This article situates Xiong Shili’s 熊十力 classic work New Treatise on the Uniqueness of Consciousness within the central dilemma of post-May Fourth China surrounding the concerns with so-called modern universalism and Chinese particularism. I look at the way the text portrays its author as situated both within particular traditions and outside of them in order to show how the figure of the author is presented as a site wherein Chinese/Asian particularism and universalism can be fused. My central aim, in doing (...) so, is to argue that within the text’s discourse on the positioning of its author resides an implicit argument for the universality of Chinese or Asian philosophy—as interpreted and subsumed by the text—and against the hegemonic intentions of Western philosophy. Yet I also suggest that the text reiterates a conception of universality and an intention to monopolize the universal which are characteristic of hegemonic discourses. (shrink)

Background: Work-related stress among healthcare professionals poses a serious economic and healthcare burden. This study aimed to investigate the prevalence of burnout as well as anxiety, depression, and stress in medical residents from different majors, and assess the effects of an online psychological intervention on the mental health status of medical residents with a high degree of burnout.Methods: We conducted an online survey that collected information on the demographics, mental health, and burnout conditions of medical residents from Shengjing Hospital. The (...) mental health condition was assessed by the Depression, Anxiety, and Stress Scale −21. Further, burnout was assessed by the Maslach Burnout Inventory. Medical residents with a total MBI score between 50 and 75 were selected to receive online psychological intervention for 3 months.Results: Two-hundred and ten medical residents completed the questionnaire, of whom, 63 residents with an MBI score between 50 and 75 received the 3-month online psychological intervention. Anesthesia residents showed the highest level of depression, anxiety, and stress, and presented with a lower sense of personal accomplishment, higher emotional exhaustion, and higher depersonalization. Furthermore, pediatric residents had the second highest DASS and MBI scores following anesthesia residents. Following the online psychological intervention, negative emotional states and burnout levels were significantly lower among anesthesia and pediatric residents. There were no differences in the level of stress and sense of personal accomplishment pre- and post-online psychological intervention among the different majors.Conclusion: Our findings revealed high levels of burnout, as well as depression, anxiety, and stress symptoms in medical residents, with marked differences among different majors. The online psychological intervention effectively improved emotional exhaustion, and depersonalization, and relieved the psychological problems such as anxiety and depression in medical residents. (shrink)

To support the sustainability of future cities, residents’ living spaces need to be built and used efficiently, while supporting residents’ communal wellbeing. Nordic superblock is a new planning, housing, and living concept in which residents of a neighborhood—a combination of city blocks—share yards, common spaces and utilities. Sharing living spaces is an essential element of this approach. In this study, our goal was to study the ways in which intelligent technology solutions—such as proactive, data-driven Artificial Intelligence (AI) applications—could support and (...) even motivate the use of common areas in superblocks. To this end, we conducted a two-phase qualitative study: in the first phase, potential superblock residents (N = 12) shared their perspectives of sharing of living spaces in general, and more specifically of how intelligent technologies could support sharing spaces. In the second phase, two workshops with experts (N = 7) were held to gather understanding of possibilities of intelligent technologies in meeting the residents’ expectations of space sharing. The results illustrate space sharing and communality as supportive factors for one another, enabled but also complicated by social interaction. Major possibilities for intelligent technologies to advance space sharing were seen in organizing the use of spaces and facilitating social interaction in the community. As an outcome, four roles incorporating several use purposes of intelligent technologies were found. The findings can inform the Human-Centered AI (HCAI) research and design improving sustainable living in future urban neighborhoods. (shrink)

Background: Discussions about medical errors facilitate professional learning for physicians and may provide emotional support after an error, but little is known about physicians’ attitudes and practices regarding error discussions with colleagues.Methods: Survey of faculty and resident physicians in generalist specialties in Midwest, Mid-Atlantic and Northeast regions of the US to investigate attitudes and practices regarding error discussions, likelihood of discussing hypothetical errors, experience role-modelling error discussions and demographic variables.Results: Responses were received from 338 participants . In all, 73% (...) of respondents indicated they usually discuss their mistakes with colleagues, 70% believed discussing mistakes strengthens professional relationships and 89% knew at least one colleague who would be a supportive listener. Motivations for error discussions included wanting to learn whether a colleague would have made the same decision , wanting colleagues to learn from the mistake and wanting to receive support . Given hypothetical scenarios, most respondents indicated they would likely discuss an error resulting in no harm , minor harm or major harm . Fifty-seven percent of physicians had tried to serve as a role model by discussing an error and role-modelling was more likely among those who had previously observed an error discussion .Conclusions: Most generalist physicians in teaching hospitals report that they usually discuss their errors with colleagues, and more than half have tried to role-model discussions. However, a significant number of these physicians report that they do not usually discuss their errors and some do not know colleagues who would be supportive listeners. (shrink)

Applied linguists and anthropologists tend to agree on the interplay between language and culture in the study of society; yet, language and culture are seldom evoked to understand crises in human relations, such as interethnic wars. Drawing from some examples of naming practices and proverbs, this paper will analyze Burundians’ perceptions of peace (amahoro) or peace-related concepts, such as calm (umutekano), or unity (ubumwe). Two major theories, i.e., Galtung’s theory of negative and positive peace, and Danesh’s Integrative Theory of (...) Peace, provide the framework for the discussion. Critical discourse analysis is applied to the content of folkloric genres, namely proverbial uses and (children) name choices to demonstrate that: (1) Burundians as a society do not have a culturally grounded peace expectation, (2) Rather, Burundian society has been built on the core principle of sharing and hospitality, which are also at the core of harmony and peace; and (3) a climate of mutual distrust and suspicion has always prevailed in Burundi regardless of ethnic rivalries. The conclusion supports the proposition that, as predicted in the nation’s folkloric literature, the restoration of peace and harmony cannot happen unless the practices of sharing and hospitality are reinstated and respected. (shrink)

Leishmania major infection of inbred mice leads to a major dichotomous response—death or survival—that depends on the strain of mice. This finding has motivated efforts to locate genetic determinants of disease susceptibility. Genotyping studies have confirmed a complex multilocus trait, but studies directed at the biology of the response suggest identifiable components of susceptibility that may direct the genetic investigations. A confluence of parasite variables—residence in macrophages, class II-dependent immunity, and avoidance of early IL-12 induction—with host factors—a prominent (...) helper T-cell precursor frequency to a dominant parasite epitope and a bias in IL-4 gene activation—conspires to drive an aberrant immune response in animals that suffer fatal disease. These insights may lead to an understanding of factors that focus responses on dominant antigens and that mold the naive T-cell repertoire. Collectively, such factors might contribute to the pathogenesis of other infectious and autoimmune diseases. BioEssays 21:510–518, 1999. © 1999 John Wiley & Sons, Inc. (shrink)

BackgroundDuring the COVID-19 outbreak in 2020, national governments took restrictive measures, such as a visitors ban, prohibition of group activities and quarantine, to protect nursing home residents against infections. As ‘safety’ prevailed, residents and close relatives had no choice but to accept the restrictions. Their perspectives are relevant because the policies had a major impact on them, but they were excluded from the policy decisions. In this study we looked into the moral attitudes of residents, close relatives and volunteers (...) regarding the restrictions in retrospect, and what moral lessons they considered important.MethodsWe conducted 30 semi-structured interviews with residents and close relatives and one focus group meeting with volunteers working in nursing homes. Data were transcribed verbatim and analyzed inductively. Subsequently, three Socratic dialogue meetings with residents, close relatives and volunteers were organized in which first analysis outcomes were discussed and dialogues were fostered into moral lessons for future pandemics. Outcomes were combined with moral theory following an empirical bioethics design. ResultsCritical perspectives regarding the COVID-19 restrictions grew in time. Various moral values were compromised and steered moral lessons for our future. The participants recognized three moral lessons as most important. First, constructing tailored (well-balanced) solutions in practice is desirable. Second, proper recognition is needed for the caring role that close relatives fulfill in practice. Third, a responsive power distribution should be in place that includes all stakeholder perspectives who are affected by the restrictions. DiscussionComparing the results with moral theory strengthens the plea for inclusion of all stakeholder groups in decision-making processes. To further concretize the moral lessons, tailored solutions can be realized with the use of moral case deliberations. Proper recognition includes actions addressing moral repair and including counter-stories in the debate. Responsive power distribution starts with providing clear and trustworthy information and including all perspectives. (shrink)

This paper reviews major structural drivers of place-based health disparities in the context of Canada, an industrialized nation with a strong public health system. Likelihood that the COVID-19 pandemic will facilitate rejuvenation of Canada’s northern and remote areas through remote working, advances in online teaching and learning, and the increased use of telemedicine are also examined. The paper concludes by identifying some common themes to address healthcare disparities for northern and remote Canadian residents.

