There is limited knowledge about sleep in adolescents with elevated levels of anxiety treated within primary health care settings, potentially resulting in sleep problems not being sufficiently addressed by primary health care workers. In the current study self-reported anxiety, insomnia, sleep onset latency, sleep duration, and depressive symptoms were assessed in 313 adolescents referred to treatment for anxiety within primary health care. Results showed that 38.1% of the adolescents met criteria for insomnia, 34.8% reported short sleep duration, and 83.1% reported (...) long sleep onset latency. Total anxiety symptoms were related to all sleep variables after controlling for age and sex. Furthermore, all anxiety symptom sub-types were associated with insomnia and sleep onset latency, whereas most anxiety subtypes were associated with sleep duration. Adolescents’ depressive symptoms accounted for most of the anxiety-sleep associations, emphasizing the importance of depressive symptoms for sleep. However, anxiety was associated with insomnia and sleep onset latency also among youth with low levels of depressive symptoms. The findings suggests that primary health care workers should assess sleep duration, sleep onset latency, and insomnia in help-seeking adolescents with anxiety. (shrink)

The aim of this article is to investigate how life in Norwegian nursing homes may affect experiences of dignity among persons with dementia. The study had a qualitative design and used a phenomenological and hermeneutic approach. Participant observation in two nursing home units was combined with qualitative interviews with five residents living in these units. The study took place between March and December 2010. The residents feel that their freedom is restricted, and they describe feelings of homesickness. They also experience (...) that they are not being seen and heard as individual autonomous persons. This lack of freedom, experiences of homesickness and feelings of not being confirmed and respected as individual autonomous persons may be a threat to their personal dignity. In order to protect and enforce the dignity of persons with dementia living in nursing home, we should confirm them as whole and as individual persons, and we should try to make the nursing homes less institutional and more home like. (shrink)

IntroductionCouple violence (CV) affects many, and the consequences of those actions are grave, not only for the individual suffering at the hand of the perpetrator but also for the other persons in the family. Violence often happens among more than just the adults within one family. Even if CV has been thoroughly investigated in the general population very few studies have investigated this objective on a clinical sample, and none of these have included family violence.AimThis article identifies and describes the (...) group of clients that have issues of physical couple and family violence. It analyses a model that can help to discover physical violence and help therapists to assess what actions to take in therapy to prevent further physical violence.MethodologyDescriptive analysis, t-tests, and structural equation modeling (SEM) are used on a sample of clients receiving couple and family therapy (CFT) in Norway (N = 830). Family violence is modeled by the partner’s expectations toward each other, levels of anger, sexual satisfaction, and self-control.ResultsOne-in-five clients experienced physical CV in their current relationship and one-in-four experienced physical family violence. The group of clients who experienced CV differed from those without such experiences in having lower income, more prior experience with psychotherapy, more experience with alcohol abuse in childhood, and far more physical family violence in their current family. Our model predicting physical coupl... (shrink)

Patients in nursing homes sometimes give accounts of episodes in which they feel their autonomy and/or self-respect are violated as a result of the care they receive from nursing staff. In these ethically difficult care situations nurses use strategies such as negotiation, explanation and, in some cases, restraint. This study investigates how nurses apply these strategies to resolve ethical dilemmas in such a way that patients experience respect rather than violation. Critical issues that will be discussed include the definition of (...) ethically difficult care situations in nursing homes and the identification of strategies for resolving such situations. Examples of the use of three strategies are presented. The use of negotiation, restraint and explanation are discussed in order to ensure respect for patients’ autonomy and thus to optimize health care outcomes. (shrink)

