This study extends on work investigating the increased application of mixed methods research in prehospital care. The complexity and diversity of the prehospital environment warrants flexibility and applicability to guide the research process, yet little attention has focused on the theoretical lens used in prehospital research when using mixed methods research. Pragmatism’s characteristics of human inquiry, problem solving, and action align with a clinical reasoning approach, supporting the prehospital researchers epistemological understanding of the world. Through further exploration of this alignment, (...) this article proposes pragmatism as a compatible theoretical lens for mixed methods in prehospital research. (shrink)

Background: Choice to live and die at home is supported by palliative care policy; however, health resources and access disparity impact on this choice in rural Australia. Rural end-of-life home care is provided by district nurses, but little is known about their role in advocacy for choice in care. Objectives: The study was conducted to review the scope of the empirical literature available to answer the research question: What circumstances influence district nurse advocacy for rural client choice to live and (...) die at home?, and identify gaps in the knowledge. Method: Interpretive scoping methodology was used to search online databases, identify suitable studies and select, chart, analyse and describe the findings. Results: 34 international studies revealed themes of ‘the nursing relationship’, ‘environment’, ‘communication’, ‘support’ and ‘the holistic client centred district nursing role. Discussion: Under-resourcing, medicalisation and emotional relational burden could affect advocacy in rural areas. Conclusion: It is not known how district nurses overcome these circumstances to advocate for choice in end-of-life care. Research designed to increase understanding of how rural district nurses advocate successfully for client goals will enable improvements to be made in the quality of end-of-life care offered. (shrink)

What enables individually simple insects like ants to act with such precision and purpose as a group? How do trillions of individual neurons produce something as extraordinarily complex as consciousness? What is it that guides self-organizing structures like the immune system, the World Wide Web, the global economy, and the human genome? These are just a few of the fascinating and elusive questions that the science of complexity seeks to answer. In this remarkably accessible and companionable book, leading complex systems (...) scientist Melanie Mitchell provides an intimate, detailed tour of the sciences of complexity, a broad set of efforts that seek to explain how large-scale complex, organized, and adaptive behavior can emerge from simple interactions among myriad individuals. Comprehending such systems requires a wholly new approach, one that goes beyond traditional scientific reductionism and that re-maps long-standing disciplinary boundaries. Based on her work at the Santa Fe Institute and drawing on its interdisciplinary strategies, Mitchell brings clarity to the workings of complexity across a broad range of biological, technological, and social phenomena, seeking out the general principles or laws that apply to all of them. She explores as well the relationship between complexity and evolution, artificial intelligence, computation, genetics, information processing, and many other fields. Richly illustrated and vividly written, Complexity : A Guided Tour offers a comprehensive and eminently comprehensible overview of the ideas underlying complex systems science, the current research at the forefront of this field, and the prospects for the field's contribution to solving some of the most important scientific questions of our time. (shrink)

al-Qāḍī Abū Yūsuf -- Abū al-Ḥasan al-Ashʻarī -- al-Qāḍī Abū Bakr al-Bāqillānī -- ʻAbd al-Qāhir al-Baghdādī -- Abū al-Ḥasan al-Māwardī -- Abū Yaʻlá -- Imām al-Ḥaramayn -- al-Ghazzālī -- Ibn Khaldūn -- al-Qalqashandī.

Twentieth century philosophers such as Simondon and Heidegger propose theories of subjectivation that inform our thinking about the definition of personhood and how it arises; including in the potentially wide-ranging context of personhood beyond the human. Simondon’s theory of transindividuation unfolds as a series of decenterings that provides a context for future persons that is a dynamic world of processes without fixity or attachment to any one kind of subject. Subjects participate in but do not cause individuation; and they exist (...) on a spectrum of capacity for action with other living beings including animals; human persons; and possibly a variety of future persons. The role of collectivity in the form of the other has been an important aspect of individuation; however I claim that the function of alterity need not be provided exclusively by a self-similar subject. Philosophical individuation theories serve as a foundation for an approach that opens up greater possibility for individuation in the context of future persons by identifying and alternatively fulfilling the underlying functionality required by individuation. (shrink)

