Background:Moral distress occurs when constraints prevent healthcare providers from acting in accordance with their core moral values to provide good patient care. The experience of moral distress in nurses might be magnified during the current Covid-19 pandemic.Objective:To explore causes of moral distress in nurses caring for Covid-19 patients and identify strategies to enhance their moral resiliency.Research design:A qualitative study using a qualitative content analysis of focus group discussions and in-depth interviews. We purposively sampled 31 nurses caring for Covid-19 patients in (...) the acute care units within large academic medical systems in Maryland and New York City during April to June 2020.Ethical considerations:We obtained approval from the Institutional Review Board at the University of Maryland, Baltimore.Results:We identified themes and sub-themes representative of major causes of moral distress in nurses caring Covid-19 patients. These included (a) lack of knowledge and uncertainty regarding how to treat a new illness; (b) being overwhelmed by the depth and breadth of the Covid-19 illness; (c) fear of exposure to the virus leading to suboptimal care; (d) adopting a team model of nursing care that caused intra-professional tensions and miscommunications; (e) policies to reduce viral transmission (visitation policy and PPE policy) that prevented nurses to assume their caring role; (f) practicing within crisis standards of care; and (g) dealing with medical resource scarcity. Participants discussed their coping mechanisms and suggested future strategies.Discussion/Conclusion:Our study affirms new causes of moral distress related to the Covid-19 pandemic. Institutions need to develop a supportive ethical climate that can restore nurses’ moral resiliency. Such a climate should include non-hierarchical interdisciplinary spaces where all providers can meet together as moral peers to discuss their experiences. (shrink)

Our daily experience, dominated by the corporate clock that so many of us contort ourselves to fit inside, is destroying us. It wasn't built for people, it was built for profit. This is a book that tears open the seams of reality as we know it-the way we experience time itself-and rearranges it, reimagining a world not centered around work, the office clock, or the profit motive. Explaining how we got to the point where time became money, Odell offers us (...) new models to live by--inspired by pre-industrial cultures, ecological, and geological time--that make a more humane, more hopeful way of living seem possible. In this dazzling, subversive, and deeply hopeful reframing of time, Jenny Odell takes us on a journey through other temporal habitats. As planet-bound animals, we live inside shortening and lengthening days, alongside gardens growing, birds migrating, and cliffs eroding. The stretchy quality of waiting and desire, the way the present may suddenly feel marbled with childhood memory, the slow but sure procession of a pregnancy, or the time it takes to heal from injuries--physical or emotional. Odell urges us to become stewards of these different rhythms of life, to imagine a life, identity, and source of meaning outside of the world of work and profit, and to understand that the trajectory of our lives--or the life of the planet--is not a foregone conclusion. In that sense, "saving" time-recovering its fundamentally irreducible and inventive nature-could also mean that time saves us. (shrink)

Collections of living organisms are reservoirs of biological knowledge that operate across times and places. From the mid-20th century, scientific institutions dedicated to the cultivation of such collections have routinized and professionalized their care. But “care,” for these collections, is focused not just on individual organisms—instead, a principal aim of a curator is to maintain the integrity of a reproducing “strain,” “variety,” “line,” or “stock,” and the composition of a collection as a whole. This paper explores the forms, the material (...) dimensions, the temporalities, and the values of that care, to recover the conditions under which scientist-custodians maintain continuity of research over many decades. This paper does so by focusing on two rather different kinds of scientific collection: that of Drosophila fruit flies on the one hand, and plant seeds on the other. Their comparison is valuable because their vastly different needs and life cycles engender very different practices of care. Comparing the materialities, life cycles, needs, and values of these divergent collections helps to draw attention to the routine and the apparently mundane. First, the paper asks: what kinds of work go into managing such collections—that is, the day-to-day management and cultivation, surveillance, and administration of information? Second, it asks: how do these practices maintain the integrity of the strains and stocks, and the collections themselves? What kinds of value does this work create? Third, what are the future imaginaries that are rhetorically drawn into the funding strategies of these collections, and how do they envision future use, ownership, and control? (shrink)

