The image of the hospital is presented to the public as a place of healing. Though the oft‐criticized total institutions of the past have been notably dismantled, the totalizing practices therein are now operationalized in the health care system. Through the lens of Erving Goffman, this article offers ways in which health care institutions operationalize totalizing practices, contributing to the mortification of patients and nurses alike in service to the bureaucratic machine. This article examines the ways in which totalizing practices (...) may disrupt the agency of both patients and nurses alike. (shrink)

Each of the antiretroviral drugs that are currently used to stop the progression of HIV infection causes its own specific side effects. Despite the expansion, multiplication, and simplification of treatment options over the past decade, side effects continue to affect people living with HIV. Yet, we see a clear disconnect between the way side effects are normalized, routinized, and framed in clinical practice and the way they are experienced by people living with HIV. This paper builds on the premise that (...) new approaches are needed to understand side effects in a manner that is more reflective of the subjective accounts of people living with HIV. Drawing on the work of Deleuze and Guattari, it offers an original application of the theory of ‘assemblage’. This theory offers a new way of theorizing side effects, and ultimately the relationship between the body and antiretroviral drugs (as technologies). Combining theory with examples derived from empirical data, we examine the multiple ways in which the body connects not only to the drugs but also to people, things, and systems. Our objective is to illustrate how this theory dares us to think differently about side effects and allows us to originally (re)think the experience of taking antiretroviral drugs. (shrink)

The purpose of this study was to compare working memory (WM), executive function, academic ability and problem classroom behaviors in children aged 8 to 11 years who were either identified via routine screening as having low WM, or had been diagnosed with ADHD. Standardised assessments of WM, executive function and reading and mathematics were administered to 83 children with ADHD, 50 children with low WM and 50 typically developing children. Teachers rated problem behaviors on checklists measuring attention, hyperactivity/impulsivity, oppositional behavior, (...) and difficulties associated with executive function in the classroom. The ADHD and low WM groups had highly similar WM and executive function profiles, but were distinguished in two key respects: children with ADHD had higher levels of rated and observed impulsive behavior, and children low WM had slower response times. Possible mechanisms for these common and distinct deficits are discussed. (shrink)

The aim of this article is to bring to the attention of the international nursing community the discrepancy between a pervasive ‘caring’ nursing discourse and a most unethical nursing practice in the United States. In this article, we present a duality: the conflict in American prisons between nursing ethics and the killing machinery. The US penal system is a setting in which trained healthcare personnel practice the extermination of life. We look upon the sanitization ofdeathworkas an application of healthcare professionals’ (...) skills and knowledge and their appropriation by the state to serve its ends. A review of the states’ death penalty statutes shows that healthcare workers are involved in the capital punishment process and shielded by American laws (and to a certain extent by professional boards through their inaction). We also argue that the law's language often masks that involvement; and explain how states further that duplicity behind legal formalisms. In considering the important role healthcare providers, namely nurses and physicians, play in administering death to the condemned, we assert that nurses and physicians are part of the states’ penal machinery in America. Nurses and physicians (as carriers of scientific knowledge, and also as agents of care) are intrinsic to the American killing enterprise. Healthcare professionals who take part in execution protocols are state functionaries who approach the condemned body as angels of death: they constitute an extension of the state which exercises its sovereign power over captive prisoners. (shrink)

Obtaining consent for medical treatment in older adults raises a number of complex challenges. Despite being required by ethics and the law, consent for medical treatment is not always validly sought in this population. The dynamic nature of capacity, particularly in individuals who have dementia or other cognitive impairments, adds complexity to obtaining consent. Further challenges arise in ensuring that older people comprehend the medical treatment information provided and that consent is not vitiated by coercion or undue influence. Existing mechanisms (...) to address issues surrounding consent for older adults only address incapacity and raise further challenges. As the ageing population increases, these issues are likely to become more profound, thus action is required to address these challenges. Raising awareness, more education, engaging with people with dementia, and conducting further research would assist in beginning to overcome these challenges. (shrink)

Competency has become a key concept in education in general over the last four decades. This article examines the development of the competency‐based movement with a particular focus on the significance it has had for nursing education. Our hypothesis is that the competency movement can only adequately be understood if it is analyzed in relation to the broad societal transformation of the last decades—often summarized under the catchword neoliberalism—and with it the emergence of managerial models for Human Resource Management (HRM) (...) for the reorganization of social services. Classical professions, which were characterized under welfarism by an esoteric knowledge based on ethical norms, have now become marketable commodities that can be evaluated in the same way as other commodities. We want to underline that while this development is still under way, it is the concept of competency that was the decisive political instrument enabling this profound change. With the widespread implementation of competency‐based education that now governs nursing knowledge, the development of a critical, oppositional perspective becomes more challenging, if not entirely impossible. We will be focusing primarily on nursing education in Canada, although we maintain that it has relevance for nursing internationally. (shrink)