Background: Providing care for a home-dwelling person with dementia who resists care is an ethical and practical complex and challenging task. Faced with a growing number of persons with dementia, the healthcare professional’s understanding of how to best care for and prevent unnecessary use of coercion with persons with dementia is of key importance. Research aim: The aim of this study was to explore the use of trust-building interventions in home-dwelling persons with dementia resisting care, as described by health professionals (...) in documents of decisions of forced treatment and care. Research design: A qualitative thematic document analysis inspired by critical realism was conducted. Participants and research context: Descriptions of trust-building interventions were extracted from 88 documents of forced treatment and care for home-dwelling persons with dementia, receiving home healthcare, in 2015 and 2016. Ethical considerations: Approved by the Regional Committee for Medical and Health Research Ethics, reference number 2017/788, and controlled by the Norwegian Centre for Research Data, reference number 54897. The study adhered to the guidelines of the Declaration of Helsinki. Findings: We found that “balancing safe care with the person’s integrity” was an overarching theme that permeated the descriptions of trust-building interventions in the study. Three main themes were identified when the data were analyzed: safeguarding care, protecting integrity, and optimizing the environment. Discussion and conclusion: Health professionals balanced on a thin line between care and integrity when met with resistance from person with dementia. However, the trust-building interventions used in the most challenging situations did not differ from the interventions used in general in dementia care. Two knowledge gaps were identified: how to perform appropriate assessments of situations of home-dwelling persons with dementia when met with resistance to care, and whether environmental initiatives may also benefit home-dwelling persons with dementia who are not easily cared for. (shrink)

Ethical problems regularly arise during daily care in nursing homes. These include violation of patients' right to autonomy and to be treated with respect. The aim of this study was to investigate how caregivers emphasize daily dialogue and mutual reflection to reach moral alternatives in daily care. The data were collected by participant observation and interviews with seven caregivers in a Norwegian nursing home. A number of ethical problems linked to 10 patients were disclosed. Moral problems were revealed as the (...) caregivers acted in ways that they knew were against patients' interest. We used a theoretical interpretation according to Habermas' discourse ethics on the importance of dialogue when deciding moral courses of action for patients. This theory has four basic requirements: communicative competence, equality, self-determination, and openness about motives. (shrink)

BackgroundThe public’s attitudes to conscientious objection are likely to influence political decisions about CO and trust towards healthcare systems and providers. Few studies examine the pub...

Introduction: Expressions of dignity as a clinical phenomenon in nursing homes as expressed by caregivers were investigated. A coherence could be detected between the concepts and phenomena of existence and dignity in relationships and caring culture as a context. A caring culture is interpreted by caregivers as the meaning-making of what is accepted or not in the ward culture. Background: The rationale for the connection between existence and dignity in relationships and caring culture is that suffering is a part of (...) existence, as well as compassion in relieving suffering, and ontological interdependency. Aim: To describe different expressions of dignity in relationships and existence in context of caring cultures from the perspective of the caregivers. Research design: The methodology and method are hermeneutic. The method used was to merge the theoretical preunderstanding as one horizon of understanding with empirical data. Participants and research context: Focus group interviews with caregivers in nursing homes. Ethical considerations: The principles of the Helsinki Declaration have been followed to, for example, preserve self-determination, integrity, dignity, confidentiality and privacy of the research persons. Findings: Data interpretation resulted in four themes: Encountering existential needs that promote dignity in a caring culture; To amplify dignity in relationships by the creative art of caring in a caring culture; Violation of dignity by ignorance or neglect in a non-caring culture and The ethic of words and appropriated ground values in a caring culture. Discussion: Dignity-promoting acts of caring, or dignity-depriving acts of non-caring are adequate to see from the perspective of dignity in relationships and existence and the caring culture. Conclusions: Dignity in relationships seems to touch the innermost existential life, as the existential life is dependent on confirmation from others. (shrink)

The language comprehension system preferentially assumes that agents come first during incremental processing. While this might reflect a biologically fixed bias, shared with other domains and other species, the evidence is limited to languages that place agents first, and so the bias could also be learned from usage frequency. Here, we probe the bias with electroencephalography (EEG) in Äiwoo, a language that by default places patients first, but where sentence-initial nouns are still locally ambiguous between patient or agent roles. Comprehenders (...) transiently interpreted nonhuman nouns as patients, eliciting a negativity when disambiguation was toward the less common agent-initial order. By contrast and against frequencies, human nouns were transiently interpreted as agents, eliciting an N400-like negativity when the disambiguation was toward patient-initial order. Consistent with the notion of a fixed property, the agent bias is robust against usage frequency for human referents. However, this bias can be reversed by frequency experience for nonhuman referents. (shrink)

