Background:Collaboration between physicians and nurses is key to improving patient care. We know very little about collaboration and interdisciplinary practice in African healthcare settings.Research question/aim:The purpose of this study was to explore the ethical challenges of interdisciplinary collaboration in clinical practice and education in Botswana Participants and research context: This qualitative descriptive study was conducted with 39 participants (20 physicians and 19 nurses) who participated in semi-structured interviews at public hospitals purposely selected to represent the three levels of hospitals in (...) Botswana (referral, district, and primary).Ethical considerations:Following Institutional Review Board Approval at the University of Pennsylvania and the Ministry of Health in Botswana, participants’ written informed consent was obtained.Findings:Respondents’ ages ranged from 23 to 60 years, and their duration of work experience ranged from 0.5 to 32 years. Major qualitative themes that emerged from the data centered on the nature of the work environment, values regarding nurse–doctor collaboration, the nature of such collaboration, resources available for supporting collaboration and the smooth flow of work, and participants’ views about how their work experiences could be improved.Discussion:Participants expressed concerns that their work environment compromised their ability to provide high-quality and safe care to their patients. The physician staffing structure was described as consisting of a few specialists at the top, a vacuum in the middle that should be occupied by senior doctors, and junior doctors at the bottom—and not a sufficient number of nursing staff.Conclusion:Collaboration between physicians and nurses is critical to optimizing patients’ health outcomes. This is true not only in the United States but also in developing countries, such as Botswana, where health care professionals reported that their ethical challenges arose from resource shortages, differing professional attitudes, and a stressful work environment. (shrink)

Mother-to-child transmission of the Human Immunodeficiency –Virus is a serious public health problem, contributing up to 90% of childhood HIV infections. In Tanzania, the prevention-of-mother-to-child-transmission feature of the HIV programme was rolled out in 2000. The components of PMTCT include counselling and HIV testing directed at antenatal clinic attendees. It is through the process of Provider Initiated Counseling and Testing that counselling is offered participant confidentiality and voluntariness are upheld and valid consent obtained. The objective of the study was to (...) explore antenatal clinic attendees’ experiences of the concept of voluntariness vis- a- vis the implementation of prior counseling and subsequent testing for HIV under the PITC as part of their antenatal care. In-depth interviews were conducted with17 antenatal clinic attendees and 6 nursing officers working at the Muhimbili National Hospital antenatal clinic. The study data were analyzed using qualitative content analysis. Antenatal clinic attendees’ accounts suggested that counselling and testing for HIV during pregnancy was voluntary, and that knowledge of their HIV status led them to access appropriate treatment for both mother and her newborn baby. They reported feeling no pressure from nursing officers, and gave verbal consent to undergo the HIV test. However, some antenatal clinic attendees reported pressure from their partners to test for HIV. Healthcare providers were thus faced with a dilemma of disclosure/ nondisclosure when dealing with discordant couples. Antenatal clinic attendees at MNH undertook the PITC for HIV voluntarily. This was enhanced by their prior knowledge of HIV, the need to prevent mother- to- child transmission of HIV, and the effectiveness of the voluntary policy implemented by nursing officers. (shrink)

In this paper I propose a new theoretical framework to analyse socio‐technical epistemic practices and systems on the Web and beyond, and apply it to the topic of web‐based scientific publishing. This framework is informed by social epistemology, science and technology studies (STS) and feminist epistemology. Its core consists of a tripartite classification of socio‐technical epistemic systems based on the mechanisms of closure they employ to terminate socio‐epistemic processes in which multiple agents are involved. In particular I distinguish three mechanisms (...) of closure, integration, aggregation and selection, and argue that they correspond to three different types of epistemic sociality. Different systems can employ different mechanism of closure or combinations thereof. Yet each mechanism has its own epistemic merits, depends on specific social, technical and epistemic prerequisites, has different strengths and weaknesses, and is optimal for different epistemic tasks. The aim of my analysis is twofold. Distinguishing different modes of epistemic sociality is a way for me not only to put forward a more nuanced framework for analysing socio‐epistemic practices, such as web‐based scientific publishing and scholarly communication. It can also serve as the theoretical basis for improving them. (shrink)

Questioning the dominant view that Deleuze and Merleau-Ponty have little of substance in common, Judith Wambacq draws on unpublished primary sources and current scholarship in English and French to bring them into a compelling dialogue to reveal a shared concern with the transcendental conditions of thought.

