The role of nurses in leading the design and delivery of primary health care services to address health inequities is growing in prominence, specifically in rural Australia. However, limited evidence exists to inform nurse‐led primary health care in this context. Based on a focus group with nursing executives and semi‐structured interviews with registered nurses we describe nurse experiences of leading the design of a primary health care service in rural Australia and nurse transition to and practice in this service. Nurse (...) experiences were analysed using reflexive thematic analysis. The study reveals the centrality of relational integration in service design and nurse acquisition of relational practice as it relates to nurse to care recipient and nurse to nurse relationships. Tensions between primary health care nurses and their peers, and resultant de‐valuing of primary health care practice, are described. The acquisition of nurse professional agency draws attention to investments required to position nurses to lead and sustain care innovations external to hospital settings. The authors propose that relational approaches may provide nurses with the opportunity to reframe their leadership and service contributions towards community literate primary health care provision and provide a pathway to professional emancipation from constrained practice expectations. (shrink)

Background Policy decisions about childhood vaccination require consideration of multiple, sometimes conflicting, public health and ethical imperatives. Examples of these decisions are whether vaccination should be mandatory and, if so, whether to allow for non-medical exemptions. In this article we argue that these policy decisions go beyond typical public health mandates and therefore require democratic input.Methods We report on the design, implementation, and results of a deliberative public forum convened over four days in Ontario, Canada, on the topic of childhood (...) vaccination.Results 25 participants completed all four days of deliberation and collectively developed 20 policy recommendations on issues relating to mandatory vaccinations and exemptions, communication about vaccines and vaccination, and AEFI (adverse events following immunization) compensation and reporting. Notable recommendations include unanimous support for mandatory childhood vaccination in Ontario, the need for broad educational communication about vaccination, and the development of a no-fault compensation scheme for AEFIs. There was persistent disagreement among deliberants about the form of exemptions from vaccination (conscience, religious beliefs) that should be permissible, as well as appropriate consequences if parents do not vaccinate their children.Conclusions We conclude that conducting deliberative democratic processes on topics that are polarizing and controversial is viable and should be further developed and implemented to support democratically legitimate and trustworthy policy about childhood vaccination. (shrink)

In this paper I want to do the following things. First I want to show that in the part of the Theaetetus where the relationship between knowledge and perception is examined, the concept of knowledge that is in question is very clearly characterized. We are left in no doubt as to what is to count as knowing. Secondly I want to unravel in some detail the case that Socrates puts on Protagoras’ behalf where he draws on what Protagoras actually wrote (...) ; as opposed to what he may have taught secretly to his pupils. Thirdly I wish to argue that if we let the dialogue speak for itself, it is manifest that this case put up on Protagoras’ behalf at 151 E-152C is not overthrown; it is not even shaken.In that part of the dialogue where the question is under examination whether or not knowledge and perception are the same, Socrates uses an idealized concept of knowledge. That is, he restricts the use of the word by setting down what he will consider to be the essential characteristics of knowledge, the sufficient and necessary conditions of its being instantiated. An excellent piece of philosophical procedure. (shrink)

This book is a philosophical commentary on Schopenhauer's "Fourfold Root of the Principle of Sufficient Reason," dealing with each of Schopenhauer's principal ...

In this paper the authors argue that the exploration of the nature of needs and rights should begin with the actually existing organization of care and of justice in society. The authors raise two key concerns with this organization: 1) the invisibility of care to some, and 2) the inaccessibility of rights to others. Recent work by care scholars has called attention to the ways the current organization of care work perpetuates the myth of self-sufficiency for some, while reducing others (...) to mere dependents. Law and Society scholars have demonstrated the problems of uneven access to legal remedies within the current organization of the legal system. Addressing these concerns simultaneously reveals both the problems of the current organization of needs and rights as well as illuminating alternative possibilities. The authors argue, first, that a justice perspective, based on rights is inadequate because its presumed universality is belied by the reality of the inaccessibility of rights to many. Second, the authors argue that a care perspective, currently formulated upon the assumption that only some people have needs, is also flawed because its presumed particularity distorts the human experience and subsequent policies. Instead, the authors need to conceive of care in a public way that permits both rights and needs to be understood as applicable to all. The authors propose some initial thoughts about how to create such a public concept of care. (shrink)

The rubber hand paradigm is used to create the illusion of self-touch, by having the participant administer stimulation to a prosthetic hand while the Examiner, with an identical stimulus , administers stimulation to the participant’s hand. With synchronous stimulation, participants experience the compelling illusion that they are touching their own hand. In the current study, the robustness of this illusion was assessed using incongruent stimuli. The participant used the index finger of the right hand to administer stimulation to a prosthetic (...) hand while the Examiner used a paintbrush to administer stimulation to the participant’s left hand. The results indicate that this violation of tactile expectations does not diminish the illusion of self-touch. Participants experienced the illusion despite the use of incongruent stimuli, both when vision was precluded and when visual feedback provided clear evidence of the tactile mismatch. (shrink)

Youths with disruptive behavior disorders and psychopathic traits showed reduced amygdala responses to fearful expressions under low attentional load but no indications of increased recruitment of regions implicated in top- down attentional control. These findings suggest that the emotional deficit observed in youths with disruptive behavior disorders and psychopathic traits is primary and not secondary to increased top- down attention to nonemotional stimulus features.