Given the profound influence of social media and emerging evidence of its effects on human behavior and health, bioethicists have an important role to play in the development of professional standards of conduct for health professionals using social media and in the design of online systems themselves. In short, social media is a bioethics issue that has serious implications for medical practice, research, and public health. Here, we inventory several ethical issues across four areas at the intersection of social media (...) and health: the impact of social networking sites on the doctor‐patient relationship, the development of e‐health platforms to deliver care, the use of online data and algorithms to inform health research, and the broader public health consequences of widespread social media use. In doing so, we review discussions of these topics and emphasize the need for bioethics to focus more deeply on the ways online technology platforms are designed and implemented. We argue that bioethicists should turn their attention to the ways in which consumer engagement, bias, and profit maximization shape online content and, consequently, human behavior and health. We also offer a set of recommendations and suggest future directions for addressing ethical challenges in these domains. (shrink)

This paper examines six cross-sector partnerships in South Africa and Zambia. These partnerships were part of a research study undertaken between 2003 and 2005 and were selected because of their potential to contribute to poverty reduction in their respective countries. This paper examines the context in which the partnerships were established, their governance and accountability mechanisms and the engagement and participation of the partners and the intended beneficiaries in the partnerships. We argue that a partnership approach which has proven successful (...) in one context can be used as a valuable learning resource. However, a partnership's work, which includes all aspects of the partnership and its activities, cannot necessarily be transferred directly to another partnership without a thorough and locally informed analysis of the context in which it is implemented. In addition, we suggest that it is difficult to assess whether the good intentions behind partnerships were translated into real benefits for target groups as effective monitoring and evaluation procedures were not in place in the partnerships studied. Similarly, the absence of regularised governance and accountability systems in partnerships made it difficult to support partner and beneficiary participation and engagement. We conclude that there is a need to move beyond a 'one-size-fits-all' approach to partnerships and that partnership replication should focus more strongly on the transfer of learning about partnership processes instead of simply copying partnership activities. Moreover, the development of stronger mechanisms for assessing and ensuring accountability towards both partners and intended beneficiaries is required if partnerships are to meet their intended objectives. (shrink)

Melanie Sarzano | : In this paper, I compare cases of self-deception and cases of pragmatic encroachment and argue that confronting these cases generates a dilemma about rationality. This dilemma turns on the idea that subjects are motivated to avoid costly false beliefs, and that both cases of self-deception and cases of pragmatic encroachment are caused by an interest to avoid forming costly false beliefs. Even though both types of cases can be explained by the same belief-formation mechanism, only (...) self-deceptive beliefs are irrational: the subjects depicted in high-stakes cases typically used in debates on pragmatic encroachment are, on the contrary, rational. If we find ourselves drawn to this dilemma, we are forced either to accept—against most views presented in the literature—that self-deception is rational or to accept that pragmatic encroachment is irrational. Assuming that both conclusions are undesirable, I argue that this dilemma can be solved. In order to solve this dilemma, I suggest and review several hypotheses aimed at explaining the difference in rationality between the two types of cases, the result of which being that the irrationality of self-deceptive beliefs does not entirely depend on their being formed via a motivationally biased process. | : Dans cet article, je compare les cas classiques de duperie de soi aux cas que l’on trouve dans les débats sur la question de l’empiètement pragmatique et défends l’idée selon laquelle ces deux types de cas peuvent être compris comme étant produits par un même mécanisme visant à éviter la formation de croyances fausses coûteuses. Cette comparaison nous mène naturellement à former un dilemme à propos de la rationalité des croyances. Le dilemme repose sur l’idée que bien que ce mécanisme mène à la formation de croyances irrationnelles dans les cas de duperie de soi, il ne semble pas affecter la rationa-lité du sujet dans les cas d’empiètement pragmatique : alors que les sujets autodupés sont irrationnels, les sujets décrits dans les cas d’empiètement pragmatique ne le sont pas. Pour résoudre ce dilemme sans rejeter les présupposés selon lesquels les croyances issues de la duperie de soi sont irrationnelles et que les cas sur lesquels repose l’empiètement pragmatique sont rationnels, je propose plusieurs hypothèses visant à expliquer cette différence, prouvant ainsi que ce dilemme n’est qu’apparent et que l’irrationalité de la duperie de soi ne peut uniquement dépendre de ce mécanisme sous l’influence de considérations pratiques. (shrink)

In _Jain Approaches to Plurality_ Melanie Barbato offers a new perspective on the Jain teaching of plurality and how it allowed Jains to engage with other discourses from Indian inter-school philosophy to global interreligious dialogue.