Toute oeuvre veut tenir l'attention, la diriger et produire de l'effet. Mais l'attention et l'effet ne sont pas les memes selon que l'oeuvre en dit plus ou en dit moins c'est-a-dire selon sa densite. Le developpe ou le concis, l'emphatique ou l'elude, le riche ou l'austere ne produisent pas les memes intensites. En explorant les variations de la densite litteraire, on retrouve directement des enjeux essentiels. Que vise l'ideal du complet face a l'ideal du pur? Comment la litterature se rapporte-t-elle (...) au langage ordinaire? Quel peut etre le minimum artistique qui subsiste au bord du silence? Comment comprendre l'echec de la lecture, l'interet perdu et l'ennui? (shrink)

This chapter explores the influence of Messianism on modern German thought. It analyzes philosophical and literary works on Messianic nationalism; Messianic suffering; National Socialism as Messianic ideology; and Jewish Messianism. Particular attention is given to the work of Martin Heidegger, who represents the most interesting crossroads between nationalist Messianism, ‘existential’ and deconstructionist anti-Messianism, and a residual religious Messianism.

Use this comprehensive framework and developmentally appropriate activities to teach young children compassion, conflict resolution, respect, and other positive, pro-social values as you cultivate a peaceful and supportive learning environment for all children.

Choisir un livre, c'est en exclure beaucoup d'autres, contribuer à circonscrire le cercle lumineux de l'attention, participer à une aventure dont l'enjeu est la survie; vivre dans les lettres, ce n'est pas s'installer dans un patrimoine mais l'inventer, faire du soleil et de la place, inséparablement. Rééditer ce livre dans une édition de poche, ce n'est pas seulement faire en sorte qu'il soit de nouveau disponible; c'est en prolonger le rayonnement mais aussi le déplacer, l'inscrire autrement dans l'aventure de la (...) survie. Dans sa première vie, La Mémoire des œuvres s'est imposé à quelques-uns comme un bréviaire. Écrit pour tous et pour chacun, il demande et appelle l'amitié d'un plus large public, c'est un livre ami de la mémoire, qui aide à penser et qui aide à vivre, à habiter plus librement le séjour des livres. (shrink)

As nursing and healthcare continue to change, we need nurses who are committed both to a solid understanding of their profession and to caring well for patients and their families. Offering a historically and theologically grounded vision of the nurse's call, this thoroughly revised third edition of a classic text includes practical features for educators, students, and practitioners.

Judith Still offers a comprehensive discussion of Derrida's contribution to the long-standing philosophical and political debate which insists on defining 'man' against 'the animal'. She makes extensive reference to the two volumes recently published, in French and English, of Derrida's seminar series The Beast and the Sovereign, with particular attention to his source texts such as Defoe, Hobbes, La Fontaine, Rousseau, Agamben and Heidegger.

Proposer une oeuvre nouvelle, developper une idee neuve ou une vision personnelle differente, c'est dire autre chose. Mais c'est aussi dire quelque chose qui n'est pas radicalement inoui et sans connexion. Impacts, emprunts, initiatives, traditions ou ruptures: ces relations d'influence traversent la vie des idees et des oeuvres, leurs rapports entre elles, leurs caracteres de famille, et ce qui les rend chacune distincte. Invention et memoire vont ensemble. Leur liaison et leur ecart organisent ce qu'il y a d'autonome et d'unique (...) dans un point de vue novateur, et ce qu'il y a de commun et de partage. (shrink)

John White is one of the leading philosophers of education currently working in the Anglophone world. Since first joining the London Institute of Education in 1965, he has made significant contributions to the landscape of the discipline through his teaching, research and numerous publications. His academic work encompasses a broad range of rich philosophical issues, ranging from questions surrounding the child's mind, through the moral and pedagogical obligations of teachers and schools, to local and national questions of educational policy. In (...) this volume, international contributors address key issues in the philosophy of education, touching on significant contemporary concerns and demonstrating the breadth and influence of John White's work. Each chapter critically examines, builds on, and pays tribute to John White's unique contribution, considering how his work has impacted on the discipline of education as we know it today. Topics covered include: - policy and the role of philosophy of education - liberal education - the aims of education - moral education - leadership. Education, Philosophy and Wellbeing will appeal to postgraduate students and academics in the fields of history, policy, education studies, and philosophy, as well as to policy-makers, educational administrators and teachers. (shrink)

It describes and explains the patient-centered model examining and evaluating qualitative and quantitative research. It comprehensively covers the evolution and the six interactive components of the patient-centered clinical method, taking the reader through the relationships between the patient and doctor and the patient and clinician. All the editors are professors in the Department of Family Medicine at the University of Western Ontario, London, Canada.

