Clinical ethics support, in particular Moral Case Deliberation, aims to support health care providers to manage ethically difficult situations. However, there is a lack of evaluation instruments regarding outcomes of clinical ethics support in general and regarding Moral Case Deliberation (MCD) in particular. There also is a lack of clarity and consensuses regarding which MCD outcomes are beneficial. In addition, MCD outcomes might be context-sensitive. Against this background, there is a need for a standardised but flexible outcome evaluation instrument. The (...) aim of this study was to develop a multi-contextual evaluation instrument measuring health care providers’ experiences and perceived importance of outcomes of Moral Case Deliberation. (shrink)

BackgroundThere is a lack of empirical research regarding the outcomes of such clinical ethics support methods as moral case deliberation (MCD). Empirical research in how healthcare professionals perceive potential outcomes is needed in order to evaluate the value and effectiveness of ethics support; and help to design future outcomes research. The aim was to use the European Moral Case Deliberation Outcome Instrument (Euro-MCD) instrument to examine the importance of various MCD outcomes, according to healthcare professionals, prior to participation.MethodsA North European (...) field survey among healthcare professionals drawn from 73 workplaces in a variety of healthcare settings in the Netherlands, Norway and Sweden. The Euro-MCD instrument was used.ResultsAll outcomes regarding the domains of moral reflexivity, moral attitude, emotional support, collaboration, impact at organisational level and concrete results, were perceived as very or quite important by 76%–97% of the 703 respondents. Outcomes regarding collaboration and concrete results were perceived as most important. Outcomes assessed as least important were mostly about moral attitude. ‘Better interactions with patient/family’ emerged as a new domain from the qualitative analysis. Dutch respondents perceived most of the outcomes as significantly less important than the Scandinavians, especially regarding emotional support. Furthermore, men, those who were younger, and physician-respondents scored most of the outcomes as statistically significantly less important compared with the other respondents.ConclusionsThe findings indicate a need for a broad instrument such as the Euro-MCD. Outcomes related to better interactions between professionals and patients must also be included in the future. The empirical findings raise the normative question of whether outcomes that were perceived as less important, such asmoralreflexivity andmoralattitude outcomes, should still be included. In the future, a combination of empirical findings (practice) and normative reflection (theories) will contribute to the revision of the instrument. (shrink)

This work aims to analyze complex noun phrases of the qualitative binominal kind (an N of an N) in a Southern Italo–Romance language, namely Apulian. The principle of compositionality – even if it represents a good working hypothesis for syntactic analysis – faces several challenges with linguistic expressions such as idioms (with which binominal qualitatives share several properties), whose meaning is not yielded compositionally (Szabò, 2004). The data under analysis here are particularly interesting for two main reasons. The first pertains (...) to the nature of the preposition, and whether it is an a priori specified element depending on the syntactic embedding; two main working hypotheses are found: Den Dikken (2006) posits two different derivations, one for binominal qualitative of and one for genitive of. On the other hand, Kayne (1994) posits a unitary derivation for both instances of the preposition. The second reason pertains to the problem of the overall interpretation of the phrase, i.e., an intersectional interpretation of the predicate and the subject of the predication, and the focus/topic subdivision in the phrase (Villalba, 2007): the interpretation depends on the marked order of the predicate with respect to the subject. Given that N1 is a predicate and usually an adjectivized noun or a nominalized adjective and that in southern Italo–Romance only few adjectives can precede a noun, cases in which the predicate precedes the noun can be considered as displaying a marked order. Even though the case of the preposition might seem a challenge for compositionality, it will be shown that a proper characterization of such an element confirms that compositionality can still account for instances such as those of binominal qualitatives. (shrink)

We investigate adverbial agreement in Sandəmarkesə (S. Marco in Lamis, Apulia) proposing phase-bound, local agreement relations, reducible to coordination, as in past and absolute participial constructions, suggesting a copulaless analysis where arguments are subjects in a small clause. With disjunct nominals with matching φ-features, the adverb agrees separately with each part in the set, otherwise resulting in ‘non-agreeing’ forms, which we test also with negative polarity items (niʃun-, ‘nobody’ and nentə, ‘nothing’). With fragment answers, the negation scopes over adverbs agreeing (...) with the two proposed topics: matching of the φ-features of both nouns values the negative operator with the same features. In fronted adverbs, agreement occurs when the question contains overt coordinated arguments, elements continuing a chain, and if coordinated arguments have matching φ-features. In agreement in topical contexts with fronted adverbs, agreement occurs with the aboutness-shift topic closely preceding them, rather than with the embedded direct object. (shrink)