In a Norwegian study on how children aged 7-12 years cope during a period of serious illness within the family and on their quality of life at this time, several ethical questions became apparent. These were mainly concerned with the vulnerability of children during research, with their ability to make autonomous decisions, and with considerations regarding how to respect their right to confidentiality during the research process. In this article we approach these questions using our experience from this previous study, (...) discussing them within the framework of theories of ethics and relevant research ethical guidelines. Finally, we discuss our experience in the light of the overall purpose of this article: how to deal with the ethical dilemmas that may appear during research involving young children. (shrink)

This article explores the status of a UN mandate for military intervention, especially in the aftermath of the non-mandated interventions in Kosovo and Iraq. It examines the realist and positivist approaches to this issue, and proposes a third approach, called the ?human rights model? in which public legitimacy plays a key role. It shows that not only political assessments but also legal ones differ on this question according the premises they are based on. The article further analyses how normative and (...) military power interacts in today's global public debate, and concludes that legitimacy for an intervention is established on a case-by-case basis. The existence of a UN mandate no longer gives automatic legitimacy. (shrink)

Journal Name: Cognitive Linguistics Issue: Ahead of print.

A Greek English Lexicon of the New Testament, being Grimm's Wilke's Clavis Novi Testamenti. Translated, Revised and Enlarged by Joseph Henry Thayer, D.D., Bussey Professor of New Testament Criticism and Interpretation in the Divinity School of Harvard University. Edinburgh, T. and T. Clark. 1886. 4to. pp. 726. 36s.Biblico Theological Lexicon to New Testament Greek. by Hermann Cremer, D.D., Professor of Theology in the University of Greifswald. Third English Edition. With Supplement. Translated from the latest German Edition by William Uewick, M.A. (...) Edinburgh, T. and T. Clark. 1886. 4to. pp. 943. 38s. (shrink)

In this article, an attempt is made to analyse important implications of the hermeneutic approach in qualitative studies. The article discusses the hermeneutic circle with regard to reasoning contexts, on which the researcher's interpretation is based. Problems in connection with achievement of ‘proper’ understanding in an interpretative process are discussed in light of Gadamer's hermeneutic philosophy. Some features of qualitative studies are addressed. This is concerned with arguments in the presentation of findings in qualitative studies using the hermeneutic approach. The (...) essence of the article is there are grounds for reasonable understanding, even though it cannot be absolute in the hermeneutic. (shrink)

Historically, the care of hospitalized children has evolved from being performed in isolation from parents to a situation where the parents and the child are regarded as a unit, and parents and nurses as equal partners in the child’s care. Parents are totally dependent on professionals’ knowledge and expertise, while nurses are dependent on the children’s emotional connection with their parents in order to provide optimal care. Even when interdependency exists, nurses as professionals hold the power to decide whether and (...) to what extent parents should be involved in their child’s care. This article focuses on nurses’ responsibility to act ethically and reflectively in a collaborative partnership with parents. To illuminate the issue of nurses as moral practitioners, we present an observation of contemporary child care, and discuss it from the perspective of the Danish moral philosopher KE Løgstrup and his book The ethical demand. (shrink)

Much is known about the phenomenon of dignity, yet there is still a need for implementing this understanding in clinical practice. The main purpose of this study was to find out how persons suffering from multiple sclerosis experience and understand dignity and violation in the context of a rehabilitation ward. A phenomenological-hermeneutic approach was used to extract the meaningful content of narratives from 14 patients with multiple sclerosis. Data were collected by personal research interviews. The findings revealed three main themes: (...) (1) ‘invisibly captured in fatigue’; (2) ‘fighters’ law: one who does not ask will not receive’; and (3) ‘dignity is humanity’. The essence of the findings in this study is that dignity is humanity. According to the participants, dignity requires time and is experienced only in a context of empathy and mutual confidence. (shrink)

