ANGUS J, HODNETT E and O’BRIEN-PALLAS L. Nursing Inquiry 2003; 10: 218–228Implementing evidence-based nursing practice: a tale of two intrapartum nursing unitsDespite concerns that the rise of evidence-based practice threatens to transform nursing practice into a performative exercise disciplined by scientific knowledge, others have found that scientific knowledge is by no means the preeminent source of knowledge within the dynamic settings of health-care. We argue that the contexts within which evidence-based innovations are implemented are as influential in the outcomes (...) as the individual practitioners who attempt these changes. A focused ethnography was done in follow-up to an earlier trial that evaluated the effectiveness of a marketing strategy to encourage the adoption of evidence-based intrapartum nursing practice. Bourdieu's (1990, 1991) concepts of habitus, capital and social field were used in our refinement of the analysis of the ethnographic findings. Nursing leadership, interprofessional struggle with physicians, the characteristics of the community and the physical environment were prominent issues at all of the sites. Detailed descriptions of the sociohistorical context and of the experiences at two sites are presented to illustrate the complexities encountered when implementing innovations. (shrink)

This work has been selected by scholars as being culturally important, and is part of the knowledge base of civilization as we know it. This work was reproduced from the original artifact, and remains as true to the original work as possible. Therefore, you will see the original copyright references, library stamps (as most of these works have been housed in our most important libraries around the world), and other notations in the work.This work is in the public domain in (...) the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work.As a reproduction of a historical artifact, this work may contain missing or blurred pages, poor pictures, errant marks, etc. Scholars believe, and we concur, that this work is important enough to be preserved, reproduced, and made generally available to the public. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)

The growth and sustainability of the nursing profession depends on the ability to recruit and retain the upcoming generation of professionals. Understanding the career choice experiences and professional expectations of Millennial nurses (born 1980 or after) is a critical component of recruitment and retention strategies. This study utilized Polkinghorne's interpretive, narrative approach to understand how Millennial nurses explain, account for and make sense of their choice of nursing as a career. The positioning of nursing as a virtuous choice was both (...) temporally and contextually influenced. The decision to enter the profession was initially emplotted around a traditional understanding of nursing as a virtuous profession: altruistic, noble, caring and compassionate. The centricity of virtues depicts one‐dimensional understanding of the nursing profession that alone could prove dissatisfying to a generation of professionals who have many career choices available to them. The narratives reveal how participants' perceptions and expectations remain influenced by a stereotypical understanding of nursing, an image that remains prevalent in society and which holds implications for the future recruitment, socialization and retention strategies for upcoming and future generations of nurses. (shrink)

One of the most significant changes in modern healthcare delivery has been the evolution of the paper record to the electronic health record (EHR). In this paper we argue that the primary change has been a shift in the focus of documentation from monitoring individual patient progress to recording data pertinent to Institutional Priorities (IPs). The specific IPs to which we refer include: finance/reimbursement; risk management/legal considerations; quality improvement/safety initiatives; meeting regulatory and accreditation standards; and patient care delivery/evidence based practice. (...) Following a brief history of the transition from the paper record to the EHR, the authors discuss unintended or contested consequences resulting from this change. These changes primarily reflect changes in the organization and amount of clinician work and clinician‐patient relationships. The paper is not a research report but was informed by an institutional ethnography the aim of which was to understand how the EHR impacted clinicians and administrators in a large, urban hospital in the United States. The paper was also informed by other sources, including the philosophies of Jacques Ellul, Don Idhe, and Langdon Winner. (shrink)

This review article analyses the topic of phenomenological Marxism, examining its historical formulations, critical contributions, and contemporary re-enactments. It begins with an overview of the works of Enzo Paci and the Milan school of phenomenology, as well as Jan Patočka and Karel Kosík. In addition, it explores the recent work by Ian H. Angus, whose book, Groundwork of Phenomenological Marxism (2021), presents an innovative perspective on the relationship between phenomenology and Marxism. Angus’s work emphasizes the intersection of Husserl (...) and Marx’s ontologies of the lifeworld and labour, offering a fresh perspective on the discourse surrounding the relationship between nature, labour, and culture. Drawing on both phenomenological and Marxist categories, Angus argues for the need for an ethics of responsibility in response to the ecological crisis currently facing humanity. Angus posits that an ethics of responsibility grounded in phenomenological Marxism offers a promising avenue for addressing this pressing global issue. (shrink)

