Bedingt durch den demographischen Wandel wird der Anteil an alten Patienten in Kliniken und Arztpraxen zunehmen. Damit müssen sich Ärzte verstärkt auf die spezifischen Anforderungen der Behandlung von alten Patienten einstellen. Diese sind wesentlich durch die Faktoren Alter, Multimorbidität und Demenz geprägt. Die Abhandlung analysiert die hiermit gegebenen sozial- und personalethischen Implikationen für Ausbildung und Arbeitsalltag der Ärzte sowie für das Gesundheitssystem.

ZusammenfassungIn der Erfahrung, Kommunikation und Bewältigung von Krankheit spielen Metaphern eine wichtige Rolle: Als Denkkonzepte spiegeln sie zugrundeliegende Haltungen gegenüber den durch sie beschriebenen Vorgängen wider. Susan Sontag hat mit ihrem Essay „Illness as Metaphor“ nachhaltig die moralisch kritischen Implikationen einer unreflektierten Metaphernverwendung im Umgang mit Erkrankung aufgezeigt, indem sie deren stigmatisierende und hierin zusätzlich belastende Wirkung für Erkrankte reflektiert.In der gegenwärtigen Situation der Covid-19-Pandemie trifft ein bisher unbekanntes Virus mit der Macht und Dynamik der Globalisierung auf die hierauf nicht (...) vorbereiteten spätmodernen Gegenwartsgesellschaften, die nun nach Erklärung und Sinnzuschreibung suchen. Auch hier fungieren Metaphern als Denkkonzepte und Vehikel von Interpretation. Im Rückgriff auf die Perspektive Susan Sontags und ihren Appell für einen entmystifizierten Umgang mit Krankheit geht dieser Beitrag folgenden Fragen nach: Welche Bilder werden in der Berichterstattung über CoV‑2 vermittelt? Welche Einstellung gegenüber Gesundheit und Krankheit wird mit den Metaphern transportiert, und welche Lebenshaltung liegt dieser zugrunde? Welche Einsichten für einen gesunden Umgang mit Covid-19 und Krankheit generell ergeben sich, wenn man die Pandemie aus ihren Metaphern und zugrundliegenden Denkkonzepten herausschält? (shrink)

During the last two years several committees discussed the question of enlarging patients' autonomy in living wills. The problern is to tind a way to grant patients' wishes without violating the state's duty to preserve human life. One basic question in the debate is the meaning of human dignity. Deducing from the Christian image of man the author describes chances and Iimits of living wills and presents a way of handling them. In her opinion living wills represent a chance for (...) a succeeding, trusting physician-patient- relationship in the age of high-tech medicine. (shrink)

ZusammenfassungBedingt durch den demographischen Wandel wird der Anteil an alten Patienten in Kliniken und Arztpraxen zunehmen. Damit müssen sich Ärzte verstärkt auf die spezifischen Anforderungen der Behandlung von alten Patienten einstellen. Diese sind wesentlich durch die Faktoren Alter, Multimorbidität und Demenz geprägt. Die Abhandlung analysiert die hiermit gegebenen sozial- und personalethischen Implikationen für Ausbildung und Arbeitsalltag der Ärzte sowie für das Gesundheitssystem.

Der Artikel spürt den subtilen Veränderungen nach, die bei Patienten, die mit tiefer Hirnstimulation behandelt werden, möglicherweise beobachtet werden können. Dabei sollen im Rückgriff auf Konzeptionen zur narrativen Identität mittels einer möglichst genauen Beschreibung und Analyse der Selbstwahrnehmung der Patienten sowie der Wahrnehmung ihres Umfelds die Änderungen im praktischen Selbstverhältnis untersucht werden, u. a. am Beispiel technomorpher Metaphern, die von den Patienten in ihren Selbstbeschreibungen verwendet werden. Ziel ist es, die Neuartigkeit und das Spezifische der Neurotechnologien – über die bisherigen (...) Untersuchungen hinaus – hinsichtlich des Umgangs mit sich selbst herauszuarbeiten und greifbar zu machen. Abschließend werden auf Basis der Analyse der Patienten-Narrationen die entsprechenden normativen Implikationen für eine ethische Bewertung des Einsatzes von Neurotechnologien benannt. (shrink)

In their most informative text, Zuk et al. (2023) describe the perspectives researchers take on DBS and aDBS when discussing changes in patients’ personality, mood, or behavior. To this end, Zuk et...