Projective contents, which include presuppositional inferences and Potts's conventional implicatures, are contents that may project when a construction is embedded, as standardly identified by the FAMILY-OF-SENTENCES diagnostic. This article establishes distinctions among projective contents on the basis of a series of diagnostics, including a variant of the family-of-sentences diagnostic, that can be applied with linguistically untrained consultants in the field and the laboratory. These diagnostics are intended to serve as part of a toolkit for exploring projective contents across languages, thus (...) allowing generalizations to be examined and validated crosslinguistically. We apply the diagnostics in two languages, focusing on Paraguayan Guaraní, and comparing the results to those for English. Our study of Paraguayan Guaraní is the first systematic exploration of projective content in a language other than English. Based on the application of our diagnostics to a wide range of constructions, four subclasses of projective contents emerge. The resulting taxonomy of projective content has strong implications for contemporary theories of projection, which were developed for the projective properties of particular subclasses and fail to generalize to the full set of projective contents. (shrink)

Debate about the responsibilities of affluent people to act to lessen global poverty has dominated ethics and political philosophy for forty years. But the controversy has reached an impasse, with the main approaches either demanding too much of ordinary mortals or else letting them off the hook. In Distant Strangers I show how a preoccupation with standard moral theories and with the concepts of duty and obligation have led philosophers astray. I argue that there are serious limits to what can (...) be demanded of ordinary human beings, but that this does not mean we must abandon the moral imperative to reduce poverty. Drawing on findings from behavioral economics and psychology, I show how we can motivate better-off people to lessen poverty without excessively taxing their moral virtue. And I argue that this approach is not just pragmatically but morally appropriate. (shrink)

Two decades of research on euthanasia in the Netherlands have resulted into clear insights in the frequency and characteristics of euthanasia and other medical end-of-life decisions in the Netherlands. These empirical studies have contributed to the quality of the public debate, and to the regulating and public control of euthanasia and physician-assisted suicide. No slippery slope seems to have occurred. Physicians seem to adhere to the criteria for due care in the large majority of cases. Further, it has been shown (...) that the majority of physicians think that the euthanasia Act has improved their legal certainty and contributes to the carefulness of life-terminating acts. In 2005, eighty percent of the euthanasia cases were reported to the review committees. Thus, the transparency envisaged by the Act still does not extend to all cases. Unreported cases almost all involve the use of opioids, and are not considered to be euthanasia by physicians. More education and debate is needed to disentangle in these situations which acts should be regarded as euthanasia and which should not. Medical end-of-life decision-making is a crucial part of end-of-life care. It should therefore be given continuous attention in health care policy and medical training. Systematic periodic research is crucial for enhancing our understanding of end-of-life care in modern medicine, in which the pursuit of a good quality of dying is nowadays widely recognized as an important goal, in addition to the traditional goals such as curing diseases and prolonging life. (shrink)

In the debate about the nature of social cognition we see a shift towards theories that explain social understanding through interaction. This paper discusses autopoietic enactivism and the we-mode approach in the light of such developments. We argue that a problem seems to arise for these theories: an interactionist account of social cognition makes the capacity of shared intentionality a presupposition of social understanding, while the capacity of engaging in scenes of shared intentionality in turn presupposes exactly the kind of (...) social understanding that it is intended to explain. The social capacity in question that is presupposed by these accounts is then analyzed in the second section via a discussion and further development of Searle’s ‘sense of us’ and ‘sense of the other’ as a precondition for social cognition and joint action. After a critical discussion of Schmid’s recent proposal to analyze this in terms of plural pre-reflective selfawareness, we develop an alternative account. Starting from the idea that infants distinguish in perception between physical objects and other agents we distinguish between affordances and social affordances and cash out the notion of a social affordance in terms of “interaction-oriented representations”, parallel to the analysis of object affordances in terms of “action-oriented representations”. By characterizing their respective features we demonstrate how this approach can solve the problem formulated in the first part. (shrink)

Three experiments investigated the processing of the implicature associated with some using a “gumball paradigm.” On each trial, participants saw an image of a gumball machine with an upper chamber with 13 gumballs and an empty lower chamber. Gumballs then dropped to the lower chamber and participants evaluated statements, such as “You got some of the gumballs.” Experiment 1 established that some is less natural for reference to small sets and unpartitioned sets compared to intermediate sets. Partitive some of was (...) less natural than simple some when used with the unpartitioned set. In Experiment 2, including exact number descriptions lowered naturalness ratings for some with small sets but not for intermediate size sets and the unpartitioned set. In Experiment 3, the naturalness ratings from Experiment 2 predicted response times. The results are interpreted as evidence for a Constraint-Based account of scalar implicature processing and against both two-stage, Literal-First models and pragmatic Default models. (shrink)

