gap. Newly available data on the brokerages’ internal transfers of accounts among brokers allows measurement of performance-support bias. Gender differences in the quality and (...) quantity of transferred accounts provide a way to measure gender differences in the assignment of sales opportunities and support. Sales generated from internally transferred accounts, controlling for the accounts’ sales histories, provide a “natural experiment” testing for gender differences in sales capacities. The evidence for performance-support bias is women are assigned inferior accounts and women produce sales equivalent to men when given accounts with equivalent prior sales histories. (shrink)

The Cultural Career of Coolness: Discourses and Practices of Affect Control in European Antiquity, the United States, and Japan. Edited by Ulla Haselstein, Irmela Hijiya-Kirschnereit, Catrin Gersdorf, and Elena Giannoulis. Lanham, Md.: Lexington Books, 2013. Pp. vi + 283. $100.

Kindheit in der japanischen Geschichte: Vorstellungen und Erfahrungen / Childhood in Japanese History: Concepts and Experiences. Edited by Michael Kinski, Harald Salomon, and Eike Grossmann. Wiesbaden: Harrassowitz Verlag, 2015. Pp. xv + 542. $133.

Animalism, according to its strongest proponents, is the view that human beings are ‘essentially or most fundamentally animals’. Specifically, ‘we are essentially animals if we couldn’t possibly exist without being animals’ (Olson 2008). Although contemporary animalism offers an account superior to its Lockean competitors, Olson’s ‘biological approach’ has certain limitations, particularly in its denial of any psychological continuity whatsoever as either necessary or sufficient for individual persistence through time. I propose a number of amendments towards a Thomistic variety of animalism (...) that avoids these difficulties. Although prone to misinterpretation, animalism understood properly is compatible with Aquinas’s theory of subsistent intellect. Against recent challenges, I defend the view that Thomistic animalism not only is intelligible, but is indeed crucial for understanding Aquinas’s view of human nature and rationality. (shrink)

This essay argues that religion is a distinctive form of human activity, and offers a philosophical account of what religion fundamentally is (and what it is not), within the context of the Free Exercise Clause. §I promotes religion as an action-theoretic concept. §II presents the claim that atheism can be regarded as a religion: this claim is rejected on the basis that religion cannot be defined as a set of propositional beliefs concerning metaphysics and morality. §III defends a paradigmatic account (...) of religion as a kind of activity ordered to a concept of transcendence or superior nature, and argues that morally excellent human actions can be identified as religious, but only in a secondary or derivative way. §IV contends with the problem of including act-omissions as instantiations of religious exercise, and proposes a solution with reference to recent arguments implicating two-way powers. (shrink)

This thesis develops a disjunctivist approach to action as an alternative to the standard causal theory, or 'causalism'. The standard theory promotes a concept of action as constituted by a bodily event joined to certain mental conditions by a bond of causation. A disjunctivist approach, in contrast, claims that action must be distinguished by more than merely its etiology: action and mere movement are fundamentally different kinds. Recent objections to the causal theory of action are first surveyed, and the common (...) causalist assumption claiming Aristotle as the progenitor of the causal theory is examined and dismissed. More refined interpretations of Aristotle's thought on action yield two different concepts: action as change, and action as a unified psychophysical process. The latter in particular is argued to hold promise as a basis for developing the disjunctivist approach to action. The remainder of the thesis therefore considers a contemporary account of psychophysicality, known as 'embodiment theory', with the conclusion that the intelligibility of the account depends on appeal to a recent variant of top-down causation. The thesis also concludes that consideration of the concept of an animal agent makes it entirely unsurprising that the mental and physical are always found together in voluntary movement, and that the embodiment theory’s central notion of ‘property fusion’ potentially complements a naturalistic variant of top-down causation in explanations of agency. (shrink)

