The Global Health Security Agenda (GHSA) is a multilateral, multisectoral partnership comprised of more than 70 countries, international organizations, foundations, and businesses to strengthen global health security.

Concerns regarding corporate ethics have grown steadily throughout the past decade. In order to remain competitive, many organizational leaders are faced with the challenge of creating an ethical environment within their organization. A model is presented showing the process and elements necessary for the institutionalization of organizational ethics. The transformational leadership style lends itself well to the creation of an ethical environment and is suggested as a means to facilitate the institutionalization of corporate ethics. Finally, the benefits of using transformational (...) leadership are demonstrated through the components of a psychological contract, organizational commitment, and ethical culture to institutionalize organizational ethics. (shrink)

Human rights are foundational to the health and well-being of all individuals and have remained a central tenet of nursing’s ethical framework throughout history. The purpose of this study is to explore continuity and changes to human rights in nursing codes of ethics in the Canadian context. This study examines nursing codes of ethics between the years 1953 and 2017, which spans the very first code in Canada to the most recently adopted. The historical method is used to compare and (...) contrast human rights language, positioning and descriptions between different code editions. The findings suggest there has been very little change in how human rights have been included within the Canadian nursing codes of ethics. Furthermore, we consider how changes within the nursing profession have influenced the authority of codes of ethics and their ability to support nurses in carrying out ethical obligations specific to human rights. Finally, the impacts and implications of these changes are discussed concerning the protection of human rights in today’s healthcare landscape in Canada. (shrink)

Discourses of interdisciplinary health‐care are becoming more centralised in the context of global healthcare practices, which are increasingly based on multisystem interventions. As with all dominant discourses that are narrated into being, many others have been silenced and decentralised in the process. While questions of the nature and constituents of interdisciplinary practices continue to be debated and rehearsed, this paper focuses on the discourse of interdisciplinary collaboration using psychiatry as an example, with the aim of highlighting competing and alternative discourses. (...) The fundamental premise of this paper is that collaborative relationships form the basis of interdisciplinary practices in psychiatry. Through a critical engagement and a deconstructive reading of the pretext, context and subtexts of interdisciplinarity, we interrogate the concept of interdisciplinary practice within psychiatry. We contend that an important part of understanding and further conceptualising the discourse is through fracturing it. This process is illustrated in the successive stages of our conceptual map of discourse development: establishing, maintaining and developing discourses. An understanding of interdisciplinary practice is not only critical for psychiatry, but also offers important insights into the performance of collaborative failures and indeed successes across nursing and allied health professions. (shrink)

Background and Objectives Primary care providers (PCPs) report decreased job satisfaction and high levels of burnout, yet little is known about their experience of moral distress. The aim of this study was to gain insight into the experiences of PCPs regarding moral distress including causative factors and proposed mitigation strategies. Methods This qualitative pilot study used semi-structured interviews to identify causes of moral distress in PCPs in an academic family medicine department. Interviews were analyzed using conventional content analysis. Results Of (...) 35 eligible participants, 12 completed the study (34% participation rate). Most were white, female, and had practiced for less than 10 years. Four PCPs had considered leaving their position due to moral distress. Participants identified five causes of moral distress: policies and procedures that conflict with patient needs, the unpredictable nature of primary care, need to “bend the rules,” lack of accountability, and lack of support staff. Six internal conflicts made resolving morally distressing situations difficult: perceived powerlessness, sense of responsibility, socialization to follow orders, emotional toll of the job, competing obligations, and fear of mistakes. Conclusions These findings matched themes in the current literature and identified an unbending infrastructure. This, coupled with the chaotic nature of primary care, resulted in frequent moral distress. Participants offered solutions to reduce and mitigate moral distress (also similar with current literature) and suggested moral distress and burnout are closely linked. (shrink)

In this article, we contribute to sociological literatures on morality, professional and institutional contexts, and morally stigmatized ‘dirty work’ by emphasizing and exploring how they mutually inform one another in lawyers’ work activities. Drawing on interview data with 58 practitioners in the commercial legal industry in Singapore, we analyze how they experience professional and institutional constraints on the expressions of morality in their work. Our findings illustrate how a dominant managerial and economic focus maintains and reproduces a constrained form of (...) morality, limited to instrumental, utilitarian and commercial ends, and subordinated to lucrative client and firm interests. We discuss our findings in terms of the need to research and reform professions in ways that support more rounded and unconstrained moral reflexivity and autonomy in how work is undertaken and valued. This in turn has implications for how organizations and professions might achieve alternative moral institutional orders, and for legal work to avoid the moral and social taints of dirty work. (shrink)

