Children in the pediatric intensive care unit are indisputably in a vulnerable position, dependent on nurses to acknowledge their needs. It is assumed that children should be approached from a holistic perspective in the caring situation to meet their caring needs. The aim of the study was to unfold the meaning of nursing care through nurses’ concerns when caring for children in the pediatric intensive care unit. To investigate the qualitative aspects of practice embedded in the caring situation, the interpretive (...) phenomenological approach was adopted for the study. The findings revealed three patterns: medically oriented nursing—here, the nurses attend to just the medical needs, and nursing care is at its minimum, leaving the children’s needs unmet; parent-oriented nursing care—here, the nursing care emphasizes the parents’ needs in the situation, and the children are viewed as a part of the parent and not as an individual child with specific caring needs; and smooth operating nursing care orientation—here, the nursing care is focused on the child as a whole human being, adding value to the nursing care. The conclusion drawn suggests that nursing care does not always respond to the needs of the child, jeopardizing the well-being of the child and leaving them at risk for experiencing pain and suffering. The concerns present in nursing care has been shown to be the divider of the meaning of nursing care and need to become elucidated in order to improve the cultural influence of what can be seen as good nursing care within the pediatric intensive care unit. (shrink)

Cytoplasmic protein-tyrosine kinases (PTKs) are enzymes involved in transducing a vast number of signals in metazoans. The importance of the Tec family of kinases was immediately recognized when, in 1993, mutations in the gene encoding Bruton's tyrosine kinase (Btk) were reported to cause the human disease X-linked agammaglobulinemia (XLA).(1,2) Since then, additional kinases belonging to this family have been isolated, and the availability of full genome sequences allows identification of all members in selected species enabling phylogenetic considerations. Tec kinases are (...) endowed with Pleckstrin homology (PH) and Tec homology (TH) domains and are involved in diverse biological processes related to the control of survival and differentiation fate. Membrane translocation resulting in the activation of Tec kinases with subsequent Ca2+ release seems to be a general feature. However, nuclear translocation may also be of importance. The purpose of this essay is to characterize members of the Tec family and discuss their involvement in signaling. The three-dimensional structure, expression pattern and evolutionary aspects will also be considered. BioEssays 23:436–446, 2001. © 2001 John Wiley & Sons, Inc. (shrink)

In Alzheimer's disease (AD), pathological processes start in the brain long before clinical dementia. Biomarkers reflecting brain alterations may therefore indicate disease at an early stage, enabling early diagnosis. This raises several ethical questions and the potential benefits of early diagnosis must be weighted against possible disadvantages. Currently, there are few strong arguments favouring early diagnosis, due to the lack of disease modifying therapy. Also, available diagnostic methods risk erroneous classifications, with potentially grave consequences. However, a possible benefit of early (...) diagnosis even without disease modifying therapy is that it may enable early decision making when patients still have full decision competence, avoiding problems of hypothetical consents. It may also help identifying patients with cognitive dysfunction secondary to other diseases that may be responsive to treatment already today. (shrink)

X‐linked agammaglobulinemia is a heritable immunodeficiency disease caused by a differentiation abnormality, resulting in the virtual absence of B Iymphocytes and plasma cells. The affected gene encodes a cytoplasmic protein tyrosine kinase, Bruton's agammaglobulinemia tyrosine kinase, designated Btk. Btk and the other family members, Tec, Itk and Bmx, contain five regions, four of which are common structural and functional modules that are found in other signaling proteins. Mutations affect all domains of the gene, but amino acid substitutions seem to be (...) confined to certain regions. More than 150 unique mutations have been identified and are collected in a mutation database, BTKbase. Here we discuss the three‐dimensional structural implications of such mutations and their putative functional role. Of special interest are mutations affecting the pleckstrin homology domain, as Btk is the only disease‐associated protein so far reported to carry mutations in this particular module. (shrink)

