Name der Zeitschrift: Klio Jahrgang: 100 Heft: 2 Seiten: 523-527.

Does it follow from Wittgenstein's views about indeterminism that irregularities of nature could take place? Did he believe that chairs could simply disappear and reappear, that water could behave differently than it has, and that a man throwing a fair die might throw ones for a week? Or are these things only imaginable? Is his view simply that if we adopted an indeterministic point of view we would no longer look for causes, or would not always look for causes, because (...) we would no longer assume that there must be a cause of each event? (shrink)

If one thinks of intentions as entities of some sort, states or dispositions, for example, it should eventually strike him that there are peculiar difficulties with the idea. For example, he will have trouble counting his intentions. In a particular situation, we ask someone, ‘What are you going to do about that? And this?’ And his answer might be, ‘My intention is to pay that, and, as for this, my intention is to ignore it.’ But of course he may have (...) said, ‘My intention is to pay this and ignore that.’ For this reason and, as we will see, others, there is no such thing as a complete list of intentions that a person has. If someone told us, ‘I have just eight intentions at present’, we would think he was joking, even though he intends to do eight things—grade papers, meet a class at nine, and so on. And if we ask; ‘What are you going to do today?’, he may answer that he has a class at nine, office hours at two, and lunch already scheduled. But even though he has more to do today than yesterday, he would hardly tell us, ‘I am afraid I have more intentions today than I did yesterday.’. (shrink)

Biomedical research policy in recent years has often tried to make such research more ‘translational’, aiming to facilitate the transfer of insights from research and development to health care for the benefit of future users. Involving patients in deliberations about and design of biomedical research may increase the quality of R&D and of resulting innovations and thus contribute to translation. However, patient involvement in biomedical research is not an easy feat. This paper discusses the development of a method for involving (...) patients in biomedical research aiming to address its main challenges. (shrink)

There is an increasing recognition internationally of the critical impact of communication within healthcare. The link between ineffective communication, patient dissatisfaction and critical incidents is well established. Family Planning New South Wales has sought to address patient-centred care and communication in its policy platform. This article reports on research conducted within FPNSW, which analysed the discourse features that constituted effective doctor–patient1 communication in sexual and reproductive health consultations. The principal aim of the research was to understand how effectively messages were (...) conveyed and received and to what degree patients were active participants in their own sexual healthcare. Analysed consultations were characterised by extremely high levels of communicative competence on the part of the doctors who integrated medical expertise with the development of interpersonal relationships with patients, thus positioning patients as active contributors to the consultations and to decisions about their ongoing treatment. The detailed linguistic analysis identified characteristic features of patient-centred communication that are essential to patient-centred care. These interactions demonstrate that communicating care is just as important as delivering care and involves a drawing together of the medical and the interpersonal in consultations. The article details strategies for interweaving medical knowledge and establishing rapport that can inform practitioner communication practices across different healthcare contexts. (shrink)

The paradox of the Unexpected Hanging, related prediction paradoxes, and the Sorites paradoxes all involve reasoning about ordered collections of entities: days ordered by date in the case of the Unexpected Hanging; men ordered by the number of hairs on their heads the case of the bald man version of the Sorites. The reasoning then assigns each entity a value that depends on the previously assigned value of one of the neighboring entities. The final result is paradoxical because it conflicts (...) with the obviously correct, commonsensical value. The paradox is due to the serial procedure of assigning a value based on the newly assigned value of the neighbor. An alternative procedure is to assign each value based only on the original values of neighbors - a parallel procedure. That procedure does not give paradoxical answers. (shrink)

This article presents a meta-disciplinary and institutional framework of practices used by nurses and doctors to manage the indeterminacy of knowing in emergency departments (EDs) in Australia. We draw on Schatzkian perspectives of how practices prevail and reflect particular site ontologies. We posit that nurses and doctors draw on a repertoire of practices to finesse their knowing at patients’ bedsides: they practise knowing. Drawing on existing practice knowledges (old learnings) they tailor them in the ED (new workplace learnings). This suggests (...) that learning (practices) in the ED is teleological and emergent. This alerts us to new ways of thinking about attachments to practice knowledges, or ‘the teleological–affective structuring’ of practices (Schatzki, 2006, Organization Studies, 27, 1864), and its implications for organizational learning. (shrink)