Background: Moral Case Deliberation is one form of clinical ethics support described as a facilitator-led collective moral reasoning by healthcare professionals on a concrete moral question connected to their practice. Evaluation research is needed, but, as human interaction is difficult to standardise, there is a need to capture the content beyond moral reasoning. This allows for a better understanding of Moral Case Deliberation, which may contribute to further development of valid outcome criteria and stimulate the normative discussion of what Moral (...) Case Deliberation should contain. Objective: To explore and compare the content beyond moral reasoning in the dialogue in Moral Case Deliberation at Swedish workplaces. Methods: A mixed-methods approach was applied for analysing audio-recordings of 70 periodic Moral Case Deliberation meetings at 10 Swedish workplaces. Moral Case Deliberation facilitators and various healthcare professions participated, with registered nurses comprising the majority. Ethical considerations: No objection to the study was made by an Ethical Review Board. After oral and written information was provided, consent to be recorded was assumed by virtue of participation. Findings: Other than ‘moral reasoning’ (median (md): 45% of the spoken time), the Moral Case Deliberations consisted of ‘reflections on the psychosocial work environment’ to a varying extent (md: 29%). Additional content comprised ‘assumptions about the patient’s psychosocial situation’ (md: 6%), ‘facts about the patient’s situation’ (md: 5%), ‘concrete problem-solving’ (md: 6%) and ‘process’ (md: 3%). Conclusion: The findings suggest that a restorative function of staff’s wellbeing in Moral Case Deliberation is needed, as this might contribute to good patient care. This supports outcome criteria of improved emotional support, which may include relief of moral distress. However, facilitators need a strategy for how to proceed from the participants’ own emotional needs and to develop the use of their emotional knowing to focus on the ethically difficult patient situation. (shrink)

The notion of harm has been a recurring and a significant notion in the characterization of mental disorder. It is present in eminent diagnostic manuals such as DSM and ICD, as well as in the discussion on mental disorders in philosophy of psychiatry. Recent demotion of harm in the definition of mental disorders in DSM-5 shows a general trend towards reducing the significance of harm when thinking about the nature of mental disorders. In this paper, we defend the relevance of (...) the notion of harm in the characterization of mental disorder against some of these attacks. We approach this issue by using the method of conceptual explication pioneered by Rudolf Carnap. Within this framework, we argue that keeping the notion of harm not only helps to discriminate what is pathological from the nonpathological but also prevents potential misuses of psychiatric authority. (shrink)

Our long-standing hypothesis has been that feedforward information flow is sufficient for speech perception, reading, and sentence (syntactic and semantic) processing more generally. We are encouraged by the target article's argument for the same hypothesis, but caution that more precise quantitative predictions will be necessary to advance the field.

In this paper, which discusses data from Gargano Apulian Italo-Romance, I propose that prepositional and non-prepositional genitives are fundamentally two different types of phrases, and that the interpretation of a non-prepositional noun as the possessor is not due to a silent preposition or head-modifier inversion, but rather to an agreement mechanism taking place between the modifier and its head. We propose that, just as a genitive can agree with its head for gender and number features so it can for definiteness, (...) and that agreement for definiteness yields a genitival interpretation of the non-prepositional noun. I.e., definiteness can externalize the syntactic relation between head and modifier. We also propose that in this Apulian variety, non-prepositional genitives are syntactic phases (Chomsky 2001), and that the same holds for non-prepositional ‘qualitative’ predicative phrases in the same language. This would explain the impossibility of accessing the phrase through syntactic operations such as extraction. DOI 10.1111/1467-968X.12229 . (shrink)

This work aims at an initial description of prepositionless genitives in the Romance variety of San Marco in Lamis, spoken in the Southern Italian region of Apulia. The construction will be compared with other Romance, Semitic, Albanian, and Iranian varieties whereby the expression of possession is connected to the presence of D elements, or to morphology stemming from them. The paper deals, in particular, with the behaviour of the construction with elements such as definite and indefinite articles, demonstratives, proper names, (...) and with how pre-nominal adjectival modification of genitives and post-nominal adjectival modification of heads can only occur in the prepositional kind of the construction. This is also the case with demonstratives preceding heads and genitives in the form raised nominals. It will be seen that genitives are only interpreted as such when they are non-raised, i.e. when they are articled. The pre-genitival article is thus understood to be a pivotal element in the interpretation of the second DP as genitival. (shrink)

Sussman et al. describe an ecological property of the speech signal that is putatively functional in perception. An important issue, however, is whether their putative cue is an emerging feature or whether the second formant (F2) onset and the F2 vowel actually provide independent cues to perceptual categorization. Regardless of the outcome of this issue, an important goal of speech research is to understand how multiple cues are evaluated and integrated to achieve categorization.