Children in the pediatric intensive care unit are indisputably in a vulnerable position, dependent on nurses to acknowledge their needs. It is assumed that children should be approached from a holistic perspective in the caring situation to meet their caring needs. The aim of the study was to unfold the meaning of nursing care through nurses’ concerns when caring for children in the pediatric intensive care unit. To investigate the qualitative aspects of practice embedded in the caring situation, the interpretive (...) phenomenological approach was adopted for the study. The findings revealed three patterns: medically oriented nursing—here, the nurses attend to just the medical needs, and nursing care is at its minimum, leaving the children’s needs unmet; parent-oriented nursing care—here, the nursing care emphasizes the parents’ needs in the situation, and the children are viewed as a part of the parent and not as an individual child with specific caring needs; and smooth operating nursing care orientation—here, the nursing care is focused on the child as a whole human being, adding value to the nursing care. The conclusion drawn suggests that nursing care does not always respond to the needs of the child, jeopardizing the well-being of the child and leaving them at risk for experiencing pain and suffering. The concerns present in nursing care has been shown to be the divider of the meaning of nursing care and need to become elucidated in order to improve the cultural influence of what can be seen as good nursing care within the pediatric intensive care unit. (shrink)

The growth of Sweden’s urban population necessitates new approaches for increasing the sustainability and energy efficiency of multifamily buildings. The development of such approaches will require a holistic and integrated understanding of the factors driving the decision making of both professionals who design buildings and end-users who live in them. This paper, therefore, uses the goal framing theory to determine which aspects of multifamily buildings are considered important by these two groups of actors. An empirical study based on semi-structured interviews (...) with professionals involved in building design and development was conducted to identify goals affecting the choices made during building design and development. In parallel, a questionnaire survey of building end-users was conducted to determine which factors guided their choice of dwelling. It was found that professionals’ design choices were primarily governed by normative goals relating to environmental benefits but were also influenced by the other goals. These included gain goals relating to budgetary constraints and keeping the building’s operational and maintenance costs low. Hedonic goals were also important; some design choices were made with the aim of providing pleasant, comfortable, and convenient living environments, or of giving the buildings a distinct aesthetic or some other special features. By comparing the professionals’ responses to the end-user surveys, it was found that the two groups had similar views concerning gain goals; both considered it important for apartments to be affordable and easy to maintain. However, their views on hedonic and normative goals differed markedly. The professionals sought to strike an optimal balance between different related aspects, whereas end-users placed greater importance on aspects relating to hedonic and gain goals when choosing dwellings. The findings provide a basis for constructive discussions on building design and development, and the scope for creating buildings that encourage end-users to adopt sustainable living practices while also satisfying their needs and preferences. (shrink)

Mentalization-based family therapy and family rehabilitation represent a rich variety of approaches for assisting families with difficult interaction patterns. On the other hand, adventure therapy methods have been successfully used with families to offer them empowering experiences of succeeding together against difficult odds and to improve communication between family members. Further, the health promoting qualities of spending time outdoors are now well established and recognized. The Nordic approach to mentalization-based family rehabilitation combines adventure, outdoor, and systemic therapy. We provide three (...) examples of nature-based family rehabilitation practices that are delivered as brief, multi-family psychological interventions taking place in nearby nature and aiming to support sustainable, systemic change. The current contribution is a description of clinical practice, not a systematic review or a formal evaluation. We propose that recontextualizing mentalization-based family rehabilitation to the outdoors can not only provide added health benefits, but also strengthen intra-familial attuned interaction and emotional connectedness. The outdoor adventure provides the families with embodied, multisensory experiences of verbal and, especially, non-verbal interaction that can be usefully examined through the lens of theory of mentalization. The concreteness of adventure experiences is particularly beneficial for families that have difficulties in verbal communication and/or utilizing executive functions, perhaps due to neuropsychiatric traits, intellectual disabilities, or learning difficulties. Furthermore, outdoor adventure can support the participants’ connectedness to nature. (shrink)

Legislation for dementia care needs to be continually rethought, if the rights of older persons and other persons with dementia are to be addressed properly. We propose a theoretical framework for understanding vulnerability and dependency, which enables us to problematize the currently prevailing legal conception of adults as always able — irrespective of health or age — to act autonomously in their everyday lives. Such an approach gives rise to difficult dilemmas when persons with dementia are forced to make decisions (...) on their own about basic living conditions, such as housing and care, without decision-making support. In Sweden, for example, such matters are frequently left to the person him- or herself to decide, often without any assistance from social workers, and with family members serving as caregivers of last resort.Using vulnerability theory as the framework for our discussion, we argue that policymakers should not apply a group-oriented approach (based on factors like age, legal status, or mental capacity) to persons suffering from dementia. The needs of such individuals are as complex and varied as they themselves are. We discuss our findings from an interdisciplinary (law/social work) research project in which we examine the dilemma that social workers face when they are required, under the terms of the Swedish Social Services Act, to determine whether persons with dementia are to be granted support.We argue further that a cross-disciplinary approach — in which vulnerability theory furnishes the framework — opens up for new ways of understanding and developing social welfare law and practice. This, we believe, can help us better address the rights, interests, and needs of people with dementia, of their families, and of professionals in the social welfare system. Finally, many of the problems faced by ageing societies in general can be understood on the basis of such an approach. (shrink)

