ObjectivePatient involvement is used to describe the inclusion of patients as active participants in healthcare decision-making and research. This study aimed to investigate incoming year 1 medical (MBChB) students’ attitudes and opinions regarding patient involvement in this context.MethodsWe established a staff–student partnership to formulate the design of an online research survey, which included Likert scale questions and three short vignette scenarios designed to probe student attitudes towards patient involvement linked to existing legal precedent. Incoming year 1 medical students (n=333) were (...) invited to participate in the survey before formal teaching commenced.ResultsSurvey data (49 participants) indicate that students were broadly familiar with, and supportive of, patient involvement in medical treatment. There was least support for patient involvement in conducting (23.9%), contributing to (37.0%) or communicating research (32.6%), whereas there was unanimous support for patients choosing treatment from a selection of options (100%).ConclusionIncoming members of the medical profession demonstrate awareness of the need to actively involve patients in healthcare decision-making but are unfamiliar with the utility and value of such involvement in research. Further empirical studies are required to examine attitudes to patient involvement in healthcare. (shrink)

This comprehensive volume marks a new standard in scholarship in the still emerging field of the philosophy of chemistry. With selections drawn from a wide range of scholarly disciplines, philosophers, chemists, and historians of science here converge to ask some of the most fundamental questions about the relationship between philosophy and chemistry. What can chemistry teach us about longstanding disputes in the philosophy of science over such issues as reductionism, autonomy, and supervenience? And what new issues may chemistry bring to (...) the forefront now that it has joined physics and biology as a serious topic for philosophical reflection? This newest addition to the prestigious Boston Studies in the Philosophy of Science series marks the true arrival of philosophy of chemistry within the corpus of the philosophy of science. (shrink)

Matrix degradation and tissue remodelling directed by matrix‐degrading proteases are activated in physiological situations such as wound healing and involution of the prostate, ovaries and uterus. Recently, other activities, in addition to the cleavage of matrix proteins, have been attributed to matrix proteases including the release of growth factors from the extracellular matrix and roles in the maturation of adipocytes. This review describes extracellular proteases, including MMPs, plasminogen and cathepsins involved in the tissue remodelling processes that occur in the breast (...) during pubertal mammary development and the mammary cycle of pregnancy, lactation and weaning. It particularly focuses on development and weaning, termed mammary gland involution, when the majority of remodelling occurs. It also brings together recent findings on the exciting new functions of matrix‐degrading proteases. BioEssays 27:894–903, 2005. © 2005 Wiley Periodicals, Inc. (shrink)

There are important ethical issues to be examined before launching any public health intervention, particularly when targeting vulnerable groups. The aim of this article is to identify and discuss ethical concerns that may arise when intervening for health behavior change among adolescents identified as overweight. These concerns originate from an intervention designed to capacitate adolescents to increase self-determined physical activity. Utilizing an ethical framework for prevention of overweight and obesity, we identified three ethical aspects as particularly significant: the attribution of (...) responsibility for health behavior, liberty to choose, and the effect on the participants’ psychosocial well-being. It is discussed whether and how measures can be taken to deal with these aspects. It seems evident that the ethical aspects are mainly concerned with the vulnerability of adolescents identified as overweight. However, we claim that when individual feedback and counseling is provided, tailored interventions have a unique potential to empower adolescents to make ethically anchored decisions about their own health behavior. (shrink)

The everyday expressions of nursing practices are driven by their entanglement in complex flows of social, cultural, political and economic interests. Early expressions of trained nursing practice in the United States and Europe reflect claims of moral, spiritual and clinical exceptionalism. They were both imposed upon—and internalized by—nursing pioneers. These claims were associated with an endogenous narrative of discipline and its physical manifestation in early nursing schools and hospitals, which functioned as “total institutions.” By contrast, the external forces—diffuse yet pervasive—impacting (...) upon contemporary nursing more closely align with the power dynamics explored in Gilles Deleuze's concept of the Society of Control. The example of sensor technology and telemetric monitoring of nurses’ locations in the clinical setting exemplifies the intense presence of surveillance, performance metrics and the “rationalization” of nursing practice. It falls upon nurses to recognize, accept or challenge these dynamics in order to shape the future of nursing practice into a discipline which embodies our values and priorities. (shrink)