According to Roger Scruton, it is not possible for photographs to be representational art. Most responses to Scruton’s scepticism are versions of the claim that Scruton disregards the extent to which intentionality features in photography; but these cannot force him to give up his notion of the ideal photograph. My approach is to argue that Scruton has misconstrued the role of causation in his discussion of photography. I claim that although Scruton insists that the ideal photograph is defined by its (...) ‘merely causal’ provenance, in fact he fails to take the causal provenance of photographs seriously enough. To replace Scruton’s notion of the ideal photograph, I offer a substantive account of the causal provenance of photographs, centred on the distinctive role of ‘the photographic event’. I conclude that, with a proper understanding of the photographic process, we have good reason to re-open the question of photography as a representational art. (shrink)

Drawing from our interdisciplinary qualitative study of LGBTI conservative Christians and their allies, we name an especially toxic form of shame—what we call sacramental shame—that affects the lives of LGBTI and other conservative Christians. Sacramental shame results from conservative Christianity's allegiance to the doctrine of gender complementarity, which elevates heteronormativity to the level of the sacred and renders those who violate it as not persons, but monsters. In dispensing shame as a sacrament, nonaffirming Christians require constant displays of shame as (...) proof that LGBTI church members love God and belong in the community. Part of what makes this shame so harmful is that parents and pastors often dispense it with sincere expressions of care and affection, compounding the sense that one's capacity to give and receive love is damaged. We foreground LGBTI Christian movements to overcome sacramental shame by cultivating nonhubristic pride, and conclude by discussing briefly their new understandings of love and justice that could have far‐reaching benefits. (shrink)

In neocolonial contexts of globalization, the epistemological terrain of radical diversity poses significant ethical challenges to transnational feminisms. In view of historical associations between knowledge and discourses of love which were conditioned by imperialist brands of humanism and benevolence under colonialism, this paper argues for a deconstructionist approach to conceptualizing love in relation to knowledge and for an ethics that severs the association with benevolence, instead making alterity the basis for its account.

We are told by philosophers that photographs are a distinct category of image because the photographic process is mind-independent. Furthermore, that the experience of viewing a photograph has a special status, justified by a viewer’s knowledge that the photographic process is mind-independent. Versions of these ideas are central to discussions of photography in both the philosophy of art and epistemology and have far-reaching implications for science, forensics and documentary journalism. Mind-independence (sometimes ‘belief independence’) is a term employed to highlight what (...) is important in the idea that photographs can be produced naturally, mechanically, accidentally or automatically. Insofar as the process is physical, natural, mechanical or causal it can occur without human agency or intervention, entirely in the absence of intentional states. Presented innocuously, the idea is that although photographs are dependent on natural or mechanical processes, they can be produced independently of human agency – particularly human beliefs. Presented in a stronger form, the claim is that even if human agency is heavily involved in the production process, the definitive features that make the photograph a photograph and determine its salient properties are nonetheless independent of human minds. In epistemic debates, mind-independence is viewed as essential for explaining why photographs occupy a distinct category among images and justifying a variety of claims about their privileged epistemic and affective status in science, forensics, popular culture and journalism. But, in the philosophy of art, claims about mind-. (shrink)

Like his contemporary, Edward Weston, Ansel Adams claimed that visualization is essential for creating fine art photography. But, unlike Weston, he believed that a print from a negative is like a performance from a score. In his analogy, a photographer’s visualization is like a musician’s composition: once it has been set down in a ‘score’, it can be expressively rendered by different performers, making it possible to create and critically appreciate ‘performances’ with different qualities. I argue that this music-photography analogy (...) makes Adams’s conception of photographic visualization more fruitful than Weston’s alternative. However, while I agree with Adams that a print is analogous to a performance, I criticize his idea that a negative is like a score. I argue that he holds a traditional, single-stage conception of photography, which led him to overlook a key distinction between undeveloped film and the developed negative. The multi-stage account of photography that I defend not only remedies this problem but also shows how Adams’s proposal can be fully realized in digital photography. Most significantly, it invites theorists and practitioners to expand the music-photography analogy by considering wider varieties of music—not only performances from a score. (shrink)