This volume is a tribute to Roger Schwarzschild's immense contributions in the formal semantics of nouns, focus, degrees and space, and tense and aspect. Collectively, the papers in the volume reveal parallels across ontological domains, in particular in the context of elements with internal structure, like plural sets, alternative sets, degree intervals, temporal intervals, and vectors. This research suggests that the structure of an entity could inform the semantic behavior of that entity just as much than its semantic type or (...) lexical category. And because these structures dictate the formation of semantic alternatives, it can help inform focus semantics and scalar implicature as well. Old questions on plurals, focus and degree expressions get new answers in this collection of papers in honor of Roger Schwarzchild. Roger Schwarzschild is one of the leading scholars in semantics, and the editors have been highly successful in requesting contributions by his teachers, peers and former students. Some papers have circulated in draft form for many years, and find their final home in this edited volume, which well reflects the state of the art in the field. Prof. dr. Henriëtte de Swart, Utrecht University, The Netherlands. (shrink)

This exciting collection offers a range of perspectives from some of the most prominent feminist voices of our time, including Rosi Braidotti, Judith Butler, Claire Colebrook, Elizabeth Grosz, and Jack Halberstam. Employing experimental modes of thinking and writing, the contributors remain faithful to the feminist tradition of subversion and resistance, while refusing to submit to its political tradition of a loving sisterhood or dutiful daughterhood. Through productive disagreement and cognitive dissonance, the essays presented here reflect the specific circumstances of our (...) present, and attempt to dream and envision possible alternatives for the future. The volume thus invites us to think of the becoming of feminism itself, and the possibilities of future feminisms-to-come. (shrink)

To reduce global greenhouse gas emissions in order to limit global warming to 1.5°C, individuals and households play a key role. Behavior change interventions to promote pro-environmental behavior in individuals are needed to reduce emissions globally. This systematic literature review aims to assess the a) evidence-based effectiveness of such interventions and b) the content of very successful interventions without limiting the results to specific emitting sectors or countries. Based on the “PICOS” mnemonic and PRISMA statement, a search strategy was developed, (...) and eligibility criteria were defined. Three databases were searched to retrieve and review potential literature. As a result, 54 publications from 2010 to 2021 were included in the analysis. The results show that most interventions only have small positive effects or none at all. A total of 15 very successful interventions focused on the sectors of mobility, energy, and waste and incorporated improved structures, education, feedback, enablement or made the sustainable option the default. Six evidence-based recommendations for content, timing, and setting are deducted and given for interventions on enhancing pro-environmental behavior. In summary, although the various interventions and intervention types to promote PEB differ in their effectiveness, very successful interventions have common elements. Future research should focus on high-/low-impact and high-/low-cost behavior to develop interventions that aim at high-impact but low-cost behavior changes, or avoid low-impact but high-cost behavior. (shrink)

An ethics reflection group is one of a range of ethics support services developed to better handle ethical challenges in healthcare. The aim of this article is to evaluate the implementation process of interdisciplinary ERGs in psychiatric and general hospital departments in Denmark. To our knowledge, this is the first study of ERG implementation to include both psychiatric and general hospital departments. The implementation and evaluation strategies are inspired by action research, using a qualitative approach and systematic text condensation of (...) 28 individual interviews and 4 focus groups with clinicians, ethics facilitators and ward managers. The implementation process was influenced by both structural factors and factors related to clinicians having different values, interests and experiences. Structural barriers and promotors in the process to implement ERG included the following sub-categories: Organizational factors, recruitment and training of ethics facilitators, the deliberation model, planning and recruitment of participants to the ERGs, the support of the ward managers and the project group. Barriers and promotors found among clinicians included the following sub-categories: Expectations and pre-understandings of ERGs, understandings of a physician’s job, challenges experienced by ethics facilitators. At the end of the study, when it was decided that the ERGs should be continued, the implementation strategies were remodeled by the participants to meet new challenges. The study of ERG implementation identified important structural and professional barriers and promotors that are likely to be relevant to anyone wanting to implement ethics support services across various types of healthcare services. (shrink)