Products made from animal fur and skin have been a major part of human civilization. However, in modern society, the unsustainable consumption of these products – often considered luxury goods – has many negative environmental impacts. This study explores how people’s perceptions of biodiversity affect their attitudes and behaviors toward consumption. To investigate the information process deeper, we add the moderation of beliefs about biodiversity loss. Following the Bayesian Mindsponge Framework (BMF) analytics, we use mindsponge-based reasoning for constructing conceptual (...) models and employ Bayesian analysis aided by Markov Chain Monte Carlo (MCMC) algorithms on a dataset of 535 Vietnamese urban residents. The results show that people’s preference for using products made from animal skin/fur is negatively associated with perceived consequences of biodiversity loss when they believe biodiversity loss is real and a major problem. In contrast, if urban residents believe biodiversity loss is unreal or not a significant issue, the association between perceived consequences of biodiversity loss and personal preference happens in the opposite direction. The same effects of biodiversity loss perception on people’s possession of skin/fur products was not found, indicating a more complex information process on behaviors compared to attitudes. Nevertheless, in the scenario that people believe biodiversity loss is not a significant issue, the higher the perceived consequences of biodiversity loss are, the greater number of animal-based products they likely own. Our results suggest that policymakers should not neglect the factor of personal belief besides knowledge and awareness in environmental campaigns. (shrink)

BackgroundThe ageing of the population and the increased number of chronic diseases are associated with an increased frequency of end of life care in hospital settings. Residents rotating in hospital wards play a major part in their care, regardless of their specialty. General practitioner (GP) residents are confronted to such activities in hospital settings during their training. Our aim was to know how they feel about taking care of dying patients, as end-of-life care are very different from the clinical (...) activity they are trained to.MethodsWe surveyed all GP trainees of “Ile de France”. The survey was made of 41 questions regarding advanced directives divided in 7 sections about patients’ care, communication, mentoring and repercussion on personal life. The survey was done one time, during two pre-specified days.Results525 residents (53.8%) accepted to fulfill the survey. 74.1% of the residents thought that palliative care could have been better. Possible ways of improvements were: a reduction of unreasonable obstinacy (or therapeutic overkill, two terms defined in French law as curative treatment without reasonable hope of efficiency) (59.6%), patient’s (210 answers, 40%) and relative’s communication (information of patients and relatives about the severity of the disease and risk of death) (199 answers 37.9%). Residents also reported a lack of knowledge regarding end-of-life care specific treatments (411 answers, 79.3%) and 298 (47.2%) wished for better mentoring. Those difficulties were associated with repercussion on their private life (353 answers, 67.2%), particularly with their close relatives (55.4%). Finally, 56.2% of trainees thought that a systematic psychologic follow up should be instituted for those working in “at risk” hospital settings.ConclusionSelf-perception management of dying patients by GP resident emphasize their lack of training and supervision. The feeling of suboptimal care is associated with consequences on personal life. (shrink)

Factors such as subsistence turnover, warfare, or interaction between different groups can be major sources of cultural change in human populations. Global demographic shifts such as the transition to agriculture during the Neolithic and more recently the urbanization and globalization of the twentieth century have been major catalysts for cultural change. Here, we test whether cultural traits such as patri/matrilocality and postmarital migration persist in the face of social upheaval and gene flow during the past 150 years in (...) postcolonial South Africa. The recent history of South Africa has seen major demographic shifts that resulted in the displacement and forced sedentism of indigenous Khoekhoe and San populations. During the expansion of the colonial frontier, the Khoe-San admixed with European colonists and enslaved individuals from West/Central Africa, Indonesia, and South Asia, introducing novel cultural norms. We conducted demographic interviews among Nama and Cederberg communities representing nearly 3,000 individuals across three generations. Despite the history of colonial expansion, and the subsequent incorporation of Khoe-San and Khoe-San-descendant communities into a colonial society with strong patrilocal norms, patrilocality is the least common postmarital residence pattern in our study populations today. Our results suggest that more recent forces of integration into the market economy are likely the primary drivers of change in the cultural traits examined in our study. Birthplace had a strong effect on an individual’s odds of migration, distance moved, and postmarital residence form. These effects are at least partially explained by the population size of the birthplace. Our results suggest that market factors local to birthplaces are important drivers of residence decisions, although the frequency of matrilocal residence and a geographic and temporal cline in migration and residence patterns also indicate the persistence of some historic Khoe-San cultural traits in contemporary groups. (shrink)

Houston, Texas, is a major U.S. city with, like many, a growing aging population. The purpose of this study and ultimate book chapter is to explore the views and perceptions of long-term care (LTC) residents, family members and health care providers. Individuals primarily in independent living and group residential settings were interviewed and studied. Questions emphasized the concepts of personal autonomy, dignity, quality and location of care and decision making. Although a small sample of participants were involved, consistency was (...) noted. Keeping the elderly in caring and loving home situations (theirs or family) was most preferred. Personal choice and independence were emphasized by residents, but family members needed to act as advocates. We also noted that the legal system emphasizes family control over individual decision making as competency declines with aging. Optimal personal decision making in the residents' best interest also became more difficult with loss of individual mental capacity. (shrink)

Products made from animal fur and skin have been a major part of human civilization. However, in modern society, the unsustainable consumption of these products – often considered luxury goods – has many negative environmental impacts. This study explores how people’s perceptions of biodiversity affect their attitudes and behaviors toward consumption. To investigate the information process deeper, we add the moderation of beliefs about biodiversity loss. Following the Bayesian Mindsponge Framework (BMF) analytics, we use mindsponge-based reasoning for constructing conceptual (...) models and employ Bayesian analysis aided by Markov Chain Monte Carlo (MCMC) algorithms on a dataset of 535 Vietnamese urban residents. The results show that people’s preference for using products made from animal skin/fur is negatively associated with perceived consequences of biodiversity loss when they believe biodiversity loss is real and a major problem. In contrast, if urban residents believe biodiversity loss is unreal or not a significant issue, the association between perceived consequences of biodiversity loss and personal preference happens in the opposite direction. The same effects of biodiversity loss perception on people’s possession of skin/fur products was not found, indicating a more complex information process on behaviors compared to attitudes. Nevertheless, in the scenario that people believe biodiversity loss is not a significant issue, the higher the perceived consequences of biodiversity loss are, the greater number of animal-based products they likely own. Our results suggest that policymakers should not neglect the factor of personal belief besides knowledge and awareness in environmental campaigns. (shrink)

