Nursing policy and healthcare reform are focusing on two, interconnected areas: person‐centred care and fundamental care. Each initiative emphasises a positive nurse–patient relationship. For these initiatives to work, nurses require guidance for how they can best develop and maintain relationships with their patients in practice. Although empirical evidence on the nurse–patient relationship is increasing, findings derived from this research are not readily or easily transferable to the complexities and diversities of nursing practice. This study describes a novel methodological approach, called (...) holistic interpretive synthesis (HIS), for interpreting empirical research findings to create practice‐relevant recommendations for nurses. Using HIS, umbrella review findings on the nurse–patient relationship are interpreted through the lens of the Fundamentals of Care Framework. The recommendations for the nurse–patient relationship created through this approach can be used by nurses to establish, maintain and evaluate therapeutic relationships with patients to deliver person‐centred fundamental care. Future research should evaluate the validity and impact of these recommendations and test the feasibility of using HIS for other areas of nursing practice and further refine the approach. (shrink)

In 2004, the agricultural economies of many rural communities in the United States were impacted by the cessation of a price-support and supply-control program for tobacco production. Tobacco was not only an important livelihood, but also was central to social and cultural life. Using a social–ecological systems lens and the adaptive cycle metaphor, we examine the reorganization of agriculture in communities that previously produced tobacco under the program. Specifically, we seek to understand how transitional policy that provided financial support to (...) tobacco farmers interacted with other social, cultural, physical and human capitals to condition system reorganization. We conducted semi-structured interviews with farmers, extension agents, and policy makers in Kentucky as well as examined trends in income and number of farmers before and after the transition as indicators of reorganization. We determined that the financial support was perceived as helpful in supporting the transition and that tobacco farmers reorganized their livelihoods primarily around existing, remnant assets and endogenous capacities. In addition, we determined that though the agricultural system may be reorganizing economically, it is not necessarily supportive of the same social bonds and values that co-existed with tobacco economy. Understanding agricultural economies as part of complex social–ecological systems that consist of interconnected values, identities, ecology and social ties is important for developing policies to support systems and communities through economic transitions. (shrink)

© 2017. The American Astronomical Society. All rights reserved.We present new observations of the low-mass companion to HD 984 taken with the Gemini Planet Imager as a part of the GPI Exoplanet Survey campaign. Images of HD 984 B were obtained in the J and H bands. Combined with archival epochs from 2012 and 2014, we fit the first orbit to the companion to find an 18 au orbit with a 68% confidence interval between 14 and 28 au, an eccentricity (...) of 0.18 with a 68% confidence interval between 0.05 and 0.47, and an inclination of 119°with a 68% confidence interval between 114°and 125°. To address the considerable spectral covariance in both spectra, we present a method of splitting the spectra into low and high frequencies to analyze the spectral structure at different spatial frequencies with the proper spectral noise correlation. Using the split spectra, we compare them to known spectral types using field brown dwarf and low-mass star spectra and find a best-fit match of a field gravity M6.5 ±1.5 spectral type with a corresponding temperature of K. Photometry of the companion yields a luminosity of log=2.88 ± 0.07 dex with DUSTY models. Mass estimates, again from DUSTY models, find an age-dependent mass of 34 ±1 to 95 ±4 M Jup. These results are consistent with previous measurements of the object. (shrink)

The need for informed analyses of health policy is now greater than ever. The twelve essays in this volume show that public debates routinely bypass complex ethical, sociocultural, historical, and political questions about how we should address ideals of justice and equality in health care. Integrating perspectives from the humanities, social sciences, medicine, and public health, this volume illuminates the relationships between justice and health inequalities to enrich debates. Understanding Health Inequalities and Justice explores three questions: How do scholars approach (...) relations between health inequalities and ideals of justice? When do justice considerations inform solutions to health inequalities, and how do specific health inequalities affect perceptions of injustice? And how can diverse scholarly approaches contribute to better health policy? From addressing patient agency in an inequitable health care environment to examining how scholars of social justice and health care amass evidence, this volume promotes a richer understanding of health and justice and how to achieve both. -/- The contributors are Judith C. Barker, Paula Braveman, Paul Brodwin, Jami Suki Chang, Debra DeBruin, Leslie A. Dubbin, Sarah Horton, Carla C. Keirns, J. Paul Kelleher, Nicholas B. King, Eva Feder Kittay, Joan Liaschenko, Anne Drapkin Lyerly, Mary Faith Marshall, Carolyn Moxley Rouse, Jennifer Prah Ruger, and Janet K. Shim. (shrink)

Recent debate on the nature of probabilities in evolutionary biology has focused largely on the propensity interpretation of fitness (PIF), which defines fitness in terms of a conception of probability known as “propensity”. However, proponents of this conception of fitness have misconceived the role of probability in the constitution of fitness. First, discussions of probability and fitness have almost always focused on organism effect probability, the probability that an organism and its environment cause effects. I argue that much of the (...) probability relevant to fitness must be organism circumstance probability, the probability that an organism encounters particular, detailed circumstances within an environment, circumstances which are not the organism’s effects. Second, I argue in favor of the view that organism effect propensities either don’t exist or are not part of the basis of fitness, because they usually have values close to 0 or 1. More generally, I try to show that it is possible to develop a clearer conception of the role of probability in biological processes than earlier discussions have allowed. (shrink)