The project review as outlined in this article explores the questions: What is transformative research and what is transformation as far as the community stakeholders are concerned? To what extent has the transformative research achieved its intended outcomes? The Bokamoso project (founded by Lesego Serolong as facilitator and investor) is an integrated development project designed to create employment and to enable the community to learn while they make a living through a diverse range of farming activities. The participatory research as (...) discussed here is part of the University of South Africa’s research and community engagement programme, and is set in a remote, arid zone. This research coupled with community engagement aims to transform lives and create opportunities by enhancing their participation in education, training and employment creation. The project (which has been running since 2015) supports indigenous ways of being, knowing and doing and has succeeded in enabling the farmers trained through Bokamoso to be less dependent on social benefits (government grants). (shrink)

hobbes’s views on the existence and nature of God have occasioned much controversy.1 He has been interpreted as holding positions ranging from sincere, if unconventional, Calvinism to out-and-out atheism.2 Of particular interest has been Hobbes’s apparent endorsement of a version of the cosmological argument. Take the following, for example:For he that from any effect he seeth come to pass should reason to the next and immediate cause thereof, and from thence to the cause of that cause, and plunge himself profoundly (...) into the pursuit of causes, shall at last come to this: that there must be one first mover, that is, a first and eternal cause of all things, which is that... (shrink)

Thomas Hobbes holds that there is an intimate connection between linguistic meaning and thought. This chapter provides a general overview of Hobbes's views on language, and argues that Hobbes holds an inchoate, but recognizable, version of an inferential role or functional role semantics. On Hobbes's theory of language use and linguistic meaning, the meaning of an expression is the functional role of that expression in cognition. The chapter describes Hobbes's account of use of names in cognition – names are marks, (...) applied to objects, for the sake of recalling thoughts of those objects. According to Hobbes, a propositional attitude is a relation between a language‐using animal and a sentence. Sentences are signs of thought because they express propositional judgments. The chapter presents Hobbes's account of linguistic understanding. It argues that the understanding of linguistic expressions characteristic of mature, fully language‐competent humans is determined by the ability of language‐competent humans to deploy names in reasoning. (shrink)

Background Despite decades of anti-racism and equity, diversity, and inclusion (EDI) interventions in academic medicine, medical racism continues to harm patients and healthcare providers. We sought to deeply explore experiences and beliefs about medical racism among academic clinicians to understand the drivers of persistent medical racism and to inform intervention design. Methods We interviewed academically-affiliated clinicians with any racial identity from the Departments of Family Medicine, Cardiac Sciences, Emergency Medicine, and Medicine to understand their experiences and perceptions of medical racism. (...) We performed thematic content analysis of semi-structured interview data to understand the barriers and facilitators of ongoing medical racism. Based on participant narratives, we developed a logic framework that demonstrates the necessary steps in the process of addressing racism using if/then logic. This framework was then applied to all narratives and the barriers to addressing medical racism were aligned with each step in the logic framework. Proposed interventions, as suggested by participants or study team members and/or identified in the literature, were matched to these identified barriers to addressing racism. Results Participant narratives of their experiences of medical racism demonstrated multiple barriers to addressing racism, such as a perceived lack of empathy from white colleagues. Few potential facilitators to addressing racism were also identified, including shared language to understand racism. The logic framework suggested that addressing racism requires individuals to understand, recognize, name, and confront medical racism. Conclusions Organizations can use this logic framework to understand their local context and select targeted anti-racism or EDI interventions. Theory-informed approaches to medical racism may be more effective than interventions that do not address local barriers or facilitators for persistent medical racism. (shrink)

This article examines law’s representation of embodied female identity in the context of two medical law cases, R. v. Human Fertilisation and Embryology Authority, ex parte Blood andB v. Croydon Health Authority. Through an examination of contemporary critiques of female embodiment, in particular the work of Judith Butler, two discursive strategies are suggested for their potential to reconfigure the sexed subject within legal discourse. Firstly, the act of transgression – the flight from purportedly fixed subject positions – can be read (...) in the case of Bloodand calls into question law’s ability to contain and sustain sexed identity as prediscursive and immutable. Secondly, the exposure of the historical formation of the female subjects of legal discourse, demonstrated through a genealogical reading of B v. Croydon Health Authority, contributes to the feminist theoretical project to destabilise traditional gender categories and enables us to think beyond the category of ‘Woman’. (shrink)

This collection, the first of its kind, brings together specially commissioned academic essays to mark fifty years since the death of John Kennedy Toole.