As our interactions with nature occur increasingly within urban landscapes, there is a need to consider how 'mundane nature' can be valued as a route for people to connect to nature. The content of a three good things in nature intervention, written by 65 participants each day for five days is analysed. Content analysis produced themes related to sensations, temporal change, active wildlife, beauty, weather, colour, good feelings and specific aspects of nature. The themes describe the everyday good things in (...) nature, providing direction for those seeking to frame engaging conservation messages, plan urban spaces and connect people with nearby nature. (shrink)

Despite changes in their representation and visibility, there are still serious concerns about the inclusion and day-to-day workplace challenges various groups face (e.g., women, ethnic and cultural minorities, LGBTQ+, people as they age, and those dealing with physical or mental disabilities). Men are also underrepresented in specific work fields, in particular those in HEED (Health care, Elementary Education and the Domestic sphere). Previous literature has shown that group stereotypes play an important role in maintaining these inequalities. We outline how insights (...) from research on stigma, social-identity, and self-regulation together increase our understanding of how targets are affected by and regulate negative stereotypes in the workplace. This approach starts from the basis that members of negatively-stereotyped groups are not just passive recipients of negative attitudes, stereotypes, and behaviors, but are active individuals pursuing multiple goals, such as goals for belonging and achievement. We argue that it is only by understanding stigma from the target’s perspective (e.g., how targets are affected and respond) that we can successfully address workplace inequality. Key in this understanding is that stereotypes, prejudice and discrimination have taken on much more subtle forms, with consequences for the way members of stigmatized-groups cope. These insights lead us to propose an approach to understanding barriers to workplace equality that highlights four key aspects: a) the different (often subtle) potential triggers of identity-threat in the workplace for members of stigmatized-groups, b) the ways in which members of stigmatized-groups cope with these threats, c) the role of supportive factors that mitigate potential threats and affect self-regulation, and d) potential hidden costs for the self or others of what appears at first to be effective self-regulation. The focus on threats, coping, support, and potential hidden costs helps us understand why current diversity efforts are not always successful in increasing and maintaining members of stigmatized-groups in organizations, and provides insight into how we can aid efforts to effectively lower barriers to workplace equality. (shrink)

Proper utilization of antenatal and postnatal care services plays an important role in reducing the maternal mortality ratio and infant mortality rate. This paper assesses the utilization of health care services during pregnancy, delivery and post-delivery among rural women in Uttar Pradesh and examines its determinants. Data from a baseline survey of UP Community Mobilization project was utilized. A cross-sectional sample of currently married women who delivered a baby 15 months prior to the survey was included. Information was collected from (...) 2208 women spread over five districts of UP. Information on socio-demography characteristics, utilization of antenatal care, delivery and postnatal care services was collected. To examine the determinants of utilization of maternal health services, the variables included were three ANC visits, institutional delivery and PNC within 42 days of delivery. Separate multilevel random intercept logistic regressions were used to account for clustering at a block and gram panchayat level after adjusting for covariates. Eighty-three percent of women had any ANC. Of them, 61% reported three or more ANC visits. Although 68% of women delivered in a health facility, 29% stayed for at least 48 h. Any PNC within 42 days after delivery was reported by 26% of women. In the adjusted analysis, women with increasing number of contacts with the health worker during the antenatal period, women exposed to mass-media and non-marginalized women were more likely to have at least three ANC visits during pregnancy. Non-marginalized women and women with at least three ANC visits were more likely than their counterparts to deliver in an institution. Contacts with health worker during pregnancy, marginalization, at least three ANC visits and institutional delivery were the strong determinants for utilization of PNC services. Self-help group membership had no association with the utilization of maternal health services. Utilization of maternal health services was low. Contact with the health worker and marginalization emerged as important factors for utilization of services. Although not associated with the utilization, SHGs can be used for delivering health care messages within and beyond the group. (shrink)

