The aim of this study was to describe how patients’ participation in the care they received was documented in their health care records during the last three months of their lives. Two hundred and twenty-nine deceased adult persons were randomly identified from 12 municipalities in a Swedish county and their records were selected from different health care units. Content analysis was used to analyse the text. Four categories of patient participation were described: refusing offered care and treatments; appealing for relief; (...) desire for everyday life; and making personal decisions. The most common way for these patients to be involved in their care at the end of their life was by refusal of the treatment and care offered. Characteristic of the different ways of participation were the diverse activities represented. The description of patients’ involvement in their life situation at this time indicated their dissociation from the health care offered more than consenting to it. (shrink)

Traditional health sciences (including nursing) paradigms, conceptual models, and theories have relied heavily upon notions of the ‘person’ or ‘patient’ that are deeply rooted in humanistic principles. Our intention here, as a collective academic assemblage, is to question taken‐for‐granted definitions and assumptions of the ‘person’ from a critical posthumanist perspective. To do so, the cinematic works of filmmaker David Cronenberg offer a radical perspective to revisit our understanding of the ‘person’ in nursing and beyond. Cronenberg's work explores bodily transformation and (...) mutation, with the body as a fragile and malleable vessel. Cronenberg's work allows us to interrogate the body in all its complexity, contingency, and hybridity and provides avenues of rupture within current understandings of ‘the person’. Reinventing the definition of what it means to be human, critical posthumanism offers opportunities to both critique humanist theories and build affirmative futurities. Also drawing on the work of Deleuze and Guattari, specifically, their concept of becoming, we propose a critical posthumanist alternative to the conceptualization of the person in the health sciences, that of the becoming‐mutant, so frequently explored in Cronenberg's films. Such a conceptualization permits the inclusion of various technological interventions of the contemporary subject: The postperson. This position offers the health science disciplines a radical reconceptualization of the conceptual and theoretical approaches, extending beyond those trapped within the quagmire of humanistic principles. (shrink)

L'originalite du livre se situe proprement dans l'elaboration d'une lecture omni-comprehensive du systeme weilien et dans la conception de la vocation politique du langage.

Resumen: Este artículo tiene como foco de estudio la fonología segmental del mapudungun, en general, y el estatus de los fonos interdentales /en el chedungun hablado en Alto Biobío, en particular. Se elicitó una lista léxica adaptada de Croese, 30 colaboradores adultos, bilingües de chedungun y español, pertenecientes a 10 localidades pehuenches de esta comuna. Mediante evidencia cuantitativa, visual, palatográfica y de contraste en ambiente análogo, se concluye que dichos fonos tienen estatus fonémico en la zona señalada.: This article focuses (...) on the Mapudungún segmental phonology in general, and the status of the interdental phones / from the Chedungun spoken in Alto Biobío in particular. An adapted lexicon list by Croese was elicited from 30 adult bilingual assistants, belonging to 10 towns of this community. Through the quantitative, visual, palatographic and analog environment contrast we concluded that those phones have phonemic status in the mentioned area. (shrink)

Resumen: El artículo aborda uno de los modos de localización de entidades en situaciones espaciales estáticas: la deíxis espacial. Nuestro objetivo principal es describir la estructura y uso del sistema demostrativo en espacio de escala menor en la lengua hablada por los gitanos de Chile: el rromané jorajané. Para la obtención de los datos se utilizó The 1999 Demonstrative Questionnaire: ‘THIS’ and ‘THAT’ in comparative perspective. Los resultados del análisis destacan que los demostrativos espaciales del rromané jorajané constituyen un grupo (...) altamente simétrico, que combina un componente semántico deíctico, junto con contenidos gramaticales. Se trata de un sistema demostrativo binario en cuanto a la categoría de distancia respecto del centro deíctico. Se concluye también que la selección del demostrativo apropiado obedece al siguiente patrón: el demostrativo proximal tiene su área focal en la zona próxima al hablante, mientras que el demostrativo distal incluye en su campo de aplicación tanto la zona próxima al oyente como la zona distante al hablante.: This paper addresses one way of locating entities in static spatial situations: the spatial deixis. Our main purpose is to describe the structure and use of the demonstrative system in small-scale space in the language spoken by Gypsies in Chile: the rromané jorajané. Data collection was performed with “The 1999 Demonstrative Questionnaire: ‘THIS’ and ‘THAT’ in comparative perspective”. The analysis results highlight that spatial demonstratives in rromané jorajané are a highly symmetrical group combining a deictic semantic component with grammatical contents. It is a binary demonstrative system in terms of the category of distance from the deictic center. Additionally, it is concluded that choice of the suitable demonstrative proceeds according to the following pattern: the proximal demonstrative has its focal area in the speaker’s zone of proximity, while the distal demonstrative includes both the addressee’s zone of proximity and the speaker’s distal zone within its application field. (shrink)