This paper seeks to advance our thinking about values and justice by studying the relationship between these constructs at the organizational level. We hypothesize that collective perceptions of moral values in organizational settings will influence collective perceptions of justice. Survey results from 619 individuals in 108 departments strongly support our hypothesis that collective values influence perceptions of both procedural and overall justice climate. We discuss these results, and their implications for thinking about relationships between moral values and justice at even (...) higher levels of analysis such as society overall. (shrink)

The conversation analytic view of context is often critiqued as being too narrow. In this article, we join the ongoing debate regarding conversation analysis and context by 1) synthesizing existing scholarly attempts at either conceptualizing or exploring the possibilities of combining CA and ethnography and 2) giving further considerations to whether or how resorting to talk-extrinsic data may be beneficial. We do so by providing four illustrative cases, with increasing complexity, from four different settings. In each case, an initial CA (...) analysis is followed up with an informal ethnographic interview with the participants. By offering some specificity to this ongoing methodological controversy regarding talk-extrinsic data, we aim to begin building a useful framework within which further discussions on analysis, context, and cross-fertilization may proceed. (shrink)

The field of assisted reproduction is advancing rapidly and is ripe for regulation and guidance. In 2018, over four thousand frozen eggs and embryos were lost to approximately one thousand patients at Ahuja University Hospital in Cleveland, Ohio, due to an accidental thaw of a cryopreservation tank. The precedent that will be set by the Ahuja class‐action case is significant for both past events and future possibilities and is core to the discussion of policy involving the cryopreservation of gametes and (...) embryos. (shrink)

Julian Nida-Rümelin’s philosophical approach to rationality is radical: It transcends the reductive narrowness of instrumental rationality without denying its practical impact. Actions exist which are carried out in accordance to utility maximizing or even self-interest maximizing. Yet not all actions are to be understood in these terms. Actions that are oriented around social roles, for example, cannot count as irrational just because no underlying maximizing heuristics are found. The concept of bounded rationality tries to embed instrumental rationality into a form (...) of life to highlight limits of our cognitive capabilities and selective perceptions. However, the agent is still situated within the realm of cost-benefit reasoning. The idea of social preferences (e.g. Rabin, Fehr and Schmidt) or meta-preferences (Sen) is insufficient to reflect the plurality of human actions. According to Nida-Rümelin, those concepts ignore the plurality of reasons which drive agency. Hence, they try to fit agency into a theory which undermines humanity. His theory of structural rationality acknowledges daily patterns of interaction and meaning. (shrink)

Doubtless, the conscious brain integrates masses of information. But declaring that consciousness simply “emerges” when enough has accumulated, doesn't really explain how first person experience is implemented by neurons. Moreover, empirical observations challenge integrated information theory's (IIT) reliance on thalamo–cortical interactions as the information integrator. More likely, the cortex streams processed information to a still-enigmatic consciousness generator, one perhaps located in the brainstem.

In this chapter, Colin Marshall argues that Schopenhauer’s views about the foundations of morality pose important challenges for five tenets of contemporary metaethics. After presenting these challenges, Marshall explores the potential viability of contemporary Schopenhauerian approaches to metaethics that would leave aside his radical metaphysical monism.

This book is a major intellectual and cultural history of intolerance and toleration in early modern and early Enlightenment Europe. John Marshall offers an extensive study of late seventeenth-century practices of religious intolerance and toleration in England, Ireland, France, Piedmont and the Netherlands and the arguments that John Locke and his associates made in defence of 'universal religious toleration'. He analyses early modern and early Enlightenment discussions of toleration, debates over toleration for Jews and Muslims as well as for (...) Christians, the limits of toleration for the intolerant, atheists, 'libertines' and 'sodomites', and the complex relationships between intolerance and resistance theories including Locke's own Treatises. This study is a significant contribution to the history of the 'republic of letters' of the 1680s and the development of early Enlightenment culture and is essential reading for scholars of early modern European history, religion, political science and philosophy. (shrink)

Qualitative longitudinal research (QLR) provides temporal understanding of the human response to health, illness, and the life course. However, little guidance is available for conducting QLR in the nursing literature. The purpose of this review is to describe the methodological status of QLR in nursing. With the assistance of a medical librarian, we conducted a thorough search circumscribed to qualitative, longitudinal nursing studies of patients’ and care‐givers’ experiences published between 2006 and 2016. The methodological quality of the 74 reviewed studies (...) varied tremendously; many reports lacked sufficient detail in reporting on sampling and attrition, retention strategies, and data collection and analysis, making it difficult for readers to evaluate the credibility and transferability of study findings. Based on the strengths and limitations of the studies reviewed and findings in the literature, we provide recommendations for enhancing the reporting of the research process as a supplement to the standards for qualitative research more broadly. These recommendations are offered in the spirit of encouraging dialogue among colleagues and assisting journal reviewers and editors in their evaluation of QLR. (shrink)

An international team of eighteen doctors, philosophers, and lawyers present a fresh and thorough discussion of the ethical, legal, and social issues raised by testing and screening for HIV and AIDS. They aim to point the way to practical advances but also to give an accessible guide for those new to the debate.