German philosopher Martin Heidegger stirred educators when in 1951 he claimed teaching is more difficult than learning because teachers must ‘learn to let learn’. However in the main he left the aphorism unexplained as part of a brief four-paragraph, less than two-page set of observations concerning the relationship of teaching to learning; and concluded at the end of those observations that to become a teacher is an ‘exalted matter’. This paper investigates both of Heidegger's claims, interpreting letting learn in the (...) context of Heidegger's larger philosophical project, and suggesting why in light of that project to become a teacher is an exalted concern. The methodology guiding the inquiry is largely hermeneutic, the purpose of the essay to interpret teaching from a Heideggerian perspective: its nature and general method. (shrink)

Past research suggests that people process verbal quantifiers differently from numerical ones, but this suggestion has yet to be formally tested. Drawing from traditional correlates of dual-process...

The author explores how the discursive practices of social texts relate to the subjectivities of readers. Employing Dorothy Smith's notion of femininity as textually mediated discourse, the author analyzes how teenage girls read the depictions of femininity in the glossy advertisements of fashion magazines. Through interviews with 48 girls aged 13 to 17 years, she explores both why and how young girls negotiate “what it means to be a woman.” Most young girls in her study draw on stereotypical meanings of (...) adult femininity. By giving these stereotypes truth status, these readers valorize not only patriarchal meanings of womanhood but also naturalize associations between femininity and the commodities through which this femininity is expressed as the everyday doing of gender. The author concludes by discussing implications of this study for both a feminist theory and a feminist politics of culture. (shrink)

The “boomerang thesis” enjoys widespread currency in contemporary scholarship: that the means and ends of colonial domination would “spin back” to the metropole is an idea with intuitive grip. This article extrapolates the depth of meaning this metaphor contains, as well as what it conceals. It first considers the “boomerang” as it appears in Aimé Césaire’s Discourse on Colonialism, a poetic work that captures the moral and experiential return-effects of imperial violence. Turning to Hannah Arendt’s The Origins of Totalitarianism—the only (...) articulation of the thesis that uses the word “boomerang”—the article disaggregates the teleological, ideological, and institutional elements that spun back from European colonies in the imperial era. Finally, it traces the development of the thesis in Michel Foucault’s “Society Must Be Defended,” where it is transformed into a more general explanatory mechanism. Each theorist indicates how distance operates to transform dubious, even hateful ideas into acceptable practices. (shrink)

Some photographs show determinate features of a scene because the photographed scene had those features. This dependency relation is, rightly, a consensus in philosophy of photography. I seek to refute many long-established theories of photography by arguing that they are incompatible with this commitment. In Section II, I classify accounts of photography as either single-stage or multi-stage. In Section III, I analyze the historical basis for single-stage accounts. In Section IV, I explain why the single-stage view led scientists to postulate (...) “latent” photographic images as a technical phenomenon in early chemical photography. In Section V, I discredit the notion of an invisible latent image in chemical photography and, in Section VI, extend this objection to the legacy of the latent image in digital photography. In Section VII, I appeal to the dependency relation to explain why the notion of a latent image makes the single-stage account untenable. Finally, I use the multi-stage account to advance debate about “new” versus “orthodox” theories of photography. (shrink)

The concept of emotional intelligence has grown in popularity over the last two decades, generating interest both at a social and a professional level. Concurrent developments in nursing relate to the recognition of the impact of self‐awareness and reflexive practice on the quality of the patient experience and the drive toward evidence‐based patient centred models of care. The move of nurse training into higher education heralded many changes and indeed challenges for the profession as a whole. Traditionally, nurse education has (...) been viewed as an essentialist education, the main emphasis being on fitness for practice and the statutory competencies. However, the transfer into the academy confronts the very notion of what constitutes this fitness for practice.Many curricula now make reference in some way to the notion of an emotionally intelligent practitioner, one for whom theory, practice and research are inextricably bound up with tacit and experiential knowledge. In this paper we argue that much of what is described within curriculum documentation is little more than rhetoric when the surface is scratched. Further, we propose that some educationalists and practitioners have embraced the concept of emotional intelligence uncritically, and without fully grasping the entirety of its meaning and application. We attempt to make explicit the manner in which emotional intelligence can be more realistically and appropriately integrated into the profession and conclude by suggesting a model of transformatory learning for nurse education. (shrink)