R. G. Collingwood's philosophical work is marked both by its compelling critique of scientific experience and by an unresolved tension between the claims of philosophy and the claims of history. The three works under consideration here, Speculum Mentis, Essay on Philosophical Method, and Essay on Metaphysics, comprise a systematic expression of the character of human understanding in terms of its open-ended, dialectical character, and a sustained critique of the scientific conception of human knowledge as a denial of that character.

Lee McIntyre Hakikat-Sonrası (Post-Truth, 2018) adlı kitabında, hakikat-sonrası (post-truth) kavramını pazarlama ve televizyon dünyalarındaki tarihsel kökenlerine ve davranışsal psikolojideki kaynaklara dayanarak düşünsel bir kökene bağlar. McIntyre, bu kavramın yalnızca epistemolojik bir sorun olduğunu öne sürer. Bu makalede; ilk olarak hakikat-sonrası kavramı ile hakikatin bağdaşım kuramı arasında benzerlikler belirtilerek ortaya çıkan ortak epistemolojik sorunlar incelenecektir. Daha sonra, kişiselleştirme teknolojileri ve bunların istenmeyen sonuçları olan yankı odası, filtreleme baloncuğu ve siber-balkanlaştırma ile Althusser’in devletin ideolojik aygıtları arasında bir koşutluk kurularak (...) class='Hi'>McIntyre’ın yaklaşımı sorunsallaştırılacaktır. Dahası, söz konusu teknolojiler bireyleri birer üretici-tüketiciye (prosumer) dönüştürdüğü için hakikat-sonrası kavramının hem teorik hem de pratik felsefenin alanına girmesiyle aslında ideoloji kavramına karşılık gelen bir yeniyapımdan (neologism) fazlası olmadığı ileri sürülecektir. (shrink)

This study examines how the leading beverage company handles the strategic paradox between its core business and the social issue of obesity. A discursive analysis reveals how the organization does embrace a social goal related to obesity but not the paradoxical tension between this goal and its core business. The analysis further shows how the tension, along with the responsibility for the social goal, is projected outside the organization. This response is underpinned by the paradoxical constructions of consumers and the (...) concept of obesity in the organization’s communication. Based on these findings, I outline a new type of process for projection, one of the defensive mechanisms recognized in the literature. The findings increase our understanding of defensive responses to organizational paradoxes and help distinguish between different kinds of strategic paradoxes. They also highlight the need to further open up the complexity and multiplicity of strategic paradoxes related to corporate sustainability. (shrink)

This paper responds to two trends in debates about Plato's view of women in the Republic. First, many scholars argue or assume that Plato seeks to minimize the influence of femininity in the ideal city, and to make guardian women themselves as “masculine” as possible. Second, scholars who address the relationship between Plato's views of women and his psychological theory tend to focus on the reasoning and appetitive parts of the tripartite soul. In response to the first point, we argue (...) that the idea that Plato seeks to masculinize/de-feminize the city oversimplifies his treatment of Greek gender norms. Although he does want to eliminate some traditionally feminine qualities from the city, he also seeks to eliminate many masculine qualities as well. Moreover, while he tries to make guardian women more like men in some respects, he simultaneously aims to make guardian men more like Greek women in important ways. Regarding the second point, we argue that this project of reimagining gender norms is illuminated by Plato's psychology, but instead of emphasizing reason and appetite, we show how his views are connected to his account of the third, “spirited” part of the soul, thumos, and its dual hard/soft or aggressive/gentle nature. (shrink)

The traditional medical epistemology, resting on a biomedical paradigmatic monopoly, fails to display an adequate representation of medical knowledge. Clinical knowledge, including the complexities of human interaction, is not available for inquiry by means of biomedical approaches, and consequently is denied legitimacy within a scientific context. A gap results between medical research and clinical practice. Theories of knowledge, especially the concept of tacit knowing, seem suitable for description and discussion of clinical knowledge, commonly denoted the art of medicine. A metaposition (...) allows for inquiry of clinical knowledge, inviting an expansion of the traditional medical epistemology, provided that relevant criteria for scientific knowledge within this field are developed and applied. The consequences of such approaches are discussed. (shrink)