This paper addresses theoretical challenges, still relevant today, that arose in the first decades of the twentieth century related to the concept of the organism. During this period, new insights into the plasticity and robustness of organisms as well as their complex interactions fueled calls, especially in the UK and in the German-speaking world, for grounding biological theory on the concept of the organism. This new organism-centered biology understood organisms as the most important explanatory and methodological unit in biological investigations. (...) At least three theoretical strands can be distinguished in this movement: Organicism, dialectical materialism, and holistic biology. This paper shows that a major challenge of OCB was to describe the individual organism as a causally autonomous and discrete unit with consistent boundaries and, at the same time, as inextricably interwoven with its environment. In other words, OCB had to conciliate individualistic with anti-individualistic perspectives. This challenge was addressed by developing a concept of life that included functionalist and metabolic elements, as well as biochemical and physical ones. It allowed for specifying organisms as life forms that actively delimit themselves from the environment. Finally, this paper shows that the recent return to the concept of the organism, especially in the so-called “Extended Evolutionary Synthesis,” is challenged by similar anti-individualistic tendencies. However, in contrast to its early-twentieth-century forerunner, today’s organism-centered approaches have not yet offered a solution to this problem. (shrink)

El propósito de este artículo es refutar las objeciones de Marc Ramsey a los principios de educación cívica del liberalismo político. Argumento que Ramsey malinterpreta la distinción entre la esfera pública y la esfera privada que emana del liberalismo político, y que su opinión de que, cuando es escrutado, el liberalismo político deriva en un liberalismo comprehensivo o de la «autonomía» carece de fundamento. La relevancia del tema es que la educación de acuerdo con el liberalismo político es más tolerante (...) que la educación conforme al liberalismo comprehensivo. Aquellos padres razonablemente religiosos que no son liberales podrán aceptar un liberalismo político, pero no uno comprehensivo. (shrink)

This paper explores the distinction between perceiving an object as extended in time, and experiencing a sequence of perceptions. I argue that this distinction cannot be adequately described by any present theory of time-consciousness and that in order to solve the puzzle, we need to consider perceptual content as having three distinct constituents: Explicit content, which has a particular phenomenal character, modal content, or the kind of content that is contributed by the psychological mode, and implicit content, which lacks phenomenal (...) character. These notions are then further clarified and related to each other. (shrink)

Francois Recanati has recently argued that each perceptual state has two distinct kinds of content, complete and explicit content. According to Recanati, the former is a function of the latter and the psychological mode of perception. Furthermore, he has argued that explicit content is temporally neutral and that time-consciousness is a feature of psychological mode. In this paper it is argued, pace Recanati, that explicit content is not temporally neutral. Recanati’s position is initially presented. Three desiderata for a theory of (...) time-consciousness are subsequently introduced. It is then argued that a theory locating time-consciousness as a feature of psychological mode will fail to satisfy these desiderata. In the last section the intentionality of memories is discussed. Using the notion of shiftable indexical, it is argued that memories have the same explicit content as perceptions, but that they nevertheless can have different conditions of satisfaction since they are entertained in different modes. (shrink)

Research on the relation between sound and meaning in language has reported substantial evidence for implicit associations between articulatory–acoustic characteristics of phonemes and emotions. In the present study, we specifically tested the relation between the acoustic properties of a text and its emotional tone as perceived by readers. To this end, we asked participants to assess the emotional tone of single stanzas extracted from a large variety of poems. The selected stanzas had either an extremely high, a neutral, or an (...) extremely low average formant dispersion. To assess the average formant dispersion per stanza, all words were phonetically transcribed and the distance between the first and second formant per vowel was calculated. Building on a long tradition of research on associations between sound frequency on the one hand and non‐acoustic concepts such as size, strength, or happiness on the other hand, we hypothesized that stanzas with an extremely high average formant dispersion would be rated lower on items referring to Potency (dominance) and higher on items referring to Activity (arousal) and Evaluation (emotional valence). The results confirmed our hypotheses for the dimensions of Potency and Evaluation, but not for the dimension of Activity. We conclude that, at least in poetic language, extreme values of acoustic features of vowels are a significant predictor for the emotional tone of a text. (shrink)

