Nurses’ experiences in, and the overall effectiveness of, widely used alternative‐to‐discipline programs to manage nurses’ substance‐use problems have not been adequately scrutinized. We uncovered the conflicted official and experiential ways of knowing one such alternative‐to‐discipline program in a Canadian province. We explicated this conflict through an institutional ethnography analysis. Ethnographic data from interviews with 12 nurses who were enrolled in an alternative‐to‐discipline treatment program and three program administrators, as well as institutional texts, were analyzed to explore how institutional practices and (...) power relations co‐ordinated and managed nurses’ experiences. Analysis revealed the acritical acceptance of a standardized program not based on current norms of practice. Potential and actual conflicts of interest, power imbalances, and prevailing corporate interests were rife. Nurses were not afforded the same rights to quality ethical health care as other citizens. ‘Expert’ physicians’ knowledge was privileged while nurses’ knowledge was subordinated. Conclusions were that regulatory bodies cannot rely on the taken‐for‐granted standardized treatment model in widespread use. Individualized treatment alternatives reflecting current, scientific evidence must be offered to nurses, and nurses’ knowledge, expertise, and experiences need to be included in decision‐making processes in these programs. (shrink)

Volume 24, Issue 12, December 2024, Page 59-62.

We consider the moral and social ingredients in physicians' relationships with patients of diminished capacity by considering certain claims made about friendship and the physician's role. To assess these claims we look at the life context of two patients as elaborated examples provided in two novels: Woman on the Edge of Time (1976) by Marge Piercy, a radical feminist; and It's Hard to Leave While the Music's Playing (1977) by I. S. Cooper, a prominent physician-researcher. At issue is how the (...) doctor-patient relationship should be structured. In question is whether the physician's friendship and professional expertise, together with the diminished capacity of the patient, authorize medical paternalism. From our examination, we find compelling insights against appealing to friendship both in good doctor-patient relationships and in more typical, not-so-good ones. (shrink)

The words in children's language learning environments are strongly predictive of cognitive development and school achievement. But how do we measure language environments and do so at the scale of the many words that children hear day in, day out? The quantity and quality of words in a child's input are typically measured in terms of total amount of talk and the lexical diversity in that talk. There are disagreements in the literature whether amount or diversity is the more critical (...) measure of the input. Here we analyze the properties of a large corpus of speech to children and simulate learning environments that differ in amount of talk per unit time, lexical diversity, and the contexts of talk. The central conclusion is that what researchers need to theoretically understand, measure, and change is not the total amount of words, or the diversity of words, but the function that relates total words to the diversity of words, and how that function changes across different contexts of talk. (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)

Frequency effects are pervasive in studies of language, with higher frequency words being recognized faster than lower frequency words. However, the exact nature of frequency effects has recently been questioned, with some studies finding that contextual information provides a better fit to lexical decision and naming data than word frequency ( Adelman et al., 2006 ). Recent work has cemented the importance of these results by demonstrating that a measure of the semantic diversity of the contexts that a word occurs (...) in provides a powerful measure to account for variability in word recognition latency ( Johns et al., 2012, 2015 ; Jones et al., 2012 ). The goal of the current study is to extend this measure to examine bilingualism and aging, where multiple theories use frequency of occurrence of linguistic constructs as central to accounting for empirical results ( Gollan et al., 2008 ; Ramscar et al., 2014 ). A lexical decision experiment was conducted with four groups of subjects: younger and older monolinguals and bilinguals. Consistent with past results, a semantic diversity variable accounted for the greatest amount of variance in the latency data. In addition, the pattern of fits of semantic diversity across multiple corpora suggests that bilinguals and older adults are more sensitive to semantic diversity information than younger monolinguals. (shrink)

Although mutually advantageous cooperative strategies might be an apt account of some societies, other moral systems might be needed among certain groups and contexts. In particular, in a duty-based moral system, people do not behave morally with an expectation for proportional reward, but rather, as a fulfillment of debt owed to others. In such systems, mutualistic motivations are not necessarily a key component of morality.