Esta pesquisa tem como objetivo, apresentar a resposta que Medellín deu ao continente americano sob a luz do Vaticano II, em relação aos graves problemas que caracterizam a vida de seu povo. Por um lado, a miséria, opressão, dependência econômica, política e cultural, e, de outro, um desejo e clamor de misericórdia e libertação, de um povo impaciente por mudanças e transformações. O homem e a mulher são sujeitos da transformação do continente, como a Igreja pode ajudá-los; qual é a (...) sua missão? A metodologia dessa pesquisa faz referência bibliográfica aos principais títulos sobre o assunto. O caminho a ser percorrido será: análise da história e da realidade, reflexão de conceitos e desdobramentos práticos e pastorais. A Igreja não poderá nunca se esquecer que: “As alegrias e as esperanças, as tristezas e as angústias dos homens de hoje, sobretudo dos pobres e dos que sofrem, são também as alegrias e as esperanças, as tristezas e as angústias dos discípulos de Cristo; e não há realidade alguma verdadeiramente humana que não encontre eco no seu coração.”. (shrink)

Roger Shepard's creativity and scientific contributions have left an indelible mark on Psychology and Cognitive Science. In this tribute, I acknowledge and show how his approach to universal laws helped Oden and me shape and develop our universal law of pattern recognition, as formulated in the Fuzzy Logical Model of Perception (FLMP). [Shepard; Tenenbaum & Griffiths].

The welfare reform law of 1996 completely overhauled the nation's system of assistance to low-income families. The reauthorization of that law, now several months overdue because of congressional delays, presents an opportunity for religious social ethicists to evaluate the adequacy of our nation's anti-poverty efforts. This paper surveys policy developments from 1996 to 2003 and analyzes five key issues in the reauthorization debate: the size and structure of welfare block grants; work requirements; welfare time limits, sanctions, and exemptions; marriage promotion (...) and the family cap; and ancillary programs providing work supports such as food stamps, Medicaid, and child care subsidies. A variety of ethical critiques of policy proposals is offered, some of them from the perspective of Catholic social teaching. The trail of missed opportunities in welfare reform will probably continue, as American social policy fails to act upon an accurate portrayal of the challenges facing poor families today. (shrink)

The problem of political apathy and poor representation of women in the Belgian parliament bas been focused and seriously challenged with the 1974 parliamentary elections. Two different strategies hereby have been developed: on the one hand a separate, exclusive feminist party ; on the other hand a strategy of female candidates on the more conventional ballots. The effects of both strategies are quite remarkable : whereas the newcoming feminist party was struggling with breakthrough problems, the female candidate strategy strongly effected (...) the amount of female candidates, elected women, as well as the votes given to women, compared to previous elections. The accurate relationship between the women's campaign and its election effect can hardly be determined for the election determinant is too complex. The propaganda however, was an attempt to change the traditional image of women and to increase the political participation and emancipation of women via the instrument of parliamentary elections. The 1977 results, however, hardly equated the optimistic prospects of 1974 : the feminist party didn't survive its second participation and the candidate strategyurgently needs permanent action and political sensibilisation. (shrink)

The aim of this dissertation is an analysis of agreement in relation to genitival constructions. It proposes that the Apulian non-prepositional enitives of San Marco in Lamis can be described as regulated by a definiteness agreement mechanism manifesting itself in the necessity of articled heads (excluding vocatives) and genitival nouns, coupled with an adjacency requirement which limits the realization of post-nominal modifiers of the head in a post-genitival position, where they might only refer to the genitive noun. This work thus (...) proposes that such agreement for definiteness is the same holding in Romanian non-al genitives which result in the linker construction when agreement is disrupted. In chapter 1 we thus introduce Kartvelian genitives by Suffixaufnahme which notoriously represent a genitive-head noun morphological agreement phenomenon. Plank (1995) also shows that in a series of genitives, Suffixaufnahme shows up only on the last one, demonstrating that when it comes to agreement in genitives, local dynamics of sorts are often at stake (as it happens with the Costruct State). In 2 we move to linkers; linkers have been connected to agreement in Suffixaufnahme genitives at least since Plank (1995) and later works such as Larson and Yamakido (2006), Manzini et al (2016), and Manzini (2018), according to which linkers can be assimilated to agreement. In fact, in synthetic systems such as Romanian and Aromanian, Albanian and Arbëresh, and Kurdish varieties, linkers agree for φ with either the head or the genitive noun. Giurgea and Dobrovie-Sorin (2013: 126) further show that in Romanian non-linker constructions possessives agree for case with the head noun. In linker constructions, agreement for case is not present: it’s the linker itself which agrees with the head noun, this time for φ. Chapter 3 deals with genitival modification in Hebrew and a number of Arabic varieties. It proposes that the pseudoprepositions found in Arabic varieties are nouns in the Construct State. This was previously proposed for Palestinian Arabic in Mohammad (1999), which also shows that such elements agree for φ with the modified noun. 3.2 takes into account the Semitic preposition l-, dealing with the question of whether this lement can be characterized as possessive and locative as it happens for Romance a. 4 analyzes Apulian non-prepositional genitives and proposes as anticipated that the necessity of articled nouns in the construction is to be linked to an agreement relation taking place via D. Lastly, 5 subsumes the conclusions of this work. (shrink)

