IntroductionA symptom cluster is very common among oncological patients: cancer-related fatigue, emotional distress, sleep difficulties, pain, and cognitive difficulties. Clinical applications of interventions based on non-ordinary states of consciousness, mostly hypnosis and meditation, are starting to be investigated in oncology settings. They revealed encouraging results in terms of improvements of these symptoms. However, these studies often focused on breast cancer patients, with methodological limitations. Another non-ordinary state of consciousness may also have therapeutic applications in oncology: self-induced cognitive trance. It seems (...) to differ from hypnosis and meditation, as it involves the body more directly. Thus, investigating its clinical applications, along with hypnosis and meditation interventions, could improve available therapeutic options in oncology. This article details the study protocol of a preference-based longitudinal controlled superiority trial aiming to assess the effectiveness of 3 group interventions to improve oncological patients’ quality of life, and more specifically CRF, emotional distress, sleep, pain, and cognitive difficulties.Methods and analysisA power analysis required a total sample of 160 patients. Main inclusion criteria are: cancer diagnosis, active treatments completed for less than a year, no practice of hypnosis, meditation, or SICT, and presence of at least one of these four symptoms: fatigue, sleep difficulties, depression, or anxiety. Each participant will choose the intervention in which they want to participate. To test the effectiveness of the interventions, data will be collected by questionnaires and neurobiological measures and directly from the medical record at four time points: before inclusion in the study ; immediately after the intervention; and at 3- and 12-month follow-up. The longitudinal data in each group will then be measured.DiscussionIn addition to standard cancer therapies, there is a growing interest from patients in complementary approaches, such as hypnosis, meditation, and SICT. The results of this study will be useful to increase knowledge about short- and long-term effectiveness of 3 group interventions for CRF, emotional distress, sleep, pain, and cognitive difficulties in patients with different cancers.Clinical Trial RegistrationClinicalTrials.gov/. Retrospectively registered on the 29th of April 2021. url: https://clinicaltrials.gov/ct2/show/NCT04873661. (shrink)

Ce commentaire présente trois arguments de la pensée potterienne à partir de la lunette ergothérapique afin de soutenir les réflexions relatives au développement des pratiques durables en ergothérapie. Il permet ainsi d’initier les ergothérapeutes à une perspective de bioéthique globale susceptible de les soutenir dans l’actualisation d’une approche écosystémique respectueuse de l’environnement.

The relation between sex hormones and responses to partner infidelity was explored in two studies reported here. The first confirmed the standard sex difference in relationship jealousy, that males (n=133) are relatively more distressed by a partner’s sexual infidelity and females (n=159) by a partner’s emotional infidelity. The study also revealed that females using hormone-based birth control (n=61) tended more toward sexual jealousy than did other females, and reported more intense affective responses to partner infidelity (n=77). In study two, 47 (...) females were assessed four times across one month. Patterns of response to partner infidelity did not vary by week of menstrual cycle, but significant relations between salivary estradiol level and jealousy responses were obtained during the time of rising and high fertility risk. The implications, at least for females, are that any evolved psychological, affective, or behavioral dispositions regarding reproduction-related relationships are potentially moderated by estradiol, and that the use of synthetic hormones may disrupt this relation. (shrink)

BackgroundDementia care is essential to promote the well-being of patients but remains a difficult task prone to ethical issues. These issues include questions like whether manipulating a person with dementia is ethically permissible if it promotes her best interest or how to engage with a person who is unwilling to recognize that she has dementia. To help people living with dementia and their carers manage ethical issues in dementia care, we developed the CARE intervention. This is an intervention focused on (...) promoting the ethical self-efficacy of people living with dementia and carers, i.e., their confidence that they can manage ethical issues when they occur. The purpose of this paper is to explain and discuss how we have developed the CARE intervention to promote the ethical self-efficacy of people living with dementia, their family, and professional carers through a specific and, we believe, new use of literary texts.MethodsThe CARE intervention has been developed in two phases: First, we conducted a needs assessment of the occurrence of ethical issues in dementia care and the need for an intervention to support people living with dementia and their carers in managing such issues. Second, in a design phase, we developed the CARE intervention to meet identified needs.ResultsTo address identified ethical issues in dementia care we designed the CARE intervention as a workshop format where people living with dementia and carers can meet, discuss literary texts, and deliberate on how to solve such issues. The workshop is structured by the following elements: An agenda of ethical issues, a collection of literary cases exemplifying ethical issues, a moderator with an understanding of dementia care, and an overview of the ethical principles relevant to the discussion of ethical issues. >This workshop concept is operationalized in three applications tailored to meet the specific ethical issues of each of the study´s three target groups: people living with dementia and family carers, professional and family carers, and professional carers.ConclusionWe conclude the paper by stating that it is possible to develop an intervention that promotes the ethical self-efficacy of people living with dementia and family and professional carers. (shrink)