OBJECTIVES: To study the resuscitation preferences, choice of decision-maker, views on the seeking of patients' wishes and determinants of these of elderly hospital in-patients. DESIGN: Questionnaire administered on admission and prior to discharge. SETTING: Two acute geriatric medicine units (Southampton and Poole). PARTICIPANTS: Two hundred and fourteen consecutive consenting mentally competent patients admitted to hospital as emergencies. RESULTS: Resuscitation was wanted by 60%, particularly married and functionally independent patients and those who had not already considered it. Not wanted resuscitation was (...) associated with lack of social contacts. Sixty-seven per cent welcomed enquiry about their preferences and 78% wanted participation in decision, 43% as sole decision-maker. Wishing to choose oneself was associated with not wanting resuscitation, prior knowledge of it, and lack of a spouse. Patients' opinions remained stable during their admission. CONCLUSIONS: Discussion of resuscitation is practical on hospital admission without causing distress and the views expressed endure through the period of hospitalisation. Elderly patients' attitudes depend partly on personal health and social circumstances. This may assist doctors when patients are unable to participate themselves. (shrink)

Amid the unrest, dislocation, and uncertainty of seventeenth-century Europe, readers seeking consolation and assurance turned to philosophical and scientific books that offered ways of conquering fears and training the mind—guidance for living a good life. _The Good Life in the Scientific Revolution_ presents a triptych showing how three key early modern scientists, René Descartes, Blaise Pascal, and Gottfried Leibniz, envisioned their new work as useful for cultivating virtue and for pursuing a good life. Their scientific and philosophical innovations stemmed in (...) part from their understanding of mathematics and science as cognitive and spiritual exercises that could create a truer mental and spiritual nobility. In portraying the rich contexts surrounding Descartes’ geometry, Pascal’s arithmetical triangle, and Leibniz’s calculus, Matthew L. Jones argues that this drive for moral therapeutics guided important developments of early modern philosophy and the Scientific Revolution. (shrink)

While the British Empire conventionally is recognized as a source of research subjects and objects in anthropology, and a site where anthropological expertise might inform public administration, the settler-colonial affiliations and experiences of many leading physical anthropologists could also directly shape theories of human variation, both physical and cultural. Antipodean anthropologists like Grafton Elliot Smith were pre-adapted to diffusionist models that explained cultural achievement in terms of the migration, contact and mixing of peoples. Trained in comparative methods, these fractious cosmopolitans (...) also favoured a dynamic human biology, often emphasizing the heterogeneity and environmental plasticity of body form and function, and viewing fixed, static racial typologies and hierarchies sceptically. By following leading representatives of empire anatomy and physical anthropology, such as Elliot Smith and Frederic Wood Jones, around the globe, it is possible to recover the colonial entanglements and biases of interwar British anthropology, moving beyond a simple inventory of imperial sources, and crediting human biology and social anthropology not just as colonial sciences but as the sciences of itinerant colonials. (shrink)

We show that if κ is a weakly compact cardinal, then $\left( \matrix \kappa ^{+} \\ \kappa\endmatrix \right)\rightarrow \left(\left( \matrix \alpha \\ \kappa \endmatrix \right)_{m}\left( \matrix \kappa ^{n} \\ \kappa \endmatrix \right)_{\mu}\right)^{1,1}$ for any ordinals α < κ⁺ and µ < κ, and any finite ordinals m and n. This polarized partition relation represents the statement that for any partition $\kappa \times \kappa ^{+}=\underset i<m\to{\bigcup }K_{i}\cup \underset j<\mu \to{\bigcup }L_{j}$ of κ × κ⁺ into m + µ pieces either there (...) are A ∈ [κ]κ, B ∈ [κ⁺]α, and i < m with A × B ⊆ Ki or there are C ∈ [κ]κ, D ∈ [κ⁺]α, and j < μ with C × D ⊆ Lj. Related results for measurable and almost measurable κ are also investigated. Our proofs of these relations involve the use of elementary substructures of set models of large fragments of ZFC. (shrink)

Higher education institutions are mining and analyzing student data to effect educational, political, and managerial outcomes. Done under the banner of “learning analytics,” this work can—and often does—surface sensitive data and information about, inter alia, a student’s demographics, academic performance, offline and online movements, physical fitness, mental wellbeing, and social network. With these data, institutions and third parties are able to describe student life, predict future behaviors, and intervene to address academic or other barriers to student success (however defined). Learning (...) analytics, consequently, raise serious issues concerning student privacy, autonomy, and the appropriate flow of student data. We argue that issues around privacy lead to valid questions about the degree to which students should trust their institution to use learning analytics data and other artifacts (algorithms, predictive scores) with their interests in mind. We argue that higher education institutions are paradigms of information fiduciaries. As such, colleges and universities have a special responsibility to their students. In this article, we use the information fiduciary concept to analyze cases when learning analytics violate an institution’s responsibility to its students. (shrink)

