Patient-reported outcomes are frequently used for medical decision making, at the levels of both individual patient care and healthcare policy. Evidence increasingly shows that PROs may be influenced by patients’ response shifts and dispositions. We identify how response shifts and dispositions may influence medical decisions on both the levels of individual patient care and health policy. We provide examples of these influences and analyse the consequences from the perspectives of ethical principles and theories of just distribution. If influences of response (...) shift and disposition on PROs and consequently medical decision making are not considered, patients may not receive optimal treatment and health insurance packages may include treatments that are not the most effective or cost-effective. We call on healthcare practitioners, researchers, policy makers, health insurers, and other stakeholders to critically reflect on why and how such patient reports are used. (shrink)

Dans ses recherches empiriques, philosophiques et métaphysiques la conscience humaine ne sort pas de sa propre sphère. C'est toujours la conscience qui parle. Par sa connaissance l'homme ne peut dépasser la conscience directe. Par sa pensée il tend à dépasser médiatement la conscience. Cette constatation nous est dictée par le fait scientifiquement fondé que tant la conscience humaine que son contenu sont tirés, c.a.d. révélés, des profondeurs cachées où ils sont recélés. C'est ce qui rend évident que l'homme possède un (...) merveilleux "sens sondeur", lui permettant de reconnaître les hauteurs et les profondeurs de notre conscience et aspirant à la transcendance. Le domaine de l'expérience se borne nécessairement aux phénomènes, et tandis que celui de la philosophie s'étend au fondement de ces phénomènes et à leurs rapports réciproques, la métaphysique, la science des principes, se propose de pénétrer l'origine et le sens profond de toute chose, du néant à l'ultime perfection. Après Kant qui a voulu en finir avec la métaphysique dogmatique unilatéralement déductive, la méthode inductive a pris définitivement le dessus. Cette méthode ne s'arroge pas le droit de juger d'une façon apodictique en ce qui touche aux problèmes de l'existence, qui ont donné naissance aux dispositions de la conscience humaine. Elle s'efforce, au contraire, de faire en cette matière une large part à l'inconnu en démontrant que les résultats sont heuristiques, hypothétiques et problématiques. Ainsi la théorie de la connaissance, la philosophie et la théologie s'accordent à dire que les données microcosmiques dans la sphère de la conscience humaine peuvent être les représentants des entités macrocosmiques. Si la conscience humaine poursuit ses recherches philosophiques et métaphysiques, c'est qu'elle doit sa genèse à une relation universelle dont elle est la représentation. (shrink)

Most research on ethical leadership to date investigates the consequences of ethical leadership rather than its antecedents. Here, we aim to contribute to this field by studying leader personality as a potential antecedent of ethical leader behavior. In two multisource studies, we investigated the relationships between personality traits and ethical leader behavior. Leader personality was measured through self-ratings using the five-factor personality framework. Two subordinates rated their leaders' ethical behavior. Study 1 used a unidimensional Ethical Leadership Scale (ELS). In study (...) 2 we used this scale as well as an instrument distinguishing three different ethical leader behaviors, namely, fairness, role clarification, and power sharing. Further, in study 2 we controlled for the influence of the relationship between leader and followers (LMX). As expected, conscientiousness and agreeableness were most consistently related to ethical leadership. In study 1, after controlling for the other personality traits, conscientiousness related positively with ethical leadership. In study 2, after controlling for other traits and LMX, conscientiousness related positively with ethical leadership and the behavior role clarification, and agreeableness with power sharing and fairness. Also, emotional stability related positively with ethical leadership and role clarification after controlling for LMX. As expected, openness to experience and extraversion were unrelated to ethical leader behaviors. (shrink)