BackgroundHealthcare ethics is neglected in clinical practice in LMICs such as Nepal. The main objective of this study was to assess the current status of knowledge, attitude and practice of healthcare ethics among resident doctors and ward nurses in a tertiary teaching hospital in Nepal.MethodsThis was a cross sectional study conducted among resident doctors and ward nurses in the largest tertiary care teaching hospital of Nepal during January- February 2016 with a self-administered questionnaire. A Cramer’s V value was (...) assessed to ascertain the strength of the differences in the variables between doctors and nurses. Association of variables were determined by Chi square and statistical significance was considered if p value was less than 0.05.ResultsOur study demonstrated that a significant proportion of the doctors and nurses were unaware of major documents of healthcare ethics: Hippocratic Oath, Nuremberg code and Helsinki Declaration. A high percentage of respondents said that their major source of information on healthcare ethics were lectures, books, and journals. Attitude of doctors and nurses were significantly different in 9 out of 22 questions pertaining to different aspects of healthcare ethics. More nurses had agreement than doctors on the tested statements pertaining to different aspects of healthcare ethics except for need of integration of medical ethics in ungraduate curricula,paternalistic attitude of doctor was disagreed more by doctors. Notably, only few doctors stood in support of physician-assisted dying.ConclusionsSignificant proportion of doctors and nurses were unaware of three major documents on healthcare ethics which are the core principles in clinical practice. Provided that a high percentage of respondents had motivation for learning medical ethics and asked for inclusion of medical ethics in the curriculum, it is imperative to avail information on medical ethics through subscription of journals and books on ethics in medical libraries in addition to lectures and training at workplace on medical ethics which can significantly improve the current paucity of knowledge on medical ethics. (shrink)

This present article explores the effects of cultural value, economic prosperity, and community mental wellbeing through multi-sectoral infrastructure growth projects under the Belt and Road Initiative. The implications of the social exchange theory are applied to observe the support of the local community for the China-Pakistan Economic Corridor. This study explores the CPEC initiative, it’s direct social, cultural, economic development, and risk of environmental factors that affect residents’ lives and the local community’s wellbeing. CPEC is a multibillion-dollar project to uplift (...) economic growth and free trade between Pakistan, China, and other regional stakeholders. Although CPEC is still in its initial phases with partial startups, policymakers and government officials claim this mega project as a “game-changer” in the region, mainly for Pakistan and China. This gigantic project offers the significant potential to generate business slews and employment opportunities with international outreach. Due to the term’s newness, numerous studies have recently explored the macro and microeconomic benefits of the CPEC initiatives; still, these projects are theoretical. The existing literature insufficiently explored how helpful CPEC would be to a specific group and how residents perceive its advantages. This study fills in the literature gaps and explores the likely advantageous potential of the CPEC for the regional states. The study applied a convenient sampling technique for the data collection process. It used a mixed-method approach to gain scientific results, with a standardized questionnaire survey of 459 people from five major cities of Pakistan. The study results designate that residents believe that CPEC infrastructure projects will significantly improve residents’ life quality through more job openings and community poverty reduction. Still, they raised their concerns regarding environmental protection issues in the region. The findings specified that residents had an optimistic approach to better educational productivity by adopting environment-oriented policies. Policymakers should establish new CPEC study centers in different areas, and investors should be encouraged to participate in the industrial sector. Officials can overwhelm community worries about environmental degradation. Government officials in both countries can utilize the findings to raise public awareness about CPEC’s social, economic, cultural, mental wellbeing, and ecological implications. (shrink)

Background Medical Assistance in Dying in Canada came into effect in 2016 with the passing of Bill C-14. As patient interest and requests for MAID continue to evolve in Canada, it is important to understand the attitudes of future providers and the factors that may influence their participation. Attitudes towards physician hastened death in general and the specific provision of MAID are unknown among Canadian residents. This study examined residents’ attitudes towards PHD and MAID, and identified factors that may influence (...) their decision to participate in PHD and provide MAID. Methods A cross-sectional survey was adapted from prior established surveys on MAID to reflect the Canadian setting. All Canadian family medicine programs were invited to participate. The survey was distributed between December 2016 and April 2017. Analysis of the results included descriptive statistics to characterize the survey participants and multivariable logistic regressions to identify factors that may influence residents’ attitudes towards PHD and MAID. Results Overall, 247 residents from 6 family medicine training programs in Canada participated. While residents were most willing to participate in treatment withdrawal, active participation in PHD and MAID by prescription of a lethal drug and lethal injection were less acceptable. Logistic regressions identified religion as a consistent and significant factor impacting residents’ willingness to participate in PHD and MAID. Residents who were not strictly practicing a religion were more likely to be willing to participate in PHD and MAID. Increased clinical exposure to death and dying crudely correlated with increased willingness to participate in PHD and MAID, but when examined in multivariable models, only a few activities had a statistically significant association. Other significant factors included the residents’ sex and location of training. Conclusions Residents are hesitant to provide MAID themselves, with religious faith being a major factor impacting their decision. (shrink)

Background Studies have shown that medical students and residents believe that their ethics preparation has been inadequate for handling ethical conflicts. The objective of this study was to determine the self-perceived comfort level of medical students and residents in confronting clinical ethics issues. Methods Clinical medical students and residents at the University of Maryland School of Medicine completed a web-based survey between September 2009 and February 2010. The survey consisted of a demographic section, questions regarding the respondents’ sense of comfort (...) in handling a variety of clinical ethics issues, and a set of knowledge-type questions in ethics. Results Survey respondents included 129 medical students (response rate of 40.7%) and 207 residents (response rate of 52.7%). There were only a few clinical ethics issues with which more than 70% of the respondents felt comfortable in addressing. Only a slight majority (60.8%) felt prepared, in general, to handle clinical situations involving ethics issues, and only 44.1% and 53.2% agreed that medical school and residency training, respectively, helped prepare them to handle such issues. Prior ethics training was not associated with these responses, but there was an association between the level of training (medical students vs residents) and the comfort level with many of the clinical ethics issues. Conclusions Medical educators should include ethics educational methods within the context of real-time exposure to medical ethics dilemmas experienced by physicians-in-training. (shrink)

Granting foreign permanent residents the right to vote in local elections in Japan was one of the Clean Government Party (CGP)'s major policy priorities during its 11 years governing in coalition with the Liberal Democratic Party (LDP). While the CGP proposed several bills that would have done this, none of those bills came close to passing. Why not? Conventional wisdom about Japanese conservatism suggests that the LDP would not support such a bill because the party is uniformly committed to (...) the idea that Japan is a one-ethnicity country, and thus the party is hostile to proposals that would grant those without Japanese ethnicity a role in Japanese society. However, I argue that Japanese conservatives in general, and LDP politicians in particular, have major disagreements about the appropriate role of foreign residents in Japanese society. Moreover, I argue that LDP politicians did not support the CGP's proposal to grant foreign permanent residents the right to vote in local elections in Japan because this proposal did not appeal to politicians from either of the dominant conservative schools of thought about foreign residents in Japan. (shrink)

Using Shanghai Tennis Masters as an example, this study seeks to explore the psychic income associated with major sports events hosting and whether the psychic income would predict the attitudes of local residents toward events hosting. In addition, the moderating effect of sport involvement on the relationship between psychic income and attitude is also tested. In this study, a questionnaire survey is adopted. The structured questionnaire was developed based on 4 parts, including the demographics of the residents, involvement in (...) the sport event, psychic income from the sport event, and their attitudes toward the sports event, there were 47 items in total. Data were collected from the local residents of Shanghai, as a result, 1,302 valid questionnaires were collected. A series of statistical analyses were conducted by using SPSS25.0 and AMOS 24.0 to examine the reliability and validity of the scales and to test the hypotheses. The results showed that the event has brought a significant level of psychic income to the local community, and the perceived psychic income would predict the attitudes of the residents toward the event hosting. The moderating effect of sports involvement on the relationship between psychic income and attitude is also confirmed. (shrink)

The Rights of Others examines the boundaries of political community by focusing on political membership - the principles and practices for incorporating aliens and strangers, immigrants and newcomers, refugees and asylum seekers into existing polities. Boundaries define some as members, others as aliens. But when state sovereignty is becoming frayed, and national citizenship is unravelling, definitions of political membership become much less clear. Indeed few issues in world politics today are more important, or more troubling. In her Seeley Lectures, the (...) distinguished political theorist Seyla Benhabib makes a powerful plea, echoing Immanuel Kant, for moral universalism and cosmopolitan federalism. She advocates not open but porous boundaries, recognising both the admittance rights of refugees and asylum seekers, but also the regulatory rights of democracies. The Rights of Others is a major intervention in contemporary political theory, of interest to large numbers of students and specialists in politics, law, philosophy and international relations. (shrink)

