Background As more people are living longer, they become frail and are affected by multi-morbidity, resulting in increased demands from the ambulance service. Being vulnerable, older patients may have reduced decision-making capacity, despite still wanting to be involved in decision-making about their care. Their needs may be complex and difficult to assess, and do not always correspond with ambulance assessment protocols. When needing an ambulance, older patients encounter ambulance clinicians who are under high workloads and primarily consider themselves as emergency (...) medical care providers. This situates them in the struggle between differing expectations, and ethical conflicts may arise. To resolve these, providing ethical care, focussing on interpersonal relationships and using ethical competence is needed. However, it is not known whether ambulance clinicians possess the ethical competence required to provide ethical care. Thus, the aim of this study was to deductively explore their ethical competence when caring for older patients with reduced decision-making ability. Methods A qualitative deductive and exploratory design was used to analyse dyadic interviews with ambulance clinicians. A literature review, defining ethical competence as comprising ethical sensitivity, ethical knowledge, ethical reflection, ethical decision-making, ethical action and ethical behaviour, was used as a structured categorization matrix for the analysis. Results Ambulance clinicians possess ethical competence in terms of their ethical knowledge, highlighting the need for establishing an interpersonal relationship with the older patients. To establish this, they use ethical sensitivity to interpret the patients’ needs. Doing this, they are aware of their ethical behaviour, signifying how they must act respectfully and provide the necessary time for listening and interacting. Conclusions Ambulance clinicians fail to see their gut feeling as a professional ethical competence, which might hinder them from reacting to unethical ways of working. Further, they lack ethical reflection regarding the benefits and disadvantages of paternalism, which reduces their ability to perform ethical decision-making. Moreover, their ethical knowledge is hampered by an ageist approach to older patients, which also has consequences for their ethical action. Finally, ambulance clinicians show deficiencies regarding their ethical reflections, as they reflect merely on their own actions, rather than on their values. (shrink)

Background Advances in artificial intelligence, robotics and wearable computing are creating novel technological opportunities for mitigating the global burden of population ageing and improving the quality of care for older adults with dementia and/or age-related disability. Intelligent assistive technology is the umbrella term defining this ever-evolving spectrum of intelligent applications for the older and disabled population. However, the implementation of IATs has been observed to be sub-optimal due to a number of barriers in the translation of novel applications from the (...) designing labs to the bedside. Furthermore, since these technologies are designed to be used by vulnerable individuals with age- and multi-morbidity-related frailty and cognitive disability, they are perceived to raise important ethical challenges, especially when they involve machine intelligence, collect sensitive data or operate in close proximity to the human body. Thus, the goal of this paper is to explore and assess the ethical issues that professional stakeholders perceive in the development and use of IATs in elderly and dementia care. Methods We conducted a multi-site study involving semi-structured qualitative interviews with researchers and health professionals. We analyzed the interview data using a descriptive thematic analysis to inductively explore relevant ethical challenges. Results Our findings indicate that professional stakeholders find issues of patient autonomy and informed consent, quality of data management, distributive justice and human contact as ethical priorities. Divergences emerged in relation to how these ethical issues are interpreted, how conflicts between different ethical principles are resolved and what solutions should be implemented to overcome current challenges. Conclusions Our findings indicate a general agreement among professional stakeholders on the ethical promises and challenges raised by the use of IATs among older and disabled users. Yet, notable divergences persist regarding how these ethical challenges can be overcome and what strategies should be implemented for the safe and effective implementation of IATs. These findings provide technology developers with useful information about unmet ethical needs. Study results may guide policy makers with firsthand information from relevant stakeholders about possible solutions for ethically-aligned technology governance. (shrink)