While stigmatisation is universal, stigma research in low- and middle-income countries (LMIC) is limited. LMIC stigma research predominantly concerns health-related stigma, primarily regarding HIV/AIDS or mental illness from an adult perspective. While there are commonalities in stigmatisation, there are also contextual differences. The aim of this study in DR Congo (DRC), as a formative part in the development of a common stigma reduction intervention, was to gain insight into the commonalities and differences of stigma drivers (triggers of stigmatisation), facilitators (factors (...) positively or negatively influencing stigmatisation), and manifestations (practices and experiences of stigmatisation) with regard to three populations: unmarried mothers, children formerly associated with armed forces and groups (CAAFAG), and an indigenous population. Group exercises, in which participants reacted to statements and substantiated their reactions, were held with the ‘general population’ (15 exercises, n = 70) and ‘populations experiencing stigma’ (10 exercises, n = 48). Data was transcribed and translated, and coded in Nvivo12. We conducted framework analysis. There were two drivers mentioned across the three populations: perceived danger was the most prominent driver, followed by perceived low value of the population experiencing stigma. There were five shared facilitators, with livelihood and personal benefit the most comparable across the populations. Connection to family or leaders received mixed reactions. If unmarried mothers and CAAFAG were perceived to have taken advice from the general population and changed their stereotyped behaviour this also featured as a facilitator. Stigma manifested itself for the three populations at family, community, leaders and services level, with participation restrictions, differential treatment, anticipated stigma and feelings of scapegoating. Stereotyping was common, with different stereotypes regarding the three populations. Although stigmatisation was persistent, positive interactions between the general population and populations experiencing stigma were shared as well. This study demonstrated utility of a health-related stigma and discrimination framework and a participatory exercise for understanding non-health related stigmatisation. Results are consistent with other studies regarding these populations in other contexts. This study identified commonalities between drivers, facilitators and manifestations—albeit with population-specific factors. Contextual information seems helpful in proposing strategy components for stigma reduction. (shrink)

Research on unethical leadership has predominantly focused on interpersonal and high-intensity forms of harmful leader behavior such as abusive supervision. Other forms of harmful leader behavior such as excessively pressuring subordinates or acting in self-centered ways have received less attention, despite being harmful and potentially occurring more frequently. We propose a model of four types of harmful leader behavior varying in intensity and orientation : Intimidation, Lack of Care, Self-Centeredness, and Excessive Pressure for Results. We map out how these relate (...) to other constructs in the unethical leader behavior field in order to integrate the existing work on how leaders can cause harm to followers. Next, in five studies, we develop and test a new survey instrument measuring the four proposed types of perceived HLB. We provide initial validity evidence for this new measure, establish its psychometric properties, and examine its nomological network by linking the four types of HLB to related leadership constructs and soft and hard outcome correlates at the individual and team level. We find that HLB is negatively related to constructive forms of leadership and positively to unethical ones. HLB is also related in the expected direction to job satisfaction, engagement, psychological safety, knowledge sharing, knowledge hiding, deviance, and objectively recorded team-level stress-related absenteeism. (shrink)

Burnout has important ramifications for employees and organizations and preventing burnout forms an ethical issue for managers. However, the role of the leader and especially the role of ethical aspects of leadership have received relatively little attention in relation to burnout to date. We conducted a survey among employees (N = 386) of a Dutch retail organization, nested in 122 teams with a leader. Our first contribution is that we empirically show the hypothesized opposing relationships of ethical and passive leadership (...) behavior with follower burnout. Furthermore, we examined two job characteristics as mechanisms that link these forms of leadership and burnout. Lastly, we show that the positive relationship of ethical leadership with burnout via role clarity (but not overload) is dependent on the degree of passive leadership the leader is perceived to display. Our results suggest that organizations should promote ethical leadership behaviors and limit passive leadership behaviors by stimulating leaders to be active in their role and use their social influence to promote ethical conduct. (shrink)

Although narcissists often emerge as leaders, the relationship between leader narcissism and follower performance is ambiguous and often even found to be negative. For women, narcissism seems especially likely to lead to negative evaluations. Since narcissists have the tendency to be impulsive and change their minds on a whim, they may come across as inconsistent. We propose “inconsistent leader behavior” as a new mechanism in the relationship between leader narcissism and follower performance and argue that leader gender plays an important (...) role in whether narcissistic leaders are perceived as inconsistent. Specifically, we expect leader narcissism to have a negative relationship with follower performance through perceived inconsistent leader behavior, especially for female leaders. Thus, we examine leader gender as a personal factor moderating the relationship between narcissism and perceived inconsistent behavior. Also, as perceived inconsistency is likely less problematic when a good relationship exists, we examine leader–member exchange as a contextual condition moderating the relationship between leader behavior and follower performance. We test our moderated mediation model in a multi-source study with 165 unique leader–follower dyads. As expected, leader narcissism was positively related to perceived inconsistent leader behavior, and this relationship was stronger for female leaders. Inconsistent leader behavior was negatively related to follower performance, but only when LMX was low. Our research highlights that perceived behavioral inconsistency can be problematic and—for female leaders—provides an explanation of the negative relation of leader narcissism with follower performance and of the inconsistencies in evaluations of narcissistic leaders’ effectiveness. (shrink)