This paper discusses a sequence of extensions ofNFU, Jensen's improvement of Quine's set theory “New Foundations” (NF) of [16].The original theoryNFof Quine continues to present difficulties. After 60 years of intermittent investigation, it is still not known to be consistent relative to any set theory in which we have confidence. Specker showed in [20] thatNFdisproves Choice (and so proves Infinity). Even if one assumes the consistency ofNF, one is hampered by the lack of powerful methods for proofs of consistency and (...) independence such as are available for use withZFC; very clever work has been done with permutation methods, starting with [18] and [5], and exemplified more recently by [14], but permutation methods can only be applied to show the consistency or independence of unstratified sentences (see the definition ofNFUbelow for a definition of stratification). For example, there is no method available to determine whether the assertion “the continuum can be well-ordered” is consistent with or independent ofNF. There is one substantial independence result for an assertion with nontrivial stratified consequences, using metamathematical methods: this is Orey's proof of the independence of the Axiom of Counting fromNF(see below for a statement of this axiom).We mention these difficulties only to reassure the reader of their irrelevance to the present work. Jensen's modification of “New Foundations” (in [13]), which was to restrict extensionality to sets, allowing many non-sets (urelements) with no elements, has almost magical effects. (shrink)

This article presents narratives from 13 Indigenous early career academics (ECAs) at one university in Auckland, New Zealand. These experiences are likely to represent those of Indigenous Māori and Pasifika ECAs nationally, given the small, centralised nature of the national academy of Aotearoa New Zealand. The narratives contain testimony, fictionalised vignettes of experience, and poetic expressions. Meeting the demands of an academic role in one’s first years of working at a university is a big deal for anyone; the extra pressures (...) and challenges for Indigenous Māori and Pacific staff are immense, yet little understood by White ‘others.’ A writing workshop was the initial catalyst of this collective writing project. Through these insider narratives, this article presents a collective description of, and response to, the experience of Māori and Pasifika early career academics. (shrink)

The question of how to frame agential preferences in economics finds one caught between Scylla and Charybdis. If preferences are framed in as minimal and deflationary a manner as revealed preference theory recommends, the theory falls prey to objections about its predictiveness and explanatory power. Alternatively, if too many cognitive and causal intricacies are incorporated into the preference concept, revealed preference models will violate pragmatic norms of model construction, surrendering model simplicity and generality. This paper charts a middle course, arguing (...) that the path to salvation lies through an understanding of revealed preference models as program explanations. (shrink)

At the centenary of Frank H. Knight’s Risk, Uncertainty, and Profit, we explore the continuing relevance of Knightian uncertainty to the theory and practice of entrepreneurship. There are three challenges facing such assessment. First, RUP is complex and difficult to interpret. The key but neglected element of RUP is that Knight’s account is not solely about risk and uncertainty as states of nature, but about how an agent’s beliefs about uncertain outcomes and confidence in those beliefs guide their choices. Second, (...) RUP is Knight’s only effort in this area. His subsequent career led elsewhere, so he did not engage with subsequent interpretations of this work. Third, much of the current literature emphasizes that decisions must be different under the two states of nature with a consequent misunderstanding of entrepreneurial agency. This paper addresses each challenge in sequence. First, we explicate Knight’s approach and explain why that approach is murky. Second, as a complement to Knight’s interpretation, we examine Frank P. Ramsey’s approach to subjective probabilities to help clarify Knight’s murky approach. What links Knight and Ramsey is a shared pragmatism about entrepreneurial agency under uncertainty that depends upon the beliefs about, and confidence in, their judgments of possible outcomes. This Knight-Ramsey approach does not require actor’s behaviors to be determined by the class of uncertain environment they face. We focus on the response by the entrepreneur to the existence of uncertainty in all its forms. We argue that this reductive account provides a foundation to examine common problems in management, including managerial hubris, the interaction between entrepreneurs and venture capitalists, and the need for experimentation in advance of new product and venture launches. Third, we critique current literature that favors epistemic purism about the ontology of risk and uncertainty and ignores Knight-Ramsey pragmatism in meeting uncertainty, such as using formal and informal institutions for uncertainty mitigation. Our account locates Frank Knight’s subtleties in entrepreneurial behavior firmly in the literature on entrepreneurial agency a century later. (shrink)