This thesis develops a disjunctivist approach to action as an alternative to the standard causal theory, or 'causalism'. The standard theory promotes a concept of action as constituted by a bodily event joined to certain mental conditions by a bond of causation. A disjunctivist approach, in contrast, claims that action must be distinguished by more than merely its etiology: action and mere movement are fundamentally different kinds. Recent objections to the causal theory of action are first surveyed, and the common (...) causalist assumption claiming Aristotle as the progenitor of the causal theory is examined and dismissed. More refined interpretations of Aristotle's thought on action yield two different concepts: action as change, and action as a unified psychophysical process. The latter in particular is argued to hold promise as a basis for developing the disjunctivist approach to action. The remainder of the thesis therefore considers a contemporary account of psychophysicality, known as 'embodiment theory', with the conclusion that the intelligibility of the account depends on appeal to a recent variant of top-down causation. The thesis also concludes that consideration of the concept of an animal agent makes it entirely unsurprising that the mental and physical are always found together in voluntary movement, and that the embodiment theory’s central notion of ‘property fusion’ potentially complements a naturalistic variant of top-down causation in explanations of agency. (shrink)

The mechanism(s) by which lentiviruses and related non‐oncogenic retroviruses (e.g. HTLV‐III, the etiologic agent of AIDS) escape immune surveillance, and thereby create long term progressive disease conditions, has been unknown until recently. Studies with two lentiviruses have begun to illuminate the mechanisms. In one, antigenic drift in the virus appears to be the primary mechanism of escape from immune surveillance; in the second, selective masking of the viral envelope glycoprotein epitope, which normally elicits neutralizing anti‐body, appears to provide the means (...) of escape. (shrink)

This article examines birthday party decorations as a way of understanding the materiality and religious place-making of an expanding Baptist congregation in central Sweden in the early twentieth century. The fiftieth birthday party for Magnus Johanson, held at Salem Chapel in Falun, Dalarna county, in 1906, was decorated with birch branches, large Swedish flags and bunting and an elaborately laid table featuring coffee cups and refreshments. From an analysis of these material elements and a deeper investigation into the lives of (...) Johanson and his wife Kristina, it can be seen that evangelicals had a flexible approach to their ‘sacred’ spaces. Social activities and the act of decorating them created not only a sense of congregational fellowship and belonging but also the opportunity for congregations to display their connection to external cultural and political identities. Through the construction of chapel buildings and their subsequent decoration, male and female members were able to demonstrate a complementary creativity. Together they contributed to the cre-ation of Salem as a multi-purpose, comfortable and accepted place within Falun’s evolving religious landscape. (shrink)

While the richness of Heideggerian philosophy is attractive as a healthcare research framework, its density means authors rarely utilise its fullest possibilities as an hermeneutic analytic structure. This article aims to clarify Heideggerian hermeneutic analysis by taking one discrete element of Heideggerian philosophy (Being-towards-death), and using it’s clearly defined structure to conduct a meta-synthesis of Heideggerian phenomenological studies on the experience of living with a potentially life-limiting illness. The findings richly illustrate Heidegger’s philosophy that there is either an inauthentic positioning (...) towards death, or an authentic positioning towards death with a proposition that (1) death is certain; (2) death is indefinite; (3) death is non-relational; and (4) death is not-to-be-outstripped. None of the 29 included studies on the experience of a confrontation with death fully utilised this framework, despite claiming a grounding in Heideggerian thought. This demonstrates the value in modelling how Heideggerian existential structures can be used proactively as analytical ‘hooks’ for data in research claiming a basis in this philosophy and/or method. By modelling the potential application of an important Heideggerian philosophical construct to published qualitative data, this meta-synthesis has revealed new domains and more nuanced understandings of the temporal structure of Being-towards-death. Such an approach helps to more fully unveil the existential concerns of people at the core of interpretative phenomenological enquiry and may provide a blueprint to map either primary or synthesised data to other key ontological existentials. (shrink)

Heideggerian philosophy is frequently chosen as a philosophical framing, and/or a hermeneutic analytical structure in qualitative nursing research. As Heideggerian philosophy is dense, there is merit in the development of scholarly resources that help to explain discrete Heideggerian concepts and to uncover their relevance to contemporary human experience. This paper uses a meta-synthesis methodology to pool and synthesise findings from 29 phenomenological research reports on Being-with in the nurse–patient relationship. We firstly considered and secured the most relevant Heideggerian elements to (...) nurse–patient Being-with. Under these deductive codes, we then inductively developed sub-themes that seemed to explain the multifaceted nature of Being-with, through a secondary analysis and synthesis of published data from 417 patient, carer and nurse participants. Dasein-with was enhanced when nurses had first-hand experience with a phenomenon. Nurses moved between the inauthentic they-mode, and the authentic self-mode. Through circumspection, technology and people were encountered environmentally feeding into nursing attention, assessment and communication. Nursing as a social arrangement was expressed through either leaping-in care or leaping-ahead care. There was a place for both inauthentic and authentic discourse that nurses wove through the ontic everydayness of nursing tasks. (shrink)

