The aim of this study is to understand how governance mechanisms in cross-sector collaborations (CSCs) for sustainability affect value creation and capture and subsequently the survival of this organizational form. Drawing on a longitudinal, participatory, single-case study of collaborative action in the textile industry, we identify three governance mechanisms—safeguarding, bundling and connecting—that coevolve with the rising and waning of collaborative tensions and the shifting levels of action in the CSC we studied. These mechanisms aided value creation and helped facilitate private (...) value capture. We integrate these insights into a process model that visualizes the interplay between governance mechanisms of tensions and systems of value creation and capture in CSCs for sustainability. Our study contributes to the cross-sector collaboration literature by providing a dynamic and nuanced understanding of how governance mechanisms influence outcomes in CSCs for sustainability. We also add to the business model for sustainability literature by theorizing the value creation and capture system of collaborative rather than individual organizations. Our findings have important implications for policymakers who fund collaborative organizations and practitioners who manage or participate in them. (shrink)

We endorse Amy Caruso Brown’s position that clinicians and ethicists should consider the voices of people marginalized by hierarchical family or community structures. In this open peer comme...

Feigning symptoms distorts diagnostic evaluations. Therefore, dedicated tools known as symptom validity tests have been developed to help clinicians differentiate feigned from genuine symptom presentations. While a deviant SVT score is an indicator of a feigned symptom presentation, a non-deviant score provides support for the hypothesis that the symptom presentation is valid. Ideally, non-deviant SVT scores should temper suspicion of feigning even in cases where the patient fits the DSM’s stereotypical yet faulty profile of the “antisocial” feigner. Across three studies, (...) we tested whether non-deviant SVT scores, indeed, have this corrective effect. We gave psychology students and clinical experts a case alluding to the DSM profile of feigning. In successive steps, they received information about the case, among which non-deviant SVT outcomes. After each step, participants rated how strongly they suspected feigning and how confident they were about their judgment. Both students and experts showed suspicion rates around the midpoint of the scale and did not respond to non-deviant SVT outcomes with lowered suspicion rates. In Study 4, we educated participants about the shortcomings of the DSM’s antisocial typology of feigning and the importance of the negative predictive power of SVTs, after which they processed the case information. Judgments remained roughly similar to those in Studies 1–3. Taken together, our findings suggest that students and experts alike have difficulties understanding that non-deviant scores on SVTs reduce the probability of feigning as a correct differential diagnosis. (shrink)

PurposeThe aim of this study was to investigate the effect of possible late effects of cancer treatment and of two job resources on future burnout complaints, among employees living 2–10 years beyond breast cancer diagnosis.MethodsData at T1 and at T2 were collected in 2018 and 2019. These data were part of a longitudinal study among Dutch speaking workers with a cancer diagnosis 2–10 years ago. All complaints and job resources were self-reported. Longitudinal multivariate regression analyses were executed, controlling for years (...) since diagnosis, living with cancer, and other chronic or severe diseases. Mediation by baseline burnout complaints was considered.ResultsA higher level of fatigue and cognitive complaints at baseline resulted in higher future burnout complaints, with partial mediation by baseline burnout complaints. No effect of physical complaints at T1 was observed. Higher levels of autonomy or a supportive leadership style resulted in lower burnout complaints, with full mediation by baseline burnout complaints. Buffering was observed by autonomy in the relationship of cognitive complaints with future burnout complaints. No moderation was observed by supportive leadership.ConclusionThe level of burnout complaints among employees 2–10 years beyond breast cancer diagnosis may be an effect of fatigue or cognitive complaints, and awareness of this effect is necessary. Interventions to stimulate supportive leadership and autonomy are advisable, the latter especially in the case of cognitive complaints. (shrink)