Imagination and idealism are particularly important creative epistemic virtues for the medical sciences if we hope to improve the health of the world’s ageing population. To date, imagination and idealism within the medical sciences have been dominated by a paradigm of disease control, a paradigm which has realised significant, but also limited, success. Disease control proved particularly successful in mitigating the early-life mortality risks from infectious diseases, but it has proved less successful when applied to the chronic diseases of late (...) life (like cancer). The time is ripe for the emergence and prominence of a supplementary medical research paradigm, the paradigm of ‘healthy ageing’ which prioritises the goal of rate (of ageing) control rather than disease control. This is the difference between extending the human healthspan versus extending survival by managing (or trying to eliminate) the multi-morbidities, frailty and disability currently prevalent in late life. The idealism of the disease control paradigm is myopic because it ignores the health constraints imposed by the inborn ageing process itself, a biological reality which is already inflicting significant economic and disease burdens on the world’s ageing populations. Unless the medical sciences retard the rate of biological ageing, these problems will continue to be amplified as larger numbers of persons survive into late life. (shrink)

The ever-increasing prevalence of chronic conditions over the last half century has gradually altered the demographic of patients admitted to acute care settings; environments traditionally associated with episodic care rather than chronic and complex healthcare. In consequence, the lifeworld of the hospital medical doctor often entails healthcare for a complex, multi-morbid, patient cohort. This paper examines the experience of providing complex healthcare in the pressurised and fast-paced acute care setting. Four medical doctors from two metropolitan health services were interviewed and (...) their data were analysed using a combinatorial framework of phenomenology and complexity theory. The horizon of complex care revealed itself as dynamic, expansive, immersive, and relational, entailing a specialised kind of practice that is now common in acute care settings. Yet this practice has made inroads largely without heralding the unique nature and potential of its ground. Herein lies opportunity for complex care clinicians to expand notions of health and illness, and to shape research, practice, and system design, for a future in which care for health complexity is optimised, irrespective of care settings. (shrink)

The last decade has seen a surge of interest and investment in green social prescribing, however, both healthcare and social enterprise has been impacted by the COVID-19 crisis, along with restricted access to public green spaces. This study examines the challenges and opportunities of delivering green social prescribing during and in the aftermath of COVID-19, in the light of goals of green social prescribing to improve mental health outcomes and reduce health inequalities. Thirty-five one-to-one interviews were conducted between March 2020 (...) and January 2022. Interviewees included Link Workers and other social prescribers, general practitioners, managers, researchers, and volunteers working in urban and rural Scotland and North East England. Interview transcripts were analyzed in stages, with an inductive approach to coding supported by NVivo. Findings revealed a complex social prescribing landscape, with schemes funded, structured, and delivered diversely. Stakeholders were in general agreement about the benefits of nature-based interventions, and GPs and volunteers pointed out numerous benefits to participating in schemes such as parkrun. Link Workers were more circumspect about suggesting outdoor activities, pointing out both psychological and practical obstacles, including health anxieties, mobility issues, and transport deficits. Exacerbated by the pandemic, there was a way to go before older and/multi-morbidity clients would feel comfortable and safe to socialize in open air spaces. Our findings support the premise that time spent in open green spaces can alleviate some of the negative mental health effects compounded by the pandemic. However, the creation of healthy environments is complex with population health intrinsically related to socioeconomic conditions. Social disadvantage, chronic ill health and health crises all limit easy access to green and blue spaces, while those in the most socially economically deprived areas receive the lowest quality of healthcare. Such health inequities need to be borne in mind in the planning of schemes and claims around the potential of future nature-based interventions to reduce health inequalities. (shrink)

Medicine is facing wide-ranging challenges concerning the so-called medically unexplained disorders. The epidemiology is confusing, different medical specialties claim ownership of their unexplained territory and the unexplained conditions are themselves promoted through a highly complicated and sophisticated use of language. Confronting the outcome, i.e. numerous medical acronyms, we reflect upon principles of systematizing, contextual and social considerations and ways of thinking about these phenomena. Finally we address what we consider to be crucial dimensions concerning the landscape of unexplained “matters”; fatigued (...) being, pain-full being and dys-ordered being, all expressive momentums of an aesthetic of resistance. (shrink)

