BackgroundPatient-centeredness, respect for patient autonomy, and shared decision-making have now made it to center stage in discussions on quality of care. Knowing what actually counts in care and how it should be accomplished from the patients’ and nurses’ perspective seems crucial.AimTo explore how patients and their nurses perceive the importance and enactment of values in their healthcare.Research designAn observational, cross-sectional study using a self-developed questionnaire, consisting of 15 items related to seven values (e.g. uniqueness, autonomy, professionalism, compassion, responsiveness, partnership, and (...) empowerment) as described in the taxonomy of Bastemeijer et al.Participants and research contextThe survey was completed by 384 patients and 81 nurses. Participants were recruited on eight internal medicine wards of a 1000-bed university hospital in Belgium.Ethical considerationsThis study was approved by the ethical committee of the Ghent University Hospital (B670201836799).Findings(1) Patients and nurses prioritize values of care differently; (2) nurses report not being able to enact the values they prioritize in actual practice as much as one would like to; and (3) there is a gap in experienced delivery of a comprehensible explanation of all treatment options, a conversation based on equality, making shared decisions, and being non-judgmental between nurses and patients.DiscussionOur findings challenge nurses’ overemphasis on professional compassion and uniqueness while arguing for increased attention on authentic shared decision-making and empowerment. The first step to a patient-centered culture truly involving patients in their healthcare is communication and information provision, rather than focusing on tangible and normative constructs.ConclusionOur findings revealed differences in prioritization and actual enactment of values in care between patients and nurses. This was especially so for values related to communication, provision of complete unbiased information, and shared decision-making. Nurses should prioritize providing comprehensible information and using conversations based on equality to make decision together with patients. (shrink)

La contribution de Michel Troper à la théorie générale du droit et à la théorie constitutionnelle est aujourd'hui reconnue et célébrée un peu partout dans le monde. Un talent d'architecte se tient à l'origine de cette audience rarement égalée dans la sphère francophone : celui qu'il faut pour accommoder toutes les exigences, quel que soit l'ordre de valeur dans lequel on les trouve : originalité, rigueur, souci de la fonction, esthétisme, solidité, adaptation, intelligence, inquiétude, esprit critique, renoncement, réalisme... A (...) ces mérites, on ajoutera une curiosité insatiable, un goût prononcé pour l'échange et le débat, un refus distingué de l'académisme, un sens exigeant de l'amitié et une méfiance profônde pour les adjectifs... C'est cet édifice de qualités que les élèves, collègues et amis de Michel Troper sont heureux de célébrer en lui offrant ces Mélanges. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 9.1 (2002) 55-59 [Access article in PDF] One Stage Is Not Enough Andrew W. Young and Karel W. de Pauw Keywords: delusions, Cotard delusion, Capgras delusion, cognitive neuropsychiatry. WE WELCOME THE OPPORTUNITY to offer our reflections on Philip Gerrans' interesting paper. Our opinion is that on fundamental issues we agree quite a bit—but there are clear differences when it comes to details.The most basic (...) issue concerns the nature of the enterprise. Like Gerrans, we think that it is possible to create testable accounts of the formation and maintenance of what would otherwise seem bizarre and inexplicable delusions, and that these accounts should be grounded in theoretical models of factors that underpin our everyday perception and reasoning. This general approach certainly forms part of what has been called cognitive neuropsychiatry. However, we disagree with Gerrans in that we see cognitive neuropsychiatry as an attempt to draw on the underlying logic of cognitive neuropsychology, rather than (as Gerrans implies) its current methods. The underlying logic of cognitive neuropsychological approaches has been to try to understand the effects of brain injury in terms of disruption of different components of theoretical models of normal abilities. In this approach, a model of normal performance is tested by its ability to account for the effects of brain injury. Where the model of normal performance also provides a convincing account of brain injury it is retained, and when it fails to account for effects of brain injury, it is revised or abandoned. In cognitive neuropsychiatry, the key theoretical move has been to argue that an adequate model of normal performance should be able to account for any disordered pattern (Ellis and Young 1990). The same logic of seeking to explain disordered performance by reference to models of normal function is then attempted, but for disorders that would usually fall within the province of psychiatry.In our opinion, however, cognitive neuropsychiatry will not simply involve importing the methods of cognitive neuropsychology into the new domain; they will need to be developed and adapted to fit the new agenda (Young 2000).In cognitive neuropsychology, progress has often come from the careful investigation of people with stable, selective deficits of fundamental cognitive functions involved in sensory analysis, memory, and verbal or motor output. In contrast, delusional beliefs can be relatively unstable; often they are only held for a few weeks or even days. When the delusions change, patients may modify or abandon them as suddenly as they seemed to form them, or they may give them up much more slowly and reluctantly. At the very least, this creates difficulties in the timing of investigations and in interpreting the relation of deficits and symptoms, which may be recorded on separate dates. These methodological problems [End Page 55] are exacerbated by the fact that deficits linked to complex abnormal experiences such as delusions may be multifaceted and diffuse, even when the delusions themselves have a specific content or theme. Such complications do not invalidate cognitive neuropsychiatry, but they do mean it will need to develop its own methods for dealing with them and making appropriate inferences.One of the key complexities that has surfaced already involves the idea that delusional beliefs might reflect the interaction of two or more contributory factors. Gerrans discusses a particular variant of this idea, which had been suggested by Young and Leafhead (1996) as an approach to understanding the Cotard delusion: The Cotard delusion represents a depressed person's attempt to account for abnormal perceptual experiences. It follows that the delusion is based on an unfortunate interaction between different contributory factors. One set of factors creates the abnormal perceptual experiences, which are characterised by lack of emotional responses and feelings of emptiness, depersonalisation and derealisation. The other factors result in a misinterpretation of these perceptual changes, in which the patients' depressed moods lead them correctly to attribute the changes to themselves, but to exaggerate their consequences. (Young and Leafhead, 1996, 166) Gerrans describes this as a two-stage account, but argues that a one-stage account based only on abnormal perceptual... (shrink)