Fred. L. Polak explored the mechanisms of social change in terms of “future—visions” held by a community. The future, says Polak, participates actively in the present, providing part of the context within which today's decisions are made. Barbara McClintock acquired her insights in maize genetics by developing “a feeling for the organism.” New insights, she maintains, emerge through a mutual relationship between researcher and subject. Though scholars in different fields, both acknowledge the power of images in the creative process. There (...) is a difference in the extent to which each scientist perceives this power to be available to create new ideas. (shrink)

This work has been selected by scholars as being culturally important, and is part of the knowledge base of civilization as we know it. This work was reproduced from the original artifact, and remains as true to the original work as possible. Therefore, you will see the original copyright references, library stamps (as most of these works have been housed in our most important libraries around the world), and other notations in the work. This work is in the public domain (...) in the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work. As a reproduction of a historical artifact, this work may contain missing or blurred pages, poor pictures, errant marks, etc. Scholars believe, and we concur, that this work is important enough to be preserved, reproduced, and made generally available to the public. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)

Background Ethical challenges constitute an inseparable part of daily decision-making processes in all areas of healthcare. Ethical challenges are associated with moral distress that can lead to burnout. Clinical ethics support has proven useful to address and manage such challenges. This paper explores how prehospital emergency personnel manage ethical challenges. The study is part of a larger action research project to develop and test an approach to clinical ethics support that is sensitive to the context of emergency medicine. Methods We (...) explored ethical challenges and management strategies in three focus groups, with 15 participants in total, each attended by emergency medical technicians, paramedics, and prehospital anaesthesiologists. Focus groups were audio-recorded and transcribed verbatim. The approach to data analysis was systematic text condensation approach. Results We stratified the management of ethical challenges into actions before, during, and after incidents. Before incidents, participants stressed the importance of mutual understandings, shared worldviews, and a supportive approach to managing emotions. During an incident, the participants employed moral perception, moral judgments, and moral actions. After an incident, the participants described sharing ethical challenges only to a limited extent as sharing was emotionally challenging, and not actively supported by workplace culture, or organisational procedures. The participants primarily managed ethical challenges informally, often using humour to cope. Conclusion Our analysis supports and clarifies that confidence, trust, and safety in relation to colleagues, management, and the wider organisation are essential for prehospital emergency personnel to share ethical challenges and preventing moral distress turning into burnout. (shrink)

The central conflicts of the world today are closely related to cultural, traditional, and religious differences between nations. As we move to a globalized world, these differences often become magnified, entrenched, and the cause of bloody conflict. Growing out of a conference of distinguished scholars from the Middle East, Europe, and the United States, this volume is a singular contribution to mutual understanding and cooperative efforts on behalf of peace. The term paideia, drawn from Greek philosophy, has to do with (...) responsible education for citizenship as a necessary precondition for effective democracy. (shrink)

Semantic relationships have an active role in textual study, as they are an essential tool through which the text is constructed, this is done through the sequence of sentences of saying, and these relationships lead to the growth and continuation of the subject of the text, and then linking speech, which in turn achieves textual harmony. The aim of this study is to highlight the importance of these relationships and to elaborate on them, this research dealt with two additional linkage (...) relationships: (equivalent additional relationship), and (different additional relationship), with a breakdown of each of them, and then the inclusion of poetic applications from the texts of the poet Hazem Rushak Al-Tamimi, showing the extent of the harmony, plot and coherence of these texts. (shrink)