Only by the method of free-association could Sigmund Freud have demonstrated how human consciousness is formed by the repression of thoughts and feelings that we consider dangerous. Yet today most therapists ignore this truth about our psychic life. This book offers a critique of the many brands of contemporary psychoanalysis and psychotherapy that have forgotten Freud's revolutionary discovery. Barnaby B. Barratt offers a fresh and compelling vision of the structure and function of the human psyche, building on the pioneering (...) work of theorists such as André Green and Jean Laplanche, as well as contemporary deconstruction, feminism, and liberation philosophy. He explores how ‘drive’ or desire operates dynamically between our biological body and our mental representations of ourselves, of others, and of the world we inhabit. This dynamic vision not only demonstrates how the only authentic freedom from our internal imprisonments comes through free-associative praxis, it also shows the extent to which other models of psychoanalysis tend to stray disastrously from Freud's original and revolutionary insights. This is a vision that understands the central issues that imprison our psychic lives - the way in which the reflections of consciousness are based on the repression of our innermost desires, the way in which our erotic vitality is so often repudiated, and the way in which our socialization oppressively stifles our human spirit. Radical Psychoanalysis restores to the discipline of psychoanalysis the revolutionary impetus that has so often been lost. It will be essential reading for psychoanalysts, psychoanalytic psychotherapists, mental health practitioners and students and academics with an interest in the history of psychoanalysis. (shrink)

The responsible research and innovation framework seeks to bring science closer to society, with scientific research conducted not just for the benefit of society, but with role players in society engaging with scientists on research and innovation at every stage. A central focus of the RRI framework is the approach taken to embed these concepts in the higher education training of science students. In this study the direct engagement between science students and the public is explored as an opportunity for (...) achieving RRI learning outcomes. The study also explores the potential benefits that such direct engagement with the public holds for postgraduate biotechnology students. The case study described here suggests that even brief interactions with the public through science engagement activities such as “Speed-Date-a-Scientist” can contribute towards affirmation of choice of career, students’ motivation as researchers and shaping of their identity as scientists, important processes in their own learning to become scientists. Students also indicated a greater sense of motivation to do research that benefits the public, resonating with RRI learning outcomes. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reifying Relevance in Mild Cognitive Impairment:An Appeal for Care and CautionJanice E. Graham (bio) and Karen Ritchie (bio)KeywordsAlzheimer’s disease, construction, dementia, market forces, mild cognitive impairmentWe thank the reviewers for their thoughtful comments that probe shadowy areas in our argument, and we welcome this opportunity to elucidate our position. First, we are not repudiating the natural and social facts of pathologic brain degeneration and the physical and cognitive impairments (...) that manifest in people affected by dementia disorders. We are, however, questioning the epistemology, politics, and persistence by some to harden the construct of mild cognitive impairment (MCI) prematurely as a "natural" precursor to dementia. We suggested insufficiencies in viewing MCI as prodromal to Alzheimer's disease (AD; Graham and Ritchie 2006, 36), and pointed to evidence for the prognostic irrelevance of some MCI subcategories (35). The commentators have read our manuscript as suggesting that AD and MCI are different kinds, and that a diagnosis of AD is more "real" than that of MCI. But AD is also fraught with classification issues, as we describe in the section of our paper that deals with consensus committees, published practice guidelines, and the determination of treatment efficacy. Like MCI, AD is a heterogeneous condition, but unlike MCI, AD is a constructed practical kind that does some "work" beyond essentialist (neural degeneration, brain atrophy) claims. Its criteria identify people with well-defined dementia symptoms and multiple cognitive and functional impairments who are in need of, and benefit from, support. Even with these criteria, however, there have been great attempts to achieve definitional accuracy in dementia diagnoses. Practical refinements to the differential diagnosis of dementia based on solid research evidence have made way for more specific recognitions of vascular dementias, dementia of the Lewy body type, and other subtypes beyond AD. So AD too has been subject to more careful, more cautious operationalization in recent years, with research supporting multiple factors and the comorbidity of several types (kinds) of dementia in any one individual.Our paper takes up concerns that are not resolved for dementia and suggests that the nascent category of MCI is still so insufficiently defined as to be ambiguous, and as such, is in danger of identifying individuals with what will be, and has [End Page 57] already been, linked to a debilitating and deeply stigmatizing and fatal disorder (AD). We are not contesting the reality that some people begin to display early signs of cognitive loss, nor are we suggesting that symptoms be ignored; as researchers, we stand behind the careful tracking of symptoms and signs in patients and research participants as an essential clinical and research practice. In a era where the public has been made wary of the potentially fatal effects of new treatments whose more careful scrutiny in specific populations would have saved lives (e.g., Fontanarosa, Rennie, and DeAngelis 2004; Psaty and Furberg 2005), and made all the more popular by what Kramer coined "diagnostic bracket creep" (1993, 15), we are questioning the drivers and value of a premature diagnostic classification whose definitional accuracy is neither sufficient nor effective for specific identification of individuals.That matters of fact are constructed does not take away from their natural fact. Some people have subjective reports or show objective evidence of cognitive decline while having preserved activities of daily living—the construction of this evidence indicates they are not normal and they are not demented. Based on such evidence, where then does the balance of probability for MCI lie? A multidisciplinary international group of experts gathered in Stockholm in 2003 to discuss MCI concepts (Winblad et al. 2004). They acknowledged that the heterogeneous etiology of MCI contributes to "some confusion concerning the specific boundaries of the condition", stating that this "not normal, not demented" condition is nonetheless "useful both clinically and as a research entity" (p. 241). Importantly, they concluded that MCI needs "better definition" (p. 246). It was at this stage that we first wrote our manuscript, and in the subsequent two years we have eagerly awaited new studies, and the recognition of flexible, practical subtypes to evolve.We state "that MCI cannot be considered to be a separate clinical entity" (Graham and... (shrink)