In the context of academic research, a diversity of ethical issues, conditioned by the different roles of members within these institutions, arise. Previous studies on this topic addressed mainly the perceptions of researchers. However, to our knowledge, no studies have explored the transversal ethical issues from a wider spectrum, including other members of academic institutions as the research ethics board (REB) members, and the research ethics experts. The present study used a descriptive phenomenological approach to document the ethical issues experienced (...) by a heterogeneous group of Canadian researchers, REB members, and research ethics experts. Data collection involved socio-demographic questionnaires and individual semi-structured interviews. Following the triangulation of different perspectives (researchers, REB members and ethics experts), emerging ethical issues were synthesized in ten units of meaning: (1) research integrity, (2) conflicts of interest, (3) respect for research participants, (4) lack of supervision and power imbalances, (5) individualism and performance, (6) inadequate ethical guidance, (7) social injustices, (8) distributive injustices, (9) epistemic injustices, and (10) ethical distress. This study highlighted several problematic elements that can support the identification of future solutions to resolve transversal ethical issues in research that affect the heterogeneous members of the academic community. (shrink)

The target article misrepresents the foundations of integrated information theory and ignores many essential publications. It, thus, falls to this lead commentary to outline the axioms and postulates of IIT and correct major misconceptions. The commentary also explains why IIT starts from phenomenology and why it predicts that only select physical substrates can support consciousness. Finally, it highlights that IIT's account of experience – a cause–effect structure quantified by integrated information – has nothing to do with “information transfer.”.

The purpose of this article is to discuss the ethical issues impacting the phenomenon of patient safety and to present implications for nursing management. Previous knowledge of this perspective is fragmented. In this discussion, the main drivers are identified and formulated in ‘the ethical imperative’ of patient safety. Underlying values and principles are considered, with the aim of increasing their visibility for nurse managers’ decision-making. The contradictory nature of individual and utilitarian safety is identified as a challenge in nurse management (...) practice, together with the context of shared responsibility and identification of future challenges. As a conclusion, nurse managers play a strategic role in patient safety. Their role is to incorporate ethical values of patient safety into decision-making at all levels in an organization, and also to encourage clinical nurses to consider values in the provision of care to patients. Patient safety that is sensitive to ethics provides sustainable practice where the humanity and dignity of all stakeholders are respected. (shrink)

Cognitive Science, Volume 46, Issue 2, February 2022.

Discovering the meaning of novel communicative cues is challenging and amounts to navigating an unbounded hypothesis space. Several theories posit that this problem can be simplified by relying on positive expectations about the cognitive utility of communicated information. These theories imply that learners should assume that novel communicative cues tend to have low processing costs and high cognitive benefits. We tested this hypothesis in three studies in which toddlers (N = 90) searched for a reward hidden in one of several (...) containers. In all studies, an adult communicated the reward's location with an unfamiliar and ambiguous cue. We manipulated the processing costs (operationalized as inferential chain length) and cognitive benefits (operationalized as informativeness) of the possible interpretations of the cues. Toddlers processing of novel communicative cues were guided by expectations of low processing costs (Study 1) and high cognitive benefits (Studies 2 and 3). More specifically, toddlers treated novel cues as if they were easy to process, informative, and accurate, even when provided with repeated evidence to the contrary. These results indicate that, from toddlerhood onward, expectations of cognitive utility shape the processing of novel communicative cues. These data also reveal that toddlers, who are in the process of learning the language and communicative conventions of people around them, exert a pressure favoring cognitive efficiency in communicative systems. (shrink)

Objective correlates—behavioral, functional, and neural—provide essential tools for the scientific study of consciousness. But reliance on these correlates should not lead to the ‘fallacy of misplaced objectivity’: the assumption that only objective properties should and can be accounted for objectively through science. Instead, what needs to be explained scientifically is what experience is intrinsically— its subjective properties—not just what we can do with it extrinsically. And it must be explained; otherwise the way experience feels would turn out to be magical (...) rather than physical. We argue that it is possible to account for subjective properties objectively once we move beyond cognitive functions and realize what experience is and how it is structured. Drawing on integrated information theory, we show how an objective science of the subjective can account, in strictly physical terms, for both the essential properties of every experience and the specific properties that make particular experiences feel the way they do. (shrink)