The paper consists of two parts. The first contains the paradox of Truth-teller, i.e. a sentence which asserts own truth. The paradox appears when we apply logic of rejection to the Truth-teller sentence. The Truth-teller paradox is symmetric with respect to the Liar paradox. The second part considers a sentence which asserts own provability. This sentence is unprovable on the base of rejection logic. This leads to counterparts of the Gödel incompleteness theorems and other metamathematical results.

This work has been selected by scholars as being culturally important, and is part of the knowledge base of civilization as we know it. This work was reproduced from the original artifact, and remains as true to the original work as possible. Therefore, you will see the original copyright references, library stamps (as most of these works have been housed in our most important libraries around the world), and other notations in the work. This work is in the public domain (...) in the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work. As a reproduction of a historical artifact, this work may contain missing or blurred pages, poor pictures, errant marks, etc. Scholars believe, and we concur, that this work is important enough to be preserved, reproduced, and made generally available to the public. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)

In this paper I will argue how Descartes in the First and Second Meditation of the Meditations uses a very clear suspension of judgments or assent that in many ways resembles the epoché of the ancient skepticism, especially that of pyrrhonistic variant. First I show how the pyrrhonistic epoché works and what purpose it was used. After that I show how this Cartesian epoché both resembles and differs from the ancient epoché. My main argument is that Descartes, when using the (...) method of doubt, doesn’t really dismiss or abandon earlier knowledge or beliefs, as he is sometimes been viewed, but more likely doesn’t take any stance in them, suspending his judgment on the existence of the outside-world. I base my argument both on my reading of Meditations and the “as it were sensing” -interpretation of Descartes’ use of method of doubt by John Carriero. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Leibniz & Clarke: A Study of Their Correspondence by Ezio VailatiJan A. CoverEzio Vailati. Leibniz & Clarke: A Study of Their Correspondence. New York and Oxford: Oxford University Press, 1997. Pp. xii + 250. Cloth, $45.00.When Leibniz received the 1710 issue of the Royal Society’s Philosophical Transactions in early 1711, he read John Keill’s public charge that he had stolen the calculus from Newton. Leibniz twice sought amends (...) from the Society in the form of a retraction, in response to which a committee was formed to investigate and issue a report. The resulting Commercium epistolicum, written by the good Isaac Newton himself and condemning Leibniz, was published in early 1713. In Vienna at the time, Leibniz learned of its contents in a June letter from Johann Bernoulli, who complained about this “scarcely civilized way” of holding what was in effect a tribunal from which the chief witness was absent. By year’s end Leibniz had enlisted Wolff to see into print Leibniz’s anonymous statement—overstatement, in fact—of his case, and nine months later Keill replied with an equally overstated rejoinder. Late autumn of 1714 found Leibniz back in Hannover, suffering from gout and the tiresome pressure to advance his work on the history of the house of Brunswick-Lüneburg. If only he felt better and had more free time, he could collect his mathematical papers and set an end to the dispute by writing his own Commercium epistolicum: as it was (Leibniz told Wolff in the spring of 1715), he had no intention of giving Newton’s cronies the luxury of his time.The Leibniz-Clarke exchange began in the shadows of this dispute, contributing to Leibniz’s already established distaste for parts of British philosophy. Already in 1690 he was describing (to Huygens and others) Newton’s gravitational attraction as “inexplicable.” Soon after Leibniz was surprised to discover that Locke had accepted Newtonian attraction in the second edition of the Essay—surprised, at least, until he came to see it as part and parcel of the dangerous idea that God could attach any old property whatever to matter if He chose, including thought. Materialism and frequent miracles [End Page 533] were just around the corner, and from there it was a short distance to the mortality of the soul, and a mean view of God’s power; the decay of natural theology itself could only follow. Leibniz’s misgivings didn’t see the light of day in the early 1700s, when he penned them in the Preface to the Nouveaux Essais; but he went out of his way to work an explicit complaint about Mr. Newton and Mr. Locke into the Théodicée of 1710 (§19 of the Preliminary Discourse). The calculus dispute followed. By the time Leibniz got round to writing Princess Caroline about the dispute in a letter of May 1715, he was insisting that the Newtonians deserved public censure, and that the Britons deserved Leibniz as historiographer of England. For her own part, Caroline now wondered if Samuel Clarke, who had translated Newton’s Opticks into Latin, would in the end be unbiased enough to translate Leibniz’s Théodicée into English. Moreover Caroline doubted that Clarke’s notion of the soul was theologically innocent. Replying in November, Leibniz summarized his view that natural religion was in great decline in England, and the famous exchange began.Despite there being no monograph devoted to it until now, the Correspondence ıs (and was) famous. If a book-length study is overdue, so perhaps are three reminders—that a significant portion of the Correspondence is devoted to issues other than space and time and gravitation, that the depth to which its issues are pursued was compromised by impatience on the side of both parties, and that Clarke’s philosophical views aren’t so well-understood as Leibniz’s own. Nowhere does Vailati set out to make these points explicitly, but they emerge over the course of his book, and together with exegetical soundness are its chief contributions. While this volume makes no historical or philosophical waves, it indirectly (perhaps unwittingly) explains why none are readily forthcoming in a book... (shrink)