This article evaluates the effect of different human resource management (HRM) practices on organizations’ environmental performance. We develop a model to evaluate the influence of a broad range of HRM practices, including environmental performance criteria in managers’ performance evaluations and two types of internal corporate social responsibility (CSR) practices: socially responsible employee benefits and corporate volunteering practices. To this end, we analyze a sample of 142 manufacturing companies that have completed B Lab’s Impact Assessment process to certify their environmental performance. (...) The results show that including environmental criteria in a higher proportion of managers’ performance evaluations directly impacts organizations’ environmental performance and strengthens the positive effect of other environmental management practices. The findings also demonstrate the direct effects of both types of CSR practices on an organization’s environmental performance. Our study advances recent work on Green HRM and CSR by identifying the specific HRM practices that allow organizations to move from being part of the world’s environmental problem to being part of the solution. (shrink)

This book contends that the crises of well-being, distress, and dysfunction currently afflicting the legal profession, other professions, and our politics can best be addressed by encouraging people to pursue a flourishing life of meaning and purpose in communities of excellence and virtue. It draws centrally upon the work of Alasdair MacIntyre, arguably the most famous living moral philosopher and notorious for his critique of liberal democracy, its capitalist, large-scale market economy, and hyper-individualism in late Modernity. Constructing a fishing village (...) called Piscopolis as a central image and theoretical ideal, the book integrates relevant aspects of MacIntyre's Thomistic-Aristotelianism into a clear, comprehensible, and original synthesis that also significantly expands and supplements MacIntyre's theoretical approach, including insights drawn from Heideggerian phenomenology. It examines the legal polis, the "fishing village of the law" called Juropolis, to illustrate how the Piscopolis ideal challenges members of the professions and suggests how the ideal might be deployed more broadly to organically transform the liberal democratic state into a "republic of virtue." With the Covid-19 pandemic starkly revealing the need for such transformation, the book will interest both the MacIntyrean expert and novice alike and appeal broadly to moral and political philosophers, ethicists, theologians, legal professionals, and scholarly lay readers. (shrink)

Psychology in its intellectual context -- The work of integration and a Christian view of persons -- Neuroscience, embodiment and mind -- Behavior genetics and responsible personhood -- Positive and applied psychology and sanctification -- Psychology of religion and truth.

This study explores how the intersection of race and emotions, or racialized emotions, influenced Black high school students’ civic reasoning. Drawing from the students’ photo-elicitation and focus group interviews, we found that racialized emotions not only informed how students conceptualized civic engagement during the Civil Rights Movement but also shaped their civic participation and their critiques of legal systems and other democratic processes. These findings highlight the significant role that racialized emotions had on students’ civic reasoning, suggesting that the intersection (...) of race and emotions is not just a peripheral aspect of civic education but rather a central component. We contend that ignoring emotions in civics instruction, standards, and curriculum not only diminishes students’ learning experiences but can also be harmful and inauthentic. To address this issue, we offer strategies for educators on how to center students’ racialized emotions in their civics instruction. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:BOOK REVIEWS Metaphysics as a Guide to Morals. By IRIS MURDOCH. Harmondsworth: Allen Lane; New York: Viking, 1992. $35.00. Dame Iris Murdoch is familiar to most people as a witty and en· gaging novelist whose twenty-four hooks of fiction can he read on a variety of levels. They are wonderful stories, hut the philosophically acute reader will also enjoy Murdoch's judgments, polemics, and inhouse jokes about philosophers and philosophical (...) views. Comparatively few people are aware of Murdoch's previous scholarly studies: Sartre, Romantic Rationalist, The Sovereignty of the Good, The Fire and the Sun; and Acastos. Even so, those familiar with these hooks will recognize the profound impact she has had on debates within moral philosophy. She has been at the forefront of the move· ment that has rehabilitated the central importance of such notions as goodness, the Good, virtue, and the moral life as a journey. So it is not surprising that Murdoch has returned to the genre of philosophical argument to advance her views on the relationship between metaphysics and morals. But it is surprising that her argument exhibits neither the clarity of thought characteristic of the analytic philosophy in which she was trained nor the dramatic narrative of her novels. Indeed the hook reads like a collage of lecture notes, complete with extensive quotations from other people's thoughts with minimal com· mentary. Further, the chapter titles (e.g., " Fact and Value," " Schopenhauer," " Consciousness and Thought-I," " Derrida and Struc· turalism," " Consciousness and Thought-II," "Notes on Will and Duty," " Axioms, Duties, Eros," " Void ") shed little light on the overall structure or argument of the hook. One cannot help hut have the impression that Murdoch spent less time crafting the argument of this hook than she does in crafting the story line and characters of her novels. This is not to say, of course, that there is not much to he learned from Murdoch's perspective. She is remarkably erudite, and her discussion of various themes, figures, and issues often yields fascinating insights. But the whole is considerably less than the sum of its often interesting parts. I have already suggested that this is partly because of the structure and style in which the hook is written. But the hook 687 688 BOOK REVIEWS is also disappointing, and perhaps more determinatively, because of the overall perspective she seeks to deploy and defend. Readers of Murdoch's work have heretofore often wondered about the relationship between her avowed Platonism and her interest in Christianity. Metaphysics as a Guide to Morals has the virtue of clarifying that relationship, hut the result is unpersuasive. At the heart of Murdoch's Platonism is her recasting of the allegory of the cave from The Republic. The moral life is an arduous struggle to ascend from the cave (represented, as in her earlier works, by " the fat, relentless ego ") by a dispossession of the self so that we can apprehend a little less imperfectly the perfect form of the Good. As Murdoch puts it, Plato assumes the internal relation of value, truth, cogmtion. Virtue (as compassion, humility, courage) involves a desire for and achievement of truth instead of falsehood, reality instead of appearance. Goodness involves truth.seeking knowledge and ipso facto a discipline of desire. ' Getting things right ', as in meticulous grammar or mathematics, is truth-seeking as virtue. Learning anything properly demands (virtuous ) attention. Here the idea of truth plays a crucial role (as it does also in Kant) and reality emerges as the object of truthful vision, and virtuous action as the product of such vision. This is a picture of the omnipresence of morality and evaluation in human life (p. 39). Such a depiction ought to resonate quite deeply with Christians, something not lost on Murdoch when she writes a few pages earlier: "There are innumerable points at which we have to detach ourselves, to change our orientation, to redirect our desire and refresh and purify our energy, to keep on looking in the right direction: to attend upon the grace that comes through faith " (p. 25). But Murdoch's "grace" and her "truth-seeking as virtue," among other themes, involve something quite different from what Christians... (shrink)