A new realislic local model of light propagation and detection is described. The authors propose a novel stochastic model of low-intensity photon detection in which background noise is added to a part of the photon prior to absorption. In this model, in agreement with Planck, there is no quantization of the propagating field. The model has some similarities to theories advanced by E. Santos and T. Marshall in the last decade, but also has substantial deviations from these. A mechanism, conserving (...) energy and momentum, is proposed by which a sudden collapse of the wave-packet is avoided. The experimental Bell inequality violation of Aspect. Grangier and Roger [Phys. Rev. Lett.47, 460 (1981)]is discussed. The authors have carried out a computer simulation of a radio frequency (RF) analogue of the Einstein-Podolsky-Rosen thought experiment to illustrate how the manipulation of certain factors, especially signal to noise ratio, detector threshold and characteristics of the noise, enables the same Bell inequality to be either satisfied or violated by a realistic local model. Building on arguments by Santos. [Phys. Rev. A46. 3646 (1992)],the appropriateness of this Bell lest is discussed. Neither the authors' stochastic-optical model, nor their RF analogue, involves an enhancement assumption of the type defined by Clauser and Horne [Phys. Rev. D10, 526 (1974)]. (shrink)

A simple experimental paradigm creates the powerful illusion that one is touching one’s own hand even when the two hands are separated by 15 cm. The participant uses her right hand to administer stimulation to a prosthetic hand while the Examiner provides identical stimulation to the participant’s receptive left hand. Change in felt position of the receptive hand toward the prosthetic hand has previously led to the interpretation that the participant experiences self-touch at the location of the prosthetic hand, and (...) experiences a sense of ownership of the prosthetic hand. Our results argue against this interpretation. We assessed change in felt position of the participant’s receptive hand but we also assessed change in felt position of the participant’s administering hand. Change in felt position of the administering hand was significantly greater than change in felt position of the receptive hand. Implications for theories of ownership are discussed. (shrink)

Health care is provided in many contexts—not just hospitals, clinics, and community health settings. Different institutional settings may significantly influence the design and delivery of health care and the ethical obligations and practices of health care practitioners working within them. This is particularly true in institutions that are established to constrain freedom, ensure security and authority, and restrict movement and choice. We describe the results of a qualitative study of the experiences of doctors and nurses working within two women’s prisons (...) in the state of New South Wales (NSW), Australia. Their accounts make clear how the provision and ethics of health care may be compromised by the physical design of the prison, the institutional policies and practices restricting movement of prisoners and practitioners, the focus on maintaining control and security, and the very purpose of the prison and prison system itself. The results of this study make clear the impact that context has on professional practice and illustrate the importance of sociology and anthropology to bioethics and to the development of a more nuanced account of professional ethics. (shrink)

This essay results from a common interest in the history of emotions shared by an academic with appointments in philosophy and psychiatry (Charland) and a literary historian (White). Where our interests converge is in the early modern concept of 'the passions,' as explanatory of what we now call mental illness. The task we have set ourselves is to see how this might: (a) be exemplified in a 'case study' of the dramatic revelation of Leontes's jealousy in the first half (...) of William Shakespeare's The Winter's Tale, and his 'cure' which takes sixteen years. Both events have troubled literary critics as implausible, lacking in realistic motivation, and clumsy as narrative devices, but can be explained in terms of theories of the passions ; and (b) open up a greater, modern understanding of irrational, pathological states, their onset and termination, by using as an explanatory model the early modern understanding of passions as revived and refined in the nineteenth century by Théodule Ribot. Janus-like, this chapter faces into the past and the future (our present) via a play written in 1610 that is still performed to receptive audiences today. We hope to show that the theory can illuminate a playtext, and that the play can revivify the theory, and to contend that historical analysis can shed light on modern clinical problems. The particular historical distinction which lies at the heart of our approach derives from early modern terminology offered by Thomas Wright in his book, The Passions of the Minde in Generall (first published in 1601; corrected, enlarged and augmented in 1604), and presented in more modern fashion in the nineteenth century by Théodule Ribot, in his La Psycholgie des sentiments * We dedicate this essay to Philippa Maddern, whose inspiration has generated so much inter-disciplinary research in the history of emotions and has brought so many like-minded scholars into fertile contact—in our cases, linking Western Ontario and Western Australia. (shrink)

The authors present a case study involving truth telling responsibilities in the setting of nonepileptic seizures. Specifically, over the course of several suspected nonepileptic seizures, a patient’s seizures stopped after he received a saline flush meant to precede the administration of anti-seizure medication. The patient and his surrogate believed he had received the medication each time, and the team wondered whether they should disclose the truth. Some worried that disclosure would reinforce the suspected psychogenic behavior, exacerbating the patient’s condition. In (...) this way, the case study presents a twist on the traditional truth telling archetype. While most truth telling cases center on navigating cultural differences or worries about emotional harm, this case presented concerns about medical harm in the form of exacerbating the patient’s condition. The authors describe the complex patient-family-team dynamic that preceded this ethical dilemma, describe the case, analyze the ethical issue, and describe the outcome. (shrink)

ABSTRACTThis research investigated whether precues engage proactive control to reduce emotional interference during speech production. A picture-word interference task required participants to name target pictures accompanied by taboo, negative, or neutral distractors. Proactive control was manipulated by presenting precues that signalled the type of distractor that would appear on the next trial. Experiment 1 included one block of trials with precues and one without, whereas Experiment 2 mixed precued and uncued trials. Consistent with previous research, picture naming was slowed in (...) both experiments when distractors were taboo or negative compared to neutral, with the greatest slowing effect when distractors were taboo. Evidence that precues engaged proactive control to reduce interference from taboo distractors was found in Experiment 1. In contrast, mixing precued trials in Experiment 2 resulted in no taboo cueing benefit. These results suggest that item-level proactive control can b... (shrink)