This paper presents Integrated Information Theory (IIT) 4.0. IIT aims to account for the properties of experience in physical (operational) terms. It identifies the essential properties of experience (axioms), infers the necessary and sufficient properties that its substrate must satisfy (postulates), and expresses them in mathematical terms. In principle, the postulates can be applied to any system of units in a state to determine whether it is conscious, to what degree, and in what way. IIT offers a parsimonious explanation of (...) empirical evidence, makes testable predictions, and permits inferences and extrapolations. IIT 4.0 incorporates several developments of the past ten years, including a more accurate translation of axioms into postulates and mathematical expressions, the introduction of a unique measure of intrinsic information that is consistent with the postulates, and an explicit assessment of causal relations. By fully unfolding a system's irreducible cause-effect power, the distinctions and relations specified by a substrate can account for the quality of experience. (shrink)

Membership in the Kyoto School of philosophy is defined by both formal and conceptual criteria. Keta Masako 氣多雅子 is a member in good standing in both senses. Formally speaking, she currently occupies the Chair in Religious Studies at Kyoto University.1 This chair, together with the Chair in Philosophy, constitutes the formal nexus of the Kyoto School.2 Keta is the first woman to hold the chair, constellating her in a network that radiates “from the rather substantial circle of students and professors (...) that had formed around Nishida [Kitarō] during his final years at Kyoto and that had continued with Tanabe [Hajime].”3 Conceptually speaking, the Kyoto School is defined by a critical reflection on Asian and European... (shrink)

Ethical climate (EC) has been broadly described as how well institutions respond to ethical issues. Developing a tool to study and evaluate EC that aims to achieve sustained improvements requires a contemporary framework with identified relevant drivers. An extensive literature review was performed, reviewing existing EC definitions, tools and areas where EC has been studied; ethical challenges and relevance of EC in contemporary paediatric intensive care (PIC); and relevant ethical theories. We surmised that existing EC definitions and tools designed to (...) measure it fail to capture nuances of the PIC environment, and sought to address existing gaps by developing an EC framework for PIC founded on ethical theory. In this article, we propose a Paediatric Intensive Care Ethical Climate (PICEC) conceptual framework and four measurable domains to be captured by an assessment tool. We define PICEC as the collective felt experience of interdisciplinary team members arising from those factors that enable or constrain their ability to navigate ethical aspects of their work. PICEC both results from and is influenced by how well ethical issues are understood, identified, explored, reflected on, responded to and addressed in the workplace. PICEC encompasses four, core inter-related domains representing drivers of EC including: (1) organisational culture and leadership; (2) interdisciplinary team relationships and dynamics; (3) integrated child and family-centred care; and (4) ethics literacy. Future directions involve developing a PICEC measurement tool, with implications for benchmarking as well as guidance for, and evaluation of, targeted interventions to foster a healthy EC. (shrink)

The patient’s home is a common setting for palliative care. This means that we need to understand current palliative care philosophy and how its goals can be realized in home‐care nursing encounters (HCNEs) between the nurse, patient and patient’s relatives. The existing research on this topic describes both a negative and a positive perspective. There has, however, been a reliance on interview and descriptive methods in this context. The aim of this study was to explore planned HCNEs in palliative care. (...) The design was a multiple case study based on observations. The analysis includes a descriptive and an explanation building phase. The results show that planned palliative HCNEs can be described as a process of co‐creating possibilities for the patient to reach vital goals through shared knowledge in a warm and caring atmosphere, based on good caring relations. However, in some HCNEs, co‐creation did not occur: Wishes and needs were discouraged or made impossible and vital goals were not reached for the patients or their relatives. Further research is needed to understand why. The co‐creative process presented in this article can be seen as a concretization of the palliative care ideal of working with a person‐centered approach. (shrink)

TOT states may be viewed as a temporary and reversible microamnesia. We investigated the effects of lorazepam on TOT states in response to general knowledge questions. The lorazepam participants produced more commission errors and more TOTs following commission errors than the placebo participants . The resolution of the TOTs was unimpaired by the drug. Neither feeling-of-knowing accuracy nor recognition were affected by lorazepam. The higher level of incorrect recalls produced by lorazepam participants may be due to the fact that they (...) were more frequently temporarily unable to access a known item. For some of these items, the awareness of the retrieval failure resulted in a commission TOT . The resolution of the TOT conflict is discussed in the light of the anxiolytic and anticonflict effects of lorazepam. The data are discussed in terms of contemporary theories of TOTs and the effects that benzodiazepines have on semantic memory. (shrink)