The phenomenon of entrepreneurship has attracted researchers from a variety of disciplines and a diverse number of analytical approaches. Currently, there is a considerable amount of confusion and a variety of conflicting theories which are being used interchangeably and ambiguously. In this important new book, the authors argue that there are analytically distinct forms of entrepreneurship, each of them having an individual logic of their own. They highlight the role of individual economic agents with endowments of new knowledge or new (...) combinations of old knowledge as entrepreneurs, and thus identify them as dynamic factors in the knowledge economy. Overall, this book not only provides a contemporary overview of current research in the field, but also summarizes the policy conclusions that can be drawn from current research. (shrink)

Este artículo aporta al conocimiento de la fonología suprasegmental del Mapudungun (específicamente, del acento), aspecto que ha sido escasamente abordado, en comparación con la fonía segmental de esta lengua. Sus focos principales son determinar cómo se distribuye el acento léxico en el Lafkenche hablado en la localidad de Los Álamos, Octava Región de Chile; y la comparación con el trabajo de Ortiz (2021), el cual se ocupa de este aspecto prosódico en el cordón cordillerano de habla Pewenche. Para ello, se (...) determinaron las sílabas tónicas de palabras monomorfémicas bisilábicas y trisilábicas elicitadas a 6 hablantes adultos bilingües de Mapudungun-español. Los resultados muestran una clara tendencia a emplear una acentuación paroxítona, lo que difiere del habla del cordón cordillerano de habla Pewenche, donde predomina la acentuación oxítona. Esta diferencia puede explicarse por el mayor grado de contacto del Lafkenche con el español. Además, se estableció que la ocurrencia de la sílaba CVC no cumple un rol prominente en la asignación del acento en la zona. (shrink)

Tous deux résistants, Cavaillès et Lautmann ont été fusillés par les Allemands.Ils étaient l’un et l’autre « philosophes des mathématiques », mais leur réflexion proprement philosophique porte sur les rapports des mathématiques et de la logique, et, plus généralement, sur la pensée formelle.À la notion lautmanienne de « dialectique » mathématique, s’oppose – ou du moins se juxtapose –, du côté de Cavaillès, l’idée de la nécessité interne d’une histoire des concepts.Both resisting during WWII, Cavaillès et Lautmann were shot by (...) the Germans.Both were « philosophers of maths » but their true philosophical thoughts deal with the relationships between mathematics and logics and, more specifically, with formal thought.To the Lautmanian reflection on mathematical « dialectics », Cavaillès opposes – or rather, juxtaposes – the idea of an internal necessity of a history of concepts. (shrink)