BackgroundSome people with progressive neurological diseases find they need additional support with eating and drinking at mealtimes, and may require artificial nutrition and hydration. Decisions concerning artificial nutrition and hydration at the end of life are ethically complex, particularly if the individual lacks decision-making capacity. Decisions may concern issues of life and death: weighing the potential for increasing morbidity and prolonging suffering, with potentially shortening life. When individuals lack decision-making capacity, the standard processes of obtaining informed consent for medical interventions (...) are disrupted. Increasingly multi-professional groups are being utilised to make difficult ethical decisions within healthcare. This paper reports upon a service evaluation which examined decision-making within a UK hospital Feeding Issues Multi-Professional Team.MethodsA three month observation of a hospital-based multi-professional team concerning feeding issues, and a one year examination of their records. The key research questions are: a) How are decisions made concerning artificial nutrition for individuals at risk of lacking decision-making capacity? b) What are the key decision-making factors that are balanced? c) Who is involved in the decision-making process?ResultsDecision-making was not a singular decision, but rather involved many different steps. Discussions involving relatives and other clinicians, often took place outside of meetings. Topics of discussion varied but the outcome relied upon balancing the information along four interdependent axes: Risks, burdens and benefits; Treatment goals; Normative ethical values; Interested parties.ConclusionsDecision-making was a dynamic ongoing process with many people involved. The multiple points of decision-making, and the number of people involved with the decision-making process, mean the question of ‘who decides’ cannot be fully answered. There is a potential for anonymity of multiple decision-makers to arise. Decisions in real world clinical practice may not fit precisely into a model of decision-making. The findings from this service evaluation illustrate that within multi-professional team decision-making; decisions may contain elements of both substituted and supported decision-making, and may be better represented as existing upon a continuum. (shrink)

BackgroundThe COVID-19 pandemic has changed the healthcare landscape drastically. Stricken by sharp surges in morbidity and mortality with resource and manpower shortages confounding their efforts, the medical community has witnessed high rates of burnout and post-traumatic stress amongst themselves. Whilst the prevailing literature has offered glimpses into their professional war, no review thus far has collated the deeply personal reflections of physicians and ascertained how their self-concept, self-esteem and perceived self-worth has altered during this crisis. Without adequate intervention, this may (...) have profound effects on their mental and physical health, personal relationships and professional efficacy.MethodsWith mentions of the coronavirus pervading social media by the millions, this paper set out to collate and thematically analyse social media posts containing first-person physician reflections on how COVID-19 affected their lives and their coping mechanisms. A consistent search strategy was employed and a PRISMA flowchart was used to map out the inclusion/exclusion criteria.ResultsA total of 590 social media posts were screened, 511 evaluated, and 108 included for analysis. Salient themes identified include Disruptions to Personal Psycho-Emotional State, Disruptions to Professional Care Delivery, Concern for Family, Response from Institution, Response from Society and Coping Mechanisms.ConclusionIt is evident that the distress experienced by physicians during this time has been manifold, multi-faceted and dominantly negative. Self-concepts were distorted with weakened self-esteem and perceived self-worth observed. The Ring Theory of Personhood (RToP) was adopted to explain COVID-19’s impact on physician personhood as it considers existential, individual, relational and social concepts of the self. These entwined self-concepts serve as ‘compensatory’ to one another, with coping mechanisms buffering and fortifying the physician’s overall personhood. With healthcare institutions playing a vital role in providing timely and targeted support, it was further proposed that a comprehensive assessment tool based on the RToP could be developed to detect at-risk physicians and evaluate the presence and effectiveness of established support structures. (shrink)

The detection and spread of pandemic 2009 H1N1 influenza in the United States led to a complex and multi-faceted response by the public health system that lasted more than a year. When the first domestic case of the virus was detected in California on April 15, 2009, and a second, unrelated case was identified more than 130 miles away in the same state on April 17, 2009, the unique combination of influenza virus genes in addition to its emergence and rapid (...) spread at the end of the typical Northern Hemisphere influenza season suggested the potential for a high morbidity, high mortality event. In response, federal, state, and local public health officials conducted epidemiologic investigations with federal and state laboratory support to help to determine the scope of the H1N1 pandemic. On April 26, the Secretary of the U.S. Department of Health and Human Services declared a public health emergency that was renewed through June 23, 2010. The pandemic that ensued tested virtually every aspect of U.S. public health preparedness and response systems, from laboratory capabilities and capacities to social distancing plans. (shrink)

