Background: In spite of a national strategy for reducing coercion in the mental health services, Norway still has a high rate of involuntary treatment compared to other European countries. It is therefore crucial to study various parties involved in involuntary treatment in order to reduce coercion. Research question: How do patients and staff in a Norwegian locked psychiatric ward experience coercion? Research design: Participant observation and interviews. Participants: A total of 12 patients and 22 employees participated in this study. Ethical (...) considerations: This study is accepted by the National Committee for Medical Health Research Ethics. Findings: The participants experienced coercion in different ways. Patients often felt inferior, while many of the staff felt guilty for violating patients’ dignity, although they ascribed responsibility for their actions to the “system.” The main themes are (1) corrections and house rules, (2) coercion is perceived as necessary, (3) the significance of material surroundings, and (4) being treated as a human being. Discussion: The discussion draws upon the concepts of vulnerability, guilty conscience, and ethical sensitivity, related to the staffs’ divergent views on coercion. Conclusion: Especially among staff, there are divergent views of coercion. Professionals being physically and emotionally close to the patient are more likely to understand him or her as a unique person with individual needs. If patients are kept at a distance, professionals as a group change to understand patients as members of a group with common needs and common restrictions. (shrink)

Person‐centred care is founded on ethics as a basis for organizing care. In spite of healthcare systems claiming that they have implemented person‐centred care, patients report less satisfaction with care. These contrasting results require clarification of how to practice person‐centred ethics using Paul Ricoeur's ‘Little ethics’, summarized as: ‘aiming for the good life, with and for others in just institutions’. In this ethic Kantian morality is at once subordinate and complementary to Aristotelian ethics because the ethical goal needs to be (...) critically assessed and passed through the examination of the norm in each care situation. This paper presents examples that describes a person‐centred care practice that balance a critical review of care activities based on a conviction of aiming for patients' wellbeing. In contrast to patients' experiences of person‐centred care in real life, research projects have shown that if the clinical performers comprehend and apply the practice of person‐centred ethics, patients report positive outcomes. The implementation of person‐centred care therefore demands that stakeholders and managers enables and requires that healthcare staff study ethics in the same way as studying for example pharmacology is required when handling patients' medicines. (shrink)

The exposure of scientific scandals and the increase of dubious research practices have generated a stream of studies on Questionable Research Practices (QRPs), such as failure to acknowledge co-authors, selective presentation of findings, or removal of data not supporting desired outcomes. In contrast to high-profile fraud cases, QRPs can be investigated using quantitative, survey-based methods. However, several design issues remain to be solved. This paper starts with a review of four problems in the QRP research: the problem of precision and (...) prevalence, the problem of social desirability bias, the problem of incomplete coverage, and the problem of controversiality, sensitivity and missing responses. Various ways to handle these problems are discussed based on a case study of the design of a large, cross-field QRP survey in the social and medical sciences in Sweden. The paper describes the key steps in the design process, including technical and cognitive testing and repeated test versions to arrive at reliable survey items on the prevalence of QRPs and hypothesized associated factors in the organizational and normative environments. Partial solutions to the four problems are assessed, unresolved issues are discussed, and tradeoffs that resist simple solutions are articulated. The paper ends with a call for systematic comparisons of survey designs and item quality to build a much-needed cumulative knowledge trajectory in the field of integrity studies. (shrink)