Palliative care seeks to improve the quality of life for patients suffering from the impact of life‐limiting illnesses. Palliative care encompasses but is more than end‐of‐life care, which is defined as care during the final hours/days/weeks of life. Although palliative care policies increasingly require all healthcare professionals to have at least basic or non‐specialist skills in palliative care, international evidence suggests there are difficulties in realising such policies. This study reports on an action research project aimed at developing respiratory nursing (...) practice to address the palliative care needs of patients with advanced chronic obstructive pulmonary disease (COPD). The findings suggest that interlevel dynamics at individual, team, interdepartmental and organisational levels are an important factor in the capacity of respiratory nurses to embed non‐specialist palliative care in their practice. At best, current efforts to embed palliative care in everyday practice may improve end‐of‐life care in the final hours/days/weeks of life. However, embedding palliative care in everyday practice requires a more fundamental shift in the organisation of care. (shrink)

I develop a theory of counterfactuals about relative computability, i.e. counterfactuals such as 'If the validity problem were algorithmically decidable, then the halting problem would also be algorithmically decidable,' which is true, and 'If the validity problem were algorithmically decidable, then arithmetical truth would also be algorithmically decidable,' which is false. These counterfactuals are counterpossibles, i.e. they have metaphysically impossible antecedents. They thus pose a challenge to the orthodoxy about counterfactuals, which would treat them as uniformly true. What’s more, I (...) argue that these counterpossibles don’t just appear in the periphery of relative computability theory but instead they play an ineliminable role in the development of the theory. Finally, I present and discuss a model theory for these counterfactuals that is a straightforward extension of the familiar comparative similarity models. (shrink)

The Greek word eoikos can be translated in various ways. It can be used to describe similarity, plausibility or even suitability. This book explores the philosophical exploitation of its multiple meanings by three philosophers, Xenophanes, Parmenides and Plato. It offers new interpretations of the way that each employs the term to describe the status of their philosophy, tracing the development of this philosophical use of eoikos from the fallibilism of Xenophanes through the deceptive cosmology of Parmenides to Plato's Timaeus. The (...) central premise of the book is that, in reflecting on the eoikos status of their accounts, Xenophanes, Parmenides and Plato are manipulating the contexts and connotations of the term as it has been used by their predecessors. By focusing on this continuity in the development of the philosophical use of eoikos, the book serves to enhance our understanding of the epistemology and methodology of Xenophanes, Parmenides and Plato's Timaeus. (shrink)

Introduction -- Time and matter: temporality, embodied subjectivity and film phenomenology -- Knowing and nothing: Chris Marker, subjective temporalities and vocalic bodies in the future tense -- Agnès Varda's Trinket box: subjective relationality, affect and temporalised space -- Burlesque gestures and bodily attention: phenomenologies of the ephemeral in Chantal Akerman -- Threatened corporealities: thinking with the films of Philippe Grandrieux -- Conclusion: rethinking cinematic subjectivity and beyond.

The aim of this thematic literature review is to explore nurses' perceptions of ethical issues in the care of older people. Electronic databases were searched from September 1997 to September 2007 using specific key words with tight inclusion criteria, which revealed 17 primary research reports. The data analysis involved repeated reading of the findings and sorting of those findings into four themes. These themes are: sources of ethical issues for nurses; differences in perceptions between nurses and patients/relatives; nurses' personal responses (...) to ethical issues; and the patient—nurse relationship. The findings reveal that ageism is one of the major sources of the ethical issues that arise for nurses caring for older people. Education and organizational change can combat ageist attitudes. Wider training is required in the care of older people, workplace skills, palliative care and pain management for older people. The demands of a changing global demography will necessitate further research in this field. (shrink)