Many researchers have documented how AI and data driven technologies have the potential to have profound effects on our lives—in ways that make these technologies stand out from those that went before. Around the world, we are seeing a significant growth in interest and investment in AI in healthcare. This has been coupled with rising concerns about the ethical implications of these technologies and an array of ethical guidelines for the use of AI and data in healthcare has arisen. Nevertheless, (...) the question of if and how AI and data technologies can be ethical remains open to debate. This paper aims to contribute to this debate by considering the wide range of implications that have been attributed to these technologies and asking whether current ethical guidelines take these factors into account. In particular, the paper argues that while current ethics guidelines for AI in healthcare effectively account for the four key issues identified in the ethics literature (transparency; fairness; responsibility and privacy), they have largely neglected wider issues relating to the way in which these technologies shape institutional and social arrangements. This, I argue, has given current ethics guidelines a strong focus on evaluating the impact of these technologies on the individual, while not accounting for the powerful social shaping effects of these technologies. To address this, the paper proposes a Multiscale Ethics Framework, which aims to help technology developers and ethical evaluations to consider the wider implications of these technologies. (shrink)

In recent decades, evidence-based medicine has become one of the foundations of clinical practice, making it necessary that healthcare practitioners develop keen critical appraisal skills for scientific papers. Worksheets to guide clinicians through this critical appraisal are often used in journal clubs, a key part of continuing medical education. A similar need is arising for health professionals to develop skills in the critical appraisal of medical ethics papers. Medicine is increasingly ethically complex, and there is a growing medical ethics literature (...) that modern practitioners need to be able to use in their practice. In addition, clinical ethics services are commonplace in healthcare institutions, and the lion’s share of the work done by these services is done by clinicians in addition to their usual roles. Education to support this work is important. In this paper, we present a worksheet designed to help busy healthcare practitioners critically appraise ethics papers relevant to clinical practice. In the first section, we explain what is different about ethics papers. We then describe how to work through the steps in our critical appraisal worksheet: identifying the point at issue; scrutinising definitions; dissecting the arguments presented; considering counterarguments; and finally deciding on relevance. Working through this reflective worksheet will help healthcare practitioners to use the ethics literature effectively in clinical practice. We also intend it to be a shared evaluative tool that can form the basis of professional discussion such as at ethics journal clubs. Practising these critical reasoning skills will also increase practitioners’ capacity to think through difficult ethical decisions in daily clinical practice. (shrink)

This article describes our efforts to screen and enrol clinical trial participants conscientiously in the COVID-19 pandemic setting. We present the standard screening and enrolment process prior to, and our process of adapting to, the pandemic. Our goal was to develop a way to screen and enrol people for clinical trials that was both equitable and effective. In addition, we outline the steps our research department took to ensure that ethical, clinical and logistical factors were considered when matching a patient (...) to a clinical trial. (shrink)

As we become more aware of the potential causes and consequences of climate change we are left wondering: who is responsible? Climate change has the potential to harm large portions of the global population and, arguably, is already doing so. Further, climate change is argued to be human-caused. If this is true, then it seems to be the case that we can analyze climate change in terms of responsibility. I argue that we can approach environmental harms, such as climate change, (...) through a theory of collective responsibility. I propose an account of reductive collective responsibility that can apply to the unstructured collective causing climate change and determine what we are each individually morally responsible for. To avoid the critiques of reductive collective responsibility for large unstructured harms, I propose we separate the determination of membership and eligibility for responsibility from the attribution of responsibility. Through this method, I can speak to the individual responsibility of each member who contributes to climate change without holding them responsible for that which is outside their control. (shrink)

While the Web Ontology Language (OWL) provides a mechanism to import ontologies, this mechanism is not always suitable. Current editing tools present challenges for working with large ontologies an...

