This study examines how news factors in press releases influence journalists’ decisions and the journalistic treatment of press release information after its initial selection for the news agenda: These journalists can transform press releases into a news story, which involves little journalistic capital investment, or use these releases for a unique news production, which requires significant journalistic capital investment. The data elicited from the content analysis show that the more profound the presence of certain news factors in press releases, the (...) higher the chance that journalists will choose to invest their journalistic capital in these press releases. This result means that journalists will only invest journalistic capital in press releases that contain specific news factors. (shrink)

Cardiovascular disease (CVD) and sustained high blood glucose as prediabetes are an established comorbidity. People's experience in reconciling these long‐term conditions requires deeper appreciation if nurses are to more effectively support person‐centred care for people who have them. Our analysis explores the initial experience of people admitted to hospital with CVD who then find they also have sustained high blood glucose. Our methodology is informed by the philosophy of Gadamer and applies interpretive description to develop an interpretation of participant experiences. (...) The major theme emerging from participant interviews was the ‘invisible disequilibrium’ characterised by three subthemes: ‘losing equilibrium’, ‘becoming embattled’ and ‘evolving illness’. This study examines CVD and prediabetes in conjunction with the Gadamerian notion of the ‘whole’, as being in a social and emotional world in which illness is also a component part. We explore how participants lived within an ‘invisible disequilibrium’, with prediabetes frequently remaining unnoticed, while CVD was manifest. To identify multiple conditions and support effective intervention to manage them as part of person‐centric care, nursing practice should explore the ‘whole’ of the person's experience, value people’s knowledge as potential indicators of complex illness, thereby reducing the risk of accelerating complex illness. (shrink)

At the end of Lecture 3 of The Empirical Stance, Bas van Fraassen suggests that we see the change of view involved in scientific revolutions as being, at least in part, emotional. In this paper, I explore one plausible way of cashing out this suggestion. Someone’s emotional approval of a description of the world, I argue, thereby shows that she takes herself to have reason to take that description seriously. This is true even if she is convinced—as a scientific community (...) is when it considers alternative theories—that this description is false, that it is not the way the world is. (shrink)

This article presents an ethics support instrument for healthcare professionals called CURA. It is designed with a focus on and together with nurses and nurse assistants in palliative care. First, we shortly go into the background and the development study of the instrument. Next, we describe the four steps CURA prescribes for ethical reflection: (1) Concentrate, (2) Unrush, (3) Reflect, and (4) Act. In order to demonstrate how CURA can structure a moral reflection among caregivers, we discuss how a case (...) was discussed with CURA at a psychogeriatric ward of an elderly care home. Furthermore, we go into some considerations regarding the use of the instrument in clinical practice. Finally, we focus on the need for further research on the effectiveness and implementation of CURA. (shrink)

We argue that a modified version of Mill’s method of agreement can strongly confirm causal generalizations. This mode of causal inference implicates the explanatory virtues of mechanism, analogy, consilience, and simplicity, and we identify it as a species of Inference to the Best Explanation (IBE). Since rational causal inference provides normative guidance, IBE is not a heuristic for Bayesian rationality. We give it an objective Bayesian formalization, one that has no need of principles of indifference and yields responses to the (...) Voltaire objection, van Fraassen’s Bad Lot objection, and John Norton’s recent objection to IBE. (shrink)

The traditional emphasis on the physics of the very small is questioned, and the suggestion made that a crucial test of contributions to the philosophy of science ought to be their applicability to areas which are more representative of the scientific enterprise. Life science is cited as just such an area. It is quantum physics, rather than biology, which nurtures anti-realism. The most respected anti-realism today is that provided by Bas C van Fraassen; and the persuasiveness of his "Constructive Empiricism" (...) is attested to by the failure of avowed realists, such as Ian Hacking, to distance themselves very far from van Fraassen's ideas. A detailed critique of van Fraassen is presented with particular attention paid to his ideas on scientific explanation - the question of whether good explanations are true explanations being one which tends to divide realist and anti-realist. The conclusion is reached that, while realism raises - and fails to answer - a number of philosophical questions, the anti-realism provided by Bas van Fraassen is no better at answering those questions. Moreover, it is argued, van Fraassen's ideas lack plausibility as a description of science and the attitudes of scientists - particularly when attention is shifted from physics to biology. Finally, a number of suggestions are made as to how the philosophical questions posed by realism might be answered in the future. (shrink)

