This study explores the experiences of nurses that provide ‘complex’, generalist healthcare in hospital settings. Complex care is described as care for patients experiencing acute issues additional to multimorbidity, ageing or psychosocial complexity. Nurses are the largest professional group of frontline healthcare workers and patients experiencing chronic conditions are overrepresented in acute care settings. Research exploring nurses’ experiences of hospital‐based complex care is limited, however. This study aims to add to what is known currently. Four ‘complex care’ nurses undertook in‐depth (...) semistructured interviews and their narratives were analysed using the conceptual framework of complex adaptive phenomenology. Two overarching themes constituting the ‘essence’ of complex care nursing were identified: Contextual factors and attribute/value‐based elements. Creating meaningful patient outcomes and feeling part of a team were experienced as fulfilling, whereas time constraints, institutional settings and systemic barriers to comprehensive caregiving diminished the experience of providing complex care. Overall, work meaning presented as a dynamic phenomenon, shaped by personal and professional values, local settings and systemic factors. It is recommended that more expansive research be undertaken to explore the experience of complex care for nurses. Such knowledge can contribute to initiatives that draw a skilled, effective and engaged hospital‐based complex care nursing workforce. (shrink)

The ever-increasing prevalence of chronic conditions over the last half century has gradually altered the demographic of patients admitted to acute care settings; environments traditionally associated with episodic care rather than chronic and complex healthcare. In consequence, the lifeworld of the hospital medical doctor often entails healthcare for a complex, multi-morbid, patient cohort. This paper examines the experience of providing complex healthcare in the pressurised and fast-paced acute care setting. Four medical doctors from two metropolitan health services were interviewed and (...) their data were analysed using a combinatorial framework of phenomenology and complexity theory. The horizon of complex care revealed itself as dynamic, expansive, immersive, and relational, entailing a specialised kind of practice that is now common in acute care settings. Yet this practice has made inroads largely without heralding the unique nature and potential of its ground. Herein lies opportunity for complex care clinicians to expand notions of health and illness, and to shape research, practice, and system design, for a future in which care for health complexity is optimised, irrespective of care settings. (shrink)

This article argues that despite individual Fellows’ interest in artistic practices, and similarities between a philosophical and a connoisseurial appreciation of art, the Royal Society as an institution may have been wary of image-making as a way of conveying knowledge because of the power of images to stir the passions and sway the intellect. Using Robert Hooke as a case study it explores some of the connections between philosophers and makers in Restoration London. It goes on to suggest that some (...) epistemic images were in fact designed to elicit an emotional response in their viewers in order to force them to re-evaluate the subject-matter by presenting it in a new and surprising way. (shrink)

This is the first complete edition of the writings of the merchant, scholar, and F.R.S. Francis Lodwick. He wrote extensively on language, religion, and experimental philosophy, much of it too controversial to be published during his lifetime. This edition includes an introduction, a commentary, and primary and secondary bibliographies.

In lieu of an abstract, here is a brief excerpt of the content:Towards Language Justice:A Call to Identify and Overcome Structural BarriersFelicity RatwayThe patient I am interpreting for praises my interpretation. I've done nothing particularly noteworthy to merit her praise; I followed basic ethical tenets, nothing more. Hearing everything the provider says rather than a brief synopsis exceeds her expectations after many experiences working with untrained interpreters, or being refused interpreting services altogether. The bar shouldn't be this low.I am exhausted. (...) Like most interpreters, I am an independent contractor. I must work 5 am–9 pm to get paid for 8 hours of work. With some language companies, I earn less than minimum wage. To many new interpreters, $35 per hour sounds great—then they realize that driving to and from a one-hour appointment involves two hours of unpaid drive time. In rural areas, this really takes a toll. I spend hours checking pay stubs; I find errors nearly every pay period, but I wouldn't have a court case for the repeated underpayments because when I reach out to ask for the errors to be fixed, they are eventually corrected. Despite my state and national certifications and Master's degree in Interpreting and Translation Studies, medical interpreting doesn't pay the bills. I supplement my income through multiple other jobs.Laws intended to protect the patients we work with as interpreters are seldom enforced. Title VI Guidance defines a competent interpreter as one who has been trained, demonstrated proficiency, demonstrated interpreting skills, and agrees to abide by ethical standards. Patients fare better when competent interpreters are available, but when most patient and provider experiences are with interpreters who haven't met competency standards, patients and providers (understandably) lose trust in the profession. The profession has few opportunities for advancement and struggles to attract interpreters to go through rigorous training or build a long-term career. Skilled interpreters soon leave for greener pastures: the Oregon Health Authority (OHA) houses a registry of interpreters who meet minimum state training and proficiency requirements, and a 2019–2021 study found that roughly 92% of interpreters due to renew dropped off of the registry instead.When I began interpreting, I was shocked by how infrequently laws protecting patients' rights to interpreting services were followed in practice. At primary care appointments, patients often cannot answer questions about specialist visits because interpretation was not provided at the specialist's office. I knew recipients of federal funds couldn't [End Page 164] legally bill patients for interpreting services, yet I was asked to sight-translate paperwork that stated patients would be billed for interpreting services if they were late to an appointment. I reported the issue; years later, the same paperwork would still appear on their public-facing website. I discovered that though state law required credentialed interpreters to be made available, no agency had been tasked with enforcing that law; all that could be done with my complaint was to refer it to the patient's insurance company.In Oregon, Coordinated Care Organizations (CCOs) manage Medicaid plans, and are required to pay for interpreting services for their members. Instead of hiring interpreters directly, many contract with language companies that, in turn, hire us. Providers must book interpreters through the specific language companies contracted with the patient's CCO to avoid paying for the interpreter themselves. I am often called to interpret for speakers of indigenous languages even though I am not able to meet their needs as a Spanish interpreter. I offer contact information for organizations that could provide interpretation in the appropriate language, but the receptionist tells me that she can only go through specific vendors because the clinic doesn't want to have to pay out-of-pocket. Indigenous-led organizations that pay indigenous interpreters a living wage are not contracted with the CCOs in my region. In some cases, when interpreters are not available for a particular language through the CCO's preferred vendor, providers instead ask that an appointment be rescheduled, hoping that an interpreter will be available later. I have seen speakers of rare languages seeking primary care end up in the hospital after being rescheduled several times.Providers I work with often don't know... (shrink)