Children’s and young persons’ rights have received increasing been focus in recent decades, due in a significant degree to the UN Convention on the Rights of the Child. In Sweden, compulsory care in the social-services system is disputed, not least for the forceful measures that facility personnel have at their disposal to control children in certain conflict situations. The general aim of this article is to examine how the increased emphasis in Sweden on children’s rights is promoting resilience for children (...) and youth in youth compulsory secure-care settings. A more general question is whether the child-rights discourse leads in practice to increased resilience for children and youth in this setting, or even in general. The empirical material shows that children and young people’s perceptions of care and treatment are strongly linked to their interactions with staff and how the staff use restrictive measures. Applying Martha Fineman’s vulnerability theory in this context means that achieving resilience demands an analysis of the institutional settings in which children and young persons live their day-to-day lives, including their relationships in this setting. Comparing the legal possibilities of physical constraint with interviews of children and personnel reveals that relevant legislative frameworks and children’s-rights discourse should serve as a protection mechanism for children and youths, but in real life, these seem to have limited effect. (shrink)

PurposeThe purpose of this paper is to discuss some ethical issues in the internet encounter between customer and bank. Empirical data related to the difficulties that customers have when they deal with the bank through internet technology and electronic banking. The authors discuss the difficulties that customers expressed from an ethical standpoint.Design/methodology/approachThe key problem of the paper is “how does research handle the user's lack of competence in a web‐based commercial environment?” The authors illustrate this ethical dilemma with data from (...) a Danish Bank collected in 2002. The data have been structured by an advanced text analytic method, Pertex.FindingsThe authors can conclude that the experience of lack of competency in internet banking implies a severe damage on the experience of the ethics of the good life and of the respect for the basic ethical principles of customer autonomy, dignity, integrity and vulnerability. However, increased experience of competency may imply experience of increased feeling of ethical superiority and of the good life among customers.Research limitations/implicationsThe important implication for managerial research of this study would be for banks to focus on customer competency with an ethical concern instead of only being concerned with technical solutions for effective internet operations.Practical implicationsSince more and more businesses are digitally based, the authors can foresee a potential generic problem of lack of competence for certain age groups and also of people from different social groups.Originality/valueThe paper provides an analysis of the ethics of on‐line banking on the basis of Pertex methodology and with the use of basic ethical principles of autonomy, dignity, integrity and vulnerability. (shrink)

In an effort to inform the discussion surrounding existential risks from AI, we formulate Extinction-level Goodhart’s Law as “Virtually any goal specification, pursued to the extreme, will result in the extinction of humanity”, and we aim to understand which formal models are suitable for investigating this hypothesis. Note that we remain agnostic as to whether Extinction-level Goodhart’s Law holds or not. As our key contribution, we identify a set of conditions that are necessary for a model that aims to be (...) informative for evaluating specific arguments for Extinction-level Goodhart’s Law. Since each of the conditions seems to significantly contribute to the complexity of the resulting model, formally evaluating the hypothesis might be exceedingly difficult. This raises the possibility that whether the risk of extinction from artificial intelligence is real or not, the underlying dynamics might be invisible to current scientific methods. (shrink)

It is not unusual in real-life that one has to choose among finitely many alternatives when the merit of each alternative is not perfectly known. Instead of observing the actual utilities of the alternatives at hand, one typically observes more or less precise signals that are positively correlated with these utilities. In addition, the decision-maker may, at some cost or disutility of effort, choose to increase the precision of these signals, for example by way of a careful study or the (...) hiring of expertise. We here develop a model of such decision problems. We begin by showing that a version of the monotone likelihood-ratio property is sufficient, and also essentially necessary, for the optimality of the heuristic decision rule to always choose the alternative with the highest signal. Second, we show that it is not always advantageous to face alternatives with higher utilities, a non-monotonicity result that holds even if the decision-maker optimally chooses the signal precision. We finally establish an operational first-order condition for the optimal precision level in a canonical class of decision-problems, and we show that the optimal precision level may be discontinuous in the precision cost. (shrink)