Within the context of neoliberal healthcare, nurses and other health professionals face working conditions that leave them perpetually feeling inadequate, as though they are not enough. They are consistently expected to achieve more with less resources. In such an environment, mere professionalism proves wholly insufficient, enforcing norms of altruism and kindness. Professionals must transcend this disciplinary tool and embody a ‘more‐than‐professional’ approach. This study, informed by critical posthumanism, employs three mythical archetypes—the Medusa, the Witch and the Siren—to illuminate potential avenues (...) for resistance against prevailing trends in healthcare. Drawing on the perspectives of Hélène Cixous, Silvia Federici and Jacques Rancière, we introduce a process of resistance for healthcare professionals pushing back against the challenges of crumbling healthcare systems. Cixous' feminist reimagining of Medusa symbolizes intensified embodied sensory experiences, emphasizing the power of irony, laughter and writing in highlighting the daily struggles faced by healthcare workers. Federici's depiction of the Witch exposes clandestine alliances among healthcare workers and patients, akin to a pact with the devil, countering the individualistic, alienating approach to care provision and resisting neoliberal pressures. The Witch archetype embodies resistance grounded in creativity against the commodification of public healthcare. Finally, Rancière's ‘politics of the Siren' offers a strategy for disrupting entrenched hierarchies from the underworld. Like Sirens, healthcare workers and patients can subversively transform their silence into songs of resistance, simultaneously operating from beneath the surface of accountability measures. Our intention is to showcase the emergence of posthuman ‘professionals’ who adapt by forging new modes of social relations in response to neoliberal constraints, straying from conventional, apolitical notions of ‘professionalism’. Drawing lessons from mythical figures of resistance offers a fresh understanding of subversion as a catalyst for social and political transformation within the healthcare sector. (shrink)

La philosophie est-elle un savoir? Y a-t-il des vérités philosophiques? Peut-on démontrer en philosophie? Deux tentations opposées sont ici dénoncées. L'une porte à présenter la philosophie comme une sorte de science éminente et dogmatique ; l'autre à la confondre avec l'exposé poétique et passionné de quelques états d'âme. L'auteur, au contraire, essaie d'établir que la philosophie, à travers sa diversité, constitue une véritable connaissance, irréductible à celle que fournit la science et n'y suppléant en aucun cas : une connaissance capable (...) de rigueur, quoique non démonstrative, une connaissance paradoxalement sans objets. (shrink)

BackgroundHealth data-driven activities have become central in diverse fields (research, AI development, wearables, etc.), and new ethical challenges have arisen with regards to privacy, integrity, and appropriateness of use. To ensure the protection of individuals’ fundamental rights and freedoms in a changing environment, including their right to the protection of personal data, we aim to identify the ethical approaches adopted by scientists during intensive data exploitation when collecting, using, or sharing peoples’ health data.MethodsTwelve scientists who were collecting, using, or sharing (...) health data in different contexts in Sweden, were interviewed. We used systematic expert interviews to access these scientists’ specialist knowledge, and analysed the interviews with thematic analysis. Phrases, sentences, or paragraphs through which ethical values and norms were expressed, were identified and coded. Codes that reflected similar concepts were grouped, subcategories were formulated, and categories were connected to traditional ethical approaches.ResultsThrough several examples, the respondents expressed four different ethical approaches, which formed the main conceptual categories: consideration of consequences, respect for rights, procedural compliance, and being professional.ConclusionsTo a large extent, the scientists’ ethical approaches were consistent with ethical and legal principles. Data sharing was considered important and worth pursuing, even though it is difficult. An awareness of the complex issues involved in data sharing was reflected from different perspectives, and the respondents commonly perceived a general lack of practical procedures that would by default ensure ethical and legally compliant data collection and sharing. We suggest that it is an opportune time to move on from policy discussions to practical technological ethics-by-design solutions that integrate these principles into practice. (shrink)

Tratamos neste artigo de algumas questões concernentes aos aspectos do pensamento nas obras científicas e à relação entre ciência e filosofia.

A principle is a starting point of departure as well as a rule. In science principles are either alleged evident rules or generalizations of already accepted laws, or formal determinations for objects in a given domain. Thus two problems arise: first, does their nature have a conventional character? and sencond, what kind of truth is to be assigned to them. In philosophy principles are taken as a method of thinking as well as fundamental experiences. Even though they are points of (...) departure, their true meaning is known only after a philosophical job is done. Thus, paradoxically enough, we can say that in both science and philosophy a principle is at the same time in the begining and in the end. (shrink)

The aim of the present study was to describe variations in patient participation in decisions about care planning during the final phase of life for a group of gravely ill patients, and how the different actors’ manner of acting promotes or impedes patient participation. Thirty-seven qualitative research interviews were conducted with relatives of the patients. The patients’ participation in the decisions could be categorized into four variations: self-determination, co-determination, delegation and nonparticipation. The manner in which patients, relatives and caregivers acted (...) differed in the respective variations; this seemed either to promote or to impede the patients’ opportunities of participating in the decision making. The possibility for participation seems to be context dependent and affected by many factors such as the dying patient’s personality, the social network, the availability of different forms of care, cultural values, and the extent to which nurses and other caregivers of the different forms of care can and want to support the wishes of the patients and relatives in the decision-making process. (shrink)

Neste artigo, apresentamos o intuicionismo como uma atitude epistêmica geral, caracterizada pelo rigor de suas exigências de verificação não apenas na matemática e na lógica, mas em todo conhecimento cientifico.