What constitutes a scientific discovery? What role do discoveries play in science, its dynamics and social practices? Must every discovery be attributed to an individual discoverer (or a small number of discoverers)? The paper explores these questions by first critically examining extant philosophical explications of scientific discovery—the models of scientific discovery, propounded by Kuhn, McArthur, Hudson, and Schindler. As a simple, natural and powerful alternative, we proffer the “change-driver model”: in a nutshell, it takes discoveries to be cognitive scientific results (...) that have epistemically advanced science. The model overcomes the shortcomings of its precursors, whilst preserving their insights. We demonstrate its intensional and extensional superiority, especially with respect to the link between scientific discoveries and the dynamics of science, as well as the award system of science. Both as an illustration, and as an application to a recent scientific and political controversy, we apply the considered models of discovery to one of the most momentous discoveries of science: the expansion of the universe. We oppose the 2018 proposal of the International Astronomers’ Union as too simplistic vis-`a-vis the historical complexity of the episode. The change- driver model yields a more nuanced and circumspect verdict: (i) The redshift-distance relation shouldn’t be named the “Hubble-Lemaître Law”, but “Slipher-Lundmark-Hubble-Humason Law”; (ii) Its interpretation in terms of an expanding universe, however, Lemaître ought to be given credit for; but (iii) The establishment of the expansion of the universe, as an evidentially sufficiently warranted result, is a communal achievement, emerging in the 1950s or 1960s. (shrink)

Problems with clinical research that create conflicts between doctors' therapeutic and research obligations may be fueled by a rigid view of science as determiner of truth, a heavy reliance on statistics, and certain features of randomized clinical trials. I suggest some creative, feminist approaches to such research and explore ways to provide choice for patients and to use values in directing both therapy and science - to enhance the effectiveness of each.

Systems TRC and TRCU of illative combinatory logic are introduced and shown to be equivalent in consistency strength and expressive power to Quine's set theory ‘New Foundations’ and the fragment NFU + Infinity of NF described by Jensen, respectively. Jensen demonstrated the consistency of NFU + Infinity relative to ZFC; the question of the consistency of NF remains open. TRC and TRCU are presented here as classical first-order theories, although they can be presented as equational theories; they are not constructive.

The inner ache: an experiential perspective on IonelinessThis paper examines the various theoretical approaches that have informed both the conceptualizations and the research approaches to investigations of loneliness. A focus on phenomenological and existential perspectives of loneliness can assist in an understanding of what is essentially a subjective distressing experience. The elderly, particularly those residing in nursing homes, are vulnerable to feelings of existential loneliness because following busy lives, often they are left without meaningful roles. Concomitant to this sense of (...) loss of meaning is an alteration in the perception of lived time. It is the purpose of this paper to stimulate research into what is a common but profoundly distressing experience. (shrink)

The view from inside : gendered embodiment and the medical representation of sex / Shelley Wall -- The politics of medico-legal recognition : the terms of gendered subjectivity in the UK Gender Recognition Act / Sarah Burgess -- Journeys of choice? : abortion, travel, and women's autonomy / Christabelle Sethna and Marion Doull -- The code of ethics in medicine : intertextuality and meaning in Plato's Sophist and Hippocrates' oath / Twyla Gibson -- Sleeping ethics : gene, episteme, and the (...) body politic / Deborah Lynn Steinberg -- The last temptation of Marion Woodman : the anorexic remainder in bone : dying into life / David L. Clark. (shrink)

Recovery is a model of care in (forensic) mental health settings across Western nations that aims to move past the paternalistic and punitive models of institutional care of the 20th century and toward more patient‐centered approaches. But as we argue in this paper, the recovery‐oriented services that evolved out of the early stages of this liberating movement signaled a shift in nursing practices that cannot be viewed only as improvements. In effect, as “recovery” nursing practices became more established, more codified, (...) and more institutional(ized), a stasis developed. Recovery had been reterritorialized. The purpose of this paper is to examine some of the threads of recovery, from its early days of antipsychiatry activism to its codification into mental health—including forensic mental health—institutions through the lens of poststructuralist philosophers Gilles Deleuze and Felix Guattari. We believe that Deleuze and Guattari's scholarship provides the necessary, albeit uncomfortable, framework for this critical examination. From a conceptualization of recovery as an assemblage, we critically examine how we can go about creating something new, caught in a tension between stasis and change. (shrink)

An eloquent introduction to the ethical and philosophical values at stake in biological conservation, this book familiarizes readers with the general issues and possible solutions to the problems societies face in simultaneously conserving nature and promoting culture.

Journal Name: Apeiron Issue: Ahead of print.