The impact of COVID-19 on chronic pain in non-infected vulnerable South American subjects is unknown. Healthcare workers are at increased risk for CP. During the pandemic, many HCWs with CP kept working. Knowing how cognition is affected by CP in these subjects is an important subject for work safety. The attention domain has a pivotal role in cognition. Previously, the Continuous Visual Attention Test was applied to detect specific attention deficits in fibromyalgia patients. The present investigation described CP prevalence in (...) non-infected Brazilian HCWs during the pandemic and assessed HCWs’ attentional performance with the aid of the CVAT. This study was carried out at a reference University Hospital in Rio de Janeiro, Brazil. HCWs of both sexes, aged 20 or older, were interviewed from August to December 2020. A 90-second version of the CVAT was performed. The average reaction time to correct responses and the respective intraindividual reaction time variability for correct responses to target was determined. Omission and commission errors were also calculated. Then, for each participant we calculated the Z-scores of the CVAT variables based on the distribution of CVAT performance of 211 healthy subjects. HCWs with Z-scores > 1.64 were classified as significantly impaired. From the 154 selected HCWs, 72 reported CP during the pandemic. Post hoc ANCOVAs showed that the average correct VRT was significantly higher in the CP group than in the non-CP group. The percentage of participants with impaired VRT performance was 30% in the CP group and 16% in the non-CP group. The difference between these two propositions reached significance. As VRT is associated with the sustained-attention subdomain, our data suggest that this subdomain is disrupted in the CP group. (shrink)

This document presents the Bonn PRINTEGER Consensus Statement: Working with Research Integrity—Guidance for research performing organisations. The aim of the statement is to complement existing instruments by focusing specifically on institutional responsibilities for strengthening integrity. It takes into account the daily challenges and organisational contexts of most researchers. The statement intends to make research integrity challenges recognisable from the work-floor perspective, providing concrete advice on organisational measures to strengthen integrity. The statement, which was concluded February 7th 2018, provides guidance on (...) the following key issues: § 1.Providing information about research integrity § 2.Providing education, training and mentoring § 3.Strengthening a research integrity culture § 4.Facilitating open dialogue § 5.Wise incentive management § 6.Implementing quality assurance procedures § 7.Improving the work environment and work satisfaction § 8.Increasing transparency of misconduct cases § 9.Opening up research § 10.Implementing safe and effective whistle-blowing channels § 11.Protecting the alleged perpetrators § 12.Establishing a research integrity committee and appointing an ombudsperson § 13.Making explicit the applicable standards for research integrity. (shrink)

This paper examines the role of clinical practitioners and clinical researchers internationally in establishing the utility of harm-reduction approaches to substance use. It thus illustrates the potential for clinicians to play a pivotal role in health promoting structural interventions based on harm-reduction goals and public health models. Popular media images of drug use as uniformly damaging, and abstinence as the only acceptable goal of treatment, threaten to distort clinical care away from a basis in evidence, which shows that some ways (...) of using drugs are far more harmful than others and that punitive approaches and insistence on total abstinence as the only goal of treatment often increases the harms of drug use rather than reducing drug use. Therefore the leadership and scientific authority of clinicians who understand the health impact of harm-reduction strategies is needed. Through a review of harm-reduction interventions in Canada, the United Kingdom, the United States, Australia, Switzerland, and the Netherlands, we identify three ways that clinicians have helped to achieve a paradigm shift from punitive approaches to harm-reduction principles in clinical care and in drug policy: through clinical research to provide data establishing the effectiveness and feasibility of harm-reduction approaches, by developing innovative clinical programmes that employ harm reduction, and thereby changing the standard of care to include routine use of these evidence-based approaches in their practices. We argue that through promotion of harm-reduction goals and methods, clinicians have unique opportunities to improve the health outcomes of vulnerable populations. (shrink)

There is a relationship between the different means of action of pressure groups - aimed at exerting pressure on the national government - and its effectiviness on policy level. Because a theoretical analysis is indispensable for further emperical research, the study first focuses on a general survey of possible means of action. This theoretical scheme is applied to four pressure groups. The analysis ofJour quite different pressure groups: 'Vrouwen Overleg Komitee', 'Bond Beter Leefmilieu', 'Vlaams Artsensyndicaat' and 'Belgische Boerenbond' shows that (...) the use of indirect means of action produces a greater effectiviness on policy level. But the choice of the means of action by an organisation depends on several determining factors. Following hypothesis can be sustained by this emperical study: stronger pressure groups, like Vlaams Artsensyndicaat and Belgische Boerenbond, mostly use indirect means of action and are characterised by a greater effectiviness than the two other organisations. (shrink)