Under the pretense of defending an obscure treatise by a Catalan theologian, Sebond, Montaigne attacks the philosophers who attempt rational explanations of the universe and argues for a skeptical Christianity based squarely on faith rather than reason. The result is the _Apology for Raymond Sebond_, a classic of Counter-Reformation thought and a masterpiece of Renaissance literature. This new translation by Roger Ariew and Marjorie Grene achieves both accuracy and fluency, conveying at once the nuances of Montaigne’s arguments and his distinctive (...) literary style. (shrink)

Familial disclosure of genetic information is an important, long-standing ethical issue that still gives rise to much debate. In France, recent legislation has created an innovative and unprecedented procedure that allows healthcare professionals, under certain conditions, to disclose relevant information to relatives of a person carrying a deleterious genetic mutation. This article will analyse how HCPs in two medical genetics clinics have reacted to these new legal provisions and show how their reticence to inform the patients’ relatives on their behalf (...) leads them to use this option sparingly. (shrink)

A superb achievement, one that successfully brings together in accessible form the work of two major writers of Renaissance France. This is now the default version of Montaigne in English. --Timothy Hampton, Professor of French and Comparative Literature, University of California, Berkeley.

Diderot escreve, na Enciclopédia, um longo verbete, “Tear de meias”, no qual compara o tear a um raciocínio cuja conclusão seria o têxtil. Ele retoma esta comparação na Refutação de Helvétius: ali, é o próprio Leibniz que se torna uma máquina de reflexão, similar ao “tear de meias”. A opção materialista do homem máquina retoma uma tradição que assimila o texto ao tecido. Encontramos a mesma imagem no Fausto de Goethe, que é citado por Freud em A interpretação dos sonhos, (...) e na novela de Henry James O motivo no tapete. A invenção é sempre cruzamento, tecelagem e mestiçagem, numa interação entre criação técnica e representação da atividade intelectual. O sistema de programação dos teares foi posteriormente adaptado às primeiras máquinas analíticas, ancestrais de nossos computadores atuais. A Enciclopédia teorizou esta interação, reabilitando os teares e concebendo o pensamento como um trabalho. (shrink)