Is the history of philosophy one of philosophical disciplines? Should not one give up pursuing the traditional history of philosophy on behalf of the history of philosophical culture as a historical discipline? Considerable divergences in defining the history of philosophy and its relation to philosophy and history show profound differences in the views on philosophy itself. The differences are an essential part of the history of philosophy. This paper does not intend to give a critical assessment of all positions that (...) concern the relationship between the history of philosophy and philosophy. We shall address the issue of consequences of historicism that bear on the history of philosophy. The main negative point of reference will R. Rorty\'s standpoint, which is representative of the radical version of historicism. The American neo-pragmatist\'s manners of pursuing philosophy and the relations between them will be submitted to criticism. In the perspective of radical historicism (historical and cultural relativism) the inquiries on the history of philosophy have no strictly philosophical importance. They may be cognitively interesting only from the historical point of view, for the history of culture, to be precise. Moderate historicism does not mean acceptance for the relativistic theory of truth. It makes us reconsider the issue of the difference between true knowledge and adequate knowledge, the difference well-known in tradition. Overcoming radical historicism prepares grounds for the pursuit of the history of philosophy as a philosophical discipline, the discipline that studies the history of philosophical problems in their variability and permanence. (shrink)

In our increasingly interactive and interdependent world, we are confronted almost daily with issues in international law: think, for instance, of the recent Pinochet and Öcalan cases, the crises in Iraq, Kosovo and East Timor, or the banana and hormone disputes in the WTO. Add to this continual reports about the activities of international organizations, from the UN to the European Union, and it becomes clear that international law is the order of the day. Whoever follows these international developments, as (...) I do, and whoever is committed to the construction of a solid legal order for the international community, finds himself constantly torn between hope and despair. Signs of hope in recent years include the approval of a statute for the International Criminal Court in Rome on July 17, 1998; the Pinochet decisions of the House of Lords of November 1998 and March 1999; and the coming into force of the Ottawa agreement on anti-personnel mines in March of 1999. Yet who could witness the course of events during the NATO bombing campaign in Yugoslavia, and the long period of UN inaction against the violence that broke out in East Timor following the referendum, without feeling some sense of desperation? The mood of the present day, however, should not prevent us from taking a long-term perspective. What kind of international legal order are we moving towards on the threshold of the twenty-first century? Building up a solid international legal order is probably one of the greatest challenges facing humanity at present. Our national legal systems are strongly developed and during the last fifty years, Western Europe has succeeded in constructing an EU legal order which has made possible a peaceful society, welfare and the integration of peoples in Europe. But where do we stand on the world level? Is international law not all too slowly limping behind globalization? And yet, the century we are looking back on has been the century in which international law and the law of international organizations flourished: in the framework of the League of Nations, and then the UN, we have succeeded in codifying, consolidating and developing international law in numerous multilateral treaties ranging from human rights and maritime law to international labour, trade and environmental norms. Never before had the world witnessed such an extensive network of international organizations . Never before did states make such intensive use of treaties for arranging their mutual concerns: more than 30,000 are registered at the UN. (shrink)