Mixed results regarding the role of gender in moral reasoning prompted an investigation of an alternative characteristic that may be more influential in the process: sex role orientation. We present an empirical assessment of the relationship between an individual’s moral reasoning level and his/her sex role orientation, gender, and several academic factors. Our results indicate that sex role orientation is not related to moral reasoning level. Gender is related to moral reasoning in our study, women reasoning at higher levels than (...) men. We found a positive relationship between education and moral reasoning level, and moral reasoning levels differed across academic institutions. Our results also show business students have lower moral reasoning levels than students in other fields, although this result did not reach statistical significance. (shrink)

Photography is valued as a medium for recording and visually reproducing features of the world. I seek to challenge the view that photography is fundamentally a recording process and that every photograph is a record—a view that I claim is based on a ‘single-stage’ misconception of the process. I propose an alternative, ‘multi-stage’ account in which I argue that causal registration of light is not equivalent to recording and reproducing an image. Intervention or non-intervention by photographers is more sophisticated than (...) the traditional view allows. Using the multi-stage account, I describe four models for producing photographic images and pictures. (shrink)

Courts and legislatures are increasingly being called upon to restrict the autonomy of pregnant women by requiring them to behave in ways that others determine are best for the fetuses they carry. The state should not attempt to transform pregnant women into ideal baby‐making machines. Pregnant women make decisions about their behavior in the context of the rest of their lives, with all the attendant complexities and pressures. Our interest in helping future children by improving prenatal care would best be (...) furthered by helping pregnant women to make informed, less constrained choices, not by punishing women or depriving them of choices altogether. (shrink)

In 1773, the Scottish traveller Patrick Brydone published an account of visiting Mount Etna, in which he drew on three distinct categories of thought: the scientific, the aesthetic, and the cultural. He carried his barometer up the volcano to measure it; he was overwhelmed with awe on viewing the sunrise from its summit; and he carefully set his account in the context of different mythological and philosophical explanations of Etna, largely drawn from the writings of classical authors. In preceding centuries, (...) Thomas Burnet’s Theory of the Earth and Athanasius Kircher’s Mundus Subterraneus viewed mountains as laboratories for better understanding nature, for evoking a sense of eschatological awe, and as embedded in long traditions of cultural appreciation. Earlier still, Pietro Bembo in 1496 recounted his journey to the summit of Etna which wove together personal observation, classical insights, and aesthetic admiration. In an ancient example, the first-century anonymous Aetna poem urged readers to move beyond mythological explanations for volcanic activity and to instead enjoy true aesthetic pleasure in investigating the volcano and its causes for themselves. This article offers a close reading of these texts in order to demonstrate three key points. The first is that an intense aesthetic experience of volcanoes can be found in accounts predating the eighteenth-century articulation of the ‘natural sublime’. The second is that the compulsion to investigate and understand natural phenomena, as a key element of aesthetic appreciation, is also evident before the Enlightenment. Third, the article suggests that a sense of Etna as ‘classic ground’—as a feature which both intensified the viewer’s interest in its natural phenomena and produced an ‘interested’ aesthetic experience of its natural greatness—likewise extends back even to the ancient texts from which later travellers would draw their own cultural associations. (shrink)

In The Origins of Totalitarianism (1951) and the “Society Must Be Defended” lectures (1975–1976), Hannah Arendt and Michel Foucault present unexpected engagements with Thomas Hobbes’ Leviathan. This article contextualizes and elucidates their interpretations of Hobbes by foregrounding the genealogical aspect of their projects. Their readings of Leviathan reflect common methodological commitments and figure the distinct but related problematics which Foucault and Arendt articulate, encapsulating the differences between their influential conceptions of power. The article concludes with a reading of Hobbes’ theory (...) of the liberty of subjects, which, while not explicitly addressed by Arendt or Foucault, lends support to their treatments of his text. Comparing their readings of Hobbes opens a potentially generative dialogue between their critiques of sovereignty and racialized state violence. (shrink)