Much work on intellectual humility has focused on its epistemic benefits. We suggest that displaying (or failing to display) intellectual humility also has effects on how others perceive us and that, as a result, intellectual humility can serve reputation management purposes, in at least four ways: (i) Intellectual humility can be used to signal we are a good source of information; (ii) Intellectual humility can be used to signal we are competent through countersignaling; (iii) Intellectual humility can be used to (...) make sure others do not believe we are overclaiming superiority; (iv) lack of intellectual humility (or intellectual arrogance) can be used to signal dominance. The evidence suggests that intellectual humility (or lack thereof) can have each of these effects. Seeing intellectual humility as (inter alia) a reputation management tool predicts that people will be more or less likely to display intellectual humility in some contexts. For instance, people in a position of power might stand to lose less if they fail to be intellectual humble; accordingly, evidence suggests that they tend to display less intellectual humility. In conclusion, we speculate that understanding intellectual humility as reputation management could help construct environments more conducive to displays of intellectual humility. (shrink)

We explore ChatGPT’s handling of left-peripheral phenomena in Italian and Italian varieties through prompt engineering to investigate 1) forms of syntactic bias in the model, 2) the model’s metalinguistic awareness in relation to reorderings of canonical clauses (e.g., Topics) and certain grammatical categories (object clitics). A further question concerns the content of the model’s sources of training data: how are minor languages included in the model’s training? The results of our investigation show that 1) the model seems to be biased (...) against reorderings, labelling them as archaic even though it is not the case; 2) the model seems to have difficulties with coindexed elements such as clitics and their anaphoric status, labeling them as ‘not referring to any element in the phrase’, and 3) major languages still seem to be dominant, overshadowing the positive effects of including minor languages in the model’s training. (shrink)

Une nouvelle écrite pour l’anthologie Octavia’s Brood: Science Fiction Stories from Social Justice Movements [enfants d’Octavia: des histoires SF tirées des mouvements de justice sociale], éditée par adrienne maree brown et Walidah Imarisha. L’histoire parle d’un futur dans lequel toutes les personnes handicapées (appelées I. P. ou ImParfait·es) ont été envoyées sur une autre planète où, débarrassées des soldats envoyés pour les surveiller, ielles se sont créé une vie faite d’entraide. Cette vie est menacée par les Parfait·es, qui s’apprêtent à (...) revenir prendre le contrôle et créer une nouvelle dystopie pour eux. (shrink)

Cognitive models of social anxiety disorder suggest that memory biases for negative social information contribute to symptoms of social anxiety. However, it remains unclear whether memory bias...

BackgroundBesides balancing burdens and benefits of intensive care, ethical conflicts in the process of decision-making should also be recognised. This calls for an ethical analysis relevant to clinicians. The aim was to analyse ethically difficult situations in the process of deciding whether a patient is admitted to intensive care unit.MethodsAnalysis using the ‘Dilemma method’ and ‘wide reflective equilibrium’, on ethnographic data of 45 patient cases and 96 stakeholder interviews in six UK hospitals.Ethical analysisFour moral questions and associated value conflicts were (...) identified. Who should have the right to decide whether a patient needs to be reviewed? Conflicting perspectives on safety/security. Does the benefit to the patient of getting the decision right justify the cost to the patient of a delay in making the decision? Preventing longer-term suffering and understanding patient’s values conflicted with preventing short-term suffering and provision of security. To what extent should the intensivist gain others’ input? Professional independence versus a holistic approach to decision-making. Should the intensivist have an ongoing duty of care to patients not admitted to ICU? Short-term versus longer-term duty to protect patient safety. Safety and security were key values at stake in the ethical conflicts identified. The life-threatening nature of the situation meant that the principle of autonomy was overshadowed by the duty to protect patients from harm. The need to fairly balance obligations to the referred patient and to other patients was also recognised.ConclusionProactive decision-making including advance care planning and escalation of treatment decisions may support the inclusion of patient autonomy. However, our analysis invites binary choices, which may not sufficiently reflect reality. This calls for a complementary relational ethics analysis. (shrink)