Prosthetic devices that replace a lost limb have become increasingly performant in recent years. Recent advances in both software and hardware allow for the decoding of electroencephalogram signals to improve the control of active prostheses with brain-computer interfaces. Most BCI research is focused on the upper body. Although BCI research for the lower extremities has increased in recent years, there are still gaps in our knowledge of the neural patterns associated with lower limb movement. Therefore, the main objective of this (...) study is to show the feasibility of decoding lower limb movements from EEG data recordings. The second aim is to investigate whether well-known neuroplastic adaptations in individuals with an amputation have an influence on decoding performance. To address this, we collected data from multiple individuals with lower limb amputation and a matched able-bodied control group. Using these data, we trained and evaluated common BCI methods that have already been proven effective for upper limb BCI. With an average test decoding accuracy of 84% for both groups, our results show that it is possible to discriminate different lower extremity movements using EEG data with good accuracy. There are no significant differences in the decoding performance of these movements between healthy subjects and subjects with lower extremity amputation. These results show the feasibility of using BCI for lower limb prosthesis control and indicate that decoding performance is not influenced by neuroplasticity-induced differences between the two groups. (shrink)

Prosthetic devices that replace a lost limb have become increasingly performant in recent years. Recent advances in both software and hardware allow for the decoding of electroencephalogram signals to improve the control of active prostheses with brain-computer interfaces. Most BCI research is focused on the upper body. Although BCI research for the lower extremities has increased in recent years, there are still gaps in our knowledge of the neural patterns associated with lower limb movement. Therefore, the main objective of this (...) study is to show the feasibility of decoding lower limb movements from EEG data recordings. The second aim is to investigate whether well-known neuroplastic adaptations in individuals with an amputation have an influence on decoding performance. To address this, we collected data from multiple individuals with lower limb amputation and a matched able-bodied control group. Using these data, we trained and evaluated common BCI methods that have already been proven effective for upper limb BCI. With an average test decoding accuracy of 84% for both groups, our results show that it is possible to discriminate different lower extremity movements using EEG data with good accuracy. There are no significant differences in the decoding performance of these movements between healthy subjects and subjects with lower extremity amputation. These results show the feasibility of using BCI for lower limb prosthesis control and indicate that decoding performance is not influenced by neuroplasticity-induced differences between the two groups. (shrink)

One of the many drastic changes caused by Covid-19 was the quick implementation of distance learning which represented a great technological challenge to many teachers and students. In fact, Italy ranks 24th amongst the 27-EU member countries in digital competitiveness which testifies to the significant delays and gaps in basic digital skills amongst the population. Based on the difficulties encountered in organizing distance learning, we assumed that teachers' perceived stress increased. Given that transversal skills can be associated with this relationship, (...) we hypothesized that among these skills, self-efficacy mediated the relationship between the difficulties in organizing distance learning and perceived stress. Since we targeted teachers from Italy and other European countries, we also hypothesized that this mediator effect would be different for both samples. Our sample was composed of a total of 366 primary/middle school teachers of which 86% female. After doing a mediation analyses with Process, Hayes' Model 4, we confirmed H1 but not H2: resulting in a partial mediation effect of self-efficacy for each individual group of teachers. Since difficulties of distance learning can affect the perception of stress, we believe that the promotion of transversal skills, such as self-efficacy, can better equip teachers when facing stressful situations. (shrink)

We consider a situation where an individual is facing an uncertain situation, but may costly alter his knowledge of the uncertainties. We study in this context how risk aversion may modify the individual search behavior. We consider a one-armed bandit problem (where one arm is safe and the other is risky) and study how the agent risk aversion can change the sequence of arms selected. The main result is that when the utility function is more concave, the agent has more (...) chances to select the safe arm. We also discuss how search is affected by risk aversion. (shrink)

in this article, we experience the exercise of a screen ethnocartography in agency with the film Beasts of the southern wild by the director Benh Zeitlin. We tested a film experimentation that led to a renewed writing ways of life. We bet on cinema and childhood as possibilities for creating cracks and a stutter of language for the creation of new worlds and ways of living. In cinema images less as a representation, and more as art that proposes incompleteness, fissure, (...) a hole in appearances. In childhood as an exercise of differentiation and resistance to dominant narratives in a given context. In childhood as a limiting experience of/in language, tirelessly exposing the human condition in front of the world. Thus, accompanying the main character of the plot, little Hushpuppy — a six-year-old resident of the “Charles Doucet Island”, experienced as “the Bathtub” —, we are shaken by the forms of life there, considered bestial and not recognized by city humans. Hushpuppy, his father and friends resist attempts to destroy their existence by the forms of the state that try to domesticate them, imbued with the logic that primitives must come to civilization, just as children must become adults. (shrink)