The term “emotional practices” is gaining currency in the historical study of emotions. This essay discusses the theoretical and methodological implications of this concept. A definition of emotion informed by practice theory promises to bridge persistent dichotomies with which historians of emotion grapple, such as body and mind, structure and agency, as well as expression and experience. Practice theory emphasizes the importance of habituation and social context and is thus consistent with, and could enrich, psychological models of situated, distributed, and (...) embodied cognition and their approaches to the study of emotion.It is suggested here that practices not only generate emotions, but that emotions themselves can be viewed as a practical engagement with the world. Conceiving of emotions as practices means understanding them as emerging from bodily dispositions conditioned by a social context, which always has cultural and historical specificity. Emotion-as-practice is bound up with and dependent on “emotional practices,” defined here as practices involving the self , language, material artifacts, the environment, and other people. Drawing on Pierre Bourdieu's concept of habitus, the essay emphasizes that the body is not a static, timeless, universal foundation that produces ahistorical emotional arousal, but is itself socially situated, adaptive, trained, plastic, and thus historical. Four kinds of emotional practices that make use of the capacities of a body trained by specific social settings and power relations are sketched out—mobilizing, naming, communicating, and regulating emotion—as are consequences for method in historical research. (shrink)

Biomedical research policy in recent years has often tried to make such research more ‘translational’, aiming to facilitate the transfer of insights from research and development to health care for the benefit of future users. Involving patients in deliberations about and design of biomedical research may increase the quality of R&D and of resulting innovations and thus contribute to translation. However, patient involvement in biomedical research is not an easy feat. This paper discusses the development of a method for involving (...) patients in biomedical research aiming to address its main challenges.After reviewing the potential challenges of patient involvement, we formulate three requirements for any method to meaningfully involve patients in biomedical research. It should enable patients to put forward their experiential knowledge, to develop a rich view of what an envisioned innovation might look like and do, and to connect their experiential knowledge with the envisioned innovation. We then describe how we developed the card-based discussion method ‘Voice of patients’, and discuss to what extent the method, when used in four focus groups, satisfied these requirements. We conclude that the method is quite successful in mobilising patients’ experiential knowledge, in stimulating their imaginaries of the innovation under discussion and to some extent also in connecting these two. More work is needed to translate patients’ considerations into recommendations relevant to researchers’ activities. It also seems wise to broaden the audience for patients’ considerations to other actors working on a specific innovation. (shrink)

The question we raise in this paper is, whether patient involvement might be a beneficial way to help determine and achieve the aims of translational research and, if so, how to proceed. TR is said to ensure a more effective movement of basic scientific findings to relevant and useful clinical applications. In view of the fact that patients are supposed to be the primary beneficiaries of such translation and also have relevant knowledge based on their experience, listening to their voice (...) early on in the innovation process might very well increase the effectiveness of the translation. After explaining how the concept of TR emerged and what it entails, this paper shows through a literature review which arguments have been put forward to promote patient involvement in health care research in a more general sense. We examine whether, and if so how, these arguments are relevant for the discourse on TR and we identify pitfalls and dilemmas. Ultimately, we conclude that it may be worthwhile to experiment with patient involvement in TR but that the design of such involvement requires careful consideration. (shrink)

Embodiment theories have proposed a reciprocal relationship between emotional state and bodily reactions. Besides large body postures, recent studies have found emotions to affect rather subtle bodily expressions, such as slumped or upright sitting posture. This study investigated back muscle activity as an indication of an effect of positive and negative emotions on the sitting position. The electromyography activity of six back muscles was recorded in 31 healthy subjects during exposure to positive and negative affective pictures. A resting period was (...) used as a control condition. Increased muscle activity patterns in the back were found during the exposure to negative emotional stimuli, which was mainly measured in the lumbar and thorax regions. The positive emotion condition caused no elevated activity. The findings show that negative emotions lead to increased differential muscle activity in the back and thus corroborate those of previous research that emotion affects subtle bodily expressions. (shrink)

An important discussion in contemporary ethics concerns the relevance of empirical research for ethics. Specifically, two crucial questions pertain, respectively, to the possibility of inferring normative statements from descriptive statements, and to the danger of a loss of normativity if normative statements should be based on empirical research. Here we take part in the debate and defend integrated empirical ethical research: research in which normative guidelines are established on the basis of empirical research and in which the guidelines are empirically (...) evaluated by focusing on observable consequences. We argue that in our concrete example normative statements are not derived from descriptive statements, but are developed within a process of reflection and dialogue that goes on within a specific praxis. Moreover, we show that the distinction in experience between the desirable and the undesirable precludes relativism. The normative guidelines so developed are both critical and normative: they help in choosing the right action and in evaluating that action. Finally, following Aristotle, we plead for a return to the view that morality and ethics are inherently related to one another, and for an acknowledgment of the fact that moral judgments have their origin in experience which is always related to historical and cultural circumstances. (shrink)