Boorse’s biostatistical theory states that diseases should be defined in ways that reflect disturbances of biological function and that are objective and value free. We use three examples from contemporary medicine that demonstrate the complex issues that arise when defining the boundaries of disease: polycystic ovary syndrome, chronic kidney disease, and myocardial infarction. We argue that the biostatistical theory fails to provide sufficient guidance on where the boundaries of disease should be drawn, contains ambiguities relating to choice of reference class, (...) and is out of step with medical processes for identifying disease boundaries. Although proponents of the biostatistical theory might regard these practical issues as irrelevant to the aim of providing a theoretical account of disease, we take them to indicate the need for a theoretical account that is adequate for current needs—including limiting new forms of medicalization that are driven by the identification of disease based on dysfunction. Our processes for determining the boundaries for disease need to recognize that there is no value-free method for making these decisions. (shrink)

James Frederick Ferrier James Frederick Ferrier was a mid-nineteenth-century Scottish metaphysician who developed the first post-Hegelian system of idealism in Britain. Unlike the British Idealists in the latter half of the nineteenth century, he was neither a Kantian nor a Hegelian. Instead, he largely develops his idealist metaphysics via his defense of Berkeley and … Continue reading Ferrier, James Frederick →.

This collection of essays, on French and francophone prose, poetry, drama, visual art, cinema and thought, assesses guilt and shame in relation to structures of ...

It has become increasingly clear that social learning and culture occur much more broadly, and in a wider variety of animal communities, than initially believed. Recent research has expanded the list to include insects, fishes, elephants, and cetaceans. Such diversity allows scientists to expand the scope of potential research questions, which can help form a more complete understanding of animal culture than any single species can provide on its own. It is crucial to understand how culture and social learning present (...) in different communities, as well as what influences community structure and culture may have on one another, so that the results across these different studies may most effectively inform one another. This review presents an overview of social learning in species across a spectrum of community structures, providing the necessary infrastructure to allow a comparison of studies that will help move the field of animal culture forward. (shrink)

People frequently gesture when a word is on the tip of their tongue (TOT), yet research is mixed as to whether and why gesture aids lexical retrieval. We tested three accounts: the lexical retrieval hypothesis, which predicts that semantically related gestures facilitate successful lexical retrieval; the cognitive load account, which predicts that matching gestures facilitate lexical retrieval only when retrieval is hard, as in the case of a TOT; and the motor movement account, which predicts that any motor movements should (...) support lexical retrieval. In Experiment 1 (a between‐subjects study; N = 90), gesture inhibition, but not neck inhibition, affected TOT resolution but not overall lexical retrieval; participants in the gesture‐inhibited condition resolved fewer TOTs than participants who were allowed to gesture. When participants could gesture, they produced more representational gestures during resolved than unresolved TOTs, a pattern not observed for meaningless motor movements (e.g., beats). However, the effect of gesture inhibition on TOT resolution was not uniform; some participants resolved many TOTs, while others struggled. In Experiment 2 (a within‐subjects study; N = 34), the effect of gesture inhibition was traced to individual differences in verbal, not spatial short‐term memory (STM) span; those with weaker verbal STM resolved fewer TOTs when unable to gesture. This relationship between verbal STM and TOT resolution was not observed when participants were allowed to gesture. Taken together, these results fit the cognitive load account; when lexical retrieval is hard, gesture effectively reduces the cognitive load of TOT resolution for those who find the task especially taxing. (shrink)

The Enlightenment commitment to reason naturally gave rise to a belief in the perfectibility of man. Influenced by John Locke and Jean-Jacques Rousseau, many eighteenth-century writers argued that the proper education and upbringing—breeding—could make any man a member of the cultural elite. Yet even in this egalitarian environment, the concept of breeding remained tied to theories of blood lineage, caste distinction, and biological difference. Turning to the works of Locke, Rousseau, Swift, Defoe, and other giants of the British Enlightenment, Jenny (...) Davidson revives the debates that raged over the husbandry of human nature and highlights their critical impact on the development of eugenics, the emergence of fears about biological determinism, and the history of the language itself. Combining rich historical research with a keen sense of story, she links explanations for the physical resemblance between parents and children to larger arguments about culture and society and shows how the threads of this compelling conversation reveal the character of a century. A remarkable intellectual history, _Breeding_ not only recasts the fundamental concerns of the Enlightenment but also uncovers the seeds of thought that bloomed into contemporary notions of human perfectibility. (shrink)