Collaboration for nursing is a core competence and therefore educational interventions are essentials for collaborative skills. To identify such interventions, we carried out a study to understand nursing students' collaborative process. A narrative inquiry method was used to explore the collaborative process of first‐year undergraduate nursing students. The analysis was conducted on field notes from 70 h of observation of 87 nursing students' collaboration during skills lab activities. It also included transcriptions of four focus group discussions with 11 students. The (...) results are presented as a sequential process of (1) navigating in unfamiliar territory, (2) navigating together to cope, and (3) navigating together towards independency and the future nursing profession. We identified a transition from teacher‐led assistance and guidance to student interdependency and reciprocal learning, ending with student‐led assistance supporting independency. In line with Vygotsky's theory of zone of proximal development, different scaffolding interventions are needed depending on where the students are in the collaborative process. (shrink)

S’inscrivant dans un courant qui reconsidère aujourd’hui la place des femmes dans l’histoire, Mélanie Fabre publie une édifiante biographie de Dick May, une intellectuelle largement oubliée de la Belle Époque, fondatrice notamment du Collège libre des sciences sociales en 1895, de la première École supérieure de journalisme française en 1899 et de l’École libre des hautes études sociales en 1900. Elle a été aussi active dans la fondation du Musée social en 1894, dans la formation de l’univers...

To explore literary silence is to explore the relationships between literary texts and the silence of the ineffable. It is to enquire what dynamics texts develop as they strive to 'say the unsayable', and it is to think literature as a silence that speaks itself. This study describes these literary and silent dynamics through readings of Pascal's Pensées, Rousseau's Rêveries, and Beckett's trilogy Molloy, Malone meurt, and L'Innommable. It contributes to our understanding of three major writers and challenges our idea (...) of what silence is. The subject of silence and of the ineffable has a long philosophical and critical tradition. A careful study of this tradition reveals the dominance of a limiting dualistic understanding of silence and its relationship to noise or language: silence becomes the negative other, the beyond, about which there remains nothing to say. The study of literary silence seeks rather to trace a language that becomes its own silence. It compromises the attempt to think a silence that moves within and through texts, that is inherent to the literary expression. Central to this theoretical endeavour are thinkers like Derrida, Deleuze, Gadamer, and Vattimo. The theoretical understanding of silence permits an effective methodology for reading literary silence. Notions of repetition, the aporia and the implosion, which are developed in reference to Kierkegaard and Bataille, describe textual strategies of literary silence and structure the readings. Finally, the reading of literary silence has its point of reference in writers like Mallarmé, Blanchot, and Beckett. It is their texts that have taught us to become topological readers, to move in and out of texts' movements; they have shown us how the literary expression is irreducible to linear, meaning oriented language. As readers of such texts we have been prepared to read the dynamics of the unsayable, and finally to start discerning the silences of the literary. (shrink)

Recent studies have shown that schizophrenia may be a disease affecting the states of consciousness. The present study is aimed at investigating metamemory, i.e., the knowledge about one's own memory capabilities, in patients with schizophrenia. The accuracy of the Confidence level (CL) in the correctness of the answers provided during a recall phase, and the predictability of the Feeling of Knowing (FOK) when recall fails were measured using a task consisting of general information questions and assessing semantic memory. Nineteen outpatients (...) were paired with 19 control subjects with respect to age, sex, and education. Results showed that patients with schizophrenia exhibited an impaired semantic memory. CL ratings as well as CL and FOK accuracy were not significantly different in the schizophrenic and the control groups. However, FOK ratings were significantly reduced for the patient group, and discordant FOK judgments were also observed more frequently. Such results suggest that FOK judgments are impaired in patients with schizophrenia, which confirms that schizophrenia is an illness characterized by an impaired conscious awareness of one's own knowledge. (shrink)

Subjective reports and theories about memory may have an influence on other beliefs and behaviours. Patients with schizophrenia suffer a wide range of deficits affecting their awareness of daily life, including memory. With the Metamemory Inventory in Adulthood we ascertained patients’ memory knowledge and thoughts about their own cognitive capacities and about several aspects of cognitive functioning: personal capacities, knowledge of processes, use of strategies, perceived change with ageing, anxiety, motivation and mastery. The participants’ ratings were correlated with their intellectual, (...) cognitive and psychiatric data. Patients felt they had a lower capacity and marginally lower mastery over their memory than comparison subjects. They reported less recourse to strategies, and higher levels of memory-related anxiety. However, their knowledge of basic memory processes, motivation to succeed, and perception of ageing effects were similar. So patients with schizophrenia do not suffer a general and non specific impairment of their metacognitive knowledge. (shrink)