The overall purpose of this cross-country Nordic study was to gain further knowledge about maintaining and promoting dignity in nursing home residents. The purpose of this article is to present results pertaining to the following question: How is nursing home residents’ dignity maintained, promoted or deprived from the perspective of family caregivers? In this article, we focus only on indignity in care. This study took place at six different nursing home residences in Sweden, Denmark and Norway. Data collection methods in (...) this part of this study consisted of individual research interviews. Altogether, the sample consisted of 28 family caregivers of nursing home residents. The empirical material was interpreted using a hermeneutical approach. The overall theme that emerged was as follows: ‘A feeling of being abandoned’. The sub-themes are designated as follows: deprived of the feeling of belonging, deprived of dignity due to acts of omission, deprived of confirmation, deprived of dignity due to physical humiliation, deprived of dignity due to psychological humiliation and deprived of parts of life. (shrink)

There is a need to understand more of the risk factors involved in the process from suicide ideation to suicide attempt. Cognitive control processes may be important factors in assessing vulnerability to suicide. A version of the Stroop procedure, Delis–Kaplan Executive Function System Color–Word Interference Test and Behavior Rating Inventory of Executive Function were used in this study to test attention control and cognitive shift, as well as to assess everyday executive function of 98 acute suicidal psychiatric patients. The Columbia (...) Suicide History Form was used to identify a group of suicide ideators and suicide attempters. Results showed that suicide attempters scored lower on attention control than suicide ideators who had no history of attempted suicide. The self-report in the BRIEF-A inventory did not reflect any cognitive differences between suicide ideators and suicide attempters. A logistic regression analysis showed that a poorer attention control score was associated with the suicide attempt group, whereas a poorer cognitive shift score was associated with the suicide ideation group. The results found in this study suggest that suicide attempters may struggle with control of attention or inhibiting competing responses but not with cognitive flexibility. (shrink)

Abstract I argue that the two primary motivations in the literature for positing seemings as sui generis mental states are insufficient to motivate this view. Because of this, epistemological views which attempt to put seemings to work don’t go far enough. It would be better to do the same work by appealing to what makes seeming talk true rather than simply appealing to seeming talk. Content Type Journal Article Pages 1-12 DOI 10.1007/s11406-012-9363-8 Authors T. Ryan Byerly, Department of Philosophy, Baylor (...) University, Waco, TX, USA Journal Philosophia Online ISSN 1574-9274 Print ISSN 0048-3893. (shrink)

T. A. Cavanaugh defends double-effect reasoning (DER), also known as the principle of double effect. DER plays a role in anti-consequentialist ethics (such as deontology), in hard cases in which one cannot realize a good without also causing a foreseen, but not intended, bad effect (for example, killing non-combatants when bombing a military target). This study is the first book-length account of the history and issues surrounding this controversial approach to hard cases. It will be indispensable in theoretical ethics, applied (...) ethics (especially medical and military), and moral theology. It will also interest legal and public policy scholars. (shrink)

Depression is a highly recurrent disorder with limited treatment alternatives for reducing risk of subsequent episodes. Acceptance and commitment therapy (ACT) and attention bias modification (ABM) separately have shown some promise in reducing depressive symptoms. This study investigates (a) if group-based ACT had a greater impact in reducing residual symptoms of depression over a 12-month follow-up than a control condition, and (b) if preceding ACT with ABM produced added benefits. This multisite study consisted of two phases. In phase 1, participants (...) with a history of depression, currently in remission (N= 244), were randomized to either receive 14 days of ABM or a control condition. In phase 2, a quasi- experimental design was adopted, and only phase-1 participants from the Sørlandet site (N= 124) next received an 8-week group-based ACT intervention. Self-reported and clinician-rated depression symptoms were assessed at baseline, immediately after phase 1 and at 1, 2, 6, and 12 months after the conclusion of phase 1. At 12-month follow-up, participants who received ACT exhibited fewer self-reported and clinician-rated depressive symptoms. There were no significant differences between ACT groups preceded by ABM or a control condition. There were no significant differences between ACT groups preceded by ABM or a control condition. Group-based ACT successfully decreased residual symptoms in depression over 12 months, suggesting some promise in preventing relapse. (shrink)