Pervasive, easy-to-use privacy services are keys to enabling users to maintain control of their private data in the online environment. This paper proposes (1) an online privacy lifecycle from the user perspective that drives and categorizes the development of these services, (2) a layered platform design solution for online privacy, (3) the evolution of the PeCAN (Personal Context Agent Networking) architecture to a platform for pervasively providing multiple contexts for user privacy preferences and online informational privacy services, and (4) use (...) of platform network effects for increasing wide-scale user adoption of privacy services. One implication of this paper’s concepts is that platform-mediated networks, which are reportedly the vehicles for most of the revenue earned by 60 of the world’s largest companies, and other platforms that commonly host millions of users, will not have to individually reinvent and manage sophisticated user services for privacy protection since universal privacy platforms can be layered on them in future. (shrink)

The traditional doctrine that God is impassible is subject to the objection that it is incompatible with belief that God is loving and compassionate. However, the doctrine that God is passible has grave difficulties as well. I argue that Christian believers should take an analogical approach, by believing that God does something relevantly similar to loving us in a way that involves vulnerability to suffering, and thus conceiving of God as loving us in that way, while simultaneously believing that God (...) is in fact impassible. I conclude with answers to several likely objections. (shrink)

We thank the commentators for their thoughtful engagement with our paper.1 In different ways, they make the same substantial point: our suggested interventions are not enough to solve the problems of organisational failure. On this we wholeheartedly agree. Organisational failure in healthcare is complex and multifaceted, it cannot be solved by one intervention in medical education. We did not intend to imply that our proposals alone would solve organisational failure, and this positioning misconstrues the aims of our paper. We had (...) more modest ambitions, we wanted to shift the analytical emphasis away from the individual and explore the implications raised by our analysis for our piece of the jigsaw—medical education. Having stepped away from such grand claims, the commentators make some valid points to which we would like to respond more specifically. Jesudason makes the distinction that normalisation of deviance (NoD) is well suited to understand institutional misfeasance but not malfeasance.2 We are inclined to agree; NoD can do some things but not all. Likewise, …. (shrink)

In the Tractatus Logico-Philosophicus Wittgenstein appeals to clarity when he characterises the aim, task and results of philosophy. In this essay I suggest that his ‘picture theory’ of language implies that clarity has aesthetic significance in philosophical work. Wittgenstein claims that the task of philosophy is to make thoughts clear. In the ‘picture theory’ of thought and language, a thought expressed in language is a proposition with a sense and a proposition is a picture of reality. The question I pose (...) is: how should we construe clarity, if making a thought clear is making clear a picture of reality? Following a close analysis of the picture theory, paying particular attention to the notions of depicting, presenting and mirroring, I conclude that the result of philosophical work – the clarification of propositions – will be pleasurable, inexpressible and intrinsically valuable. For these reasons I suggest that the attainment of a clear thought is an aesthetic experience. (shrink)

This article introduces and defines the Health in All Policies concept and examines existing state legislation, with a focus on California. The article starts with an overview of HiAP and then analyzes the status of HiAP legislation, specifically addressing variations across states. Finally, the article describes California's HiAP approach and discusses how communities can apply a HiAP framework not only to improve health outcomes and advance health equity, but also to counteract existing laws and policies that contribute to health inequities.

Poovey has argued that the anesthetized “unresisting body” can offer no impediment to a doctor's interpretation of its conduct. In contrast, drawing on ethnographic data of anesthetic practice, this article suggests that the technological augmentation of the body required by present-day anesthesia enhances the ability of an unconscious body to convey its needs and shape the course of the anesthetic. In analyzing the expressions of anesthesia's cyborgs, the author draws on Haraway, Latour, and Suchman to reconsider the characteristics of agency (...) and how an unconscious body might “resist” or inform a doctor's interpretation. This attempt to explore the nature and distribution of agency within a collective is intended as a contribution to the debates surrounding medical dominance and those theorizing the role of technology in health care. (shrink)

A recent paper(1) describing the stage‐specific loss of ubiquitin (UBQ) and ubiquitinated proteins (UBQ‐Ps) during pollen development has raised some interesting questions regarding our understanding of the regulation of protein turnover during cellular differentiation and the specialized development of the pollen grain. The authors, Callis and Bedinger(1), describe experiments in which the profiles of free and protein‐conjugated ubiquitin were examined during pollen development. UBQ and UBQ‐Ps were immunologically detected in extracts of microspores and maturing pollen of maize at six developmental (...) stages. Their results remarkably demonstrate that UBQ and UBQ‐Ps decline to barely detectable levels during the final stages of pollen development. (shrink)