This paper takes a critical perspective on corporate social responsibility and examines the ways in which an industry organization discursively manages the relationship between the industry and its stakeholders in a situation where the legitimacy of the industry is called into question. Drawing on the literature on organizational narcissism and sensemaking the paper develops the construct of narcissistic CSR orientation and empirically elaborates on three defensive rhetorical strategies through which the organization makes sense of the accountability and responsibility of the (...) industry for the negative societal effects of their business. The paper advances knowledge in the field of critical CSR by proposing a new framework for critically examining organization-stakeholder relationships and organizational responses to stakeholder demands in contexts where the interests of organizations are in conflict with the public good. (shrink)

Reason and Value collects 15 new papers by leading contemporary philosophers on themes from the work of Joseph Raz. Raz has made major contributions in a wide range of areas, including jurisprudence, political philosophy, and the theory of practical reason; but all of his work displays a deep engagement with central themes in moral philosophy. The subtlety and power of Raz's reflections on ethical topics make his writings a fertile source for anyone working in this area. Especially significant are his (...) explorations of the connections between practical reason and the theory of value, which constitute a sustained and penetrating treatment of a set of issues at the very center of moral philosophy as it is practiced today. The contributors to the volume acknowledge the importance of Raz's contributions by engaging critically with his positions and offering independent perspectives on the topics that he has addressed. The volume aims both to honour Raz's accomplishments in the area of ethical theorizing, and to contribute to an enhanced appreciation of the significance of his work for the subject. (shrink)

The following piece is a summary of a talk given to address the subject of women writing about male protagonists and from a male point of view, arguing that in Gunn’s own work traditional male characters are posited at the centre of texts that are actually female in perspective, so allowing for the reader to have the experience of a sort of inversion of reading. She does this by prioritizing female agency: thus the traditional male becomes someone else, the male (...) gaze transported to another kind of looking that instead of containing and exerting power over the women who are seen, rather reflects them back as powerful influential figures. Gunn defines what she calls this “breaking open the gaze,” the fracturing of a singular point of view into a multiple one, a seeing and a being seen, as a key feature of her own fictions, energizing and transforming the roles of both male and female characters in her work. (shrink)

In recent decades political philosophers have increasingly been engaged with the issue of educational equality. However, egalitarians typically focus on achieving equality in the distribution of education, and ignore the relevance of an alternative, relational conception of equality. An exception to this is Elizabeth Anderson, who applies relational egalitarian principles to education in her 2007 article ‘Fair Opportunity in Education: A Democratic Equality Perspective’. Although Anderson remains one of the few relational egalitarians to consider what this ideal requires in education, (...) her arguments have received less attention than they deserve. In this article I examine Anderson's theory of fair educational opportunities for a democratic society of equals and develop an internal critique of her approach. I suggest that the sufficientarian standard Anderson proposes for education has the propensity to undermine the process of integration and the relations of equality she aspires to. Even if all children receive a sufficient education, inequality above the threshold could result in social divisions and status differentials that encourage informal segregation because people typically prefer to associate with other people who are similar to themselves. The article will finish by considering what implications this has for Anderson's relational egalitarian approach to education. (shrink)

Measures and theories of information abound, but there are few formalised methods for treating the contextuality that can manifest in different information systems. Quantum theory provides one possible formalism for treating information in context. This paper introduces a quantum inspired model of the human mental lexicon. This model is currently being experimentally investigated and we present a preliminary set of pilot data suggesting that concept combinations can indeed behave non-separably.

Ten nurses at a university hospital in Norway were interviewed as part of a comprehensive investigation into the narratives of nurses and physicians about being in ethically difficult situations in surgical units. The transcribed interview texts were subjected to a phenomenological-hermeneutic interpretation. The main theme in the narratives was being close to and moved by the suffering of patients and relatives. The nurses' responsibility for patients and relatives was expressed as a commitment to act, and they needed to ask themselves (...) whether their responsibility had been fulfilled, that nothing had been left undone, overlooked or neglected, before they could leave the unit. When there was confirmation by the patients, relatives, colleagues and themselves that the needs of patients and relatives had been attended to in a morally and professionally satisfying manner, this increased the nurses' confidence and satisfaction in their work, and their strength to live with the burden of being in ethically difficult situations. (shrink)