The detection and spread of pandemic 2009 H1N1 influenza in the United States led to a complex and multi-faceted response by the public health system that lasted more than a year. When the first domestic case of the virus was detected in California on April 15, 2009, and a second, unrelated case was identified more than 130 miles away in the same state on April 17, 2009, the unique combination of influenza virus genes in addition to its emergence and rapid (...) spread at the end of the typical Northern Hemisphere influenza season suggested the potential for a high morbidity, high mortality event. In response, federal, state, and local public health officials conducted epidemiologic investigations with federal and state laboratory support to help to determine the scope of the H1N1 pandemic. On April 26, the Secretary of the U.S. Department of Health and Human Services declared a public health emergency that was renewed through June 23, 2010. The pandemic that ensued tested virtually every aspect of U.S. public health preparedness and response systems, from laboratory capabilities and capacities to social distancing plans. (shrink)

Previous research suggests that individuals diagnosed with morbid jealousy have jealousy mechanisms that are activated at lower thresholds than individuals with normal jealousy, but that these mechanisms produce behavior that is similar to individuals with normal jealousy. We extended previous research documenting these similarities by investigating sex differences in partner-directed violence committed by individuals diagnosed with morbid jealousy. The results support some of our predictions. For example, a greater percentage of men than women diagnosed with morbid jealousy used physical violence, (...) attempted to kill, and actually killed their partners, and used their hands rather than an object to kill their partners. These results replicate results generated for individuals with normal jealousy. Discussion addresses implications of the current research and highlights directions for future research on the psychology of morbid jealousy. (shrink)

We suggest that morbid jealousy falls on the extreme end of a jealousy continuum. Thus, many features associated with normal jealousy will be present in individuals diagnosed with morbid jealousy. We apply Boyer & Lienard's (B&L's) prediction one (P1; target article, sect. 7.1) to morbid jealousy, suggesting that fitness-related life-cycle dimensions predict sensitivity to cues, and frequency, intensity, and content of intrusive thoughts of partner infidelity. (Published Online February 8 2007).

ABSTRACT:Although the literature on multi-stakeholder initiatives for sustainability has grown in recent years, it is scattered across several academic fields, making it hard to ascertain how individual disciplines, such as business ethics, can further contribute to the debate. Based on an extensive review of the literature on certification and principle-based MSIs for sustainability, we show that the scholarly debate rests on three broad themes : theinputinto creating and governing MSIs; theinstitutionalizationof MSIs; and theimpactthat relevant initiatives create. While our discussion reveals (...) the theoretical underpinnings of the 3Is, it also shows that a number of research challenges related to business ethics remain unaddressed. We unpack these challenges and suggest how scholars can utilize theoretical insights in business ethics to push the boundaries of the field. Finally, we also discuss what business ethics research can gain from theory development in the MSI field. (shrink)

The possibility of multi-location—of one entity having more than one exact location—is required by several metaphysical theories such as the immanentist theory of universals and three-dimensionalism about persistence. One of the most pressing challenges for multi-location theorists is that of making sense of exact location—in that extant definitions of exact location entail a principle called ‘functionality’, according to which nothing can have more than one exact location. Recently in a number of promising papers, Antony Eagle has proposed and defended a (...) definition of exact location in terms of weak location that does not entail functionality. This paper provides the first thorough assessment of Eagle’s proposal. In particular, we argue that it cannot account for the location of immanent universals, the multi-location of mereologically changing three-dimensional objects, the multi-location of mereologically complex objects, and that it makes extended simples impossible. (shrink)

KNUTSEN IR, TERRAGNI L and FOSS C. Nursing Inquiry 2011; 18: 348–358 Morbidly obese patients and lifestyle change: constructing ethical selvesIn contemporary societies, bodily size is an important part of individuals’ self‐representation. As the number of persons clinically diagnosed as morbidly obese increases, programmes are developed to make people reduce weight by changing their lifestyle, and for some, by bariatric surgery. This article presents findings from interviews with 12 participants undergoing a prerequisite course prior to bariatric surgery that is intended (...) both as a preparation for further (surgical) treatment and as a tool to empower individuals regarding lifestyle changes. In this study, we investigate how power operates by looking at how the participants position themselves throughout the course. Findings reveal how participants construct their ability to act in line with norms of lifestyle change. They do this by positioning themselves as both included group members and as ‘morally’ acceptable individuals. Despite some resistance, the participants tend to glide into the role of ‘good patients’ acting in compliance with the aims of the course in their hope and striving for new positions as ‘normal‐sized’. The intention in the course is to empower individuals towards lifestyle changes. The findings provide a basis to question whether these kinds of courses create new forms of compliance and dependency. (shrink)

