Background: Older, frail patients with multimorbidity are at an especially high risk for disease severity and death from COVID-19. The social restrictions proved challenging for the residents, their relatives, and the care staff. While these restrictions clearly impacted daily life in Norwegian nursing homes, knowledge about how the pandemic influenced nursing practice is sparse. Aim: The aim of the study was to illuminate ethical difficult situations experienced by Norwegian nurses working in nursing homes during the COVID-19 pandemic. Research design and (...) participants: The research design involved semistructured individual interviews conducted with 15 nurses working in 8 nursing homes in 3 health regions in Norway, within both urban and rural areas. Ethical considerations: Oral and written information about the study was provided before the participants gave their written consent. The transcribed interviews were de-identified. The study was approved by the Norwegian Centre for Research Data. Findings: Four ethical difficult situations were identified: (a) turning the nursing home into a prison; (b) using medication to maintain peace and order; (c) being left alone with the responsibility; and (d) s. impact on decision-making. Conclusions: The nurses’ ethical challenges were intertwined with external factors, such as national and local guidelines, and the nurses’ own internalized factors, which were connected to their subjective professionality. This duality inflicted emotional distress and gave nurses few opportunities to perform nursing in a professionally sound and safe manner. (shrink)

Our study presents an overview of the issues that were brought forward by participants of a moral case deliberation (MCD) project in two elderly care organizations. The overview was inductively derived from all case descriptions (N = 202) provided by participants of seven mixed MCD groups, consisting of care providers from various professional backgrounds, from nursing assistant to physician. The MCD groups were part of a larger MCD project within two care institutions (residential homes and nursing homes). Care providers are (...) confronted with a wide variety of largely everyday ethical issues. We distinguished three main categories: ‘resident’s behavior’, ‘divergent perspectives on good care’ and ‘organizational context’. The overview can be used for agendasetting when institutions wish to stimulate reflection and deliberation. It is important that an agenda is constructed from the bottom-up and open to a variety of issues. In addition, organizing reflection and deliberation requires effort to identify moral questions in practice whilst at the same time maintaining the connection with the organizational context and existing communication structures. Once care providers are used to dealing with divergent perspectives, inviting different perspectives (e.g. family members) to take part in the deliberation, might help to identify and address ethical ‘blind spots’. (shrink)

Involving patients in decisions on primary prevention can be questioned from an ethical perspective, due to a tension between health promotion activities and patient autonomy. A nurse-led intervention for prevention of cardiovascular diseases, including counselling (risk communication, and elements of shared decision-making and motivational interviewing) and supportive tools such as a decision aid, was implemented in primary care. The aim of this study was to evaluate the nurse-led intervention from an ethical perspective by exploring in detail the experiences of patients (...) with the intervention, and their views on the role of both the nurse and patient. The study had a qualitative design. 18 patients who had received the intervention participated. Data were gathered by in-depth interviews. The interviews were analysed using directed content analysis. The findings revealed that patients perceived the consultations not as an infringement on their autonomy, but as supportive to risk reduction efforts they tried but found hard to realise. They specifically emphasised the role of the nurse, and appreciated the nurse's realistic advice, encouragement, and help in understanding. Patients' views on and experiences with risk management are in line with notions of relational autonomy, caring cooperation and communicative action found in the literature. We conclude that patients define the relationship with the nurse as shared work in the process of developing a healthier lifestyle. (shrink)

Le volume s'enquiert des liens entre l'affectivite et l'activite philosophique. Sur le mode historique et/ou problematique il s'agit de traiter de questions telles que: Y a-t-il une ou des tonalites affectives specifiques a la philosophie: etonnement, angoisse, ennui, serenite, melancolie,...? L'activite philosophique est-elle associee a un deni de l'affectivite et sous quelles formes: nihilisme, detachement, refoulement...? Quel rapport le philosophe noue-t-il a l'ambivalence de l'affect (indecidabilite, double bind,...)? Qu'en est-il de la reception thematique de l'affectivite en philosophie: une philosophie ou (...) une phenomenologie de l'affectivite est-elle possible? Quel statut philosophique pour des sciences nouvelles - les neurosciences -qui pretendent etudier objectivement et techniquement l'affectivit. (shrink)

With online communication being of growing importance in the organizational context, the aim of this research is to measure its relevance and acceptance among Nigerian businesses and employees. Therefore, a case study focusing on Nigeria Breweries Plc. has been designed and conducted, permitting conclusions on the implementation, efficiency, overall perception, and challenges related to the use of online communication tools in the context of Nigerian businesses of today and tomorrow.