J.S. Mill's plural voting proposal in Considerations on Representative Government presents political theorists with a puzzle: the elitist proposal that some individuals deserve a greater voice than others seems at odds with Mill's repeated arguments for the value of full participation in government. This essay looks at Mill's arguments for plural voting, arguing that, far from being motivated solely by elitism, Mill's account is actually driven by a commitment to both competence and participation. It goes on to argue that, for (...) Mill, much of the value of political participation lies in its unique ability to educate the participants. That ability to educate is not, however, a product of participation alone; rather, for Mill, the true educative benefits of participation obtain only when competence and participation work together in the political sphere. Plural voting, then, is a mechanism for allowing Mill to take advantage of the educative benefits that arise from the intersection of competence and participation. (shrink)

J M Tarrant; J. Wilson and B. Cowell on the Democratic Myth, Journal of Philosophy of Education, Volume 18, Issue 1, 30 May 2006, Pages 123–127, https://doi.org.

Thomas J.J. Altizer is one of the most important theologians of the twentieth and early twenty-first centuries, and all radical theology must pass through and be conversant with his work and the historical significance of his earlier contributions. This chapter presents Altizer’s essential ideas in a straightforward and accessible manner and provides a guide for the beginning reader.

The texts collected in this volume, which was originally published in 1969, contain Herder's most original and stimulating ideas on politics, history and language. They had for the most part not been previously available in English. In his introduction, Professor Barnard analyses the basic premises of Herder's political thought against the background of the Enlightenment. He examines Herder's concepts of language, community and culture, his theory of historical interaction, and his approach to the problem of change and progress. Finally, he (...) provides a brief comparative analysis of traditionalist thought following the French Revolution, showing how substantive writers like Burke differed from Herder despite the close similarity of political vocabulary. (shrink)

This essay is written on the following premises and argues for them. “Enlightenment” is a word or signifier, and not a single or unifiable phenomenon which it consistently signifies. There is no single or unifiable phenomenon describable as “the Enlightenment,” but it is the definite article rather than the noun which is to be avoided. In studying the intellectual history of the late seventeenth century and the eighteenth, we encounter a variety of statements made, and assumptions proposed, to which the (...) term “Enlightenment” may usefully be applied, but the meanings of the term shift as we apply it. The things are connected, but not continuous; they cannot be reduced to a single narrative; and we find ourselves using the word “Enlightenment” in a family of ways and talking about a family of phenomena, resembling and related to one another in a variety of ways that permit of various generalizations about them. We are not, however, committed to a single root meaning of the word “Enlightenment,” and we do not need to reduce the phenomena of which we treat to a single process or entity to be termed “the” Enlightenment. It is a reification that we wish to avoid, but the structure of our language is such that this is difficult, and we will find ourselves talking of “the French” or “the Scottish,” “the Newtonian” or the “the Arminian” Enlightenments, and hoping that by employing qualifying adjectives we may constantly remind ourselves that the keyword “Enlightenment” is ours to use and should not master us. (shrink)

The first English translation of Fichte’s second set of 1804 lectures on the Wissenschaftslehre.

In the paper I offer a brief sketch of one of the sources of utilitarianism. Our biological ancestry is a matter of fact that is not altered by the way we describe ourselves. With philosophical theories it is otherwise. Utilitarianism can be described in ways that make it look as if it is as old as moral philosophy – as J. S. Mill thought it was. For my historical purposes, it is more useful to have an account that brings out (...) what is specific about Benthamism and its descendants. Let us try to make do with the following. First, utilitarianism asserts that the fundamental requirement of morality is that we are to maximize good, for everyone and not just for the agent. This basic principle presupposes that it makes sense to think of aggregating goods to make a total, and of comparing amounts of good thus aggregated. Second, the good to be brought about is located in feelings of pleasure, and the evil to be avoided in feelings of pain. These feelings have inherent value or disvalue regardless of how they are caused to exist and regardless of their own consequences. Third, all moral principles can be derived from the requirement that good be maximized. The principles involved in evaluating agents as well as in giving moral direction to action are nothing but applications of the basic principle. (shrink)