Writing is a staple activity in many philosophy courses. Yet it is a common complaint among philosophy instructors that students arrive to the undergraduate classroom ill-equipped to produce the writing expected of them. What is a philosophy teacher to do? In this essay I draw on pedagogical research in composition studies to argue that philosophers ought to adopt a Writing to Learn and Engage (WTL/E) approach in the lower-division philosophy classroom. Doing so will produce better writing, more capable writers, and (...) better philosophy. By contrast, traditional ways of incorporating writing into the philosophy classroom—including the standard analyze-and-evaluate paper—tend to reflect a Writing in the Disciplines (WID) approach, which I argue is ill-suited to lower-division philosophy courses. After arguing for the intentional adoption of a WTL/E approach, I offer concrete suggestions for implementing the approach in the non-major undergraduate philosophy classroom. (shrink)

In March 2004 the French parliament controversially adopted legislation regulating the wearing of symbols indicating religious affiliation in public educational establishments. This note discusses several features of the new law indicating its origins, its rationale and its position within French constitutional discourse on religious freedom and secularity. It is based on a panel discussion held in April 2004 within the Gender Studies Programme at the Robert Schuman Centre for Advanced Studies, European University Institute, Florence. Placing the French legislative initiative in (...) the context of recent developments in national and European case law (suggesting clear limitations to freedom of religion), the note explores the complexity of issues of gender, identity and difference in the present debate, especially when considered in the light of reactions to the law in Islamic countries. (shrink)

A key property of relational representations is their generativity: From partial descriptions of relations between entities, additional inferences can be drawn about other entities. A major theoretical challenge is to demonstrate how the capacity to make generative inferences could arise as a result of learning relations from non-relational inputs. In the present paper, we show that a bottom-up model of relation learning, initially developed to discriminate between positive and negative examples of comparative relations, can be extended to make generative inferences. (...) The model is able to make quasi-deductive transitive inferences and to qualitatively account for human responses to generative questions such as “What is an animal that is smaller than a dog?” These results provide evidence that relational models based on bottom-up learning mechanisms are capable of supporting generative inferences. (shrink)

In this article, we will consider how the regulation of populations is not just a feature of prisons, but of all institutions and organisations that control members though hierarchies, divisions and norms. While nurses and other allied health professionals are considered to be predominantly self‐regulatory, practice is guided by a code of conduct and codes of ethics that act as rules that serve to uphold the safety of the patient, whether they are a sick person in a hospital bed or (...) an inmate in a prison. The codes of conduct espouse a number of rules that to a certain extent govern the behaviour of individual and groups of practitioners through reciprocal rewards and punishments. Supervision is one method of monitoring the effectiveness of the codes of conduct and ethics while regulating both the minimum standard of individual practice and of training organisations. It is posited that one of the possible effects of clinical supervision is to make the person effectively self‐regulatory as, an autonomous practitioner. We take the view that professional autonomy is a highly problematic concept requiring closer examination. (shrink)

The goals of vascular composite allotransplantation for hand are to maximize functional status and psychosocial wellbeing and to improve quality of life. Candidates are carefully vetted by transplant programs through an extensive evaluation process to exclude those patients with contraindications and to select those that are most likely to attain functional or quality of life benefit from transplant. Patient choice for any treatment, however, requires that candidates be able to understand the risks, benefits, and alternatives before choosing to proceed. This (...) study aimed to understand patients’ knowledge and perceptions about treatment options for hand loss, including hand transplant. This study will be used to inform a standardized education approach and develop conversation aids for use by clinicians and patients throughout the treatment decision process. Ten individuals who had experienced hand amputation or had congenital limb loss were interviewed to better understand previous and current decisions about treatment, experiences in adjusting to their treatment, and perceptions about hand VCA. From this qualitative interview data, four findings emerged: knowledge and education around VCA as a treatment option; adaptation of individuals with limb loss; fear of risk associated with transplantation; issues of aging and overuse injuries to existing limbs. Results suggests that there is opportunity for expanding education about all treatment options for patients with new loss, long-term loss, and congenital limb loss. Establishing a baseline of knowledge about all options–prosthetics, rehabilitative strategies, and VCA—can help patients evaluate their values and goals of treatment. Issues associated with aging, including overuse and injury, and adaptability over the life course should be included in considerations about treatment choices. Data indicate the need for routinely assessing patient preferences about treatment choice so patients can plan for their future as they adapt and age and as technology for treatments change. To assure that thorough information is provided for current and future decision-making, education about treatment choices and selection procedures for VCA should be standardized. (shrink)