In the last few years, justice has emerged as a matter of concern for the contemporary constitution of technoscience. Increasingly, both practicing scientists and engineers and scholars of science and technology cite justice as an organizing theme of their work. In this essay, I consider why “science and justice” might be arising now. I then ask after the opportunities, but also the dangers, of this formation. By way of example, I explore the openings and exclusions created by the recent conjugation (...) of science and justice in the field of personal genomics. Finally, I conclude with reflections on what other forms “science and justice” might take, and what might be gained or lost in fostering them. (shrink)

In this essay, I argue that to create a genomics that offers more gifts than weights, central attention must be paid to questions of justice. This will require expanding bioethical imaginations so that they grasp and can respond to questions of structural inequity. It will necessitate building novel coalitions and collaborations that turn the attention of bioethical governance away from narrow individual questions such as, “Do I consent?” and toward the broader collective question, is this just? What kind of lives (...) and collectivities are made possible? What rights and principles should govern them? The essay ends with one example of this novel coalition building arising from the Science and Justice Research Center at the University of California, Santa Cruz. It draws lessons from this effort to build new alliances that bridge the social sciences and natural sciences, arts and engineering, to create new kinds of training and thinking that create a genomics that more adequately responds to fundamental questions of justice. (shrink)

Ancient Greek and Roman philosophy is often characterised in terms of competitive individuals debating orally with one another in public arenas. But it also developed over its long history a sense in which philosophers might acknowledge some other particular philosopher or group of philosophers as an authority and offer to that authority explicit intellectual allegiance. This is most obvious in the development after the classical period of the philosophical 'schools' with agreed founders and, most importantly, canonical founding texts. There also (...) developed a tradition of commentary, interpretation, and discussion of texts which itself became a mode of philosophical debate. As time went on, the weight of a growing tradition of reading and appealing to a certain corpus of foundational texts began to shape how later antiquity viewed its philosophical past and also how philosophical debate and inquiry was conducted. In this book leading scholars explore aspects of these important developments. (shrink)

Graphical AbstractSocial learning and culture occur in a wide variety of animal species and across many different types of community structures. In article number 1900060, Jenny A. Allen present an overview of social learning in species across a spectrum of community structures, providing the necessary infrastructure to allow a comparison of studies that will help move the field of animal culture forward. Art designer: Emma Hilton.

Does the real difference between non-consequentialist and consequentialist theories lie in their approach to value? Non-consequentialist theories are thought either to allow a different kind of value (namely, agent-relative value) or to advocate a different response to value ('honouring' rather than 'promoting'). One objection to this idea implies that all normative theories are describable as consequentialist. But then the distinction between honouring and promoting collapses into the distinction between relative and neutral value. A proper description of non-consequentialist theories can only (...) be achieved by including a distinction between temporal relativity and neutrality in addition to the distinction between agent-relativity and agent-neutrality. (shrink)

The core idea of social constructivism in mathematics is that mathematical entities are social constructs that exist in virtue of social practices, similar to more familiar social entities like institutions and money. Julian C. Cole has presented an institutional version of social constructivism about mathematics based on John Searle’s theory of the construction of the social reality. In this paper, I consider what merits social constructivism has and examine how well Cole’s institutional account meets the challenge of accounting for the (...) characteristic features of mathematics, especially objectivity and applicability. I propose that in general social constructivism shows promise as an ontology of mathematics, because the view can agree with mathematical practice and it offers a way of understanding how mathematical entities can be real without conflicting with a scientific picture of reality. However, I argue that Cole’s specific theory does not provide an adequate social constructivist account of mathematics. His institutional account fails to sufficiently explain the objectivity and applicability of mathematics, because the explanations are weakened and limited by the three-level theoretical model underlying Cole’s account of the construction of mathematical reality and by the use of the Searlean institutional framework. The shortcomings of Cole’s theory give reason to suspect that the Searlean framework is not an optimal way to defend the view that mathematical reality is socially constructed. (shrink)

