This discussion paper aims to explore potential ethical and moral implications of (patient) centredness in nursing and healthcare. Healthcare is experiencing a philosophical shift from a perspective where the health professional is positioned as the expert to one that re‐centres care and service provision central to the needs and desires of the persons served. This centred approach to healthcare delivery has gained a moral authority as the right thing to do. However, little attention has been given to its moral and (...) ethical theoretical grounding and potential implications for nurses, persons served and the healthcare system. Based upon a review of academic and grey literature, centredness is proposed as a value‐laden concept in nursing inquiry. Potential moral and ethical implications of centredness on nurses/healthcare providers, persons served and the healthcare system are discussed. These challenges are then considered within the context of normative and relational ethical theories. These perspectives may offer guidance relative to how one should act in those circumstances as well as an understanding as to how interdependency and engagement with the other person(s) can help navigate the challenges of a centred care approach. Viewing centredness through an ethical theoretical lens provides a valuable discourse to nursing in efforts to expand the knowledge base and integrate centred approaches into practice and policy. (shrink)

_341_ _Objectives: _In patients with multivessel disease both the detection of the culprit lesion and the exact allocation are important preconditions for sufficient treatment and improved outcome. In a vessel based approach the combination of quantitative coronary angiography and fractional flow reserve measured by a pressure wire should be advantageous compared to myocardial SPECT, as morphological and functional information is delivered simultaneously. Therefore our aim was to evaluate MS in the detection and allocation of hemodynamically significant stenoses obtained by the (...) combined gold standard QCA plus FFR in patients with multivessel disease. _Methods: _FFR and QCA of 95 vessels in 80 patients have been evaluated. Hemodynamically significant target lesions were defined as intermediate stenoses between 50 and 75% with an FFR. (shrink)

This book updates and adds to the classic Social Movements of the Sixties and Seventies, showing how social movement theory has grown and changed.

This study investigated potential risk factors (coping, perfectionism and self-regulation) for substantial injuries in contemporary dance students using a prospective cohort design, as high-quality studies focusing on mental risk factors for dance injuries are lacking. Student characteristics (age, sex, BMI, educational program and history of injury) and psychological constructs (coping, perfectionism and self-regulation) were assessed using the Performing artist and Athlete Health Monitor (PAHM), a web-based system. Substantial injuries were measured with the Oslo Sports Trauma Research Center (OSTRC) Questionnaire on (...) Health Problems and recorded on a monthly basis as part of the PAHM system. Univariate and multivariate logistic regression analyses were conducted to test the associations between potential risk factors (i.e. student characteristics and psychological constructs) and substantial injuries. 99 students were included in the analyses. During the academic year 2016-2017, 48 students (48.5%) reported at least one substantial injury. Of all factors included, coping skills (OR: 0.91; 95% CI: 0.84–0.98), age (OR: 0.67; 95% CI: 0.46–0.98) and BMI (OR: 1.38; 95% CI: 1.05–1.80) were identified as significant risk factors in the multivariate analysis. The model explained 24% of the variance in the substantial injury group. Further prospective research into mental risk factors for dance injuries with larger samples sizes is needed to develop preventive strategies. Yet, dance schools could consider including coping skills training as part of injury prevention programs and, perhaps, providing special attention to younger dancers and those with a higher BMI through transitional programs to assist them in managing the stress they experience throughout their (academic) career. (shrink)

The acquisition and evolution of speech production, discourse and communication can be negatively impacted by brain malformations. We describe, for the first time, a case of developmental dynamic dysphasia (DDD) in a right-handed adolescent boy (subject D) with cortical malformations involving language-eloquent regions (inferior frontal gyrus) in both the left and the right hemispheres. Language evaluation revealed a markedly reduced verbal output affecting phonemic and semantic fluency, phrase and sentence generation and verbal communication in everyday life. Auditory comprehension, repetition, naming, (...) reading and spelling were relatively preserved, but executive function was impaired. Multimodal neuroimaging showed a malformed cerebral cortex with atypical configuration and placement of white matter tracts bilaterally and abnormal callosal fibers. Dichotic listening showed right hemisphere dominance for language and functional magnetic resonance imaging (fMRI) additionally revealed dissociated hemispheric language representation with right frontal activation for phonology and bilateral dominance for semantic processing. Moreover, subject D also had congenital mirror movements (CMM), defined as involuntary movements of one side of the body that mirror intentional movements of the other side. Transcranial magnetic stimulation and fMRI during voluntary unimanual (left and right) hand movements showed bilateral motor cortex recruitment and tractography revealed a lack of decussation of bilateral corticospinal tracts. Genetic testing aimed to detect mutations that disrupt the development of commissural tracts correlating with CMM (e.g., Germline DCC mutations) was negative. Overall, our findings suggest that DDD in subject D resulted from the underdevelopment of the left inferior frontal gyrus with limited capacity for plastic reorganization by its homologous counterpart in the right hemisphere. Corpus callosum anomalies probably contributed to hinder interhemispheric connectivity necessary to compensate language and communication deficits after left frontal involvement. (shrink)