BackgroundHealth research funding agencies are placing a growing focus on knowledge translation (KT) plans, also known as dissemination and implementation (D&I) plans, in grant applications to decrease the gap between what we know from research and what we do in practice, policy, and further research. Historically, review panels have focused on the scientific excellence of applications to determine which should be funded; however, relevance to societal health priorities, the facilitation of evidence-informed practice and policy, or realizing commercialization opportunities all require (...) a different lens.DiscussionWhile experts in their respective fields, grant reviewers may lack the competencies to rigorously assess the KT components of applications. Funders of health research—including health charities, non-profit agencies, governments, and foundations—have an obligation to ensure that these components of funding applications are as rigorously evaluated as the scientific components. In this paper, we discuss the need for a more rigorous evaluation of knowledge translation potential by review panels and propose how this may be addressed.ConclusionWe propose that reviewer training supported in various ways including guidelines and KT expertise on review panels and modalities such as online and face-to-face training will result in the rigorous assessment of all components of funding applications, thus increasing the relevance and use of funded research evidence. An unintended but highly welcome consequence of such training could be higher quality D&I or KT plans in subsequent funding applications from trained reviewers. (shrink)

No one looking ahead at the middle of the last century could have foreseen the extent and the importance of the ensuing environmental crises. Now, more than a decade into the next century, no one can ignore it. A New Environmental Ethics: the Next Millennium for Life on Earth offers clear, powerful, and oftentimes moving thoughts from one of the first and most respected philosophers to write on the environment. Rolston, an early and leading pioneer in studying the moral relationship (...) between humans and the earth, surveys the full spectrum of approaches in the field of environmental ethics. This book, however, is not simply a judicious overview. Instead, it offers critical assessments of contemporary academic accounts and draws on a lifetime of research and experience to suggest an outlook for the future. As a result, this focused, forward-looking analysis will be a necessary complement to any balanced textbook or anthology in environmental ethics, and will teach its readers to be responsible global citizens, and residents of their landscape, helping ensure that the future we have will be the one we wish for. (shrink)

This article examines the creation of words in De Rerum Natura through a close reading of two extended passages concerning the problem of where words come from and what they do. The first is the account of speech production, work entrusted to the daedala lingua in Book 4. This physiological process is mimicked at the phylogenic level in the discussion on the origins of language in Book 5, where voice is first shaped by a body responding to the impact of (...) objects, then by utilitas. The adjective daedalus and the intervention of utilitas both signal, I argue, a shift away from an understanding of language as reaction towards an understanding of language as fabrication, a shift with important implications for the relationship of words to the world they represent. (shrink)

In an earlier article in Classical Quarterly, S. J. Harrison explored the varying frequency of hexameter-endings of the type discordia taetra, where a noun that ends in short a is followed by its epithet with the same termination. It appears from this that while most pre-Augustan poets allow a fairly high frequency of such verse-endings , some Augustan poets and their imitators show a distinct tendency to avoid them , while some almost exclude them altogether . The hexameters of elegiac (...) poetry might be subject to the same restriction; the following are figures for elegy from Catullus to Martial. (shrink)

This paper extends the results of an earlier paper by the author . New subsystems of the combinatory logic TRC shown in that paper to be equivalent to NF are introduced; these systems are analogous to subsystems of NF with predicativity restrictions on set comprehension introduced and shown to be consistent by Crabbé. For one of these systems, an exact equivalence in consistency strength and expressive power with the analogous subsystem of NF is established.

A problem of paramount importance to understanding John Dewey’s ethics is to clarify his conception of judgment and his distinction between judgments and propositions. Depending upon how one interprets him on this matter, different answers suggest themselves to some of the most basic questions underlying his ethical theory, particularly those dealing with the relationship between science and ethics, the relationship between practical judgments and descriptive statements, and the differentiae of moral and scientific judgments within the genus practical judgment. Oversimplified answers (...) are usually given to these, the stock interpretation being that he believes that ethics is reducible to science, that practical judgments are descriptive and hence that moral judgments are essentially scientific in nature. Although he undeniably says much to invite such an interpretation, it nonetheless fails to do justice to his considered view, and a probe of his account of the nature of judgments and propositions reveals that he views the whole relationship of moral to scientific judgments, hence of ethics to science, in a different light than is generally supposed. In consequence, much of his ethics needs reappraisal, particularly as having relevance to topics in the forefront of contemporary British and American ethical thought. (shrink)

The increasing popularity of local food consumption can be attributed to the heightened awareness of food safety concerns, carbon emissions produced from food transportation, and an understanding of how large corporations’ obtain their food supplies. Although there is increasing discussion on both the local and organic food movement independently, there is not a wide availability of literature examining the motivations and perceptions of consumers with regard to farmers’ markets. Issues such as perceptions about what type of food consumers are purchasing (...) at markets, nor the main motivations for frequenting such establishments are discussed. Therefore the purpose of this study was to determine consumer motivations, benefits, and perceptions of farmers’ markets. Using the case study location of Toronto, Canada, this study surveyed 300 participants during the fall of 2011. Findings indicated that the main purpose for visiting famers’ markets is not solely to fulfill grocery needs. Quality of products offered and the ability to support the local community were the primary motivators to visit the markets. (shrink)