The subject of the current study is the process of implementing the social housing policy and its impact on increasing the quality of life of vulnerable people. The analysis is related to the Social Housing Program introduced by the city of Gdańsk. The study has been carried out using the case study method with the use of document analysis, analysis of existing data, and five in-depth interviews with program managers. The theoretical framework has been developed around three major explicatory (...) perspectives: multi-level governance, QOL, and social exclusion. Meeting the housing needs is one of the primary tasks of local governments. If such a policy is to be called positive, it should be combined with social policy tasks related to social inclusion, and it should be carried out through partnerships forming housing cooperation networks. A characteristic feature of the cooperation is the cross-sectoral nature of the actors. The results have revealed a significant positive relationship between the use of social housing tools and the quality of satisfying the living needs of the residents. This study contributes to the discussion by revealing the role of social work and social and professional activation in meeting housing needs. The results suggest that a combination of housing and social policy measures can help vulnerable people develop social competencies conducive to housing maintenance and increase the social cohesion of local environments. (shrink)

The American Urological Association (AUA) and American College of Surgeons (ACS) codes of professionalism require surgeons to disclose the specific roles and responsibilities of trainees to patients during the informed consent process. The objective of this study is to analyze how these requirements are met by urology training programs. An anonymous electronic survey was distributed to the program directors (PDs) of the 143 Accreditation Council for Graduate Medical Education urology residency programs in the United States in 2021. Information was collected (...) regarding program demographics, aspects of the program’s consent process, and the disclosure to patients of the role and participation of residents in their surgery. There were 49 responses to the survey (34.3% response rate). Nearly 70 percent of PDs reported that attending physicians lead the consent process. The topics covered during consent discussion include possible complications (25%), expected recovery time (23%), length of the surgery (22%), the people involved (18%), and their specific roles (7%). Many PDs do not explicitly discuss trainee involvement (48.8%) or when a resident is to perform the majority of the case (87.8%). The majority of PDs (78.8%) communicate medical student involvement, but 73.2 percent reported having a patient decline participation of a trainee after describing their role. Despite the AUA and ACS codes of professionalism, many urologists do not disclose resident involvement in surgery to patients. Further discussions are needed to explore how to better balance resident education and patient autonomy. (shrink)

Background Physicians face competing values of truth-telling and beneficence when deception may be employed in patient care. The purposes of this study were to assess resident physicians' attitudes towards lying, explore lie types and reported reasons for lying. Method After obtaining institutional review board review and receiving exempt status, posts written by Loma Linda University resident physicians in response to forum questions in required online courses were collected from 2002 to 2007. Responses were blinded and manually coded by (...) two investigators using NVivo software. Qualitative and quantitative analyses of the data were performed with links to various attributes. A 95% binomial proportion CI was used to analyse the attribute data. Results The study found that the majority of residents would disclose the truth about medical errors. Similarly, many residents would disclose the truth regarding unanticipated events, especially if the error was serious enough to result in a malpractice suit. However, many residents would not reveal a near miss event because they believe it has no impact on patient health. Some residents would deceive the insurance company for additional patient benefits. Of those willing to lie, only a small group gave self-serving reasons. Conclusions This study demonstrates that the ethical issues related to deception that trouble attending physicians also exist at the resident physician level. Residents primarily lie for altruistic reasons and rarely for egoistic or self-serving purposes that may or may not result in harm to patients, insurance companies and/or physicians themselves. (shrink)

Se realiza la investigación con el objetivo de perfeccionar la obtención del consentimiento informado en las amputaciones mayores de causa vascular en el Servicio de Angiología del Hospital Universitario Manuel Ascunce Domenech. Se constató debilidades en la institucionalización del consentimiento informado y específicamente en el caso de tales amputaciones. Se utilizaron métodos y técnicas del nivel empírico: encuestas a 30 pacientes con riesgo inminente de amputación. El 64% eran mayores de 65 años, 73 % femeninos, todos escolarizados y 73% residentes (...) urbanos. Los resultados más relevantes fueron: que el 54% de los pacientes manifestaron debe existir consentimiento en la aceptación de la amputación, aunque un grupo no despreciable el 37% declinó este derecho a favor de sus familiares. A los médicos se les realizó una entrevista y aunque no hubo unanimidad de criterios, todos coincidieron en que debía legislarse este consentimiento, como parte del perfeccionamiento de los servicios de salud. Research is conducted to improve the process of obtaining informed consent for major amputations due to vascular causes in the Angiology Service of the Manuel Ascunce Domenech Teaching Hospital. Deficiencies were identified in the institutionalization of informed consent protocols, most specifically as they relate to major lower limb amputations. Empirical methods and techniques were used. Thirty patients at imminent risk of amputation were surveyed by questionnaire methods; 64% of those surveyed were of 65 years of age, 73% were female, all of them had an average educational level, and 73% were urban residents. The results indicated that 54% of patients recognized the importance of informed consent in cases of amputation, although a rather considerable group declined this right for their families. Physicians were also interviewed and, although there was no unanimity of criteria, all of them considered that this consent should be legislated as part of the improvement of health services. (shrink)

The importance of bioethics education as a valuable tool to be responsive to medicine’s complexities is affirmed by graduate medical education accreditation bodies and professional organizations alike. The Accreditation Council for Graduate Medical Education, the body that accredits the majority of medical residency and fellowship programs in the United States, affirms the importance of ethics training for physicians in training. How this is accomplished is largely left to the prerogative of individual programs to manage, as benchmarks or milestones to ascertain (...) this are not firmly in place. However, there is doubt that significant education in bioethics is being accomplished by individual residency programs. This review searched the PubMed database for relevant articles on the scope and objectives of ethics education in US and Canadian family medicine residency programs. (shrink)

The importance of bioethics education as a valuable tool to be responsive to medicine’s complexities is affirmed by graduate medical education accreditation bodies and professional organizations alike. The Accreditation Council for Graduate Medical Education, the body that accredits the majority of medical residency and fellowship programs in the United States, affirms the importance of ethics training for physicians in training. How this is accomplished is largely left to the prerogative of individual programs to manage, as benchmarks or milestones to ascertain (...) this are not firmly in place. However, there is doubt that significant education in bioethics is being accomplished by individual residency programs. This review searched the PubMed database for relevant articles on the scope and objectives of ethics education in US and Canadian family medicine residency programs. (shrink)

The debate between legal constitutionalists and critics of constitutional rights and judicial review is an old and lively one. While the protection of minorities is a pivotal aspect of this debate, the protection of disenfranchised minorities has received little attention. Policy-focused discussion—of the merits of the Human Rights Act in Britain for example—often cites protection of non-citizen migrants, but the philosophical debate does not. Non-citizen residents or ‘denizens’ therefore provide an interesting test case for the theory of rights as trumps (...) on ordinary representative politics. Are they the ultimate success story of the human rights framework? Or was Michael Walzer correct to describe government of denizens by citizens as a modern form of ‘tyranny’? This paper argues that neither liberal rights theorists nor democratic republicans provide a coherent response to the existence of denizens. Liberal rights theorists overstate the extent to which a politically powerless status can secure individual rights, while democratic republicans idealise the political process and wrongly assume that all those affected by laws are eligible for political participation. The paper outlines an alternative model for assessing the accountability of states to their non-citizen population, informed by the republican ideal of non-domination. It identifies gaps in state accountability to denizens–such as where there is inadequate diplomatic protection—and argues that these gaps are particularly troubling if their exit costs of leaving the state are high. (shrink)