This study investigated Belgian and Dutch parental opinions on confidentiality and consent regarding medical decisions about adolescents. Through an online survey, we presented six cases (three on confidentiality, and three on consent) to 1,382 Belgian and Dutch parents. We studied patterns in parental confidentiality and consent preferences across and between cases through binomial logistic regressions and latent class analysis. Participants often grant the right to consent for a treatment to the adolescent, but the majority diverges from the adolescent’s preferences regarding (...) confidentiality. More educated participants would rather not be informed about cases regarding a sexually transmitted disease or depression than lower educated participants. Further analysis shows that participants’ preferences correspond to authoritative (47%), permissive (30%) and authoritarian (17%) parenting styles. Belgian and Dutch parents are willing to grant some degree of autonomy, but they want to be informed about specific health issues. Parental views on confidentiality and granting consent appear to mirror existing parenting styles. (shrink)

This article addresses the question whether a basic income will be a just social policy for women. The implementation of a basic income will have different effects for different groups of women, some of them clearly positive, some of them negative. The real issues that concern feminist critics of a basic income are the gender-related constraints on choices and the current gender division of labour, which are arguably both playing at the disadvantage of women. It is argued that those issues (...) are not adequately addressed by a basic income proposal alone, and therefore basic income has to be part of a larger packet of social policy measures if it wants to maximise real freedom for all. (shrink)

Amsterdam University Press is a leading publisher of academic books, journals and textbooks in the Humanities and Social Sciences. Our aim is to make current research available to scholars, students, innovators, and the general public. AUP stands for scholarly excellence, global presence, and engagement with the international academic community.

Background:The global COVID-19 pandemic has imposed challenges on healthcare systems and professionals worldwide and introduced a ´maelstrom´ of ethical dilemmas. How ethically demanding situations are handled affects employees’ moral stress and job satisfaction.Aim:Describe priority-setting dilemmas, moral distress and support experienced by nurses and physicians across medical specialties in the early phase of the COVID-19 pandemic in Western Norway.Research design:A cross-sectional hospital-based survey was conducted from 23 April to 11 May 2020.Ethical considerations:Ethical approval granted by the Regional Research Ethics Committee in (...) Western Norway (131421).Findings:Among the 1606 respondents, 67% had experienced priority-setting dilemmas the previous two weeks. Healthcare workers who were directly involved in COVID-19 care, were redeployed or worked in psychiatry/addiction medicine experienced it more often. Although 59% of the respondents had seen adverse consequences due to resource scarcity, severe consequences were rare. Moral distress levels were generally low (2.9 on a 0–10 scale), but higher in selected groups (redeployed, managers and working in psychiatry/addiction medicine). Backing from existing collegial and managerial structures and routines, such as discussions with colleagues and receiving updates and information from managers that listened and acted upon feedback, were found more helpful than external support mechanisms. Priority-setting guidelines were also helpful.Discussion:By including all medical specialties, nurses and physicians, and various institutions, the study provides information on how the COVID-19 mitigation also influenced those not directly involved in the COVID-19 treatment of patients. In the next stages of the pandemic response, support for healthcare professionals directly involved in outbreak-affected patients, those redeployed or those most impacted by mitigation strategies must be a priority.Conclusion:Empirical research of healthcare workers experiences under a pandemic are important to identify groups at risks and useful support mechanisms. (shrink)

Blackshaw and Hendricks have recently developed and defended the impairment argument against abortion, arguing that the immorality of giving a child fetal alcohol syndrome (FAS) provides us with reason to believe that abortion is immoral. In this paper, we forward two criticisms of the impairment argument. First, we highlight that, as it currently stands, the argument is very weak and accomplishes very little. Second, we argue that Blackshaw and Hendricks are fundamentally mistaken about what makes giving a child FAS immoral. (...) Once we acknowledge this, it is clear that our intuitions about giving a child FAS provide no support for the supposed immorality of abortion. (shrink)

During the past decade, screening tests using computed tomography have disseminated into practice and been marketed to patients despite neither conclusive evidence nor professional agreement about their efficacy and cost-effectiveness at the population level. This phenomenon raises questions about physicians' professional roles and responsibilities within the setting of medical innovation, as well as the appropriate scope of patient autonomy and access to unproven screening technology. This article explores how physicians ought to respond when new screening examinations that lack conclusive evidence (...) of overall population benefit emerge in the marketplace and are requested by individual patients. To this end, the article considers the nature of evidence and how it influences decision-making for screening at both the public policy and individual patient levels. We distinguish medical and ethical differences between screening recommended for a population and screening considered on an individual patient basis. Finally, we discuss specific cases to explore how evidence, patient risk factors and preferences, and physician judgment ought to balance when making individual patient screening decisions. (shrink)