In lieu of an abstract, here is a brief excerpt of the content:These Things I BelieveA. M. ShuhamI am a health care professional who has worked in the field for two decades. I have been part of small miracles and heartbreaking events, which kept me up at night. Although I do not [End Page 120] provide direct patient care, my advanced education and expertise allows me to advise members of the health care team when difficult questions arise about the goals (...) of treatment, questions about competency and interpreting patient preferences. I believe my interest in the field was shaped by my family’s experience dealing with the challenges that come with terminal illness and advancing age. I am humbled to have been part of their journey as they faced death with dignity and grace.Living in a small community presents significant challenges that may never occur in a large urban setting. The team you work with knows your family or the names of your children because in their spare time they are the piano teacher or soccer coach for your children, friends that knew you growing up. This close knit atmosphere can be a blessing when things go well and unbearable when mistakes are made or professionals disagree, because you still interact with one another outside the context of your professional role and this is when moral distress begins.I began working with A. J. ten years ago to facilitate the completion of a health care directive. At the time A. J was beginning to show the signs of a neuro–muscular disease experienced by other members of the family. In early 2000 most directives were fairly straightforward with the option to choose artificial nutrition and hydration or not. A. J. very specifically checked “none.” Years went by living independently for A. J. but as most illnesses progress so did A. J’s, and admission to a health care institution became necessary. In many situations medically assisted nutrition and hydration would be indicated, but in this case the wishes of the patient were known in the form of a health care directive. The decision makers inability to honor the directive was the purpose for my involvement almost a decade after my initial work with A. J.No matter where you stand in the debate regarding medically assisted nutrition and hydration being burdensome or ordinary care, most people believe in the importance of a health care directive given the histories of Nancy Cruzan, Karen Quinlan and Terri Schiavo. My objective was to compile the legal information that would elucidate the patient preferences and help staff and the decision maker understand it was time to honor the directive given the advanced stage of disease. Numerous attempts were made with the surrogate and health care professionals to help them understand state statutes on health care directives supporting a patient’s right to chose. It became clear that some of the team seemed disinterested in my concerns or my responsibility as a professional, and I began to believe the difficulty was a failure on my part to communicate clearly.During that first year conversations and meetings were scheduled with the patients decision makers and they felt unable to make a decision and requested the entire family provide input. Although they understood A. J’s wishes, they felt everyone should be in agreement. In my experience when leaving decisions of this magnitude to a large extended family, communications deteriorate and little can be accomplished. Some members in the family held fundamental religious beliefs and thought a miracle could change the prognosis. While I believe as health care professionals we must respect individual religious beliefs and values, we are also morally obligated to advocate on behalf of our patients a fundamental principle I hold dear.The health care team was no more eager to address the issue than the family. I had produced specific state statutes regarding the health care directive of a previously competent person and even in light of this information, some individuals continued to believe the surrogates decision took precedence over the directive. This growing tension left me feeling angry and ineffective, questioning my role in the organization, while watching A. J. linger in a state not chosen. I believed I had failed... (shrink)

We are printing in its entirety the discussion document which sets out a code of professional conduct for nurses published by the Royal College of Nursing in November 1976 together with commentaries by the Assistant Secretary of the British Medical Association, a professor of nursing studies, student nurses and a lawyer. The image of the nurse is still that of one of Florence Nightingale's young ladies or of a member of a religious order who is wholly dedicated to caring for (...) the sick. Today, as this document and the comments upon it show, 'dedication' is still part of the motive which leads a man or woman to become a nurse but in addition, and this is where the public may be ignorant or choose to be ignorant, nursing offers a career where intellectual achievement and the satisfaction of a demanding job bring their proper financial reward and place in the professional community. We are grateful to the Royal College of Nursing for permission to publish this document. (shrink)

A. M. Ritchie; XII—Can Animals See? A Cartesian Query, Proceedings of the Aristotelian Society, Volume 64, Issue 1, 1 June 1964, Pages 221–242, https://doi.org/.