Human beings talk to themselves; sometimes out-loud, other times in inner speech. In this paper, I present a resolution to the following dilemma that arises from self-talk. If self-talk exists then either, we know what we are going to say and self-talk serves no communicative purpose, and must serve some other purpose, or we don’t know what we are going to say, and self-talk does serve a communicative purpose, namely, it is an instance of us communicating with ourselves. Adopting was (...) the strategy taken by Bart Geurts, who claims that the primary purpose of self-talk is to entrain commitments, and is not communicative. While accepting that self-talk can usefully play this role, I criticise the view that entraining commitments is self-talk’s fundamental role. I argue that adopting the view that we are self-blind, at least to a significant degree, means that we can accept that self-talk does play a communicative role. (shrink)

This article investigates the place of trust in learning relations in the classroom, not only between teacher and student, but also between student and student. To do this, it will first examine a pedagogy called community of inquiry, espoused by John Dewey and used in most Philosophy for Children courses in Australia. It will then consider what different forms of trust are involved in other power relations in the classroom, particularly the rational structuralism of R.S Peters, or the experiential philosophy (...) of Maria Montessori. It concludes that a community of inquiry shifts the ethical learning relation in significantly different ways because for educational growth, it values ethical trust more highly than a strategic trust in logical principle, duty, Truth, or cost/benefit analysis. (shrink)

More than any other early modern text, Montaigne's Essais have come to be associated with the emergence of a distinctively modern subjectivity, defined in opposition to the artifices of language and social performance. Felicity Green challenges this interpretation with a compelling revisionist reading of Montaigne's text, centred on one of his deepest but hitherto most neglected preoccupations: the need to secure for himself a sphere of liberty and independence that he can properly call his own, or himself. Montaigne and the (...) Life of Freedom restores the Essais to its historical context by examining the sources, character and significance of Montaigne's project of self-study. That project, as Green shows, reactivates and reshapes ancient practices of self-awareness and self-regulation, in order to establish the self as a space of inner refuge, tranquillity and dominion, free from the inward compulsion of the passions and from subjection to external objects, forces and persons. (shrink)

This chapter explores some of the similarities and differences in the philosophical methods of five philosophers often considered existentialists: Heidegger, Sartre, Merleau-Ponty, de Beauvoir and Marcel. The relationship between existentialism and phenomenological methods, as well as transcendental reasoning in general, is examined.

This article investigates how the turn to affect within the humanities and social sciences re-imagines the relationship between cultural theory and science. We focus on how the writings of two neuroscientists (Antonio Damasio and Joseph LeDoux) and one developmental psychologist (Daniel Stern) are used in order to ground certain claims about affect within cultural theory. We examine the motifs at play in cultural theories of affect, the models of (neuro)biology with which they work, and some fascinating missteps characterizing the taking (...) up of scientific literature. While neuroscience frames the affective as part of a system of regulation that makes both self and social coherence possible, in cultural theory’s narratives, by contrast, affectivity becomes a placeholder for the inherent dynamism and mutability of matter. The article interrogates the consequences of cultural theory’s strange borrowings from neuroscience and developmental psychology in their institution of a model of subjectivity preoccupied with a lived present in excess of the hold of habit and embodied history. (shrink)

Beyond impressionistic observations, little is known about the role and influence of scientific societies on research conduct. Acknowledging that the influence of scientific societies is not easily disentangled from other factors that shape norms and practices, this article addresses how best to study the promotion of research integrity generally as well as the role and impact of scientific societies as part of that process. In setting forth the parameters of a research agenda, the article addresses four issues: (1) how to (...) conceptualize research on scientific societies and research integrity; (2) challenges and complexities in undertaking basic research; (3) strategies for undertaking basic research that is attentive to individual, situational, organizational, and environmental levels of analysis; and (4) the need for evaluation research as integral to programmatic change and to assessment of the impact of activities by scientific societies. (shrink)

This book offers a provocative account of interdisciplinary research across the neurosciences, social sciences and humanities. Setting itself against standard accounts of interdisciplinary 'integration,' and rooting itself in the authors' own experiences, the book establishes a radical agenda for collaboration across these disciplines. Rethinking Interdisciplinarity does not merely advocate interdisciplinary research, but attends to the hitherto tacit pragmatics, affects, power dynamics, and spatial logics in which that research is enfolded. Understanding the complex relationships between brains, minds, and environments requires a (...) delicate, playful and genuinely experimental interdisciplinarity, and this book shows us how it can be done. This book is open access under a CC-BY license and funded by The Wellcome Trust. (shrink)

The direct protection of civilians from the violence and harms of armed conflict is most often understood in fixed, identity-centred terms: of what protection is, where it is located, of who provid...