Personal and professional success in the digital age requires digital abilities. Increased expectations that graduates be adept in digitisation while joining the job need higher education institutions to successfully incorporate digital aspects. This study evaluates university EFL students' digital integrative attitudes and instructors' digital proficiency. Digital tools are emphasised for collaborative learning. Researchers seek to address two key questions: What are EFL students’ perspectives on digital learning? How do they assess teachers' IT skills? It appears through the end result not (...) all instructos have the same digital competency and it is strictly field dependent. This variance in the digital capalities and field orientation decideis the choice of their preferredd pedagogical tools. Digital collaborative learning was used by both categories of students: engineering students and non-engineering EFL students to variable degrees. This suggests that punishing students may affect preferences and behaviours in this area. EFL students were confident in their digital tool usage, although they didn't comprehend all the features. This study's results may improve instructional techniques, institutional standards, and professional development programmes to improve educators' digital abilities. As digital technology integration evolves, global higher education consequences are enormous. (shrink)

In light of the ongoing development and implementation of core competencies in bioethics, it is important to proceed with a clear sense of how bioethics knowledge is utilized in the functioning of hospital ethics committees (HECs). Without such an understanding, we risk building a costly edifice on a foundation that is ambiguous at best. This article examines the empirical relationship between traditional paradigms of bioethics theory and actual decision making by HEC members using survey data from HEC members. The assumption (...) underlying the standardization of qualifications and corresponding call for increased education of HEC members is that they will base imminent case decisions on inculcated knowledge. Our data suggest, however, that HEC members first decide intuitively and then look for justification, thereby highlighting the need to re-examine the pedagogical processes of ethics education in the process of standardizing and improving competencies. (shrink)

To determine the effectiveness of current ethical teaching and to suggest ways to reform the current ethical curriculum in light of students’ perspectives and experiences. Students of Dow Medical College were selected for this cross-sectional study conducted between the year 2020 till 2023. The sample size was 387, calculated by OpenEpi. A questionnaire consisting of 17 close-ended questions was used to collect data from participants selected via stratified random sampling. The questionnaire consisted of two parts. The first part included the (...) demographics. While the second contained 15 questions designed to assess the participants’ current teaching of ethics and effective ways to further improve it. The data obtained were analyzed using IBM SPSS statistics 26. Out of the 376 students who gave consent, the majority of the respondents (64.6%) encountered situations where they felt that their current teaching of ethics was insufficient and (54%) believed that the current teaching of ethics could be improved and made further effective. Practical sessions, PBLs (problem-based learning), case analysis, and ward visits were some of the ways the participants believed could help improve the teaching of medical ethics. Most students (92.8%) agreed that external factors like burnout and excessive workload have an impact on medical professionals’ ethical practices. In light of our study, a refined curriculum with a focus on ethical teaching must be established, with input from students to ensure that the medical students have the necessary expertise to manage an ethical dilemma. (shrink)

We are trying to show the importance of the event patterns and their presence in the wondrous Shuaibi story as a traditional structural form that has its place and manifestations in the literary narrative. It is also considered a suggestive and indicative product of the writer’s imagination, which uses the everyday variable and formulates it in a way different from what it is to show us an interesting miraculous story. Folk tales in general, and the book "Folk Tales" specifically, play (...) a significant role in preserving popular heritage. These tales are transmitted through a chain of narrators or from one storyteller to a group of narrators. Each narrator has their language and method of conveying the story without strict adherence to the original, aiming to reconstruct it according to the situation based on the prominent elements of the tale highlighted by that situation or element. The tale may serve purposes such as entertainment, moral teaching, wisdom, putting children to sleep, or news, or it may involve a miraculous dimension built on the extraordinary and unreal. (shrink)