ZusammenfassungDie Odysseus-Verfügung ist als besondere Form der Patientenverfügung zumindest in der Literatur hinlänglich bekannt. Die Verwendung des Begriffs und damit sein Gegenstandsbereich sind hingegen noch immer umstritten. Zudem wird oft nicht beachtet, dass es innerhalb dieses Gegenstandsbereichs Varianten von OVs zu differenzieren gilt, die sich auch in ihrer moralischen Rechtfertigung unterscheiden. Nicht zuletzt ist die Grundstrukturstruktur dieser Rechtfertigung umstritten. Vor diesem Hintergrund plädieren wir im Folgenden zunächst für eine Eingrenzung des Begriffs, mit der argumentative und klinisch-praktische Verwirrungen vermieden werden können. (...) Anschließend betrachten wir zwei Varianten von – Zwang legitimierenden – OVs, die sich in der individuellen Kompetenz des Destinatärs unterscheiden. Schließlich zeigen wir, dass deren Rechtfertigung ungeachtet des Umstandes, dass OVs auf Wiedererlangung der Urteils- und Steuerungsfähigkeit des Patienten angelegt sind, weder in einer gemutmaßten noch gar in einer faktischen retrospektiven Billigung von Zwang durch den Patienten liegt. Die primäre Legitimationsgrundlage von OVs besteht vielmehr in der ex ante erfolgenden Autorisierung durch den Betroffenen selbst. Die hier einzuräumende Autorität wiederum basiert auf dem Recht jeder Person auf lebensplanerische Selbstbestimmung. In einem kurzen abschließenden Teil skizzieren wir dann noch die besondere Bedeutung der Odysseus-Vereinbarung als einer Unterform der OV. (shrink)

David Chalmers has recently argued that Relativity Theory supports the notion that shapes are Twin-Earthable. In this paper this argument is challenged. I reconstruct the argument in five steps where the last step is the conclusion. I proceed to argue that one step in the argument can be interpreted in two different ways. The problem is that on the first interpretation of the step, the conclusion does not follow. And on the second interpretation of the step, it contradicts a previous (...) step in the argument. I conclude that Relativity Theory does not entail that phenomenal and functional twins could represent different shapes. (shrink)

When we first anticipated the research project concluded with this special issue, about 8 years ago, it seemed timely and appropriate to investigate the opportunities and the challenges of self-management in mental health care. At the time self-management was well on the rise in general health care, offering both empowerment to patients and efficiency and cost-effectiveness to the health care system. It seemed a most promising approach in an era that celebrates individualistic self-reliance. And we were sure about our insight (...) that self-management in mental health care would deserve comprehensive investigation because “the self” that was supposed to do the management would itself be the core problem in psychiatric... (shrink)

We apply a paraconsistent strategy to reasoning about fractions.

This contribution deals with the consequences of European integration for the relation between civil servants and policians. Data of Belgian senior servants who are not involved in European policy networks are compared with data of Belgian officals who are in charge of European negotiations.This comparison shows firstly that officials are more central in European policy networks than in national policy networks. Politicians have only a limited and indirect access to these European networks. Secondly, the more civil servants are involved in (...) these European policy networks, the less their political alienation. Furthermore, the organisational self-esteem do not affect the communication networks among civil servants and politicians. Finally, alienation and self-esteem do not affect the communication networks among civil servants and politicians. The exposure to politics and anciennity seem to be more important predictors. (shrink)