The “Morbid Fear of the Subjective” (copyright by Roy Wood Sellars) represents a key-element of the American naturalist debate of the Mid-twentieth century. On the one hand, we are witnessing to the unconditional trust in the objectivity of scientific discourse, while on the other (and as a consequence) there is the attempt to exorcise the myth of the “subjective” and of its metaphysical privateness. This theoretical roadmap quickly assumed the shape of an even sociological contrast between the “democraticity” of natural (...) sciences and the fanaticism implicit in supernatural metaphysical systems. In between these two extremes stood phenomenology, in its early days on American soil. Its notion of “evidence”, which is less easily to naturalize than it might seem, was in fact hardly consistent with the widespread concept of “natural experience” of the world. (shrink)

ABSTRACT:Global multi-stakeholder initiatives are important instruments that have the potential to improve the social and environmental sustainability of global supply chains. However, they often fail to comprehensively address the needs and interests of various supply-chain participants. While voluntary in nature, MSIs have most often been implemented through coercive approaches, resulting in friction among their participants and in systemic problems with decoupling. Additionally, in those cases in which deliberation was constrained between and amongst participants, collaborative approaches have often failed to materialize. (...) Our framework focuses on two key aspects of these breakdowns: assumptions about the orientation of MSI participants, and the deliberation processes that participants use to engage with each other to create these initiatives and sustain them over time. Drawing from stakeholder and deliberation theories, we revisit the concept of MSIs and show how their deliberative capacity may be enhanced in order to encourage participants to collaborate voluntarily. (shrink)

This study is based on the 1983 Rural Health Survey of Ethiopia. Patterns and levels of child morbidity by age, sex, geographic region, and sanitary facilities are examined. Morbidity levels peak in the second year of life. Diarrhoeal diseases are of major importance, especially among infants and toddlers. Parasitic diseases, and respiratory diseases other than pneumonia, become increasingly important with age.There are no significant sex differentials in morbidity except for higher rates of diarrhoeal diseases among female children. Geographic differentials are (...) quite marked with particularly high morbidity levels from all disease types in the western mountainous regions of Ethiopia. Access to high quality drinking water, a latrine, and garbage disposal, are strongly related to reduced overall morbidity levels, though not necessarily to reduced diarrhoeal disease levels. (shrink)

Responsible research practices are critical to maintaining integrity in research and the provision of institutional trainings is an important means of promoting research integrity. However, studies show contrasting results on the efficacy of institutional training and that these approaches may not be fully effective in promoting research integrity among individuals and improving the overall climate in research integrity. Therefore, a more comprehensive multi-dimensional learning strategy seems to be needed. This includes continuous and tailored training at different institutional levels, the incorporation (...) of training sessions focusing on the development of the moral character of researchers, and the use of different mentoring practices. With this comprehensive approach, research institutions can foster a culture of integrity in research, improve the overall research integrity climate and promote responsible research practices by individuals. (shrink)

In this study conducted during the 2020 Coronavirus pandemic, I explored how trait morbid curiosity was related to interest in 1) factual information about Coronavirus that was specifically morbid; 2) general factual information about Coronavirus; 3) pandemic and virus genres of films and TV shows; and 4) genres of film and TV shows that center around threat more broadly. Participants who scored high in morbid curiosity reported increased interest, compared to usual, in pandemic/virus genres as well as horror and thriller (...) genres. Morbidly curious participants were also more interested specifically in morbid information about Coronavirus. Furthermore, disgust sensitivity was unrelated to these preferences. These results provide initial evidence that trait morbid curiosity can predict particular media preferences in the face of a real threat, and that morbid curiosity may reflect an adaptive predisposition in some individuals toward learning about the dan­gerous and disgusting aspects of a threat. (shrink)