Ever decreasing numbers of applicants arrive in language departments at UK universities. In the face of this decline, and against the backdrop of higher education languages departments being reduced across the UK, it is important to investigate the supply chain of languages undergraduates in the pre-entry sector. This article reports on a collaborative action research project between Language Networks for Excellence, University of Wolverhampton, and King Edward VI College, Stourbridge. The objective was to investigate how the HE sector can effectively (...) influence and support linguists and post-16 establishments in enhancing progression to studying languages at university and how the post-16 sector can ensure they meet language students’ needs in progression to HE. The research presents a number of conclusions and recommendations, not least that, whilst support from HE for 17—18-year-old school students and their institutions is welcome and contributes to students’ confidence and skills, there may be merit in targeting students much further down the supply chain, encouraging progression to HE through tailored linguistic and motivational support strategies. (shrink)

Abordagem do protagonismo social, analisando sua relação com a informação, concluindo pela compreensão deste como objetivo do trabalho informacional, situando a mediação da informação como sua ação central. Parte da apresentação das origens conceituais em torno do protagonismo, buscando, à medida que debate as referências acerca do tema, demonstrar a relação do desenvolvimento do protagonismo social com o trabalho informacional, assim como sua posição de meta da atividade da mediação da informação, executada nas suas cinco dimensões e na condição de (...) elemento central desse trabalho. As assertivas apresentadas são resultado do estudo crítico da bibliografia da área da Ciência da Informação que aborda o protagonismo e a mediação da informação, assim como de estudos de filósofos e pensadores que abordam os aspectos sociais e políticos da comunicação e da formação de sujeitos socialmente ativos, permitindo a identificação das relações entre protagonismo e mediação da informação, como também que a mediação consciente favorece o primeiro, concluindo que o apoio ao seu desenvolvimento representa a principal responsabilidade social do trabalho com a informação. (shrink)

Excerpt from Allgemeines Handwörterbuch der Philosophischen Wissenschaften Nebst Ihrer Literatur und Geschichte Nfcfl'oc bet %ilofopln'e an bet univafitdt an 269n mb sum: bet Ginil= 88(tbientloxcns. About the Publisher Forgotten Books publishes hundreds of thousands of rare and classic books. Find more at www.forgottenbooks.com This book is a reproduction of an important historical work. Forgotten Books uses state-of-the-art technology to digitally reconstruct the work, preserving the original format whilst repairing imperfections present in the aged copy. In rare cases, an imperfection in (...) the original, such as a blemish or missing page, may be replicated in our edition. We do, however, repair the vast majority of imperfections successfully; any imperfections that remain are intentionally left to preserve the state of such historical works. (shrink)

The author traces the ways in which various patients and collective associations of patients come to regard themselves as the users of future stem cell technologies. The author uses Althusser’s notion of interpellation, whereby an identity is the result of the situated encounter of a subject and an authority, to analyze the ways in which patient associations’ current involvement with basic research is related to the enactment of science as a series of technology development projects. The author argues that this (...) ‘‘project-ness’’ forms a certain privileged logic that interpellates patients and their associations in specific ways. Through the listings of illnesses circulated in the mass media, which are hoped to be treatable or curable with stem cell therapies, patients come to recognize themselves as the projected users of stem cell technologies. The author fleshes out the process of this userfication and the various responses made by patients and their associations when hailed by the entrepreneurial projects of stem cell research. (shrink)

Nous avons cherché à identifier un aspect du refoulement du cosmopolitismel'des Lumières, complémentaire de la fabrique des identités nationales enl'Europe au XIXe siècle et dans l'entre-deux-guerres. L'idée de civilisation communel'serait maintenue par la capacité réciproque de traduction des langues nationales, dul'fait de leurs origines communes indo-européennes. L'utopie de la langue remplaceraitl'le parcours matériel des Lumières. C'est l'échec de la construction du mythe indianistel'européen et non pas son succès qui explique le dévoiement idéologique des relationsl'entre langue et nation. La promotion manquée (...) de la langue tsigane dans le mondel'académique illustre bien cet échec. Après la Première Guerre mondiale, la transformationl'du principe des nationalités en ethnopolitique fit disparaître jusqu'au souvenirl'de cette ambition commune. (shrink)