This is a very high quality book with a slightly misleading title. It is difficult to see how it could serve as an introduction for anyone except the mathematically mature or, at least, a student who has already been introduced to formal logic through the lower predicate calculus. Not that these topics are not covered in the book—they comprise the first 92 pages; but the discussion quickly moves into intellectual high gear with sophisticated treatments of the independence of systems of (...) propositional logic, first-order theories, isomorphism of interpretations, and completeness and decidability. With this caveat, Mendelson's book is one of the best of the "second generation" of books on mathematical logic. It is lucid and rigorous, and contains no "frills." It does, however, contain numerous exercises in which the student will have the pleasure of developing for himself some of the more important theorems in the various subjects treated. Among these are chapters on formal number theory, including Gödel's incompleteness theorem, recursive undecidability, Tarski's theorem; a chapter on axiomatic set theory with Hartog's theorem, the axiom of choice, and the axiom of restriction ; and a truly excellent chapter on effective computability which takes off from the notion of an algorithm, and then uses this as a basis upon which to develop the theories of Markov algorithms, Turing algorithms, the theories of Herbrand and Gödel, recursively enumerable sets and undecidable problems. An appendix contains a version of K. Schütte's consistency proof for formal number theory.—H. P. K. (shrink)

We will prove in Zermelo-Fraenkel set theory without axiom of choice that the transitive hull R* of a relation R is not much “bigger” than R itself. As a measure for the size of a relation we introduce the notion of κ+-narrowness using surjective Hartogs numbers rather than the usul injective Hartogs values. The main theorem of this paper states that the transitive hull of a κ+-narrow relation is κ+-narrow. As an immediate corollary we obtain that, for every infinite cardinal (...) κ, the class HCκ of all κ-hereditary sets is a set with von Neumann rank ϱ(HCκ) ≤ κ+. Moreover, ϱ(HCκ) = κ+ if and only if κ is singular, otherwise ϱ(HCκ) = κ. The statements of the corollary are well known in the presence of the axiom of choice (AC). To prove them without AC - as carried through here - is, however, much harder. A special case of the corollary (κ = ω1, i.e., the class HCω1 of all hereditarily countable sets) has been treated independently by T. JECH. (shrink)

Los convulsos acontecimientos de estos últimos años han demostrado, a escala global, cuán enajenante es nuestra experiencia presente del tiempo. Las tendencias actuales de la teoría crítica y otros enfoques histórico-sociológicos insisten en el ritmo devorador de la aceleración (P. Virilio; H. Rosa) y en la reconfiguración temporal a partir del “presentismo” (Koselleck; F. Hartog). Sin embargo, sabemos que estas cuestiones distan de ser absolutamente nuevas, y que ya preocupaban a los filósofos y a los fenomenólogos en la primera (...) mitad del siglo XX. La publicación reciente de los últimos tratados del Ereignis y de los Cuadernos negros, redactados en los años 1930 y 1940, nos permite acceder a una reflexión original sobre lo que Heidegger nombra la maquinación o fabricación [Machenschaft]. Nos gustaría analizar la manera en la que, a partir de la fabricación, se puede replantear el sentido de nuestra experiencia temporal íntima frente a la situación moderna. Más concretamente, ahondaremos en las formas en las que la primacía de la fabricación funciona como cerrazón de posibilidades, llegando a impedir que pueda ocurrir algo realmente “histórico”. (shrink)

This paper defends a 'punctivist' conception of consciousness from recent attacks by Ian Phillips and Matthew Soteriou. As we intend it, 'punctivism' is the view that a subject's experience over some interval is determined by their experiential states at each instant during it. Phillips and Soteriou both offer ingenious arguments purporting to show that the punctivist is unable to make sense of motion perception; and that only by adopting an 'holistic' conception -- whereby a subject's instantaneous experiences are determined by (...) their experience over the interval -- can we make sense of the puzzles such phenomena pose. We contend that both arguments invoke dubious claims, their proffered solutions come with highly controversial commitments, and, if we take punctivism seriously, it is difficult to see why the so-called puzzles should be puzzling in the first place. A punctivist model of motion perception is proposed in response, and objections anticipated. (shrink)

The philosophy of medicine cum bioethics has become the socially recognized source for moral and epistemic direction in health-care decision-making. Over the last three decades, this field has been accepted politically as an authorized source of guidance for policy and law. The field's political actors have included the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research, the Department of Health, Education, and Welfare, the President's Commission for the Study of Ethical Problems in Medicine and Biomedical (...) and Behavioral Research , the National Bioethics Advisory Commission, and the new Council on Bioethics; these groups and agencies have set forth rules on issues ranging from the role of humans in biomedical research to the production of human embryos for research, the definition of death, and the permissibility of human cloning. The members of the field are not just scholars and teachers in an academic realm directed to both theoretical and applied issues. They are, in addition, practitioners of a conceptual and moral trade that possesses a legal and political standing. This essay critically addresses the sudden emergence of bioethics as a societally recognized source of moral guidance, a source replete with authorized moral experts. Attention is directed to moral and conceptual assumptions that have led the philosophy of medicine, and especially bioethics, to acquire a quasi-juridical/political role in guiding clinical choices, framing health-care policy, and directing court holdings. (shrink)