The frequency and severity of natural disasters and extreme weather events are increasing, taking a dramatic economic and relational toll on the communities they strike. Given the critical role that entrepreneurship plays in a community’s viability, it is necessary to understand how small business owners respond to these events and move forward over time. This study explores the long-term dynamics and trajectory of individuals within the broader business community following a natural disaster, paying particular attention to the influence of social (...) identity. Results suggest that the community identity changes over the course of recovery and rebuilding, underscoring the need for a holistic approach so that intervening agencies can achieve the sustainable economic recovery desired. (shrink)

What Is Race? Evidence from Scientists is a picture book for schoolchildren published by UNESCO as part of its high-profile campaign on race. The 87-page, oblong, soft-cover booklet contains bold, semi-abstract, pared-down images accompanied by text, devised to make scientific concepts ‘more easily intelligible to the layman’. Produced by UNESCO’s Department of Mass Communication, the picture book represents the organization’s early-postwar confidence in the power of scientific knowledge as a social remedy and diplomatic tool. In keeping with a significant component (...) of the race campaign, What Is Race? presented genetics as the route to an enlightened, scientific, non-prejudiced understanding of race. This article seeks to explain the book’s management, aesthetics and framing in the context of postwar disciplinary and international politics. Viewing UNESCO’s race campaign as a high point for an internationalist ideology of mass education, this article also analyses the visual and literary arguments of What Is Race? and proposes that the enduring image of genetics as technical and neutral knowledge was in part shaped by UNESCO’s efforts to communicate scientific authority to an apparently ‘popular’ audience. (shrink)

The ever increasing ability of medical technology to reshape the human body in fundamental ways—from organ and tissue transplants to reconstructive surgery and prosthetics—is something now largely taken for granted. But for a philosopher, such interventions raise fundamental and fascinating questions about our sense of individual identity and its relationship to the physical body. Drawing on and engaging with philosophers from across the centuries, Jenny Slatman here develops a novel argument: that our own body always entails a strange dimension, a (...) strangeness that enables us to incorporate radical physical changes. (shrink)

The social model of disability gives us the tools not only to challenge the discrimination and prejudice we face, but also to articulate the personal experience of impairment. Recognition of difference is therefore a key part of the assertion of our common humanity and of an ethics of care that promotes our human rights.

This book explores how and why some people and practices are made invisible in science, featuring 25 case studies and commentaries that explore how invisibility can bolster or undermine credibility, how race, gender, class, and nation frame who can see what, how invisibility empowers and marginalizes, and the epistemic ramifications of concealment.

This special issue aims to spotlight the individual, lived experiences of caregivers and those receiving care–areas often overshadowed by clinical and medicalized narratives within clinical ethics. Our aim is to enrich the discourse by incorporating stories and narratives of medical care and challenge existing clinical practices by emphasizing patient and practitioner experiences. Through a blend of clinical and academic insights, this issue provides phenomenological narratives, highlighting the importance of lived experiences in understanding and improving clinical caregiving practices. The contributions, ranging (...) from theoretical analyses to personal narratives, explore various aspects of caregiving. Each article contributes to a deeper understanding of the phenomenologies of care, advocating for a more inclusive, patient-centered approach in clinical ethics and practice. (shrink)

This edition includes a new chapter on scepticism.

Avec l'essor des journaux spécialisés, le paysage éditorial mathématique évolue considérablement pendant la première moitié du xixe siècle. Parallèlement, la publication des Disquisitiones arithmeticae de Gauss en 1801, avec son introduction de la notion de congruence, marque l'histoire de la théorie des nombres. Cet article propose une analyse de la double évolution du paysage éditorial et des congruences dans la première moitié du xixe siècle, en se concentrant sur les circulations mathématiques. Après avoir identifié le corpus des textes par lesquels (...) la notion de congruence circule, nous en dressons un portrait général avant de nous focaliser sur des cas d'étude particulièrement significatifs. Congruences et périodiques sont ainsi envisagés, tour à tour, comme des objets et des moyens d'étude. (shrink)