The impact of managed care on nurses’ workplace learning and teaching This paper examines the impact of managed care on the informal learning process for nurses in a major US‐based health organisation. Through the analysis of focus group data we report the nurses’ view of the effect recent changes have had on the nurse/patient/care relationship. Managed care, our research indicates, has transformed the learning milieus for nurses with two effects. First, nurses have seen their need for informal learning increase while (...) the time and context for that learning has diminished. Second, the process of teaching patients and families has also been adversely affected even as managed care creates the need for more patient education. We report the analysis of the data collected at group interviews involving nurses working in both hospital and community settings of a leading US‐based HMO. All interviews took place during September of 1997 at various sites in California. This study is part of a larger Social Science Research Council of Canada funded investigation into managed care in the US and Canada. (shrink)

Bhattacharyya, K. The Advaita concept of subjectivity.--Deutsch, E. Reflections on some aspects of the theory of rasa.--Nakamura, H. The dawn of modern thought in the East.--Organ, T. Causality, Indian and Greek.--Chatterjee, M. On types of classification.--Lacombe, O. Transcendental imagination.--Bahm, A. J. Standards for comparative philosophy.--Herring, H. Appearance, its significance and meaning in the history of philosophy.--Chang Chung-yuan. Pre-rational harmony in Heidegger's essential thinking and Chʼan thought.--Staal, J. F. Making sense of the Buddhist tetralemma.--Enomiya-Lassalle, H. M. The mysticism of Carl Albrecht (...) and Zen.--Parrinder, G. The nature of mysticism.--Cairns, G. E. Axiological contributions of East and West to the spiritual development of mankind.--Mayeda, S. Śaṇkara's view of ethics.--Mercier, A. On peace.--Barlingay, S. S. A discussion of some aspects of Gaudapāda's philosophy. (shrink)

Mindfulness and compassion meditation are thought to cultivate prosocial behavior. However, the lack of diverse representation within both scientific and participant populations in contemplative neuroscience may limit generalizability and translation of prior findings. To address these issues, we propose a research framework calledIntersectional Neurosciencewhich adapts research procedures to be more inclusive of under-represented groups. Intersectional Neuroscience builds inclusive processes into research design using two main approaches: 1) community engagement with diverse participants, and 2) individualized multivariate neuroscience methods to accommodate neural (...) diversity. We tested the feasibility of this framework in partnership with a diverse U.S. meditation center (East Bay Meditation Center, Oakland, CA). Using focus group and community feedback, we adapted functional magnetic resonance imaging (fMRI) screening and recruitment procedures to be inclusive of participants from various under-represented groups, including racial and ethnic minorities, gender and sexual minorities, people with disabilities, neuropsychiatric disorders, and/or lower income. Using person-centered screening and study materials, we recruited and scanned 15 diverse meditators (80% racial/ethnic minorities, 53% gender and sexual minorities). The participants completed the EMBODY task – which applies individualized machine learning algorithms to fMRI data – to identify mental states during breath-focused meditation, a basic skill that stabilizes attention to support interoception and compassion. All 15 meditators’ unique brain patterns were recognized by machine learning algorithms significantly above chance levels. These individualized brain patterns were used to decode the internal focus of attention throughout a 10-min breath-focused meditation period, specific to each meditator. These data were used to compile individual-level attention profiles during meditation, such as the percentage time attending to the breath, mind wandering, or engaging in self-referential processing. This study provides feasibility of employing an intersectional neuroscience approach to include diverse participants and develop individualized neural metrics of meditation practice. Through inclusion of more under-represented groups while developing reciprocal partnerships, intersectional neuroscience turns the research process into an embodied form of social action. (shrink)

This paper builds on London and Hart’s critique that Prahalad’s best-selling book prompted a unilateral effort to find a fortune at the bottom of the pyramid. Prahalad’s instrumental, firm-centered construction suggests, perhaps unintentionally, a buccaneering style of business enterprise devoted to capturing markets rather than enabling new socially entrepreneurial ventures for those otherwise trapped in conditions of extreme poverty. London and Hart reframe Prahalad’s insight into direct global business enterprise toward “creating a fortune with the base of the pyramid” rather (...) than at the BoP. This shift in language requires a recalibration of strategic focus, we argue, and will necessitate implementation of “moral imagination” to formulate new mental models that can frame the possibility of local entrepreneurs working collaboratively and discursively with development partners drawn from civil society, corporate, and government sectors. Successful partnerships will arise from interactive processes of emergent, co-creative learning within a shared problem domain or “community of practice”. We call attention to three related pluralist framings of situated learning within such communities of practice: decentered stakeholder networks; global action networks; and a focus on “faces and places” as a cognitive lens to humanize and locally situate diverse inhabitants within base of the pyramid partnership projects. (shrink)

A relative value of life dependent on age has been produced from a survey of 721 randomly selected individuals together with other observations of professional practice. The results are presented in diagrammatic form. If two identical people, except for age, present for medical treatment for a life-threatening condition and only one can be treated then the diagram indicates what the choice should be.