Artificial intelligence is not only disrupting industries and businesses, particularly the ones have fallen behind the adoption, but also significantly impacting public life as well. This calls for government authorities pay attention to public opinions and sentiments towards AI. Nonetheless, there is limited knowledge on what the drivers behind the public perception of AI are. Bridging this gap is the rationale of this paper. As the methodological approach, the study conducts an online public perception survey with the residents of Sydney, (...) Melbourne, and Brisbane, and explores the collected survey data through statistical analysis. The analysis reveals that: the public is concerned of AI invading their privacy, but not much concerned of AI becoming more intelligent than humans; the public trusts AI in their lifestyle, but the trust is lower for companies and government deploying AI; the public appreciates the benefits of AI in urban services and disaster management; depending on the local context, public perceptions vary; and the drivers behind the public perception include gender, age, AI knowledge, and AI experience. The findings inform authorities in developing policies to minimise public concerns and maximise AI awareness. (shrink)

Residents living in the vicinity of lead smelters are subjected to particularly high levels of contamination from the toxic process of smelting. Yet, public health strategies currently promoted by state health authorities in Australia do not focus their major attention on stopping the contamination at its source. This article focuses on housecleaning regimes, largely implemented by women, aimed at stopping the toxic material from being ingested by children. Because the residential areas surrounding the smelters are degraded, their property value (...) is low and, by and large, working-class families live there. As this article shows, the recommended cleaning regimes are embedded in social class and gender relations. Analysis of the implementation of the strategy and the historical context within which it is administered provides an example of a state gender regime, the state “doing” gender and class, and a lens through which to view contemporary gender and class relations. (shrink)

The majority of obstetrician‐gynecologists in practice operate very infrequently. Most residents graduate with strong surgical skill sets, given residency requirements. Nonetheless, their practices become dominated by obstetrics, and their gynecologic surgical skills deteriorate. While cesarean sections are surgical in nature, the skill sets needed in these surgeries differ from the skills used in general gynecologic surgery. As gynecology has taken a back seat to obstetrics in our specialty, not only surgical skills but also diagnostic and management skills have deteriorated.

Residents with dementia in long-term care facilities (LTCFs) often receive antipsychotic (AP) medications without clear clinical indications. One non-clinical factor influencing the use of APs in LTCFs is low staff levels. Often, using APs is viewed and rationalised by healthcare professionals in LTCFs as a lesser evil option to manage low staff levels. This paper investigates the ethical plausibility of using APs as a lesser of two evils in resource-constrained LTCFs. I examine the practice vis-à-vis the three frequently invoked conditions (...) of lesser evil justifications as specified in the wider philosophical literature. These conditions include (1) the necessity condition, (2) the condition of sensitivity to both deontic (ie, constraint-based) and non-deontic (ie, outcome-based) considerations and (3) the commensurability condition. I argue that there are considerable difficulties in demonstrating that the practice in question satisfies the conditions of lesser evil justifications. In particular, there are major difficulties in satisfying the condition of sensitivity to deontic and outcome-based considerations, and the commensurability condition. I also argue that the current philosophical debate on lesser-evil justifications is not straightforwardly applicable to the practice of using APs for non-clinical purposes in LTCFs. I contend that caregivers are not so-called ‘generic’ agents, and the assumed rarity of lesser evil cases is questionable. I conclude that until further work is done to resolve these issues, the lesser evil reasoning cannot be, at least routinely, used to formulate robust moral justifications for the practice in question. (shrink)

A major distinction in the social organization of ant societies is the number of reproductive queens that reside in a single colony. The fire ant Solenopsis invicta exists in two distinct social forms, one with colonies headed by a single reproductive queen and the other containing several to hundreds of egg‐laying queens. This variation in social organization has been shown to be associated with genotypes at the gene Gp‐9. Specifically, single‐queen colonies have only the B allelic variant of this (...) gene, whereas multiple‐queen colonies always have the b variant as well. Subsequent studies revealed that Gp‐9 shares the highest sequence similarity with genes encoding pheromone‐binding proteins (PBPs). In other insects, PBPs serve as central molecular components in the process of chemical recognition of conspecifics. Fire ant workers regulate the number of egg‐laying queens in a colony by accepting queens that produce appropriate chemical signals and destroying those that do not. The likely role of GP‐9 in chemoreception suggests that the essential distinction in colony queen number between the single and multiple‐queen form originates from differences in workers' abilities to recognize queens. Other, closely related fire ant species seem to regulate colony social organization in a similar fashion. BioEssays 27:91–99, 2005. © 2004 Wiley Periodicals, Inc. (shrink)

Modern society faces major environmental problems, but there are many difficulties in studying the nature–human relationship from an integral psychosocial perspective. We propose the ecomind sponge conceptual framework, based on the mindsponge theory of information processing. We present a systematic method to examine the nature–human relationship with conceptual frameworks of system boundaries, selective exchange, and adaptive optimization. The theoretical mechanisms were constructed based on principles and new evidence in natural sciences. The core mechanism of ecomindsponge is the subjective sphere (...) of influence, which is the limited mental representation of information received from and processed based on the objective sphere of influence–actual interactions in reality. The subjective sphere is the sum of two sub-spheres: influencing (proactive) and being influenced (reactive). Maladaptation in thinking and behavior of the mind as an information collection-cum-processor results from the deviation of the subjective sphere from reality, which includes two main types: “stupidity” and “delusion”. Using Bayesian Mindsponge Framework (BMF) analytics on a dataset of 535 urban residents, we provide consistent statistical evidence on the proposed properties of subjective spheres. The dynamic framework of ecomindsponge can be used flexibly and practically for environmental research as well as other psychosocial fields. (shrink)

Milan Kundera's first major novel, The Joke, was written in 1961-1965, before he made the decision to leave Czechoslovakia and take up residency as a political exile in France.1 With a few noteworthy exceptions, critics of the work focused on its political message in a Cold War context. This was easy to do: its plot revolves around an avid young Czech communist (Ludvik), who writes an ironic postcard to his overly earnest girlfriend while she is away at a political (...) training camp. The year is 1950, and among intellectuals, enthusiasm for a new era of Soviet-mediated socialism is a genuine response to the chaotic disintegration of old certainties after the Nazi occupation of the country. Ludvik is dedicated to the .. (shrink)

Selected by graduating philosophy majors for a $1000 departmental teaching award, 2005 Boulder Faculty Assembly Teaching Excellence Award, University of Colorado, 2001 resident’s eaching cholar, niversity of olorado, 1992-94 Boulder Faculty Assembly Teaching Excellence Award, University of Colorado, 1981..

One of the major tasks of medical educators is to help maintain and increase trainee empathy for patients. Yet research suggests that during the course of medical training, empathy in medical students and residents decreases. Various exercises and more comprehensive paradigms have been introduced to promote empathy and other humanistic values, but with inadequate success. This paper argues that the potential for medical education to promote empathy is not easy for two reasons: a) Medical students and residents have complex (...) and mostly unresolved emotional responses to the universal human vulnerability to illness, disability, decay, and ultimately death that they must confront in the process of rendering patient care b) Modernist assumptions about the capacity to protect, control, and restore run deep in institutional cultures of mainstream biomedicine and can create barriers to empathic relationships. In the absence of appropriate discourses about how to emotionally manage distressing aspects of the human condition, it is likely that trainees will resort to coping mechanisms that result in distance and detachment. This paper suggests the need for an epistemological paradigm that helps trainees develop a tolerance for imperfection in self and others; and acceptance of shared emotional vulnerability and suffering while simultaneously honoring the existence of difference. Reducing the sense of anxiety and threat that are now reinforced by the dominant medical discourse in the presence of illness will enable trainees to learn to emotionally contain the suffering of their patients and themselves, thus providing a psychologically sound foundation for the development of true empathy. (shrink)