In this incisive book, Michel de Certeau considers the uses to which social representation and modes of social behavior are put by individuals and groups, describing the tactics available to the common man for reclaiming his own autonomy from the all-pervasive forces of commerce, politics, and culture. In exploring the public meaning of ingeniously defended private meanings, de Certeau draws brilliantly on an immense theoretical literature to speak of an apposite use of imaginative literature.

Researchers have emphasized the value of authenticity, but not much is known about what makes a person authentic in the eyes of others. Our research takes an interpersonal perspective to examine the determinants of followers’ perceptions of leader authenticity. Building on social identity theory, we propose that two fundamental self-identifications–a leader’s sense of uniqueness and sense of belongingness–interact to influence followers’ perceptions of a leader’s authenticity via perceptions of a leader’s self-concept consistency. In a field study conducted among leader–follower dyads (...) and in a controlled laboratory experiment, we find that when a leader feels a low sense of belongingness, there is a positive relationship between a leader’s sense of uniqueness and perceptions of leader authenticity. When a leader feels a low sense of uniqueness, there is a positive relationship between a leader’s sense of belongingness and perceptions of leader authenticity. This is because followers perceive this leader as having high self-concept consistency. (shrink)

This study explores the association between different types of morally challenging interactions during military deployment and response strategies, as well as the mediating role of moral emotions. Interviews with Dutch servicemen who participated in military operations were content coded. We found a relationship between local-cultural and team-related interactions and moral justification; these effects were mediated by other-condemning emotions. Similarly, other-condemning emotions mediated the relationship between local-cultural interactions and relativism. This study points at the importance of other-condemning emotions in shaping military (...) reactions to frequently occurring morally challenging interactions. (shrink)

Telle est la sombre grandeur proposee desormais a l'historien contemporain : consacrer ses efforts a discrediter les auteurs anciens en montrant a quel point ils avaient ete tributaires de leurs aveuglements ; souligner les lacunes, la myopie, l'extravagance de leurs jugements ; debusquer prejuges de classe et stereotypes de genre ; dresser l'inventaire, la genealogie de leurs successives reinterpretations par chaque generation. Tenir en revanche leurs oeuvres pour un reservoir d'exemples, de modeles, de situations utiles pour guider notre reflexion, comme (...) le recommandait Plutarque, les considerer meme comme des chefs d'oeuvre d'une "inalterable actualite", parce qu'ils "savent dire ce que l'homme a d'humain" serait rester a la surface des choses, "dans l'ether de la culture classique". Se flatter de poursuivre avec ces vieux morts un dialogue que nos differences et notre eloignement releguent au rang de vain songe releverait de la naivete, de l'amateurisme et de l'outrecuidance. J'ai ecrit ce livre parce que je pense tout le contraire. Repudiant tout anachronisme simplificateur, mais refusant aussi de considerer le legs de l'Antiquite comme une beaute morte, infeconde, Michel De Jaeghere mobilise sa formation d'historien des idees, sa longue frequentation des auteurs antiques, et sa familiarite avec la politique contemporaine pour affronter une redoutable question : les Anciens sont-ils, en politique, encore de bon conseil? (shrink)