Geschichtliche Welten und Orientierungen haben als modale Sonderformen der Existenz zwar einen im gewissen Sinne perspektivischen Charakter; die geschichtliche Wirklichkeit, die sie tragt, jedoch nicht. Die Herausforderung der historischen Ontologie ist, durch solche Welten und Orientierungen hindurch den Sinn fur die tragende Wirklichkeit aufrechtzuerhalten. In diesem ersten Band der neuen Reihe 'Beitrage zur historischen Ontologie' wird die Tragweite dieser Konzeption aus philosophischer, philologischer, historischer und kulturwissenschaftlicher Sicht beleuchtet, um so den Bereich der historischen Ontologie fur weitere Studien zu erschliessen. Die (...) Beitrage auf Deutsch, Englisch und Franzosisch gliedern sich in sechs Abteilungen: 1) Historische Ontologie und metaphysische Tradition, 2) Personliche Historizitat, 3) Kausalitat und Wirkungsgeschichte, 4) Inhalt und Ereignis, 5) Diversitat und Dominanz und 6) Hermeneutik und Semiotik. (shrink)

The first order modal logic of closure spaces belongs to the class of equationally definable standard modal logics . One can say, it satisfies no version of the deduction lemma. Nevertheless the Robinson and Beth theorems can be proved by means of an interpretation of modal theories in classical ones. LCS is described in [1], [2], [3], [4]. The logics obtained by adjoining axioms of quasi-equality or of equality to LCS are denoted by LCSQE and LCSE.

Jaakko Hintikka był jednym z najwybitniejszych współczesnych logików i filozofów analitycznych. Filozofią zainteresował się już w szkole średniej pod wpływem lektury książek Eina Kaili i Georga Henrika von Wrighta. Hintikka rozpoczął studia matematyczne w Uniwersytecie w Helsinkach. Niedługo potem postanowił studiować także filozofię w pełnym wymiarze...

Due to the intense selection pressure against inbreeding, humans are expected to possess psychological adaptations that regulate mate choice and avoid inbreeding. From a gene’s-eye perspective, there is little difference in the evolutionary costs between situations where an individual him/herself is participating in inbreeding and inbreeding among other close relatives. The difference is merely quantitative, as fitness can be compromised via both routes. The question is whether humans are sensitive to the direct as well as indirect costs of inbreeding. Using (...) responses from a large population-based sample (27,364 responses from 2,353 participants), we found that human motivations to avoid inbreeding closely track the theoretical costs of inbreeding as predicted by inclusive-fitness theory. Participants were asked to select in a forced choice paradigm, which of two acts of inbreeding with actual family members they would want to avoid most. We found that the estimated fitness costs explained 83.6% of participant choices. Importantly, fitness costs explained choices also when the self was not involved. We conclude that humans intuit the indirect fitness costs of mating decisions made by close family members and that psychological inbreeding avoidance mechanisms extend beyond self-regulation. (shrink)

The paper presents the sources and the development of the medieval doctrine of transcendentals. In Aertsen's opinion transcendental philosophy of the Middle Ages differs considerably from the ontological doctrine of the Ancients as well as from the modern theory referring to the sphere of cognition. The beginnings of the medieval doctrine of the transcendentals were inspired mostly by considerations concerning primary conceptions of human mind included in Avicenna's "Metaphysica". Furthermore, they were connected with the Aristotelian idea of science, the Boethian (...) axiomatic method of "common conceptions of the soul", and theologians' interest in the horizon of human intellectual knowledge. Beside the Aristotelian-Avicennian reduction to the most universal predicate Albert the Great acknowledge another reduction (originating from the Christian-Neoplatonic tradition): reduction to the first cause. In his opinion, these two resolutions are complementary to each other. In the philosophy of Thomas Aquinas, transcendentals are most fundamental insofar as they are the foundations of theoretical and practical science. The principle of contradiction – considered as the beginning of theoretical science – rests on the understanding of "being", and the first precept of natural law is founded on "the good". The development of the doctrine of the transcendentals in 13th century aloows to call the period "the second beginning of metaphysics" – since it changes the understanding of the proper subject of First Philosophy. In Albert the Great, for example, matephysics ceases to be the science of the divine, and becomes the science concerning what is first and the most fundamental – "being-as-being". In St. Bonaventure's philosophy, the doctrine of the transcendentals undergoes a theologizing transformation: that, which is first in the cognitive order is, at the same time, first ontologically. For Bonaventure, the latter "first" is God. (shrink)