In debates in philosophy and cognitive science concerning short-term memory mechanisms and perceptual experience, most discussion has focused on the working memory and the various forms of sensory memory such as iconic memory. In this paper, I present a summary of some evidence for a proposed further form of memory termed conceptual short-term memory. I go on to outline some of the ways in which this additional distinctive sort of short-term memory might be of relevance to ongoing philosophical debates, specifically (...) in relation to questions about high-level perceptual phenomenology, the relationship between consciousness and reportability, and the boundary between cognition and perception. I conclude that conceptual short-term memory offers a promising new direction of research and philosophical investigation. (shrink)

The ability to make inductive inferences is important because without it, generalization of knowledge to new circumstances would be impossible. One context in which such inductive skills are likely to have been important over evolutionary time is encounters with animals. Previous research suggests that children take into account at least two kinds of relationships between animals when making inductive inferences about them: descent relationships, and design relationships. Because descent and design relationships are sometimes orthogonal, making correct inferences about particular traits (...) sometimes requires overlooking one kind of relationship in favor of the other. In this study, I used a base-to-target induction task to examine the use of two inference rules in 5 to 12 year old Shuar children from the Amazon region of Ecuador. The descent rule uses taxonomic relationships when the function of the trait being judged is ambiguous or unknown, and the design rule privileges ecological relationships over taxonomic relationships when the function of the trait is relevant to the ecological category in question. The results show that Shuar children do employ both of these rules, and are able to switch between them for different kinds of traits, as the descent/design mode hypothesis predicts. Children in both the younger age group and the older age group were able to use these rules, but the older children showed a slightly different pattern due to the use of specific acquired knowledge about some of the taxa. (shrink)

There is a well-worn image and phrase for libertarianism: "atomized individualism." This hobgoblin has spread so thoroughly that even some libertarians think their philosophy unreservedly supports private persons, whatever the situation, whatever their behavior. Smith's Self-Interest and Social Order in Classical Liberalism, corrects this misrepresentation with careful intellectual surveys of Hume, Smith, Hobbes, Butler, Mandeville, and Hutcheson and their respective contributions to political philosophy.

This paper discusses the stability and Hopf bifurcation analysis of the diffusive Kaldor–Kalecki model with a delay included in both gross product and capital stock functions. The reaction-diffusion domain is considered, and the Galerkin analytical method is used to derive the system of ordinary differential equations. The methodology used to determine the Hopf bifurcation points is discussed in detail. Furthermore, full diagrams of the Hopf bifurcation regions considered in the stability analysis are shown, and some numerical simulations of the limit (...) cycle are used to confirm the theoretical outcomes. The delay investment parameter and diffusion coefficient can have great impacts on the Hopf bifurcations and stability of the business cycle model. The investment parameters for the gross product and capital stock as well as the adjustment coefficient of the production market are also studied. These parameters can cause instability in, and the stabilization of, the business cycle model. In addition, we point out that, as the delay investment parameter increases, the Hopf bifurcation points for the diffusion coefficient values decrease considerably. When the delay investment parameter has a very small value, the solution of the business cycle model tends to become steady. (shrink)

Extant literature suggests a correlation between the thematic core of an adolescent’s personal account of depression and the trajectory of her personality development. This possible correlation has not been explored in a way that includes detailed qualitative analyses of reported experiences of adolescent depression. By discussing a single case design, this contribution illustrates and justifies an interpretative procedure that has been implemented to assist such an exploration. The paper focuses on the suitability of this approach for the investigation of all-encompassing (...) alterations of the experiential field in psychopathological conditions. I argue that this suitability is grounded in a phenomenological understanding of the explicative task in terms of a disclosure of the intentional constitution of the life-world of adolescent depression. The discussion begins with a contextualization of the single case design within a multilayered and methodologically mixed study. Against this background, I illustrate the steps of a ‘systematic of interpretation’ aimed at exposing meaning horizons. Touching on issues concerning the empirical validity of the approach, these meaning horizons are construed as objectively plausible frames of intelligibility of a subjectively particular form of experience. Drawing on a characterization of transcendental arguments, I discuss the relationship between the illustrated procedure and the investigational attitude that, according to Husserl, defines phenomenology as a properly philosophical endeavor. In this context, I eventually characterize the illustrated procedure as a crossover approach to human experiential life aligned with the tradition of phenomenological psychopathology. (shrink)