BackgroundAs hospitals have grown more complex, the ethical concerns they confront have grown correspondingly complicated. Many hospitals have consequently developed health care ethics programs (HCEPs) that include far more than ethics consultation services alone. Yet systematic research on these programs is lacking.MethodsBased on a national, cross-sectional survey of a stratified sample of 600 US hospitals, we report on the prevalence, scope, activities, staffing, workload, financial compensation, and greatest challenges facing HCEPs.ResultsAmong 372 hospitals whose informants responded to an online survey, 97% (...) of hospitals have HCEPs. Their scope includes clinical ethics functions in virtually all hospitals, but includes other functions in far fewer hospitals: ethical leadership (35.7%), regulatory compliance (29.0%), business ethics (26.2%), and research ethics (12.6%). HCEPs are responsible for providing ongoing ethics education to various target audiences including all staff (77.0%), nurses (59.9%), staff physicians (49.0%), hospital leadership (44.2%), medical residents (20.3%) and the community/general public (18.4%). HCEPs staff are most commonly involved in policy work through review of existing policies but are less often involved in development of new policies. HCEPs have an ethics representative in executive leadership in 80.5% of hospitals, have representation on other hospital committees in 40.7%, are actively engaged in community outreach in 22.6%, and lead large-scale ethics quality improvement initiatives in 17.7%. In general, major teaching hospitals and urban hospitals have the most highly integrated ethics programs with the broadest scope and greatest number of activities. Larger hospitals, academically affiliated hospitals, and urban hospitals have significantly more individuals performing HCEP work and significantly more individuals receiving financial compensation specifically for that work. Overall, the most common greatest challenge facing HCEPs is resource shortages, whereas underutilization is the most common greatest challenge for hospitals with fewer than 100 beds. Respondents’ strategies for managing challenges include staff training and additional funds.ConclusionsWhile this study must be cautiously interpreted due to its limitations, the findings may be useful for understanding the characteristics of HCEPs in US hospitals and the factors associated with these characteristics. This information may contribute to exploring ways to strengthen HCEPs. (shrink)

The current study extends previous literature regarding the effectiveness of learning about academic integrity through peer instruction by assessing the impact of a peer instructional approach for actual and perceived learning gains over time. One trained residence don provided one interactive 30-min presentation covering four major aspects of academic integrity and misconduct to groups of undergraduate students. In total, 192 participants attended the workshop and were surveyed for their knowledge of academic integrity immediately before the presentation, immediately after the (...) presentation, and after a four week delay. Perceptions regarding the presentation also were assessed. Consistent with previous literature, results indicate perceived learning gains and preference for having an interactive presentation delivered by a residence don. In addition, actual gains in knowledge were found immediately after the presentation and gains remained evident over a four-week delay. Outcomes suggest that peer instruction is a viable and effective approach for educating students about academic integrity. (shrink)

: Although "brain death" and the dead donor rule—i.e., patients must not be killed by organ retrieval—have been clinically and legally accepted in the U.S. as prerequisites to organ removal, there is little data about public attitudes and beliefs concerning these matters. To examine the public attitudes and beliefs about the determination of death and its relationship to organ transplantation, 1351 Ohio residents ≥18 years were randomly selected and surveyed using random digit dialing (RDD) sample frames. The RDD telephone survey (...) was conducted using computer-assisted telephone interviews. The survey instrument was developed from information provided by 12 focus groups and a pilot study of the questionnaire. Three scenarios based on hypothetical patients were presented: "brain dead," in a coma, or in a persistent vegetative state (PVS). Respondents provided personal assessments of whether the patient in each scenario was dead and their willingness to donate that patient's organs in these circumstances. More than 98 percent of respondents had heard of the term "brain death," but only one-third (33.7%) believed that someone who was "brain dead" was legally dead. The majority of respondents (86.2%) identified the "brain-dead" patient in the first scenario as dead, 57.2 percent identified the patient in a coma as dead (Scenario 2), and 34.1 percent identified the patient in a PVS as dead (Scenario 3). Nearly one-third (33.5%) were willing to donate the organs of patients they classified as alive for at least one scenario, in seeming violation of the dead donor rule. Most respondents were not willing to violate the dead donor rule, although a substantial minority was. However, the majority of respondents were unaware, misinformed, or held beliefs that were not congruent with current definitions of "brain death." This study highlights the need for more public dialogue and education about "brain death" and organ donation. (shrink)

Qualitative studies on assisted reproductive technology commonly focus on the perspectives of participants living in major metropolises. In doing so, the experiences of those living outside major cities, and the unique way conditions of spatiality shape access to treatment, are elided. In this paper, we examine how location and regionality in Australia impact upon access and experience of reproductive services. We conducted twelve qualitative interviews with participants residing in regional areas across Australia. We asked participants to discuss their (...) experience with assisted reproduction services and the impacts of location on access, service choice, and experience of care, and analysed the data using reflexive thematic analysis, as outlined by Braun and Clarke (2006, 2019). Participants in this study reported that their location impacted the services available to them, required considerable time in travel, and reduced continuity of care. We draw on these responses to examine the ethical implications of uneven distribution of reproductive services in commercial healthcare settings which rely on market-based mechanisms. (shrink)

The article discusses some of the major issues which need to be examined in a gendered reading of citizenship. However, its basic claim is that a comparative study of citizenship should consider the issue of women's citizenship not only by contrast to that of men, but also in relation to women's affiliation to dominant or subordinate groups, their ethnicity, origin and urban or rural residence. It should also take into consideration global and transnational positionings of these citizenships. The article (...) challenges the gender-blind and Westocentric character of many of the most hegemonic theorizations of citizenship, focusing in particular on the questions of membership in ‘the community’, group rights and social difference and the ways binaries of public/private and active/passive have been constructed to differentiate between different kinds of citizenships. The article argues that in order to be able to analyse adequately people's citizenship, especially in this era of ethnicization on the one hand and globalization on the other hand, and with the rapid pace at which relationships between states and their civil societies are changing, citizenship should best be analysed as a multi-tiered construct which applies, at the same time to people's membership in sub-, cross- and supra-national collectivities as well as in states. (shrink)

The UNESCO Statements on Race of the early 1950s are understood to have marked a consensus amongst natural scientists and social scientists that ‘race’ is a social construct. Human biological diversity was shown to be predominantly clinal, or gradual, not discreet, and clustered, as racial naturalism implied. From the seventies social constructionists added that the vast majority of human genetic diversity resides within any given racialised group. While social constructionism about race became the majority consensus view on the topic, social (...) constructionism has always had its critics. Sesardic (2010) has compiled these criticisms into one of the strongest defences of racial naturalism in recent times. In this paper I argue that Sesardic equivocates between two versions of racial naturalism: a weak version and a strong version. As I shall argue, the strong version is not supported by the relevant science. The weak version, on the other hand, does not contrast properly with what social constructionists think about ‘race’. By leaning on this weak view Sesardic’s racial naturalism intermittently gains an appearance of plausibility, but this view is too weak to revive racial naturalism. As Sesardic demonstrates, there are new arguments for racial naturalism post-Human Genome Diversity Project. The positive message behind my critique is how to be a social constructionist about race in the post-genomic era. (shrink)

Aims To examine the understanding of the ethical dilemmas associated with Big Data and artificial intelligence (AI) among Jordanian medical students, physicians in training, and senior practitioners. Methods We implemented a literature-validated questionnaire to examine the knowledge, attitudes, and practices of the target population during the period between April and August 2023. Themes of ethical debate included privacy breaches, consent, ownership, augmented biases, epistemology, and accountability. Participants’ responses were showcased using descriptive statistics and compared between groups using t-test or ANOVA. (...) Results We included 466 participants. The greater majority of respondents were interns and residents (50.2%), followed by medical students (38.0%). Most participants were affiliated with university institutions (62.4%). In terms of privacy, participants acknowledged that Big Data and AI were susceptible to privacy breaches (39.3%); however, 59.0% found such breaches justifiable under certain conditions. For ethical debacles involving informed consent, 41.6% and 44.6% were aware that obtaining informed consent posed an ethical limitation in Big Data and AI applications and denounced the concept of “broad consent”, respectively. In terms of ownership, 49.6% acknowledged that data cannot be owned yet accepted that institutions could hold a quasi-control of such data (59.0%). Less than 50% of participants were aware of Big Data and AI’s abilities to augment or create new biases in healthcare. Furthermore, participants agreed that researchers, institutions, and legislative bodies were responsible for ensuring the ethical implementation of Big Data and AI. Finally, while demonstrating limited experience with using such technology, participants generally had positive views of the role of Big Data and AI in complementing healthcare. Conclusion Jordanian medical students, physicians in training and senior practitioners have limited awareness of the ethical risks associated with Big Data and AI. Institutions are responsible for raising awareness, especially with the upsurge of such technology. (shrink)