The aim of this study was to obtain an increased understanding of the experiences of elderly people in geriatric care, with special reference to integrity. Data were collected through qualitative interviews with elderly people and, in order to obtain a description of caregivers’ integrity-promoting or non-promoting behaviours, participant observations and qualitative interviews with nursing students were undertaken. Earlier studies on the integrity of elderly people mainly concentrated on their personal and territorial space, so Kihlgren and Thorsén opened up the possibility (...) of considering the concept of integrity from a broader view by recognizing its relationship to the larger framework of the self-concept. Based on this, findings in the present study indicate that elderly people’s integrity relating to their corporal self were the least violated. On the other hand, their psycological, information and cultural selves were the most exposed. The study also identified a further dimension (i.e. one relating to social self), which should be included in the concept of integrity because respecting elderly people’s social self reduces their feelings of loneliness, isolation and seclusion. In summary, the results indicate that the concept of integrity is complex and has several dimensions. (shrink)

This article analyses the general ethical milieu in a nursing home for elderly residents and provides a decision-making model for analysing the ethical situations that arise. It considers what it means for the residents to live together and for the staff to be in ethically problematic situations when caring for residents. An interpretative phenomenological approach and Sandman’s ethical model proved useful for this purpose. Systematic observations were carried out and interpretation of the general ethical milieu was summarized as ‘being in (...) the same world without meeting’. Two themes and four subthemes emerged from the analysis. Three different ethical problems were analysed. The outcome of using the decision-making model highlighted the discrepancy between the solutions used and well-founded solutions to these problems. An important conclusion that emerged from this study was the need for a structured tool for reflection. (shrink)

Metaphysicians speak of laws of nature in terms of necessity and universality; scientists, in terms of symmetry and invariance. In this book van Fraassen argues that no metaphysical account of laws can succeed. He analyzes and rejects the arguments that there are laws of nature, or that we must believe there are, and argues that we should disregard the idea of law as an adequate clue to science. After exploring what this means for general epistemology, the author develops the empiricist (...) view of science as a construction of models to represent the phenomena. (shrink)

In this article, a teleological model for analysis of everyday ethical situations in dementia care is used to analyse and clarify perennial ethical problems in nursing home care for persons with dementia. This is done with the aim of describing how such a model could be useful in a concrete care context. The model was developed by Sandman and is based on four aspects: the goal; ethical side-constraints to what can be done to realize such a goal; structural constraints; and (...) nurses’ ethical competency. The model contains the following main steps: identifying and describing the normative situation; identifying and describing the different possible alternatives; assessing and evaluating the different alternatives; and deciding on, implementing and evaluating the chosen alternative. Three ethically difficult situations from dementia care were used for the application of the model. The model proved useful for the analysis of nurses’ everyday ethical dilemmas and will be further explored to evaluate how well it can serve as a tool to identify and handle problems that arise in nursing care. (shrink)

En quoi le corps participe-t-il de l'entente que l'homme a du monde? Que signifie dès lors écouter? Comment établir un rapport juste à l'animal? Quel sens prêter aux couleurs? Pourquoi la tonalité décisive de notre rapport au monde peut-elle advenir à la faveur d'expériences olfactives et gustatives? En quoi la tactilité incite-t-elle à considérer le corps vif comme une donnée originaire et à reconnaître qu'il est bien une vulnérabilité dotée d'aptitudes qui nous dispose au monde? Comment l'angoisse, révélée et cachée (...) tout à la fois par la maladie, est-elle chevillée au corps de l'être-au-monde, le Dasein? Qu'en est-il du corps dans la nostalgie, dans la mélancolie, dans l'ennui et dans la joie? Pourquoi la coexistence, supposant relations et rencontres, implique-t-elle l'articulation des corporéités vives comme dans le tact sensitif ou dans la jalousie amoureuse et dans l'amour pensé en terme de tonalité érotique? Comment comprendre la mobilité et parvenir ainsi jusqu'à l'éminente dignité ontologique du mouvement? De quoi la pensée est-elle redevable au corps? Telles sont les questions qui jalonnent cet ouvrage. Par son orientation résolument phénoménologique, l'Intelligence du corps entend renouveler l'entente du phénomène le plus proprement humain et, cependant, le plus malmené par la métaphysique. Prenant librement appui sur les vues inouïes de Martin Heidegger, consciente de l'actuelle soumission du corps de l'homme à l'arraisonnement technique, Ingrid Auriol ouvre une voie d'accès à l'intelligence du corps libérée de cette violence. (shrink)