Older adults were considered a vulnerable group for the COVID-19 infection and its consequences, including problems with sleep.AimTo evaluate the prevalence of sleep disorders in older adults, to describe their sleep patterns, as well as to analyse if there were any changes in comparison with the period pre-pandemic.Materials and MethodsOnline survey used for data collection received answers from 914 elderly age range 65–90 years, from April to August 2020. Results: 71% of the sample reported a pre-existent sleep disorder, and some (...) of them worsened during the pandemic, especially Insomnia in women and Obstructive Sleep Apnea in men. No difference in sleep duration before and during the pandemic was found, although there was a worsening of some aspects related to sleep, such as sleep quality, sleep efficiency, awakening quality, sleep latency and nocturnal awakenings, especially in the female gender. Educational level influenced sleep latency, indicating higher sleep latency among those with primary education when compared with the ones with Ph.D.ConclusionThe pandemic had influenced sleep patterns among the elderly, as well as worsening of pre-existent sleep disorders. Female gender and low educational level were considered risk factors for sleep alterations, and high educational level, on its turn, appeared to be a protective factor. (shrink)

First Published in 1999. Routledge is an imprint of Taylor & Francis, an informa company.

Multi-modal integration, which combines multiple neurophysiological signals, is gaining more attention for its potential to supplement single modality’s drawbacks and yield reliable results by extracting complementary features. In particular, integration of electroencephalography and functional near-infrared spectroscopy is cost-effective and portable, and therefore is a fascinating approach to brain-computer interface. However, outcomes from the integration of these two modalities have yielded only modest improvement in BCI performance because of the lack of approaches to integrate the two different features. In addition, mismatch (...) of recording locations may hinder further improvement. In this literature review, we surveyed studies of the integration of EEG/fNIRS in BCI thoroughly and discussed its current limitations. We also suggested future directions for efficient and successful multi-modal integration of EEG/fNIRS in BCI systems. (shrink)

Attempts to understand farmer conservation behavior based on quantitative socio-demographic, attitude, and awareness variables have been largely inconclusive. In order to understand fully how farmers are making conservation decisions, 32 in-depth interviews were conducted in the Eagle Creek watershed in central Indiana. Coding for environmental attitudes and practice adoption revealed several dominant themes, representing multi-dimensional aspects of environmental attitudes. Farmers who were motivated by off-farm environmental benefits and those who identified responsibilities to others (stewardship) were most likely to adopt conservation (...) practices. Those farmers who focused on the farm as business and were most concerned about profitability were less likely to adopt practices. The notion of environmental stewardship in particular was found to be much more complex than the way it is traditionally measured in quantitative studies. The interplay between on-farm and off-farm benefits to practice adoption is an issue that quantitative studies largely do not address. This study seeks to increase understanding of farmers’ environmental attitudes and the connections to conservation behavior. (shrink)

Mohandas Karamchand “Mahatma” Gandhi discussed corporate responsibility and business ethics over several decades of the twentieth century. His views are still influential in modern India. In this paper, we highlight Gandhi’s cross-level CR framework, which operates at institutional, organizational, and individual levels. We also outline how the Tata Group, one of India’s largest conglomerates, has historically applied and continues to utilize Gandhi’s concept of trusteeship. We then compare Gandhi’s framework to modern notions of stakeholder and stewardship management. We conclude that (...) trusteeship has strong potential to help firms and their stakeholders achieve shared value by considering the interactions between individual, organizational, and institutional factors, and paying attention to a range of multi-level stakeholder obligations. (shrink)

Where does agency lie in musical performance? How is it expressed? Recent music scholarship has highlighted an increasingly prominent tendency to conceive of agency as not confined to any one individual or type of individual, instead being distributed across diverse individuals that can be found occupying performance situations. . This article uses two ‘percussion’ works from the 1970s by the composer John Cage, Child of Tree (1975) and its multi-performer elaboration Branches (1976), as a foil for engaging with these practical (...) and theoretical musical concerns, and for suggesting some heretofore underappreciated distinctions within the ongoing work on multi-agential performance. (shrink)

The following topics are discussed, from psychoanalytic, philosophical, and empirical perspectives: -/- *Sociopathy *Pedantry *The nature of bureaucrats *The nature of bureaucratic institutions *Rationalization and Repression *The relationship between ignorance and mental health *The relationship sapience and mental illness *The relationship between ignorance and the ability to act *The relationship between hyper-sapience and the inability to act. *The psychological underpinnings of addiction; and finally *The differences between men and women.