The United Nation’s (UN) 3rd Annual Multi-stakeholder Forum on ‘Science, Technology and Innovation for the Sustainable Development Goals (STI Forum) - Transformation Towards Sustainable and Resilient Societies’ was held at the UN Headquarters in New York on 5th and 6th of June, 2018. This STI Forum set out to discuss a suit of the sustainable development goals, namely sustainable management of water and sanitation for all (SDG 6), sustainable consumption and production patterns (SDG 12), and sustainable terrestrial ecosystems (SDG 15). (...) It also discussed how to ensure access to affordable, reliable, sustainable and modern energy for all (SDG 7) and how to make cities and human settlements inclusive, safe, resilient and sustainable (SDG 11). I participated in the panel debate on ‘Science, Technology and Innovation for Sustainable Terrestrial Ecosystems (SDG 15)’ – emphasizing the importance of food systems in the context of SDG 15. My statement is summarized below. The panel debate aimed at helping to identify good practices and policy recommendations, as well as challenges and needs, especially as they relate to international cooperation, innovation and capacity-building, with a view to facilitate the development, scaling up adoption and dissemination of relevant technologies for SDG 15. A food system can be described as a system that embraces all the elements (environment, people, inputs, processes, institutions, infrastructure, markets and trade) and activities that relate to the production, processing, distribution and marketing, preparation and consumption of food and the outputs of these activities, including socio-economic and environmental outcomes. A sustainable food system delivers food and nutrition security for all in such a way that the economic, social and environmental bases to generate food security and nutrition for future generations are not compromised. (shrink)

This comment challenges essentialist “brain biased” interpretations of emotions from a historical perspective. (Digital) humanities research shows that the embodying of emotions is historically contingent. Emotion metaphors do not so much reflect what is happening in our brain or in other parts of the body: they reflect what people think/thought is/was happening in and outside their body.

This article is a contribution to the existing debate about the marketization of higher education and offers a detailed study of the way the practices of marketization manifest themselves at the level of discourse in higher education. Taking its point of departure in Critical Discourse Analysis and using a text-driven procedure for genre analysis, the article describes and analyses the international student prospectus as an instance of a highly promotional genre which clearly reflects the values and forces of the free (...) market. The article contains two analyses. The first analysis compares four instances of the international student prospectus genre from Finland, Scotland, Australia and Japan and tries to establish genre membership and genre characteristics by considering the overall text structure, and by looking for similarities in content and `rhetorical moves'. The second analysis is an in-depth analysis of the language use in the international student prospectus from the University of Stirling, Scotland. This analysis pays particular attention to the way the rhetorical moves and visual and lexico-grammatical features in the text are used to represent the two main participants in the text: the university and its students. Both analyses show that the student prospectus is trying to construct an image of the University of Stirling and its students which goes hand in hand with the new trend in higher education — namely that of offering innovative products to `demanding' clients on the look-out for the best possible `university experience'. (shrink)

Both of these traditional interpretations were seriously challenged by Vico and the romantic movement. Rather than viewing metaphor as an ornamental substitution for the proper word, or as a mere comparison, Vico, Croce and Collingwood insisted that metaphor historically or logically precedes the solidified meanings of conceptual language, and further performs a uniquely revelatory function. While the fixed meanings of literal and logical discourse might be practically or intellectually useful, only the fluidity of poetic metaphor can reveal the concrete physiognomy (...) of the experienced world. Still, by stressing the pre-conceptual character of metaphor, the traditional dichotomy between it and all intellectual pursuits was made even more pronounced. Moreover, on the basis of this theory, it became impossible to distinguish poetic metaphor from primitive myth, or even from the assertions of schizophrenics. Equally embarrassing is the fact that aphasiacs, who have actually lost the use of conceptual language, are also completely unable to understand metaphors of any sort. (shrink)

The theory of formal spaces is developed in terms of presentations, in order to study effectivity.

When a child is hospitalized, the parents find themselves in an unfamiliar environment and their parental role changes. They are in a stressful and often anxiety-filled situation and it may be difficult for them to participate in decisions. The purpose of this study was to examine the extent to which parents participate in decisions during the course of events when their child is hospitalized. Thirty-five parents of 24 children (aged 5 months to 18 years) were followed by mobile observation during (...) their child’s hospitalization in a paediatric department in Sweden. Three researchers analysed field notes in three steps, using manifest and latent coding. In step 1, 119 situations that included a decision process were identified. In step 2, the situations were assessed according to a five-level scale concerning how the parents’ wishes, desires or values had been respected. In step 3, each situation was scrutinized with respect to factors influencing the extent of the parents’ participation. The results showed that parents have varying ability to be involved in decision making. Professionals need to communicate more openly with them in order to identify and satisfy their needs because some parents are unwilling or incapable of expressing them. (shrink)