Nishitani deems Nietzsche a nihilist, but they both sought to overcome idealism. This shared commitment has normative and descriptive implications for the relationship between affect and history. Normatively, Nishitani praises Nietzsche for thinking history passionately. Descriptively, this praise suggests a shared belief that affectivity is in some significant respect constituted by historical inheritance. For these reasons, Nietzsche’s conception of affect and his genealogical inquiry can be part of the problem of nihilism but also integral to its solution. I make this (...) case through Nishitani’s analysis of Nietzsche’s historical-existential standpoint. From this standpoint, I revisit the nearly thirty-year debate over Nishitani’s critique of Nietzsche to argue that Nishitani’s view of Nietzsche as a consummate nihilist has a bivalent significance. On the one hand, Nishitani needs Nietzsche’s thought to negate nihilistic conceptions of affect derived from Hegel and Feuerbach. On the other hand, Nietzsche’s negation appears to remain limited by an abstract conception of space, which would impede the full liberation of affect from nihilism. (shrink)

In 1998, the Labour government introduced legislation broadening British sentencing powers in relation to crimes aggravated by the offender's hostility towards the victim's actual or perceived race, religion, sexual orientation or disability. Gender is a notable omission from this list. Through a survey of eighty-eight stakeholders working in the violence against women (VAW) sector, this paper explores both the potential benefits and possible disadvantages of adding a gender-based category concerned with VAW to British hate crime legislation. The majority of participants (...) believed that a hate crime approach would offer significant benefits, especially in terms of the symbolic power of the law to send a message to society that VAW is unacceptable. However, most also recognised that the addition of a VAW category to current legislation would involve major practical and conceptual difficulties, not least those resulting from problematic assumptions about the nature of hate crimes versus VAW, and a general unwillingness on the part of policy-makers to address the socio-cultural inequalities that underpin VAW. Overall, the fact that the majority of participants favoured inclusion, on the basis that the possible symbolic benefits were likely to outweigh the potential practical disadvantages, is significant: it speaks to the power of hate crime legislation to challenge many forms of inequality and discrimination still endemic in British society. (shrink)

This article investigates related contexts and connections that both hide and display the coercion and sexual violence manifest in Western cultural and aesthetic artefacts during ancient Greek and Roman eras and the French imperialist epoch. Exploring ‘Pan and Syrinx’ from Ovid’s ‘Book I’ of the Metamorphoses and Claude Debussy’s Syrinx for solo flute, I historicise the meanings of rape and sexual assault that informed Ovid’s epic and then revisit the genesis of Debussy’s Syrinx because of the uneasy elements surrounding its (...) creation. I show how its cultural production is complicit with the imperial in several ways. I consider how sexual violence impacts voice, subjectivity and the body, and finally, I draw on Luce Irigaray’s work to sketch an embodied Syrinx in relation with others and her environment. I suggest the desiring potential of sexual difference, with limitations, as a generative conception of figuring the feminine-maternal body beyond masculine appropriation. In this way I open the myth up to watery material-social relations. (shrink)

Corpus-assisted analyses of public discourse often focus on the lexical level. This article argues in favour of corpus-assisted analyses of discourse, but also in favour of conceptualising salient lexical items in public discourse in a more determined way. It draws partly on non-Anglophone academic traditions in order to promote a conceptualisation of discourse keywords, thereby highlighting how their meaning is determined by their use in discourse contexts. It also argues in favour of emphasising the cognitive and epistemic dimensions of discourse-determined (...) semantic structures. These points will be exemplified by means of a corpus-assisted, as well as a frame-based analysis of the discourse keyword financial crisis in British newspaper articles from 2009. Collocations of financial crisis are assigned to a generic matrix frame for ‘event’ which contains slots that specify possible statements about events. By looking at which slots are more, respectively less filled with collocates of financial crisis, we will trace semantic presence as well as absence, and thereby highlight the pragmatic dimensions of lexical semantics in public discourse. The article also advocates the suitability of discourse keyword analyses for systematic contrastive analyses of public/political discourse and for lexicographical projects that could serve to extend the insights drawn from corpus-guided approaches to discourse analysis. (shrink)