Twenty-five long-term care nurses in eight nursing homes in central Kentucky were inter viewed concerning ways in which they might assist elderly residents to preserve and enhance their personal autonomy. Data from the interviews were analysed using grounded theory methodology. Seven specific categories of assisting were discovered and described: personalizing, informing, persuading, shaping instrumental circumstances, considering, mentioning opportunities, and assessing causes of an impaired capacity for decision-making. The ethical implications of these categories of assisting for clinical prac tice are examined. (...) Although nurses recognized the importance of resident autonomy, the majority of them failed consistently to employ the categories of assistance to foster resi dent self-determination and most of them held an inadequate understanding of the con cepts of consent and decisional capacity. To assure confidentiality, pseudonyms are used in the following cases and discussions for all names of nurses, residents and facilities. (shrink)

This paper offers one explanation for the institutional basis of food insecurity in Australia, and argues that while alternative food networks and the food sovereignty movement perform a valuable function in building forms of social solidarity between urban consumers and rural producers, they currently make only a minor contribution to Australia’s food and nutrition security. The paper begins by identifying two key drivers of food security: household incomes (on the demand side) and nutrition-sensitive, ‘fair food’ agriculture (on the supply side). (...) We focus on this second driver and argue that healthy populations require an agricultural sector that delivers dietary diversity via a fair and sustainable food system. In order to understand why nutrition-sensitive, fair food agriculture is not flourishing in Australia we introduce the development economics theory of urban bias. According to this theory, governments support capital intensive rather than labour intensive agriculture in order to deliver cheap food alongside the transfer of public revenues gained from rural agriculture to urban infrastructure, where the majority of the voting public resides. We chart the unfolding of the Urban Bias across the twentieth century and its consolidation through neo-liberal orthodoxy, and argue that agricultural policies do little to sustain, let alone revitalize, rural and regional Australia. We conclude that by observing food system dynamics through a re-spatialized lens, Urban Bias Theory is valuable in highlighting rural–urban socio-economic and political economy tensions, particularly regarding food system sustainability. It also sheds light on the cultural economy tensions for alternative food networks as they move beyond niche markets to simultaneously support urban food security and sustainable rural livelihoods. (shrink)

Background:A total of 71,000 people in Norway suffer from some form of dementia in 2013, of whom approximately 30,000 are in nursing homes. Several studies focus on the experiences of those who have close relatives and who are staying in a nursing home. Results show that a greater focus on cooperation between nursing staff and relatives is a central prerequisite for an increased level of care. Benefits of developing systematic collaboration practices include relief for nursing staff, less stress, and greater (...) mutual understanding. Going through studies focusing on the experiences of nursing home patients’ relatives, negative experiences are in the majority. In this study, relatives are invited to share positive experiences regarding the care of their loved ones; a slightly different perspective, in other words.Aim:The aim of the study is to investigate relatives of persons with dementia’s experiences with quality care in nursing homes.Method:The study is a part of a larger project called Hospice values in the care for persons with dementia and is based on a qualitative design where data are generated through narrative interviews. The chosen method of analysis is the phenomenological–hermeneutical method for the study of lived experiences.Participants and research context:Participants in the project were eight relatives of persons with dementia who were living in nursing homes, long-term residences. The sampling was targeted, enrolment happened through collective invitation. All relatives interested were included.Ethical considerations:The Norwegian Regional Ethics Committee and the Norwegian Social Science Data Services approve the study.Findings:Findings show that relatives have certain expectations as to how their loved ones ought to be met and looked after at the nursing home. The results show that in those cases where the expectations were met, the relatives’ experiences were associated with engagement, inclusion and a good atmosphere. When the expectations were not met, the relatives experienced powerlessness, distrust and guilt.Discussion:The results are discussed considering the concepts of trust, power and asymmetry.Conclusion:When asked about experiences with quality care, the relatives spoke both of expectations met and of expectations not met. Results in this study are important knowledge for developing units where performing quality care is the overall aim. (shrink)

Decisions regarding life-sustaining medical treatments for young children with profound disabilities can be extremely challenging for families and clinicians. In this study, Brick and colleagues1 surveyed adult residents of the UK about their attitudes regarding withdrawal of treatment using a series of vignettes of infants with varying levels of intellectual and physical disability, based on real and hypothetical cases.1 This is an interesting study on an important topic. We first highlight the limitations of using these survey data to inform public (...) policy and then offer a different interpretation from the authors’ regarding their findings about the value the public appears to place on relational capacity. The authors asked members of the lay public to interpret a disabled child’s best interest in a series of vignettes. The respondents were 92% white; 59% were atheist or reported no religious affiliation. Though the authors note this lack of diversity as a limitation, we would add that this limitation is particularly problematic in this context. Minority views on this issue may differ significantly from the majority perspective. When the stakes are high, use of public opinion data to directly inform policy requires, at a minimum, a representative sample reflecting both the true diversity of views within the public and a method to justly account for the alternate views of the minority. Even if the sampled population were more …. (shrink)

Heinrich Heine had not only many places of residence during his years in Germany, but he also made numerous journeys throughout Europe. Thus, during his time in France, he got to know the country substantially better and furthermore he would have liked to undertake a detour to Spain. Since his student days, Spain was for him as a German Jew the epitome of a Jewish- Christian-Islamic symbiosis despite many differences and difficulties. He slipped into the role of the Moors to (...) express his own outsider role within the German Christian majority society. Heine admired the great Jewish achievements and remained critical of Christian claims, although he had become a Protestant after being baptized at the end of his law studies. His tragedy Almansor, poems from the Buch der Lieder, texts in prose and epic poems from the Parisian years as well as in his literary bequest and above all the last collection of poems called Romanzero with their moving “Spanish” texts, namely the stories about Jews, Christians and Muslims, are the most important poetic evidences of religious coexistence and its problems. (shrink)