Although death by neurologic criteria is legally recognized throughout the United States, state laws and clinical practice vary concerning three key issues: the medical standards used to determine death by neurologic criteria, management of family objections before determination of death by neurologic criteria, and management of religious objections to declaration of death by neurologic criteria. The American Academy of Neurology and other medical stakeholder organizations involved in the determination of death by neurologic criteria have undertaken concerted action to address variation (...) in clinical practice in order to ensure the integrity of brain death determination. To complement this effort, state policymakers must revise legislation on the use of neurologic criteria to declare death. We review the legal history and current laws regarding neurologic criteria to declare death and offer proposed revisions to the Uniform Determination of Death Act and the rationale for these recommendations. (shrink)

This article questions the prevailing opinion that Domitian's prohibition of castration was intended as a protective measure devised to check masters’ abuses on their slaves, as part of a larger trend towards more enlightened attitudes towards slavery among the Romans. While brutal, castration was the only type of mutilation which increased the monetary value of slaves. Banning it curtailed slaves’ chances of social climbing and narrowed their channels towards positions of power. The emasculation ban is, instead, better understood as one (...) of the many measures directed towards the control of the sexual behaviour and the sumptuary practices of the Roman elite. Introduced as a censorial decree, the ban gave Domitian the opportunity to act as the upholder of Republican traditions at the same time as he impinged on the private lives of his subjects and put senators and equestrians under his thumb. The article also argues that, contrary to what is usually argued, the constant re-enforcement of the prohibition to castrate by Domitian's successors is an indication of the effectiveness of the Roman legal machinery and its capacity to reach the most distant corners of the Roman empire. (shrink)

At the heart of Levinas’s work is the apparently simple idea that through the encounter with another person, we are forced to give up our self-concern and take heed of the ethical relation between us. But, while simple on the surface, when one tries to characterize it in more detail, it can be hard to fit together the various ways in which Levinas talks about this relation and to identify precisely what he took its normative structure to be, as this (...) is described in a number of apparently different ways, that are not obviously compatible or equivalent, such as “command,” “call,” “summons,” “demand,” and so on. In this chapter, we intend to focus on these different characterizations and show what makes them different while also endeavoring to find a way in which Levinas’s conception may nonetheless be fitted together into a coherent account of the face-to-face encounter that is at the heart of his ethics. We will begin by considering the different normative terms used to characterize the encounter in that text and show how they are conceptually distinct from one another; we will then offer a way to read Levinas’s position to nonetheless show how these different normative relations can be fitted together into a stable position. (shrink)

Some reasons are thought to depend on relations between people, such as that of a promiser to a promisee. It has sometimes been assumed that all reasons that are relational in this way are moral obligations. I argue, via a counter example, that there are non-obligatory relational reasons. If true, this has ramifications for relational theories of morality.

This paper is about the similarity between the appreciation of a piece of art, such as a cherished music album, and the loving appreciation of a person whom one knows well. In philosophical discussion about the rationality of love, the Qualities View (QV) says that love can be justified by reference to the qualities of the beloved. I argue that the oft-rehearsed trading-up objection fails to undermine the QV. The problems typically identified by the objection arise from the idea that (...) love-worthy qualities could be coarse-grained, when in fact they must be fine-grained. The analogy with appreciation of aesthetic qualities helps to draw out this point. Once the fine-grained nature of love-worthy qualities is properly understood, it is clear that critics of the QV cannot rely on the trading-up objection to motivate its rejection. Moreover, the paper’s core argument helps to illuminate the persistently aesthetic nature of interpersonal affections. (shrink)

Moral philosophers typically have confronted two distinct kinds of problems. First, they have attempted to discover the supreme principle of morality and show how it should influence our conduct by indicating what specific virtues, obligations, laws, and way of life it would require. Second, they have tried to demonstrate that we ought to live according to its demands and do what is morally right even when our immediate desires pull us in the opposite direction.

It is common for people to be sensitive to aesthetic qualities in one another’s speech. We allow the loveliness or unloveliness of a person’s voice to make impressions on us. What is more, it is also common to allow those aesthetic impressions to affect how we are inclined to feel about the speaker. We form attitudes of liking, trusting, disliking or distrusting partly in virtue of the aesthetic qualities of a person’s speech. In this paper I ask whether such attitudes (...) could ever be legitimate. This is a microcosm of the broader issue of whether people’s aesthetic qualities in general can justify the interpersonal valuing-attitudes that they so often cause. I draw from recent discussions of body aesthetics to articulate a pair of challenges. One challenge says that aesthetic judgements of speech are reliant on unjustifiable prejudices. The other holds that a person’s aesthetic qualities are irrelevant to whether they should be liked. Against these challenges I argue that some speech can bear aesthetic qualities which are not reliant on prejudice and which are relevant to whether the speaker should be liked. I develop this argument through an analysis of the concept of lyricism. (shrink)

A lineage of prominent philosophers who have discussed the second-person relation can be regarded as advancing structural accounts. They posit that the second-person relation effects one transformative change to the structure of practical reasoning. In this paper, I criticise this orthodoxy and offer an alternative, substantive account. That is, I argue that entering into second-personal relations with others does indeed affect one's practical reasoning, but it does this not by altering the structure of one's agential thought, but by changing what (...) reasons can become available. The importance of second-personal thought for action is heterogenous. Second-person relations make possible the emergence of a wide variety of different kinds of practical reasons: creating some, revealing others. Recognising this diminishes the appeal of the traditional, structural accounts of the practical significance of such second-personal relations. Moving away from structural accounts facilitates a more thorough understanding of the intersubjective form of action. (shrink)

Being able to ask others to do things, and thereby giving them reasons to do those things, is a prominent feature of our interpersonal lives. In this paper, I discuss the distinctive normative status of requests – what makes them different from commands and demands. I argue for a theory of this normative phenomenon which explains the sense in which the reasons presented in requests are a matter of discretion. This discretionary quality, I argue, is something that other theories cannot (...) accommodate, though it is a significant aspect of the relations that people stand in to one another, and the kinds of practical reasons that flow from those relations. (shrink)