This article reveals a 91-year-old cognitively intact man’s lived experiences of being cared for in a geriatric context in which the majority of the patients were cognitively impaired. A narrative patient story was analysed phenomenologically. The findings indicate that this patient’s basic needs for ethical care were not met. The staff did not see him as a unique individual with his own preferences, resources and abilities to master his life. In order to survive this lack of ethical care, he played (...) the role of an ‘old cognitively impaired man’, which provided him with at least the understanding and attention the cognitively impaired patients received from the staff. The findings also indicate that ethical care is independent of whether or not older cognitively intact and impaired patients stay or live in the same unit, but it is more dependent on a caregiver’s ability to respect and confirm each and every patient for who he or she is and would like to be. (shrink)

This paper offers a critique of Martha Nussbaum’s description of the capability approach, and offers an alternative. I will argue that Nussbaum’s characterization of the capability approach is flawed, in two ways. First, she unduly limits the capability to two strands of work, thereby ignoring important other capabilitarian scholarship. Second, she argues that there are five essential elements that all capability theories meet; yet upon closer analysis three of them are not really essential to the capability approach. I also offer (...) an alternative description of the capability approach, which is called the cartwheel view of the capability approach. This view is at the same time radically multidisciplinary yet also contains a foundationally robust core among its various usages, and is therefore much better able to make the case that the capability approach can be developed in a very wide range of more specific normative theories. Finally, the cartwheel view is used to argue against Nussbaum's claim that all capabilitarian political theory needs to be politically liberal. (shrink)

Paradoxically, the practical necessity of love seems to combine the personal character of psychological necessity with the inescapable and authoritative quality of moral necessity. Traditionally, philosophers have avoided this paradox by treating love as an amalgam of impersonal evaluative judgments and affective responses. On my account, love participates in a different form of practical necessity, one characterized by a non-moral yet normative type of expectation. This expectation is best understood as a kind of second-personal address that does not support derivative (...) third-personal demands. It is revealed when we react with hurt feelings instead of resentment upon its disappointment. (shrink)

What is empiricism and what could it be? Bas . van Fraassen, one of the world’s foremost contributors to philosophical logic and the philosophy of science, here undertakes a fresh consideration of these questions and offers a program for renewal of the empiricist tradition. The empiricist tradition is not and could not be defined by common doctrines, but embodies a certain stance in philosophy, van Fraassen says. This stance is displayed first of all in a searing, recurrent critique of metaphysics, (...) and secondly in a focus on experience that requires a voluntarist view of belief and opinion. Van Fraassen focuses on the philosophical problems of scientific and conceptual revolutions and on the not unrelated ruptures between religious and secular ways of seeing or conceiving of ourselves. He explores what it is to be or not be secular and points the way toward a new relationship between secularism and science within philosophy. (shrink)

Continuing medico-technical progress has led toan increasing medicalisation of pregnancy andchildbirth. One of the most common technologiesin this context is ultrasound. Based on someidentified `pro-technology feminist theories',notably the postmodernist feminist discourse,the technology of ultrasound is analysedfocusing mainly on social and political ratherthan clinical issues. As empirical researchsuggests, ultrasound is welcomed by themajority of women. The analysis, however, showsthat attitudes and decisions of women areinfluenced by broader social aspects. Furthermore, it demonstrates how the visualtechnology of ultrasound, in addition to otherreproductive technology (...) in maternity care, islinked to the `personification' of the foetusand has therefore contributed to a new image ofthe foetus. The exploration of these issueschallenges some arguments of feministdiscourse. It draws attention to possibleadverse implications of the technology forwomen's reproductive freedom and indicates theimportance of the topic for politicaldiscussions. (shrink)

A IDENTIFICAÇÃO DO DIREITO AMBIENTAL MARÍTIMO.

A IMPORTÂNCIA DE TRATAMENTO DE ÁGUAS RESIDUAIS ATRAVÉS DA BIORREMEDIAÇÃO: UMA ANÁLISE PRINCIPIOLÓGICA.