BackgroundLittle is known about volunteers from Northern research settings who participate in vaccine trials of highly infectious diseases with no approved treatments. This article explores the motivations of HIV immunocompromised study participants in Canada who volunteered in a Phase II clinical trial that evaluated the safety and immunogenicity of an Ebola vaccine candidate.MethodsObservation at the clinical study site and semi-structured interviews employing situational and discursive analysis were conducted with clinical trial participants and staff over one year. Interviews were recorded, transcribed (...) and analysed using critical qualitative interpretivist thematic analytical techniques. Patterns were identified, clustered and sorted to generate distinct and comprehensive themes. We then reassembled events and contexts from the study participants’ stories to develop two ideal portraits based on "composite characters" based on study participants features. These provide ethnographically rich details of participants’ meaningful social worlds while protecting individual identities.ResultsTen of the 14 clinical trial participants, and 3 study staff were interviewed. Participant demographics and socio-economic profiles expressed limited contextual diversity. Half were men who have sex with men, half were former injection drug users experiencing homelessness, one was female, none were racialized minorities and there were no people from HIV endemic countries. Fully 90% had previous involvement in other clinical studies. Their stories point to particular socio-economic situations that motivated their participation as clinical labor through trial participation.ConclusionsOur findings support Fisher’s argument of “structural coercion” in clinical trial recruitment of vulnerable individuals experiencing precarious living conditions. Clinical trials should provide more detail of the structural socio-economic conditions and healthcare needs which lie “under consent” of study participants. Going well beyond an overly convenient narrative of altruism, ethical deliberation frameworks need to sufficiently address the structural conditions of clinical trials. We offer concrete possibilities for this and acknowledge that further research and clinical data should be made available underlying study participant contexts with regards to recruitment and participation in resource poor settings, in both the South and the North. (shrink)

Rooted in the ancient holistic disciplines or energy sciences, and becoming established in the work of early psychodynamic pioneers, this new discipline, with the current growth of its bodymind methodologies, draws from phenomenological philosophies, depth psychologies, and from the latest neuroscience. This unique text explores both the remarkable history and the contemporary burgeoning of somatic psychology, and addresses the theoretical challenges that must be met if it is to realize its impressive potential. --Book Jacket.

Employs philosophy to help illuminate the nature of nursing and provide a holistic view of both nursing and persons.