The purpose of this overview of published articles on decision making in paediatric care was to identify important aspects of its possible use in clinical practice and to obtain a base for future research. A literature review was undertaken utilizing snowball sampling to identify articles because of the diversity present within the area of decision making in paediatric care. The databases PubMed and CINAHL were used. The search was limited to articles published in English during the period 1994-2004. The analysis (...) entailed a series of comparisons across articles, focusing on major areas of enquiry and patterns of results. Various levels of decision making are described because these seem to form a basis for how decisions are made. Concepts found to be of importance for decision making are described under the following headings: competence, the child’s best interests, knowledge, values and attitudes, roles and partnership, power, and economy. Further research is suggested. (shrink)

Patients are supposed to be given care according to their needs. This concept is, however, difficult to define and patients and caregivers may have different opinions about a patient’s needs. Twenty patients were interviewed and asked to give a definition of need, describe their needs while hospitalized and depict what they do to make sure their needs are fulfilled. Ten groups of needs were identified: communication, basic care, contact with other people, behaviour of staff, empathy, competent caregivers, continuity, integrity, participation (...) in decision making, and pain relief. The descriptions patients gave of how they ensured their needs were met could be divided into two groups: openly seeking attention; or not wanting to disturb the staff. Interviews with patients emphasized the importance of recognizing that they have individual needs and varying abilities to see that their needs are fulfilled. (shrink)

Level statistics and nodal point distribution in a rectangular semiconductor quantum dot are studied for different degrees of spin-orbit coupling. The chaotic features occurring from the spin-orbit coupling have no classical counterpart. Using experimental values for GaSb/InAs/GaSb semiconductor quantum wells we find that level repulsion can lead to the semi-Poisson distribution for nearest level separations. Nodal lines and nodal points are also investigated. Comparison is made with nodal point distributions for fully chaotic states.

The present article aims to scrutinize publishing ethics in the fields of paediatrics and paediatric nursing. Full-text readings of all original research articles in paediatrics from a high-income economy, i.e. Sweden, and from all low-income economies in Sub-Saharan Africa, were reviewed as they were indexed and stored in Web of Science for the search period from 1 January 2007 to 7 October 2009. The application of quantitative and qualitative content analysis revealed a marked discrepancy in publishing frequencies between the two (...) contrasting economies. Authors from 16 low-income economies in Sub-Saharan Africa, with at least one article stored, were obviously closely linked to co-authorships and foreign funding sources, predominantly from Europe and the USA. Statements concerning conflicts of interest were frequently missing (both regions), even when multiple financial sources, including companies, were involved. It is necessary to be aware of possible systematic bias when using electronic databases to search for certain topics and regions. Further research regarding publishing ethics in paediatrics and paediatric nursing is emphasized. (shrink)

The article argues that cognitive linguistic theory may prove an alternative to the Montague paradigm for designing natural language understanding systems. Within this framework it describes a system which models language understanding as a dialogical process between user and computer. The system operates with natural language texts as input and represent language meaning as entity-relationship diagrams.

The right of access to documents is constitutionally based in Sweden and has a long history. The right of access is considered crucial to Swedish democracy. On entering the EU in 1995, Sweden declared that public access to official records forms part of Sweden’s constitutional, political and cultural heritage. The members of the EU for their part declared that they took it for granted that Sweden would fully comply with Community, now Union, law with respect to openness and transparency. Sweden (...) continues to push for transparency when EU legislation potentially containing secrecy clauses is negotiated in the EU. It turns out, however, that the EU membership does pose challenges to the strong Swedish right of access to documents. The protection of personal data is controversial in Sweden to the extent that the stricter EU legislation clashes with the traditionally weak protection of privacy in Swedish law; the right of access to information has largely overridden the right to privacy. Large amounts of publicly available personal data, amassed in data bases by private actors, for commercial reasons but under the protection of the Swedish constitution, is causing problems especially since the Swedish constitutional law is considered, by Sweden, to precede EU legislation in the field. Sweden will somehow have to solve the dilemmas caused by the differing traditions of transparency between itself and other members of the EU and of other international organizations. Many answers – perhaps converging - will be provided in 2016 by Swedish official inquiries and the EU Regulation.Article first published online: 22 MARCH 2016. (shrink)