BackgroundInstrumented gait analysis post-stroke is becoming increasingly more common in research and clinics. Although overall standardized procedures are proposed, an almost infinite number of potential variables for kinematic analysis is generated and there remains a lack of consensus regarding which are the most important for sufficient evaluation. The current aim was to identify a discriminative core set of kinematic variables for gait post-stroke.MethodsWe applied a three-step process of statistical analysis on commonly used kinematic gait variables comprising the whole body, derived (...) from 3D motion data on 31 persons post-stroke and 41 non-disabled controls. The process of identifying relevant core sets involved: exclusion of variables for which there were no significant group differences; systematic investigation of one, or combinations of either two, three, or four significant variables whereby each core set was evaluated using a leave-one-out cross-validation combined with logistic regression to estimate a misclassification rate.ResultsThe best MR for one single variable was shown for the Duration of single-support or Duration of 2nd double-support phase, corresponding to an 89–90% probability of correctly classifying a person as post-stroke/control. Adding Pelvis sagittal ROM to either of the variables Self-selected gait speed or Stride length, alternatively adding Ankle sagittal ROM to the Duration of single-stance phase, increased the probability of correctly classifying individuals to 93–94%. Combining three variables decreased the MR further to 0.04, suggesting a probability of 96% for correct classification. These core sets contained: a spatial or a temporal variable, Pelvis sagittal ROM or Ankle plantarflexion during push-off, and Arm Posture Score or Cadence or a knee/shoulder joint angle variable. Adding a fourth variable did not further improve the MR.ConclusionA core set combining a few crucial kinematic variables may sufficiently evaluate post-stroke gait and should receive more attention in rehabilitation. Our results may contribute toward a consensus on gait evaluation post-stroke, which could substantially facilitate future diagnosis and monitoring of rehabilitation progress. (shrink)

In a discussion of Parfit's Drops of Water case, Zach Barnett has recently proposed a novel argument against “No Small Improvement”; that is, the claim that a single drop of water cannot affect the magnitude of a thirsty person's suffering. We first show that Barnett's argument can be significantly strengthened, and also that the fundamental idea behind it yields a straightforward argument for the transitivity of equal suffering. We then suggest that defenders of No Small Improvement could reject a Pareto (...) principle that is presupposed in Barnett's argument and our developments of it. However, this does not save No Small Improvement, since there is a convincing argument against this claim that does not presuppose the Pareto principle. (shrink)

Political candidates often believe they must focus their campaign efforts on a small number of swing voters open for ideological change. Based on the wisdom of opinion polls, this might seem like a good idea. But do most voters really hold their political attitudes so firmly that they are unreceptive to persuasion? We tested this premise during the most recent general election in Sweden, in which a left- and a right-wing coalition were locked in a close race. We asked our (...) participants to state their voter intention, and presented them with a political survey of wedge issues between the two coalitions. Using a sleight-of-hand we then altered their replies to place them in the opposite political camp, and invited them to reason about their attitudes on the manipulated issues. Finally, we summarized their survey score, and asked for their voter intention again. The results showed that no more than 22% of the manipulated replies were detected, and that a full 92% of the participants accepted and endorsed our altered political survey score. Furthermore, the final voter intention question indicated that as many as 48% (69.2%) were willing to consider a left-right coalition shift. This can be contrasted with the established polls tracking the Swedish election, which registered maximally 10% voters open for a swing. Our results indicate that political attitudes and partisan divisions can be far more flexible than what is assumed by the polls, and that people can reason about the factual issues of the campaign with considerable openness to change. (shrink)