"Kapitał społeczny ludzi starych na przykładzie mieszkańców miasta Białystok" to książka oparta na analizach teoretycznych i empirycznych, która przedstawia problem diagnozowania i używania kapitału społecznego ludzi starych w procesach rozwoju lokalnego i regionalnego. Kwestia ta jest istotna ze względu na zagrożenia i wyzwania związane z procesem szybkiego starzenia się społeczeństwa polskiego na początku XXI wieku. Opracowanie stanowi próbę sformułowania odpowiedzi na pytania: jaki jest stan kapitału społecznego ludzi starych mieszkających w Białymstoku, jakim ulega przemianom i jakie jest jego zróżnicowanie? Ludzie (...) starzy są tu postrzegani jako kategoria społeczna, czyli zbiór osób podobnych do siebie pod względem społecznie istotnych cech (takich jak wiek, posiadane role społeczne i świadomość korzystania ze świadczeń społecznych), którzy są świadomi tego podobieństwa i swojej odrębności od innych. Przyjmuje się ponadto, iż osoby takie przekroczyły 60. rok życia. Zakłada się też, że w zasobach ludzkich skumulowany jest kapitał ludzki, społeczny i kulturowy. Kapitał społeczny jest tu ujmowany szeroko jako potencjał współdziałania osadzony w powiązaniach międzyludzkich i normach społecznych, który może przynosić korzyści osobom, grupom i społeczeństwom. W części teoretycznej przedstawiono informacje o starości jako etapie w życiu jednostki, wyjaśniono pojęcie ludzi starych, omówiono społeczne teorie starzenia się, historyczne czynniki oddziaływające na położenie kategorii społecznej ludzi starych, zmiany ich miejsca w społeczeństwie polskim w trakcie transformacji ustrojowej i na początku XXI wieku, możliwe konsekwencje wzrostu długości życia w warunkach demokracji i kapitalizmu oraz charakterystykę problemu starzenia się ludności Białegostoku jako miasta pogranicza. Zaprezentowano też różnorodne koncepcje kapitału społecznego, sfery jego oddziaływania na rozwój społeczno-gospodarczy, jego stan w Polsce oraz wytyczne do strategicznego budowania jego zasobów. Przybliżono również wybrane informacje o aktywności ludzi starych w życiu publicznym, społecznym i gospodarczym jako kluczowych cechach ich kapitału społecznego. Porządkując różne stanowiska teoretyczne, wyniki badań i dane statystyczne, dążono do powiązania wielu rozproszonych źródeł w przekonaniu, iż jest to istotne w celu określenia i zagospodarowania zasobów kapitału społecznego seniorów, jak również niwelacji opóźnienia polskiej socjologii w zakresie badań nad ludźmi starymi. Pomimo, iż za podstawową perspektywę teoretyczną publikacji uznana została koncepcja kapitału P. Bourdieu, autor bierze również pod uwagę propozycje badawcze J.S. Colemana, R.D. Putnama, F. Fukuyamy, A. Giddensa, P. Sztompki i A. Sadowskiego. Drugi rozdział zawiera określenie ram metodologicznych badań przeprowadzonych na potrzeby tej publikacji. Omówiono przyjęte założenia badawcze oraz przybliżono sposób i przebieg realizacji badań. Przede wszystkim zdecydowano się na korzystanie z metody jakościowej i zastosowanie techniki wywiadu swobodnego ukierunkowanego. Uznano, iż podmiotowy kontakt z ludźmi starymi umożliwi dokładniejsze rozpoznanie kontekstu, w którym znajdują się zasoby ich kapitału społecznego. Jest to ważne, gdyż przenoszenie na rodzimy grunt opracowanych za granicą interpretacji działań ludzi starych i rozwiązań aktywizujących, może okazać się nieskuteczne lub wywołać negatywne efekty zewnętrzne. Ponadto w literaturze przedmiotu zwraca się uwagę na niedostatek badań gerontologicznych zgodnych z paradygmatem interpretatywnym. Badaniu poddano 26 respondentów w wieku od 60 do 89 lat żyjących w mieście Białystok związanych z jedną z dwóch różnych instytucji: Domem Pomocy Społecznej i Uniwersytetem Trzeciego Wieku. Poprzez porównywanie osób znajdujących się na dwóch biegunach aktywności społecznej możliwe było dostrzeżenie podobieństw i różnic w ich wyposażeniu kapitałowym, a zarazem w osiągniętych w ciągu życia pozycjach w strukturze klasowej i zasobach służących pomyślnej starości6. W trzecim rozdziale przedstawiona została część wyników analiz empirycznych. Przybliżono tu sposób, w jaki ludzie starzy myślą o podobnych sobie przodkach i osobach współczesnych, a także czynniki, w zależności od których zmienia się ich pozycja społeczna w mieście oraz problemy społeczne, jakie uznają za najważniejsze dla ludzi starych. Analizie poddano opinie o ich czasie wolnym, szansach i barierach aktywności ekonomicznej. Wyróżniono typy kapitału społecznego ludzi starych w zależności od instytucji, z którymi są związani oraz podejścia do postrzegania i wykorzystywania zróżnicowania wewnętrznego seniorów. Omówiono wizerunek seniorów w środkach masowego przekazu. Publikacja nie zawiera ścisłego zakończenia. W ostatnim rozdziale wskazano jedynie na główne wnioski płynące z badań oraz na potencjalne dalsze kierunki analiz. Uzupełnienie tego podejścia stanowią zamieszczone w aneksie zestawienia oddolnych technik budowania kapitału społecznego oraz podstawowych cech Miast Przyjaznych Starszemu Wiekowi. Z opracowania tego z pewnością będą mogli skorzystać nie tylko naukowcy zajmujący się tematyką ludzi starych, ale i pracownicy socjalni, politycy, pracodawcy, przedstawiciele mediów i organizacji pozarządowych oraz obywatele Białegostoku i innych miast. ** "Social Capital of Old People on the Example of Bialystok Residents" is a book based on theoretical and empirical study, which presents an issue of diagnosing and using of old people social capital in the local and regional development processes. This issue is significant because of the threats and challenges associated with process of rapid ageing of Polish society at the beginning of 21st century. Publication, in particular, is an attempt to give answers to the following questions: what is the state of old people social capital in Bialystok, what transformations it undergoes and how is it differentiated? In this study old people are viewed as a social category, which is a set of people similar to each other in terms of socially significant features (such as age, possessed social roles and awareness of received social benefits), who are aware of these similarities and differences between each other. Moreover, it is assumed, that such persons exceeded the 60 years of age. It is also assumed that human, social and cultural capital is accumulated in the human resources. Social capital is recognized here broadly as a potential for collaboration embedded in interpersonal relationships and social norms that may benefit individuals, groups and societies. The book consists of three chapters. The first, which is the theoretical part of work, includes information about: old age as a stage of individual life and explanation of the old people notion. It discusses social theories of ageing, historical factors affecting on the social position of old people category, changes in their place in Polish society during the system transformation and in the early 21st century. It describes the possible consequences of increased life expectancy for democracy and capitalism - including the concepts of society for all ages, silver economy. It also features ageing population issue, as well as social policy towards the elderly and old age in Bialystok as the borderland city. A variety of social capital concepts were presented; the spheres of its influence on socio-economic development, its status in Poland and guidelines for strategic building of its resources. Selected information on the activity of old people in public, social and economic life as key features of their social capital was brought closer. Putting various theoretical positions, results of research and statistical data in order was aimed to link many dispersed sources considering that it is relevant to identify and develop seniors' social capital resources, as well as leveling the delay of Polish sociology research on the elderly. Fundamental theoretical perspective of publication is the concept of capital according to P. Bourdieu. However, the proposals of J.S. Coleman, R.D. Putnam, F. Fukuyama, A. Giddens, P. Sztompka and A. Sadowski were also used. The second chapter contains a methodological framework for the purposes of study. Research assumptions, method and course of implementation of studies were discussed. The study is based on the qualitative method and the application of in-depth interview techniques. It was considered that the personal contact with old people will be more accurate than other research techniques to identify the context in which they social capital resources can be found. It is important because the transfer of developed abroad activating solutions and interpretations of old people actions may be ineffective or have negative external effects in the Polish context. Moreover, in the Polish science literature attention is paid to scarcity of gerontological research in accordance with the interpretive paradigm. Study involved 26 respondents aged 60 to 89 years living in Bialystok associated with one of two different institutions: nursing home for the elderly and University of the Third Age. By comparing the persons on two extremes of social activity it was possible to see similarities and differences in their capital equipment, and also in achievements of the life positions in the class structure and resources aimed at successful ageing. The third chapter presents the empirical analysis of the research results. This part outlines the way in which old people think about their ancestors and contemporary people. It also shows factors according to changes in their social position in the city, social issues which they consider most important for old people, their opinions about leisure time, opportunities and barriers of economic activity and types of old people social capital depending on the institution with which they are associated. Approach to the perception and use of internal disparities of seniors were also discussed. The analysis additionally contains the evaluation of senior citizens image in the polish mass media. This publication does not contain a strict ending. It only identifies the main conclusions of the research and potential directions of future analysis. Above all, older people could improve their position not by demanding increases in social benefits from which major parts are often taken away by their family members, but by highlighting their human, social and cultural capital. It is necessary to create favorable conditions for social and professional life of old people and their cooperation with members of local communities. Important role in this regard is played by institutions implementing three tasks: stimulating senior citizens' desire to satisfy previously unrealized needs; creating relationships between them so that they can solve their own problems and work for the others; and providing legal, social and vocational guidance. Stimulating cooperation between existing public, commercial and non-governmental sector organizations may serve to achieve these goals. The dissemination of bottom-up techniques of social capital building and checklist of essential features of Age-friendly Cities may also be important. -/- . (shrink)