The scene in Aristophanes' Frogs where Dionysus rows Charon's boat across the Styx to the accompaniment of the chorus of frogs is, of course, one of the most famous passages of Greek Comedy, and an essential element of the humour of the passage is the ineptitude of Dionysus as a rower. As a large part of the Athenian audience would have served in triremes as rowers, Dionysus' inability to perform this familiar task adequately will have been immediately ridiculous. Aristophanes was (...) thus exploiting an easy source of humour in depicting Dionysus as an unaccomplished rower battling against the difficulties and discomforts of the task. Had so obvious a source of humour been neglected by the playwrights of Athenian Old Comedy till the time of Frogs? We should have been obliged to answer that we had no positive indications to the contrary till the publication in 1968 of Pap. Ox. 2740, but this now furnishes us with grounds to infer that some other Old Comedy, very probably the Taxiarchs of Eupolis, contained a scene where some person was represented as rowing ineptly. (shrink)

"Aptavani 1" is the first in a series of spiritual books titled "Aptavani". In this series, Gnani Purush (embodiment of Self knowledge) Dada Bhagwan addresses age-old unanswered questions of spiritual seekers. Dadashri offers in-depth answers to questions such as: "Who am I?", "What is our purpose in life?", "What is the nature of the journey of souls?", "Why do bad things happen to good people?", "What does karma mean?", "How was the world created?", "Who is the 'Doer' (ego definition)?"Dadashri also (...) provides spiritual expositions on the topics of: "What is religion?", "How to find God?", "What is the difference in religion vs. spirituality?", "How do you define spirituality?", "How can I attain knowledge of Self?", "How can I experience my own pure Soul?", and "What is liberation?"Ultimately, Dadashri describes how the knowledge of Self is the final goal of all seeking. Without Self knowledge, one cannot attain ultimate liberation, or moksha. (shrink)

The paper is devoted to the subject status of the discipline “Philosophy of Sociology”. Philosophy of sociology is an interdisciplinary direction focusing on the main preconditions of sociological knowledge development as well as cognitive value of sociological facts, theories and conceptions. Its subject can be divided into “philosophical foundations of sociology” and “philosophical problems of sociology”. “Sociologism” as the concept of substitution of social philosophy by sociology as a science which is better empirically oriented and is able to give more (...) exact and proved picture of social reality also poses danger to social philosophy. “Sociologism” presents a positivist attack on social philosophy. Indeed, sociology is no less speculative science than social philosophy is, which is well illustrated by a lot of divergences among its theoretical constructions and empirical data. The main functions of philosophy of sociology in the world of contemporary social-humanitarian knowledge are critical function, integrative function and axiological function. (shrink)

The Lord of the Fourteen worlds is manifest here. Questioner: For whom is the title 'Dada Bhagwan' used? Dadashri: For 'Dada Bhagwan.' Not for me. I am a 'Gnani Purush A. M. Patel.' 'Dada Bhagwan' is the Lord of the fourteen worlds. He dwells within you also, but He has not awakened yet, he remains unmanifested. Here within me, He is fully awakened and manifest. He is capable of awakening the Lord within you.

The nature of quantum computation is discussed. It is argued that, in terms of the amount of information manipulated in a given time, quantum and classical computation are equally efficient. Quantum superposition does not permit quantum computers to ''perform many computations simultaneously'' except in a highly qualified and to some extent misleading sense. Quantum computation is therefore not well described by interpretations of quantum mechanics which invoke the concept of vast numbers of parallel universes. Rather, entanglement makes available types of (...) computation processes which, while not exponentially larger than classical ones, are unavailable to classical systems. The essence of quantum computation is that it uses entanglement to generate and manipulate a physical representation of the correlations between logical entities, without the need to completely represent the logical entities themselves. (shrink)

A. M. MacIver; I—The Presidential Address: The Instrumentality of Language, Proceedings of the Aristotelian Society, Volume 62, Issue 1, 1 June 1962, Pages 1–20.

The pertinence of questions of social forecasting increases in connection with the development of the revolution in science and technology and with the pressing need to predict its social consequences. The growing attention to these questions in contemporary bourgeois sociology is to be explained, on the one hand, by the need for a theoretical validation of what is termed "social programming" under the conditions of state-monopoly capitalism, by the requirements for a practical elaboration of a technique for predicting the state (...) of the economy and political situations of the future, and, on the other hand, by the effort of bourgeois ideologists to reject the very possibility of any social and historical forecasting requiring recognition of objective laws in history. (shrink)