Cosmological arguments for the existence of God face a gap problem. This is the problem of convincingly arguing that their intermediate conclusions that some first cause or necessary being exists provide evidence for their main conclusion that God exists. This paper develops a simple and innovative approach to solving this problem, applicable to many cosmological arguments. According to the proposal, the best explanation for why the necessary being is found to have necessary existence is that it is a perfect being. (...) Since a perfect being would be God, the intermediate conclusions of the relevant cosmological arguments provide abductive evidence for their main conclusions. (shrink)

The world appears to conscious creatures in terms of experienced sensory qualities, but science doesn't find sensory experience in that world, only physical objects and properties. I argue that the failure to locate consciousness in the world is a function of our necessarily representational relation to reality as knowers: we won't discover the terms in which reality is represented by us in the world as it appears in those terms. Qualia -- arguably a type of representational content -- will therefore (...) not be found in the physical world as characterized in experience or science. Instead, consciousness constitutes a subjective, representational reality for cognitive systems such as ourselves, and the physical world is a represented objective reality. I suggest that naturalistic approaches to explaining consciousness should acknowledge the non-objectivity of experience, and be constrained by evidence that consciousness accompanies certain sorts of behaviour-controlling representational functions carried out by complex, physically instantiated mind-systems. I evaluate a variety of current hypotheses about consciousness, and suggest that a mature science of representation may help explain why, perhaps as matter of representational necessity, experience arises as a natural but not objectively discoverable phenomenon. (shrink)

This text is designed to help students construct and evaluate arguments.

The COVID-19 crisis has highlighted the considerable challenge of sourcing expertise and determining which experts to trust. Dissonant information fostered controversy in public discourse and encouraged an appeal to a wide range of social indicators of trustworthiness in order to decide whom to trust. We analyze public discourse on expertise by examining how social indicators inform the reputation of Dr. Didier Raoult, the French microbiologist who rose to international prominence as an early advocate for using hydroxychloroquine to treat COVID-19. To (...) comprehend how these indicators came to inform his reputation, we outline Dr. Raoult's rise to fame based on discourse about hydroxychloroquine. We then discuss why we trust in experts like scientist-practitioners. This is followed by an examination of how social indicators of trust like status, epistemic authority, influence and values have informed Dr. Raoult's reputation. We conclude with recommendations for how to improve the selection and evaluation social indicators of trust and reputations. Our aim here, instead of making a claim about the efficacy of hydroxychloroquine or Dr. Raoult's reputation per se, is to outline through this case study how social indicators of trust inform reputation and the challenge they present to evaluating expertise. (shrink)

In social cognition, knowledge-based validation of information is usually regarded as relying on strategic and resource-demanding processes. Research on language comprehension, in contrast, suggests that validation processes are involved in the construction of a referential representation of the communicated information. This view implies that individuals can use their knowledge to validate incoming information in a routine and efficient manner. Consistent with this idea, Experiments 1 and 2 demonstrated that individuals are able to reject false assertions efficiently when they have validity-relevant (...) beliefs. Validation processes were carried out routinely even when individuals were put under additional cognitive load during comprehension. Experiment 3 demonstrated that the rejection of false information occurs automatically and interferes with affirmative responses in a nonsemantic task. Experiment 4 also revealed complementary interference effects of true information with negative responses in a nonsemantic task. These results suggest the existence of fast and efficient validation processes that protect mental representations from being contaminated by false and inaccurate information. (shrink)

This paper continues a recent exchange in this journal concerning explanationist accounts of epistemic justification. In the first paper in this exchange, Byerly argues that explanationist views judge that certain beliefs about the future are unjustified when in fact they are justified. In the second paper, McCain defends a version of explanationism which he argues escapes Byerly’s criticism. Here we contribute to this exchange in two ways. In the first section, we argue that McCain’s defense of explanationism against Byerly’s objection (...) is unsuccessful. Then, in the second section, we develop an independent objection to explanationism from a different direction. If our arguments in each section are sound, then not only do explanationist accounts of epistemic justification judge beliefs that are justified to be unjustified, but they judge beliefs that are unjustified to be justified. Explanationism faces problems on both sides. (shrink)