The failure to recognize a correlation as spurious can lead people to adopt strategies to bring about a specific outcome that manipulate something other than a cause of the outcome. However, in a 2008 paper appearing in the journal Analysis, Bert Leuridan, Erik Weber and Maarten Van Dyck suggest that knowledge of spurious correlations can, at least sometimes, justify adopting a strategy aiming at bringing about some change. This claim is surprising and, if true, throws into question the claim of (...) Nancy Cartwright and others that knowledge of laws of association is insufficient for distinguishing effective and ineffective strategies. This paper examines the nature of spurious correlations and their value in crafting strategies for change. The conclusion of the paper is that while knowledge of a spurious correlation may have practical value, the value depends on either having knowledge of the causal structure underlying the correlation or it depends on the use of ‘causal criteria’. (shrink)

This article gives an overview of the moral problems experienced and described by nurses working in a dialysis unit in the Netherlands. The nurses raised a wide variety of issues that they considered were moral problems, which were grouped into seven topics. A selection of cases are described, one of which is analysed using the Nijmegen method of ethical case deliberation. This method facilitates practical approaches to the different types of moral problems encountered. The argument is made that, owing to (...) their specific moral position and responsibility, nurses' contribution to ethical reflection in ward discussions should be valued more. All caregivers involved are indispensable in developing a basis for well-reasoned decisions when deliberating about moral problems. (shrink)

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)

This article is part of the Dossier on Tacitus published in last year's issue of Grotiana. It offers a combined study of both the content and the language and style of Grotius' account of the capture of Breda in the second book of the Historiae, published in 1657 together with the Annales under the title Annales et Historiae de rebus Belgicis. A thorough analysis of Grotius' account of this eventful and dramatic turning point in the Dutch revolt reveals that (...) it is nothing but a defective and occasionally unclear rehearsel of the standard narrative of the capture based on the well-known and in Grotius' day widely read history-books written in French and Dutch. The rather artificial imitation of Tacitus's brevitas on the stylistic level does not suffice to qualify Grotius's account as a masterful piece of Tacitean writing, because it does not highlight the motives of the chief characters in the story nor the connection between the events and their effects, and because Grotius fails to present his own perspective on this important episode in the war against Spain. (shrink)

Twenty-seven health care providers from three nursing homes were interviewed about the autonomy of stroke patients in rehabilitation wards. Data were analysed using the grounded theory method for concept development recommended by Strauss and Corbin. The core category ‘changing autonomy’ was developed, which identifies the process of stroke patients regaining their autonomy (dimensions: self-determination, independence and self-care), and the factors affecting this process (conditions (i.e. circumstances) and strategies of patients; strategies of care providers and families; and the nursing home). Teamwork (...) on increasing patient autonomy is recommended, which can be stimulated by multidisciplinary guidelines and education, and by co-ordination of the process of changing autonomy. (shrink)

This article presents standards for setting up and educating institutional ethics committees (IECs). These standards are based on experiences in the Netherlands, where IECs have been established in a large number of health care institutions. Though the IEC has become a generally accepted institution within Dutch health care, there are concerns over its effectiveness regarding the improving of the moral quality of clinical decision making. Health care practitioners and members of IECs too, experience a gap between the IEC and the (...) reality of the clinical environment. At this moment, there is interest in developing programmes which educate practitioners in moral issues and how to deal with them, using the method of a structured debate on the ward. The IEC will not be made obsolete by this development, but can play a guiding role in the implementation of such programmes. Current concerns are the lack of patient representation in the Dutch IEC, and the loss of contact with the local community of health care practitioners because of the merger of hospitals into bodies similar to UK National Health Service (NHS) trusts. (shrink)

Objectives: The official implementation of clinical pharmacy in Vietnam has arrived relatively late, resulting in various stressors. This study aims to evaluate job stress level and suggest viable solutions.Methods: A cross-sectional study was conducted on clinical pharmacists in 128 hospitals in Ho Chi Minh City. Job stress questions were derived from the Healthcare Profession Stress Inventory.Results: A total of 197 CPs participated, giving a response rate of 82.4%. Participants were found to have moderate job stress with an overall mean stress (...) score of 1.5 and stress rate of 52.8%. The sample size was statistically adequate and the HPSI was valid and reliable. Patient care responsibility was the main stressor, especially in public hospitals, followed by job conflicts. Lack of experience, low income, and inability to participate in clinical ward rounds caused significant stress to CPs regarding job recognition and job uncertainty. More practice-oriented training programs in bachelor curricula and clinical practice should be applied to help CPs gain more experience, self-confidence, and diminish job stress.Conclusion: CPs in HCMC have moderate stress. More practice-oriented training programs should be prioritized to lessen stress for CPs. (shrink)