‘It comes together at the end’: the impact of a one‐year subject in Nursing Inquiry on philosophies of nursingThis paper reframes an interpretive study as critical inquiry as the researchers interrogate their roles and authority in the ‘reading’ of what is valued as reflective. Working from data collected in written philosophies and interviews within the context of a one‐year subject aimed at developing reflective practice and an appreciation of ways of knowing, this paper examines the change in philosophies of nursing (...) perceived by three university‐based educators and their students. The study reveals a growing appreciation of the complexity of nursing but a limited consideration of the dialectic of critical theorising and everyday engagement necessary to critical reflection and reconstruction of action. More importantly, the process of research collaboration raises questions of the soul‐searching necessary for university educators to act against the institutionalised political context that determines what is seen to be of value in student learning. (shrink)

Our aim was to employ a critical analytic lens to explicate the role of nursing research in supporting the notion of caring realities. To do this, we used case exemplars to illustrate the infusion of such discourses. The first exemplar examines the fundamental concept of caring: using Florence Nightingale's Notes on Nursing, the case study surfaces caring as originally grounded in ritualized practice and subsequently describes its transmutation, via competing discourses, to a more holistic concept. It is argued that in (...) the many and varied attempts to define the dynamic concept of care, caring has now become paradoxically, a more fragmented concept despite attempts to render it more holistic and inclusive. In the second exemplar, one of the authors draws on her personal experience of the gap between theory and practice, so pronounced that it pushed the author to revisit the concept of evidence‐based practice and nursing education. In our third and final exemplar, we refer to the absence of knowledge and practice generated through natural enquiry and curiosity, an absence which has led to production of corporate led rhetoric. Drawing together the central arguments of the three exemplars, we reflect on the influential role of nursing research in enabling the deconstruction of taken for granted assumptions such as caring, evidence‐based practice and empowerment; assumptions which have been generated by discourses riddled with confusion and alienation from the reality of practice and the natural spirit of professional enquiry. (shrink)

This article explores how textual analysis can help us understand subjectivity as an empirical, rather than purely theoretical, phenomenon. The texts discussed here are advice columns in adolescent magazines; the analysis takes as its starting point girls’ accounts of magazine reading. Drawing on focus group discussions and interviews with 48 girls between the ages of 13 and 17 years, I explore how the accomplishment of ‘individuality’– as a culturally and historically-specific task of adolescence – is mediated by advice texts. Because (...) my analysis directs us to the existence of embodied subjects, I employ the notion of ‘Subject-ivity’. As a concept, ‘Subject-ivity’ reminds the analyst of the presence of an embodied, rather than theoretically constructed Self, brought into existence as a practical mode of consciousness. It thus provides a potential bridge between the sociological world of social subjects and highly theoretical work on subjectivity. (shrink)

Through 60 in-depth interviews with African American middle- and upper-middle-class mothers, this article examines how the controlling image of the “thug” influences the concerns these mothers have for their sons and how they parent their sons in light of those concerns. Participants were principally concerned with preventing their sons from being perceived as criminals, protecting their sons’ physical safety, and ensuring they did not enact the “thug,” a form of subordinate masculinity. Although this image is associated with strength and toughness, (...) participants believed it made their sons vulnerable in various social contexts. They used four strategies to navigate the challenges they and their sons confronted related to the thug image. Two of these strategies—experience and environment management—were directed at managing characteristics of their sons’ regular social interactions—and two—image and emotion management—were directed at managing their sons’ appearance. By examining parenting practices, this research illuminates the strategies mothers use to prepare their sons to address gendered racism through managing the expression of their masculinity, racial identity, and class status. (shrink)

Communities of faith have much to learn from children's experience of God and their view of the world. Theology that values the perspectives of children will address quite different questions from the ones that have dominated the Christian tradition.