When engaging in community-based research, it is important to consider ethical research practices throughout the project. While current research practices require many investigators to obtain approval from an ethics review board before starting a project, more is required to ensure that ethical principles are applied once the investigations begin and after the investigations are complete. In response to this concern, as expressed by workers at a feminist non-profit during a community placement, we developed a tool to foster both greater ethical (...) and feminist research practice in community-based research. Using feminist theories, methodologies, and concepts such as epistemic justice, epistemic trust, and coauthorship, a tool was developed to support researchers and other collaborators in building relationships of reciprocity. This tool, called the Research Responsibility Agreement (RRA) invites all members of a research project to explicitly reflect on their role in the research, their relationships with other collaborators, their responsibility to contributing meaningfully in the project, and their plans to remain accountable to one another. In doing so, the RRA adds to existing tools that support ethical research by sharing explicit reflections from all collaborators on how to prevent harm and by asking them to reflect on ethical practices beyond the initial stages of the project. The RRA also encourages greater engagement from researchers and collaborators toward building meaningful relationships with each other, and with participants, to work together in advancing social change. As a practical tool that promotes reflection, that builds relationships, and that holds all parties accountable to ethical and feminist research practices, the RRA has the potential to generate impactful change in community-based research projects and beyond. While the RRA is tailored to community-based research, it can be applied widely to any research project and has the potential to revolutionize how research relationships are built across disciplines. (shrink)

Ce texte est écrit à quatre mains : Tamara Dmitrieva est sociologue, spécialiste de l’enfance sourde, qui s’est découverte comme entendante par la rencontre avec des sourd·e·s, et Mélanie Joseph, artiste-chercheuse, sourde signante et implantée, vivant avec le trouble dans sa lutte d’éloignement de la doctrine oraliste. Cet article donne à voir des perspectives de leurs recherches respectives qui s’y entrelacent, en créant un espace de réflexion sur la condition sourde et les possibilités de faire exister les diversités dans la (...) société de demain, selon les perspectives sourdiennes. (shrink)

Paediatric Intensive Care Units (PICU) are complex interdisciplinary environments where challenging, high stakes decisions are frequently encountered. We assert that appropriate decisions are more likely to be made if the decision-making process is comprehensive, reasoned, and grounded in thoughtful deliberation. Strategies to overcome barriers to high quality decision-making including, cognitive and implicit bias, group think, inadequate information gathering, and poor quality deliberation should be incorporated. Several general frameworks for decision-making exist, but specific guidance is scarce. In this paper, we provide (...) specific guidance on collaborative complex decision-making for PICUs. The proposed approach is on principles of procedural justice and pragmatic hermeneutics. The process encompasses set-up/planning, information gathering, question formulation, analysis (perspectives, values, and principles), action plan development, decision documentation, and a review and appeal mechanism. The process can be adapted to suit other clinical contexts. Research evaluating the process, exploring how best to develop education for clinicians, and how to build a culture that values high quality deliberation, is worthwhile. (shrink)

This article examines the tensions in the identities of men who belong to the Promise Keepers movement by uncovering the social conditions that lead men to rethink gender and racial ideologies. Using participant observation and in-depth interviews, the author draws on gender and social movement scholarship to reveal how contradictory gender and racial ideologies shape PKs' identities. Furthermore, the PKs' impact on gender and race relations is also contradictory. PK fosters men's growth on an interactional level, allowing men to embrace (...) a more expressive and caring masculinity that includes cross-racial bonding. Simultaneously, however, PK ignores, and indirectly reinforces, the structural conditions that underpin gender and racial privilege among white men. (shrink)

Although features of the dentition figure prominently in discussions of early hominid phylogeny, remarkably little is known of the developmental basis of the variations in occlusal morphology and dental proportions that are observed among taxa. Recent experiments on tooth development in mice have identified some of the genes involved in dental patterning and the control of tooth specification. These findings provide valuable new insight into dental evolution and underscore the strong developmental links that exist among the teeth and the jaws (...) and cranium. The latter has important implications for cladistic studies that traditionally consider features of the skull independently from the dentition. BioEssays 23:481–493, 2001. © 2001 John Wiley & Sons, Inc. (shrink)

Considering the value of archives for dealing with the past processes, especially for the establishment of collective memory and identity, this paper discusses the role of archives in situations of conflicting memories such as in the case of the official Turkish denial of the Armenian genocide. A crucial problem of Turkish-Armenian reconciliation are the divergent perceptions of what to consider as proper ‘evidence’, i.e. as objective, reliable, impartial or trustworthy sources of knowledge in order to prove the Armenian genocide. The (...) aim of this paper is to show how in a general atmosphere of distrust or prejudiced credibility judgments, even technically reliable archival records will be perceived as unreliable and biased, lacking any evidentiary status to factually prove a genocide which is categorically denied. Therefore, this working paper discusses how claims to reliability, objectivity and other similar scientifically and epistemically relevant attributes are understood in archival science as well as memory studies, and emphasizes the problems related to their instrumentalization by political actors within the context of genocide denialism. The Turkish-Armenian context promises many important empirical as well as theoretical insights on the uses and misuses of these attributes, suggesting that measures ought to be taken beforehand to decrease intergroup prejudice and distrust toward the ‘other’, so that archives can be effective in the truth-finding process. (shrink)