To explore literary silence is to explore the relationships between literary texts and the silence of the ineffable. Philosophical and critical accounts tend to operate with a dualistic understanding of silence as the negative other of text. This study, however, seeks to place silence within the literary text. Central to this theoretical endeavour are thinkers like Blanchot, Derrida, Gadamer and Vattimo, and the result is a fundamental challenge to our ideas of silence and text. The study continues to draw on (...) the ideas of Kierkegaard and Bataille to develop an effective methodology for reading such literary silences. (shrink)

Packed with ideas designed to help children learn to sing, this booklet offers criteria for selecting songs, strategies to bring out the best in children's voices, and suggestions for games, ideas, and resources.

C’est à partir de deux exemples concrets, celui des employés de banque et des chauffeurs de taxi collectif à Beyrouth que nous nous proposons d’interroger l’« absence » de la question du temps de travail dans les revendications sociales au Liban. Une absence qui serait l’indice de la prégnance d’un autre rapport au temps : on serait en présence de régimes de temporalités hétérogènes les uns aux autres, à la mesure de la fragmentation de la société entre des mondes sociaux (...) où le travail est soumis à des contraintes radicalement opposées. (shrink)

Easeful Death sets out straightforwardly the arguments for and against the legalization of assisted suicide and euthanasia. Exploring the philosophical and legal debates as well as the medical practicalities of this sensitive issue, the authors ultimately conclude that the law should embrace a more compassionate approach to assisted dying.

Experiential evidence shows that pain is associated with common meanings. These include a meaning of threat or danger, which is experienced as immediately distressing or unpleasant; cognitive meanings, which are focused on the long-term consequences of having chronic pain; and existential meanings such as hopelessness, which are more about the person with chronic pain than the pain itself. This interdisciplinary book - the second in the three-volume Meanings of Pain series edited by Dr Simon van Rysewyk - aims to better (...) understand pain by describing experiences of pain and the meanings these experiences hold for the people living through them. The lived experiences of pain described here involve various types of chronic pain, including spinal pain, labour pain, rheumatic pain, diabetic peripheral neuropathic pain, fibromyalgia, complex regional pain syndrome, endometriosis-associated pain, and cancer-related pain. Two chapters provide narrative descriptions of pain, recounted and interpreted by people with pain. Language is important to understanding the meaning of pain since it is the primary tool human beings use to manipulate meaning. As discussed in the book, linguistic meaning may hold clues to understanding some pain-related experiences, including the stigmatisation of people with pain, the dynamics of patient-clinician communication, and other issues, such as relationships between pain, public policy and the law, and attempts to develop a taxonomy of pain that is meaningful for patients. Clinical implications are described in each chapter. This book is intended for people with pain, their family members or caregivers, clinicians, researchers, advocates, and policy makers. (shrink)

BackgroundIn the context of limited health care budgets in countries where Neglected Tropical Diseases (NTDs) are endemic, scaling up disease control interventions entails the setting of priorities. However, solutions based solely on cost‐effectiveness analyses may lead to biased and insufficiently justified priorities.ObjectivesThe objectives of this paper are to 1) demonstrate how a range of equity concerns can be used to identify feasible priority setting criteria, 2) show how these criteria can be fed into a multi‐criteria decision‐making matrix, and 3) discuss (...) the conditions under which this decision‐making procedure should be carried out in a real‐world decision‐making context.MethodsThis paper draws on elements from theories of decision analysis and ethical theories of fair resource allocation. We explore six typical NTD interventions by employing a modified multi‐criteria decision analysis model with predefined criteria, drawn from a priority setting guide under development by the WHO. To identify relevant evidence for the six chosen interventions, we searched the PubMed and Cochrane databases.DiscussionOur in vitro multi‐criteria decision analysis suggested that case management for visceral leishmaniasis should be given a higher priority than mass campaigns to prevent soil‐transmitted helminthic infections. This seems to contradict current health care priorities and recommendations in the literature. We also consider procedural conditions that should be met in a contextualised decision‐making process and we stress the limitations of this study exercise.ConclusionBy exploring how several criteria relevant to the multi‐facetted characteristics of NTDs can be taken into account simultaneously, we are able to suggest how improved priority settings among NTDs can be realised. (shrink)