Two decades of research on euthanasia in the Netherlands have resulted into clear insights in the frequency and characteristics of euthanasia and other medical end-of-life decisions in the Netherlands. These empirical studies have contributed to the quality of the public debate, and to the regulating and public control of euthanasia and physician-assisted suicide. No slippery slope seems to have occurred. Physicians seem to adhere to the criteria for due care in the large majority of cases. Further, it has been shown (...) that the majority of physicians think that the euthanasia Act has improved their legal certainty and contributes to the carefulness of life-terminating acts. In 2005, eighty percent of the euthanasia cases were reported to the review committees. Thus, the transparency envisaged by the Act still does not extend to all cases. Unreported cases almost all involve the use of opioids, and are not considered to be euthanasia by physicians. More education and debate is needed to disentangle in these situations which acts should be regarded as euthanasia and which should not. Medical end-of-life decision-making is a crucial part of end-of-life care. It should therefore be given continuous attention in health care policy and medical training. Systematic periodic research is crucial for enhancing our understanding of end-of-life care in modern medicine, in which the pursuit of a good quality of dying is nowadays widely recognized as an important goal, in addition to the traditional goals such as curing diseases and prolonging life. (shrink)

We theoretically discuss and empirically show how CEO power based on environmental expertise and formal influence over executives and directors, in the absence and presence of shareholder activism, spurs firms toward greener strategies. Our results support the idea that CEOs with informal power, grounded in expertise, reduce corporate environmental impact and this relationship is amplified when the CEO also enjoys formal power over the board of directors. Additionally, we found that any source of CEO power, whether informal or formal, is (...) a good catalyst for transforming shareholder activism into corporate greening. However, in the absence of such activism, only CEOs’ informal environmental expert power acts as a determinant of firm environmental performance. (shrink)

Accumulating evidence for the unique social, behavioral, and physical health benefits of positive emotion and related well-being constructs has led to the development and testing of positive psychological interventions to increase emotional well-being and enhance health promotion and disease prevention. PPIs are specifically aimed at improving emotional well-being and consist of practices such as gratitude, savoring, and acts of kindness. The purpose of this narrative review was to examine the literature on PPIs with a particular focus on positive emotion outcomes. (...) We evaluated the evidence on the effects of PPIs on positive emotion specifically, and discussed the range of evidence regarding the relative responsiveness of emotion measures to PPIs in order to gain a better understanding of the specific emotional pathways through which PPIs influence psychological and physical well-being. We conclude with recommendations for best evaluating effects of PPIs on positive emotion outcomes. (shrink)

Two ideas shape the epistemology of testimony. One is that testimony provides a unique kind of knowledge. The other is that testimonial knowledge is a social achievement. In traditional terms, those who affirm these ideas are anti-reductionists, and those who deny them are reductionists. There is increasing interest, however, in the possibility of affirming these ideas without embracing anti-reductionism. Thus, Sanford Goldberg uses the idea of epistemic buck-passing to argue that even reductionists can accept the uniqueness of testimonial knowledge, and (...) Jennifer Lackey gives both speaker and hearer an essential role in testimonial justification, rejecting both reductionism and anti-reductionism in favor of what she calls dualism. After distinguishing a weaker and a stronger notion of buck-passing, we show how anti-reductionists can use the stronger notion to motivate their position, and to answer Goldberg’s and Lackey’s challenges. (shrink)

This paper contributes data from Paraguayan Guaraní (Tupí-Guaraní) to the discussion of how temporal reference is determined in tenseless languages. The empirical focus of this study is on finite clauses headed by verbs inflected only for person/number information, which are compatible only with non-future temporal reference in most matrix clause contexts. The paper first explores the possibility of accounting for the temporal reference of such clauses with a phonologically empty non-future tense morpheme, along the lines of Matthewson’s (Linguist Philos 29:673–713, (...) 2006 ) analysis of a similar phenomenon in St’át’imcets (Salish). This analysis is then contrasted with one according to which temporal reference is not constrained by tense in Paraguayan Guaraní, but only by context and temporal adverbials. A comparison of the two analyses, both of which are couched in a dynamic semantic framework, suggests empirical and theoretical advantages of the tenseless analysis over the tensed one. The paper concludes with a discussion of cross-linguistic variation of temporal reference in tensed and tenseless languages. (shrink)