BackgroundResearch proactively and deliberately aims to bring about specific changes to how societies function and individual lives fare. However, in the ever-expanding field of ethical regulations and guidance for researchers, one ethical consideration seems to have passed under the radar: How should researchers act when pursuing actual, societal changes based on their academic work?Main textWhen researchers engage in the process of bringing about societal impact to tackle local or global challenges important concerns arise: cultural, social and political values and institutions (...) can be put at risk, transformed or even hampered if researchers lack awareness of how their ‘acting to impact’ influences the social world. With today’s strong focus on research impacts, addressing such ethical challenges has become urgent within in all fields of research involved in finding solutions to the challenges societies are facing. Due to the overall goal of doing something good that is often inherent in ethical approaches, boundaries to researchers’ impact of something good is neither obvious, nor easy to detect. We suggest that it is time for the field of bioethics to explore normative boundaries for researchers’ pursuit of impact and to consider, in detail, the ethical obligations that ought to shape this process, and we provide a four-step framework of fair conditions for such an approach. Our suggested approach within this field can be useful for other fields of research as well.ConclusionWith this paper, we draw attention to how the transition from pursuing impact within the Academy to trying to initiate and achieve impact beyond the Academy ought to be configured, and the ethical challenges inherent in this transition. We suggest a stepwise strategy to identify, discuss and constitute consensus-based boundaries to this academic activity. This strategy calls for efforts from a multi-disciplinary team of researchers, advisors from the humanities and social sciences, as well as discussants from funding institutions, ethical committees, politics and the society in general. Such efforts should be able to offer new and useful assistance to researchers, as well as research funding agencies, in choosing ethically acceptable, impact-pursuing projects. (shrink)

The aim of this study was to investigate the influence of clinical supervision on nurse’ moral decision making. The sample consisted of 15 registered nurses who took part in clinical supervision sessions. Data were obtained from interviews and analysed by a hermeneutic transformative process. The hermeneutic interpretation revealed four themes: increased self-assurance, an increased ability to support the patient, an increased ability to be in a relationship with the patient, and an increased ability to take responsibility. In conclusion, it seems (...) that clinical supervision enhances nurse’ ability to provide care on the basis of their decision making. However, the qualitative and structural aspects of clinical supervision have to be investigated further in order to develop professional insight into the way that nurses think and react. (shrink)

Departing from the view that genres are regulative as well as constitutive of social action, this article explores the interconnectedness of genres and Discourses that transit generic boundaries. Situating the study in a local energy transition project in Denmark and exploring what happens in a series of citizen meetings without a narrowly defined agenda, I argue that the meetings may be seen as a nexus of genres constituted by a tissue of interwoven Discourses with a lifespan that extends beyond the (...) specific communicative moment. I understand a nexus of genres as a point where genres in a wider sense meet and interact. Relating the Discourses initiated by the participating citizens to the ideational, the interpersonal and the textual metafunctions in systemic functional linguistics, I analyse topics made salient by actors participating in the citizen meetings. By following these topics intertextually across generic boundaries, I identify Discourses that are mutually entangled and genres that are taken up in the process. These include anticipatory Discourse, Discourse of legitimation, Discourse of motivation, Discourse about technology and Discourse about energy saving initiatives or in other words Discourses that exceed the boundaries of the specific genre in which they are realized. (shrink)

The Danish health care sector currently undergoes changes that imply a gradual transition from an evidence‐based activity model to a value‐based quality model centered on patient involvement and value‐based governance. The patient naturally occupies a central position in health care, and the transition therefore raises important questions about health care quality and how successive national health quality strategies value quality and ascribe roles and agency to patients. To explore the complexity of these quality strategies, we analyze and discuss how political (...) discourse moments influence the contents of the national health quality strategies and how variation in the construal of patient roles and agency indicates discursive struggle in Danish national health care policy. Underlying theoretical concepts are informed by New Public Management, the welfare state, health communication, and discourse theory. Our analytical approach is inspired by Critical Discourse Analysis and combines content analysis with linguistic analysis. (shrink)