Why does the problem of free will seem so intractable? I surmise that in large measure it does so because the free will debate, at least in its modern form, is conducted in terms of a mistaken approach to causality in general. At the heart of this approach is the assumption that all causation is fundamentally event causation. Of course, it is well-known that some philosophers of action want to invoke in addition an irreducible notion of agent causation, applicable only (...) in the sphere of intelligent agency. But such a view is generally dismissed as incompatible with the naturalism that has now become orthodoxy amongst mainstream analytical philosophers of mind. What I want to argue is that substances, not events, are the primary relata of causal relations and that agent causation should properly be conceived of as a species of substance causation. I shall try to show that by thus reconceiving the nature of causation and of agency, the problem of free will can be made more tractable. I shall also argue for a contention that may seem even less plausible at first sight, namely, that such a view of agency is perfectly compatible with a volitionist theory of action. (shrink)

A self or person does not appear to be identifiable with his or her organic body, nor with any part of it, such as the brain; and yet selves seem to be agents, capable of bringing about physical events as causal consequences of certain of their conscious mental states. How is this possible in a universe in which, it appears, every physical event has a sufficient cause which is wholly physical? The answer is that this is possible if a certain (...) kind of naturalistic dualism is true, according to which the conscious mental states of selves, although not identifiable with physical states of their brains, are emergent effects of prior physical causes. Moreover, mental causation on this model promises to explain certain aspects of physical behaviour which may appear arbitrary and coincidental from a purely physical point of view. (shrink)

Lorazepam has been repeatedly shown to induce memory impairments. The effects of this benzodiazepine on the processes involved in the strategic regulation of memory accuracy have not as yet been explored. An experimental procedure that delineates the role of monitoring and control processes was used. Fifteen lorazepam and 15 placebo subjects were examined using a semantic memory task that combined both a forced- and a free-report option and a no-incentive and an incentive condition. Memory accuracy was lower in the lorazepam (...) than in the placebo group. Lorazepam impaired control sensitivity (the extent to which volunteering of answers is affected by the confidence judgments). While the absolute aspect of monitoring was impaired (calibration scores), both the discriminative aspect (the ability to distinguish between correct and incorrect answers) and the response criterion setting (the confidence threshold set for volunteering a report) were spared. The pharmacological dissociation between monitoring effectiveness and control sensitivity indicates that these two components involve distinct processes. (shrink)

Morsella et al. argue that science should not focus on high forms of consciousness. We disagree. An understanding of high forms of consciousness is invaluable to the scientific study of consciousness. Moreover, it poses challenges to the passive frame theory. Specifically, it challenges the notions that conscious thoughts are not connected and that consciousness serves skeletomotor conflict only.

We live in turbulent times, our world is changing at accelerating speed. Information is everywhere, but wisdom appears in short supply when trying to address key inter-related challenges of our time such as; runaway climate change, the loss of biodiversity, the depletion of natural resources, the on-going homogenization of culture, and rising inequity. Living in such times has implications for education and learning. This book explores the possibilities of designing and facilitating learning-based change and transitions towards sustainability. In 31 chapters (...) contributors from across the world discuss (re)emerging forms of learning that not only assist in breaking down unsustainable routines, forms of governance, production and consumption, but also can help create ones that are more sustainable. The book has been divided into three parts: re-orienting science and society, re-connecting people and planet and re-imagining education and learning. This is essential reading for educators, educational designers, change agents, researchers, students, policymakers and entrepreneurs alike, who are concerned about the well-being of the planet and convinced of our ability to do better. The content and related issues can be discussed on the blog by editor Arjen Wals: Transformative learning. 'We are living in times of incertitude, complexity, and contestation, but also of connectivity, responsibility, and new opportunities. This book analyses the consequences of these times for learning in formal, non-formal, and informal education. It explores the possibilities offered by the concept of sustainability as a central category of a holistic paradigm which harmonizes human beings with Earth. To change people and to change the world are interdependent processes - this book contributes to both.' Moacir Gadotti, Director of Paulo Freire Institute, São Paulo, Brazil 'I hope you share my excitement about the innovations for sustainability that this book catalogues and analyses. While the ecological news is grim, the human news is not. Even in a time of accelerating change, people are showing their enormous capacities to learn, adapt, restore and protect.' From the Foreword by Juliet Schor, author of ‘True Wealth: how and why millions of Americans are creating a time-rich, ecologically-light, small-scale high-satisfaction economy’ 'This book implies a ‘culture of critical commitment’ in educational thinking and practice - engaged enough to make a real difference to social-ecological resilience and sustainability but reflexively critical enough to learn constantly from experience and to keep options open in working for a sustainability transformation.' From the Afterword by Stephen Sterling, Professor of Sustainability Education, Centre for Sustainable Futures, Plymouth University, United Kingdom. (shrink)