A multidisciplinary faculty committee designed a curriculum to shape biomedical graduate students into researchers with a high commitment to professionalism and social responsibility and to provide students with tools to navigate complex, rapidly evolving academic and societal environments with a strong ethical commitment. The curriculum used problem-based learning (PBL), because it is active and learner-centred and focuses on skill and process development. Two courses were developed: Scientific Professionalism: Scientific Integrity addressed discipline-specific and broad professional norms and obligations for the ethical (...) practice of science and responsible conduct of research (RCR). Scientific Professionalism: Bioethics and Social Responsibility focused on current ethical and bioethical issues within the scientific profession, and implications of research for society. Each small-group session examined case scenarios that included: (1) learning objectives for professional norms and obligations; (2) key ethical issues and philosophies within each topic area; (3) one or more of the RCR instructional areas; and (4) at least one type of moral reflection. Cases emphasised professional standards, obligations and underlying philosophies for the ethical practice of science, competing interests of stakeholders and oversight of science (internal and external). To our knowledge, this is the first use of a longitudinal, multi-semester PBL course to teach scientific integrity and professionalism. Both faculty and students endorsed the active learning approach for these topics, in contrast to a compliance-based approach that emphasises learning rules and regulations. (shrink)

It is often asserted that even our own past is a foreign country: the ideas of past thinkers are, in some ways, alien to us today. For the European historian of non- European philosophy, not only is the past held to be a different country, but it is also the past ofadifferentcountry. This is both convenient and problematic all at once. The historian of non- European philosophy faces a double separation from his/her subject matter; she is both a foreigner and (...) an alien. In this paper, I approach questions of how this historian should orientate herself towards her subject, and why she should care about it at all. (shrink)

Buchbinder and colleagues (2024) offer a cogent refining of the terminology and concepts of moral distress and moral stress. Their examples of clinicians’ moral distress stemming from the crisis of...

Mounting evidence suggests that endorsement of psychological continuity and the afterlife increases with age. This developmental change raises questions about the cognitive biases, social representations, and cultural input that may support afterlife beliefs. To what extent is there similarity versus diversity across cultures in how people reason about what happens after death? The objective of this study was to compare beliefs about the continuation of biological and psychological functions after death in Tanna, Vanuatu, and the United States. Children, adolescents, and (...) adults were primed with a story that contained either natural or supernatural cues. Participants were then asked whether or not different biological and psychological processes continue to function after death. We predicted that across cultures individuals would be more likely to endorse the continuation of psychological processes over biological processes and that a theistic prime would increase continuation responses regarding both types of process. Results largely supported predictions; U.S. participants provided more continuation responses for psychological than biological processes following both the theistic and non-theistic primes. Participants in Vanuatu, however, provided more continuation responses for biological than psychological processes following the theistic prime. The data provide evidence for both cultural similarity and variability in afterlife beliefs and demonstrate that individuals use both natural and supernatural explanations to interpret the same events. (shrink)