Do multi-level selection explanations of the evolution of social traits deepen the understanding provided by single-level explanations? Central to the former is a mathematical theorem, the multi-level Price decomposition. I build a framework through which to understand the explanatory role of such non-empirical decompositions in scientific practice. Applying this general framework to the present case places two tasks on the agenda. The first task is to distinguish the various ways of suppressing within-collective variation in fitness, and moreover to evaluate their (...) biological interest. I distinguish four such ways: increasing retaliatory capacity, homogenising assortment, and collapsing either fitness structure or character distribution to a mean value. The second task is to discover whether the third term of the Price decomposition measures the effect of any of these hypothetical interventions. On this basis I argue that the multi-level Price decomposition has explanatory value primarily when the sharing-out of collective resources is `subtractable'. Thus its value is more circumscribed than its champions Sober and Wilson (1998) suppose. (shrink)

In the recent literature, it has been shown that the wave function in the de Broglie–Bohm theory can be regarded as a new kind of field, i.e., a "multi-field", in three-dimensional space. In this paper, I argue that the natural framework for the multi-field is the original second-order Bohm’s theory. In this context, it is possible: i) to construe the multi-field as a real-valued scalar field; ii) to explain the physical interaction between the multi-field and the Bohmian particles; and iii) (...) to clarify the status of the energy-momentum conservation and the dynamics of the theory. (shrink)

It is a familiar point that many ordinary dispositions are multi-track, that is, not fully and adequately characterisable by a single conditional. In this paper, I argue that both the extent and the implications of this point have been severely underestimated. First, I provide new arguments to show that every disposition whose stimulus condition is a determinable quantity must be infinitely multi-track. Secondly, I argue that this result should incline us to move away from the standard assumption that dispositions are (...) in some way importantly linked to conditionals, as presupposed by the debate about various versions of the ‘conditional analysis’ of dispositions. I introduce an alternative conception of dispositionality, which is motivated by linguistic observations about dispositional adjectives and links dispositions to possibility instead of conditionals. I argue that, because of the multi-track nature of dispositions, the possibility-based conception of dispositions is to be preferred. (shrink)

Humans communicate with different modalities. We offer an account of multi-modal meaning coordination, taking speech-gesture meaning coordination as a prototypical case. We argue that temporal synchrony (plus prosody) does not determine how to coordinate speech meaning and gesture meaning. Challenging cases are asynchrony and broadcasting cases, which are illustrated with empirical data. We propose that a process algebra account satisfies the desiderata. It models gesture and speech as independent but concurrent processes that can communicate flexibly with each other and exchange (...) the same information more than once. The account utilizes the ψ-calculus, allowing for agents, input-output-channels, concurrent processes, and data transport of typed λ-terms. A multi-modal meaning is produced integrating speech meaning and gesture meaning into one semantic package. Two cases of meaning coordination are handled in some detail: the asynchrony between gesture and speech, and the broadcasting of gesture meaning across several dialogue contributions. This account can be generalized to other cases of multi-modal meaning. (shrink)

In this introductory article to the special issue on Multi-level semiosis we attempt to stage the background for qualifying the notion of “multi-levelness” when considering communication processes and semiosis in all life forms, i.e. from the cellular to the organismic level. While structures are organized hierarchically, communication processes require a kind of processual organization that may be better described as being heterarchical. Theoretically, the challenge arises in the temporal domain, that is, in the developmental and evolutionary dimension of dynamic semiotic (...) processes. We discuss the importance of this fundamental difference in order to explain how levels, domains and orders of magnitude, on the one hand, and synchronic and diachronic processes, on the other, contribute to the overall organization of every living being. To account for such multi-level organization, semiotic freedom is assumed to be a scalar property that endows living systems at different levels and domains with the capacity to ponder selectively the overall structural coherence and functional compatibility of their heterarchical processing, which is increasingly less conditioned by the underlying molecular determinism. (shrink)