"This comprehensive volume - containing 27 chapters and contributions from six continents - presents and discusses key principles, perspectives, and practices of social learning in the context of sustainability. Social learning is explored from a range of fields challenged by sustainability including: organizational learning, environmental management and corporate social responsibility; multi-stakeholder governance; education, learning and educational psychology; multiple land-use and integrated rural development; and consumerism and critical consumer education. An entire section of the book is devoted to a number of (...) reflective case studies of people, organizations and communities using forms of social learning in moving towards sustainability. 'This book brings together a range of ideas, stories, and discussions about purposeful learning in communities aimed at creating a world that is more sustainable than the one currently in prospect....The book is designed to expand the network of conversations through which our society can confront various perspectives, discover emerging patterns, and apply learning to a variety of emotional and social contexts.' From the Foreword by Fritjof Capra, co-founder of the Center of Ecoliteracy. 'Joining what is so clear and refreshing in this book with the larger movements toward a critically democratic and activist education that is worthy of its name, is but one step in the struggle for sustainability. But it is an essential step if we are to use the insights that are included in this book.' From the Afterword by Michael Apple, author of 'Educating the ""Right"" Way: Markets, Standards, God, and Inequality'.". (shrink)

The juvenile hormones of insects regulate an unusually large diversity of processes during postembryonic development and adult reproduction. It is a long‐standing puzzle in insect developmental biology and physiology how one hormone can have such diverse effects. The search for molecular mechanisms of juvenile hormone action has been guided by classical models for hormone–receptor interaction. Yet, despite substantial effort, the search for a juvenile hormone receptor has been frustrating and has yielded limited results. We note here that a number of (...) lipid‐soluble signaling molecules in vertebrates, invertebrates and plants show curious similarities to the properties of juvenile hormones of insects. Until now, these signaling molecules have been thought of as uniquely evolved mechanisms that perform specialized regulatory functions in the taxon where they were discovered. We show that this array of lipid signaling molecules share interesting properties and suggest that they constitute a large set of signal control and transduction mechanisms that include, but range far beyond, the classical steroid hormone signaling mechanism. Juvenile hormone is the insect representative of this widespread and diverse system of lipid signaling molecules that regulate protein activity in a variety of ways. We propose a synthetic perspective for understanding juvenile hormone action in light of other lipid signaling systems and suggest that lipid activation of proteins has evolved to modulate existing signal activation and transduction mechanisms in animals and plants. Since small lipids can be inserted into many different pathways, lipid‐activated proteins have evolved to play a great diversity of roles in physiology and development. BioEssays 25:994–1001, 2003. © 2003 Wiley Periodicals, Inc. (shrink)

The article explores the private nature of subjectivity in programs of integration the phenomenology with naturalism. It is considered if their tools are relevant for the phenomenological, rather than naturalistic way of subjectivity’s explaining. Justification of the key ideas is provided with the help of such concepts as “body image”, “body scheme”, (Sh. Gallagher), “ontological significance” (L. Baker), “experience”, “cognitive niches” (F. Varela), “transparent body” (T. Fuchs). Based on the traditional phenomenology of E. Husserl, it is shown that a set (...) of approaches that integrate phenomenology and naturalism within the framework of “first-person philosophy” can be characterized as a phenomenology without a phenomenological subject. It is shown that the phenomenological nature of the self-perspective in integrative programs is more likely to be understood as the qualification and privacy of subjectivity, while the transcendental aspect of the unobservable and biased consciousness is practically not taken into account. The article concludes that the logic of some projects of integration of phenomenology and naturalism overlook this transcendental peculiarity of consciousness, its fundamentally unobserved character. The classical phenomenological approach emphasizes on the extra-natural, biased, and non-empirical nature of consciousness. The role and significance of the phenomenological approach is not limited to the idea of “what-is-likeness” and privacy of subjective states. Phenomenology, which preserves the idea of the subject, means a radical break with the ontology of things and, in general, with the ontology of something objective at all. (shrink)

E. J. Lowe; Coinciding objects: in defence of the ‘standard account’, Analysis, Volume 55, Issue 3, 1 July 1995, Pages 171–178, https://doi.org/10.1093/analys/5.