In June 1928, Captain Barnett W. Harris, an amateur naturalist from Indiana, arrived in Zululand to experiment on wild animals with his invention – the mercy bullet. This “bullet”consisted of a hypodermic needle filled with anesthetic drugs that could render an animal unconscious – an early model of what is now known as the tranquilizer gun. The history of this gun typically begins with Colin Murdoch, a New Zealand pharmacist and veterinarian, who patented the invention in 1959. While largely absent (...) in the archives, through tracing popular science publications and press, this article exposes a longer history of animal tranquilizers from an unlikely source. Tracing Harris’s story allows this article to speak to different historical discourses that influenced his rise as a celebrated inventor, and later to his disappearance from the scientific arena. This article argues that debates about pain relief (for both humans and nonhuman animals) and developments in military technology at the turn of the twentieth century resulted in experiments with narcotic bullets, a precursor to this “mercy bullet moment.” While hailed across the press as the man who might transform animal capturing into a humane practice, the workings of Harris’s bullet remained ambiguous. Despite this, he promoted his invention through several lecture series and radio presentations to the American public in the 1930s, where elements of scientific showmanship can be observed. Overall, Harris’s omission from the history of animal tranquilizing demonstrates the multiple contingencies that define a moment of scientific “success” – or, in this case, push some into relative obscurity. (shrink)

This book is about the processing of information in face-to-face communication when a speaker makes both audible and visible information available to a perceiver. Both auditory and visual sources of information are evaluated and integrated to achieve speech perception. The evaluation of the information source provides information about the strength of alternative interpretations, rather than just all-or-none categorical information, as claimed by “categorical perception” theory. Information sources are evaluated independently; the integration process insures that the least ambiguous sources have the (...) most influences on the judgment. Similar processes occur in a variety of other behaviors, ranging from personality judgments and categorization to sentence interpretation and decision making. The experimental results are consistent with a fuzzy logical model of perception, positing three operations in perceptual (primary) recognition: feature evaluation, feature integration, and pattern classification. Continuously valued features are first evaluated, then integrated and matched against prototype descriptions in memory; finally, an identification decision is made on the basis of the relative goodness-of-match of the stimulus information with the relevant prototype descriptions. (shrink)

Based on a case study of a large multinational group, this paper addresses the way in which social and environmental reporting systems were changed and the consequences and controversies associated with this change. Drawing on Power’s work on the processes by which things are made auditable via underlying systems, we focus on how and why a specific programme with auditability as its ultimate aim changed the basis on which the external social and environmental report was prepared. Our analysis demonstrates that (...) the perceived alignment with the financial report preparation and the explicit pursuit of auditability legitimized SER and paved the way for data systems to be changed. The programme borrowed authority from financial accounting technologies not only to make a system change but also to push SER internally, as we suggest that an intraorganizational group used the programme to ensure the existence and organizational status of SER. However, we also illustrate some of the practical challenges associated with this change, which include issues related to internal control and the establishment of organizational boundaries. (shrink)

We investigate the morphosyntax of qualitative binominal constructions (QBCs) in a Southern Italo-Romance language from the Apulian town of San Marco in Lamis. QBCs are complex noun phrases like ‘a jewelN1 of a villageN2’, appearing here prepositionally (with the preposition də, ‘of’, allowing definites, indefinites, and demonstratives) and non-prepositionally (only allowing definites with definite articles and not proper names). We propose that in the latter, a categorial match in the determiner layer, which we call ‘match D’, relates N1 and N2. (...) N1 is embedded as a noun, allowing for: 1) the recursive DP strategy of non-prepositional genitives, and 2) the extension of this mechanism to QBCs. This leads to the impossibility of syntactic extraction, which we connect to the concept of phase. With non-denominal N1s, N1’s article is treated as a head-agreeing adjectival linker, forming a constituent with the modifier but agreeing with the head. A phrase is interpreted as a QBC if N1 and N2 share the same number features and if the features of N1 do not allow for it to be interpreted as the possessum of N2 . We also discuss external agreement with the construction, presenting data supporting the relevance of the [+HUMAN] feature for agreement relations. (forthcoming, Italian Journal of Linguistics). (shrink)