This paper examines how the Harper Government of Canada shut down both debate about threats and research into environmental risk, a strategy that Canadian scientists characterized as the “death of evidence.” Based on interviews with scientists who research risks to the marine environment, we explore the shifting relationship between science and the Canadian government by tracing the change in the mode of risk calculation supported by the Harper administration and the impact of this change. Five themes emerged from the interviews: (...) erosion of science research capacity, resulting limitations in understanding risk, declining influence on policy and regulation, redirection of public science funds to support the private sector, and the need to broaden the science knowledge base. The Canadian death of evidence controversy represents a challenge to science and technology studies scholars who wish to maintain a critical and reflexive perspective on the scientific enterprise without supporting attacks on evidence. While subsequent Canadian governments may simply return science to an unreflexively privileged knowledge status, we view this as equally damaging to broad risk calculation and democratic science. We suggest instead that a broader gathering of matters of concern will always be essential to risk assessment. (shrink)

In this paper, key concepts from the philosophy of critical realism and meta-Reality are used to develop an art education research project that can enhance the freedom of art students in their art work and, potentially, contribute to the promotion of emancipation beyond the world of art work. In the process of developing this project, the author engages in a two-way interrogation of both concepts and empirical research. The stratified model of reality, the ontological status of absence and the concepts (...) of transcendental identification, transcendental agency and the ground-state have informed decisions about data collection and contributed to the analysis of data in this study. The research results offer some empirical support for the philosophy of critical realism and meta-Reality, whilst also identifying potential inconsistencies. A further original feature of the paper is that it draws on the flow theory of Mihaly Csikszentmihalyi to complement Roy Bhaskar's account of the ground-state and of the nature of free-flowing activity; also using neuroscience to provide some neurological evidence for the differences between mindful and spontaneous activity. It is anticipated that the cross-analysis between cases resulting from the two-way interchange between theory and empirical evidence could help to generate a model for ‘unblocking the creative block’, experienced not only by students practising art-making, but also by the wider community. (shrink)

The experience of skilled action occurs in dreams if we take dream reports at face value. However, what these reports indicate requires nuanced analysis. It is uncertain what it means to perform any action in a dream whatsoever. If skilled actions do occur in dreams, this has important implications for both theory of action and theory of dreaming. Here, it is argued that since some dreams generate a convincing, hallucinated world where we have virtual bodies that interact with virtual objects, (...) there is a sense in which we can perform virtual actions. Further, we can also perform skilfully, although not all apparent skilful performance is as it seems. Since the dream world is generated by the dreamer’s own mind, it can be difficult to determine whether the dream world simply allows goals to be achieved without the abilities that would be required in a similar waking scenario. Because of this, individual dream reports alone are insufficient to determine what skills are demonstrated in a particular dream. However, taken with evidence from REM sleep behaviour disorder, incompetent dreams, lucid dreams and motor-skill practise, it is likely that skilled virtual dream performance at times involves both opportunity for virtual behaviour and the display of competence. Evidence from cognitive science suggests that dreamers can also lose competence through forgetting and other cognitive incapacities but, more surprisingly, it is possible to gain abilities in a robust sense, consistent with the idea that some dreams, at least, are virtual realities rather than imagination. (shrink)

The _Paris Agreemen_t requires that States take action to avoid dangerous climate change. It is informed by the Intergovernmental Panel on Climate Change that summarizes hundreds of scientific articles, yet the language of the treaty does not mirror the scientific literature. Instead, the Agreement encourages States to join in a collective effort without assigning responsibility for past emissions. The Agreement tells a story that does not track the truth. One justification is to see it as a "noble lie," and that, (...) like in the _Republic_, it could be the story that States need to hear to do what must be done. (shrink)