In this paper we argue that awareness comes in degrees, and we propose a novel multi-factor account that spans both subjective experiences and perceptual representations. At the subjective level, we argue that conscious experiences can be degraded by being fragmented, less salient, too generic, or flash-like. At the representational level, we identify corresponding features of perceptual representations—their availability for working memory, intensity, precision, and stability—and argue that the mechanisms that affect these features are what ultimately modulate the degree of awareness. (...) We conclude the paper by demonstrating why the original interpretations of certain empirical findings that apparently pose problems for our account are, in fact, flawed. (shrink)

My essay, “Multi-modal argumentation” was published in the journal, _Philosophy of the Social Sciences,_ in 1994. This information appeared again in my book, _Coalescent argumentation_ in 1997. In the ensuing twenty years, there have been many changes in argumentation theory, and I would like to take this opportunity to examine my now middle-aged theory in light of the developments in our discipline. I will begin by relating how a once keen intended lawyer and then formal logician ended up in argumentation (...) theory. (If you do not care to read this bit of autobiography, skip to Section 2). (shrink)

The legitimacy of multi-stakeholder initiatives (MSIs) as institutions for social and environmental governance in the global economy has received much scholarly attention over the past years. To date, however, research has yet to focus on assessing the legitimacy of MSIs in their interactions with other actors within larger systems of deliberation. Drawing on the deliberative systems perspective developed within deliberative democracy theory, we theorise a normative framework to evaluate the roles of MSIs within the broader systems of governance they co-construct (...) through their interactions with other initiatives, governments, non-governmental organisations, and other external actors. As we demonstrate in our evaluation of the illustrative case of the Bangladesh Accord on Fire and Building Safety as a MSI in the context of the Bangladeshi garment industry, this framework can help researchers assess whether a MSI ultimately serves to enhance or undermine the deliberative legitimacy of the overall system of which it forms a part. (shrink)

In the present article, we introduce a multi-type display calculus for dynamic epistemic logic, which we refer to as Dynamic Calculus. The display approach is suitable to modularly chart the space of dynamic epistemic logics on weaker-than-classical propositional base. The presence of types endows the language of the Dynamic Calculus with additional expressivity, allows for a smooth proof-theoretic treatment, and paves the way towards a general methodology for the design of proof systems for the generality of dynamic logics, and certainly (...) beyond dynamic epistemic logic. We prove that the Dynamic Calculus adequately captures Baltag–Moss–Solecki's dynamic epistemic logic, and enjoys Belnap-style cut elimination. (shrink)

The Diagnostic and Statistical Manual of Mental Disorders has elicited numerous criticisms throughout its history. Its particularly controversial status has not been resolved by the recent release of the DSM-5 ; rather, the new edition has amplified debates in psychiatry as well as philosophy and the wider public. To a certain extent, such controversies are to be expected because of the influential role the DSM plays in science and health care. Researchers have often been required to use the DSM classification (...) to get funded and published, clinicians need to use it for diagnosis, and patients need a DSM code to get reimbursed for treatment.1 Classification in psychiatry shapes the course of research... (shrink)

The problem of multi-peer disagreement concerns the reasonable response to a situation in which you believe P1 … Pn and disagree with a group of ‘epistemic peers’ of yours, who believe ∼P1 … ∼Pn, respectively. However, the problem of multi-peer disagreement is a variant on the preface paradox; because of this the problem poses no challenge to the so-called ‘steadfast view’ in the epistemology of disagreement, on which it is sometimes reasonable to believe P in the face of peer disagreement (...) about P. After some terminology is defined (§1), Peter van Inwagen's challenge to the steadfast view will be presented (§2). The preface paradox will then be presented and diagnosed (§3), and it will be argued that van Inwagen's challenge relies on the same principle that generates the preface paradox (§4). The reasonable response to multi-peer disagreement will be discussed (§5), and an objection addressed (§6). (shrink)

Over the last twenty years, in all of these neighbouring fields, modal systems have been developed that we call multi-dimensional. (Our definition of multi ...