English summary: Now that it has managed to become a science, history must remain the symposium theatre which allows us to converse with the dead. Our "connected" world delivers us up, defenceless, to the tyranny of every instant. History could be the antidote, inasmuch as it is a depository of people's collective experience. It lifts shadows up from the depth of the ages to make us share what we have learned from being who we are. We have undertaken a boundless (...) dialogue with the living. This book proposes to restore the dialogue with the dead by revisiting, through a succession of brief texts in the form of short essays and short stories, a number of episodes of universal history in an attempt to cull some lessons from it. At a time when history's progress has led to an excessive specialisation which has caused many scholars to withdraw into their ivory towers to enjoy, among experts, the fruit of their research, Michel De Jaeghere wants us to resume meditating on examples that have nourished human thought since ancient times. French description: Ils ont ete pharaons, empereurs romains, rois de France, croises, missionnaires, conquerants, batisseurs de palais et de cathedrales, decouvreurs de mondes nouveaux. Ils ont connu l'ivresse de la gloire, l'amertume de la defaite, ils ont peine dans les travaux. Ils ont incarne l'aventure de l'Occident jusqu'aux extremites de la terre, ils ont du faire face a la barbarie, a la guerre, a la terreur et a la tyrannie totalitaires. De la profondeur de l'Egypte ancienne aux conflits qui ont ouvert le XXIe siecle, ils offrent la plus etonnante des galeries de portraits. Marc Aurele y croise Christophe Colomb, Louis XVI, Honore d'Estienne d'Orves ou Helie de Saint Marc. Ils forment la compagnie des ombres, surgie du passe pour nous offrir un tete a tete. Un dialogue singulier avec les morts.L'histoire est trop souvent traitee comme un cadavre par des medecins legistes si attentifs aux organes qu'ils prelevent sur le corps dont ils font l'autopsie que leur echappe son mystere, ce qui lui donnait sa vie meme. Elle est, ailleurs, consideree comme le divertissement d'un jour, l'occasion d'une promenade sans enjeu. Les textes reunis ici comme en un recueil de nouvelles voudraient s'inscrire dans une autre tradition, celle d'une histoire meditative: une histoire tournee vers la recherche de ce qu'elle a a nous dire d'essentiel, de vital sur nous-meme. Ils se proposent de convoquer les ombres du passe pour nous donner a contempler ce qui n'est pas mort avec elles. Nous doutons aujourd'hui que l'histoire puisse etre maitresse de vie: magistra vitae, disait Ciceron. Nous voulons croire que nous n'avons plus rien a apprendre d'elle. Il nous manque d'avoir les yeux ouverts sur ce qui fait echapper ses protagonistes a leur condition mortelle; ce qui leur donne leur part d'eternite. (shrink)

Les vingt dernières années ont vu l’apparition d’une convergence forte entre une démarche appliquée se consacrant à la création de corpus de grande taille, à leur codage et à leur étiquetage, et diverses théories linguistiques dont les analyses reposent sur de tels corpus. Pour l’analyse de conversation (ou linguistique interactionnelle) une telle convergence ne semble pas possible, car son approche est qualitative et s’appuie sur de « petits » corpus. De plus, un examen approfondi du contexte social des interactions recueillies (...) est nécessaire, qui ne peut donc se réduire à la collecte de métadonnées. Une question surgit immédiatement : la notion de « petit » corpus a une validité sur le plan épistémologique? Le présent article montre qu’une réponse positive peut être apportée à cette question et qu’il est possible de fonder en raison une pratique qui, le plus souvent, se drape sous les oripeaux de l’évidence. (shrink)

According to Kuhn's speciation analogy, scientific specialisation is fundamentally analogous to biological speciation. In this paper, we extend Kuhn's original language-centred formulation of the speciation analogy, to account for episodes of scientific specialisation centred around methodological differences. Building upon recent views in evolutionary biology about the process of speciation by genetic divergence, we will show how these methodology-centred episodes of scientific specialisation can be understood as cases of specialisation driven by value divergence. We will apply our model of specialisation by (...) value divergence to an episode of methodology-centred scientific specialisation: the emergence of molecular biology. (shrink)

A basic issue in political economy is the question of how a decentralized economy is possible: How can a system survive and, moreover, be efficient, if all decisions are taken independently, that is, without any explicit coordination? The issue has two sides to it. On the one hand, it is a “thought experiment,” falsifiable only on logical grounds, an object of debate for the sake of pure intellectual interest, even for people who might not live in a market economy. On (...) the other hand, for those who do or might live in such an economy, a thought experiment of this kind contains a critical political dimension, for the conclusions derived from it will usually be appealed to in arguing about the ideal organization of the economy. (shrink)