In lieu of an abstract, here is a brief excerpt of the content:Training and Other Important Needs for Nursing AssistantsNanci RobinsonTraining of Nursing AssistantsI think the nursing assistant (NA) training programs should be longer. My original course for Long Term Care was four weeks long after that I took an additional two months at a hospital to work on a Med/ Surg floor. So, I have a combined three months of schooling.Personally, I'd like to see certified nursing assistants (CNAs) given (...) more responsibilities. I'd like to see a six-month program to include CPR and capillary blood glucose (CBG) training as well as more in depth anatomy training. I think six months would keep some, who are just looking for money, out of the field and help keep those of us who really want a career in nursing in the field. It would be a better stepping stone for those who plan to go on to a LPN or RN program.I currently have CBG training but my employer will not let me use it. It's disappointing because it's a skill I have that I can't use and it could really help out the nurses. I think if courses were a bit longer, CNAs might be taken a bit more seriously by their employers and respected by their colleagues in the medical field.I was trained in CBG while working for the hospital and received a card like a CPR card to show I was trained. I live and work and was trained in Arkansas. I'm not allowed to do CBGs in the long-term care and rehab facility where I work now, though. However, unless the resident is diabetic we do have to clip and file nails. It took many years for nurses to gain respect and be allowed to do some things that now CNAs do. For example, for many years doctors didn't feel nurses were qualified to even take vital signs. I suppose CNAs will have the same struggle. [End Page 147]"I'm wondering if extending the initial training time would not keep many out of the field, because they need a job with income ASAP." The same could be said for LPN training, could it not? Or even an RN. I don't understand why there is a train of thought that "anyone" should be allowed to be a CNA and as quickly as possible. I can tell when I'm working alongside a Certified Nursing Assistant who is in it because they want to be versus someone who wants the paycheck (not sure why, though, because to be honest Arkansas doesn't pay CNAs all that great, though I suppose for some it might be better than McDonalds). I took a $5 an hour paycut go get back into nursing because it's my passion, and while we all need a paycheck, that should not be the only reason for doing this work."If extending the initial training time would keep many out of the field because they need a job with income ASAP, maybe employer facility-specific follow-up training would seem to be much more feasible for all. A CNA-in-training could be responsible for a lighter than 'normal' shift assignment while under the guidance of a qualified proctor CNA. It could improve efficiency and quality of care in the long run and probably improve retention rate of CNAs, for those administrators that are astute enough to consider the long-term effects of their policies." This might be good—the only problem is that most facilities aren't going to want to absorb any cost this might create by having additional staff for this purpose. Also, on the job training is not appreciated by employers as much as what might be considered actual "education" hours. Most CNAs want to do as much patient care as they can for the nurse—learning to assist with dressing changes, CBGs and other things that would be beneficial for both CNAs and the Nurse.Ensuring there is enough staff and that those staff members are there for the right reasons would do much more to improve the retention rate of NAs or CNAs. (I'm a... (shrink)

This book explores policy innovation for same-sex couples throughout the Americas and includes same-sex marriage legislation, civil unions, and other new developments for same-sex couples throughout the Americas at both national and sub-national levels. This scholarship is innovative because though much has been written regarding developments in North America, there is very little work dealing with recent developments in the rest of the Americas.

Providing the most thorough coverage available in one volume, this comprehensive, broadly based collection offers a wide variety of selections in four major genres, and also includes a section on film. Each of the five sections contains a detailed critical introduction to each form, brief biographies of the authors, and a clear, concise editorial apparatus. Updated and revised throughout, the new Fourth Edition adds essays by Margaret Mead, Russell Baker, Joan Didion, Annie Dillard, and Alice Walker; fiction by Nathaniel Hawthorne, (...) Ursula K. LeGuin, Anton Chekov, James Joyce, Katherine Mansfield, F. Scott Fitzgerald, William Faulkner, Alice Walker, Louise Erdrich, Donald Barthelme, and James McPherson; poems by John Donne, Robert Browning, Walt Whitman, Edwin Arlington Robinson, e.e. cummings, Langston Hughes, W.H. Auden, Philip Levine, and Louise Gluck; and plays by August Wilson, Marsha Norman, Wendy Wasserstein, and Vaclav Havel. The chapter devoted to film examines the relation of film to literature and gives the complete screenplay for Citizen Kane plus close analysis of a scene from the film. With its innovative structure, comprehensive coverage, and insightful and stimulating presentation of all kinds of literature, this is an anthology readers will turn to again and again. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Pride in Giving Care and Other Life Lessons from Certified Nursing AssistantsDelese WearMy father spent the last three weeks of his life in a hospice care facility. It's funny, now reading these narratives written by Certified Nursing Assistants (CNAs), that I can't picture him without Gloria, the CNA who worked the 7-3 shift, floating quietly in and out of his room, tending to him, tending to us, speaking quietly (...) to Dad even when he was no longer conscious, offering us conversation, often her affectionate observations of Dad and curiosity about his life, sometimes about life on the "outside," a kind of respite from total attention on Dad and our grieving. I remember the smell of the lotion she rubbed on his body. I remember no other caregivers in his room; there obviously were, but I can't picture them now, only Gloria. We never spoke directly to the medical director of the hospice. He was a phantom, rounding at 5 or 6 a.m.; we came to believe he did so to avoid speaking to families.Those three weeks led to my conceptions about CNAs—the nature of the work they do, the kinds of people who do such work, the awesome responsibilities involved in such work, and not least, the physical and emotional resiliency of those who undertake such work. My and my family's often recited, "How does she do this every day?" was answered time and again in the narratives written by CNAs in this issue of the journal.But before moving forward, I want to make note of how I will refer to the authors of these narratives. The name of one's occupation, the title one uses, and how others refer to your occupation, is obviously meaningful. If the snapshots of CNAs provided in these narratives are somewhat representative, we find those who refer to themselves and their occupation as nursing assistants, nurse assistants, Certified Nursing Assistants (CNAs), State Licensed Nursing Assistants (SLNA), or simply aides, to name a few. While it is beyond the space offered here, I want to make note of this, recognizing that titles/labels matter, and to acknowledge that status. As CNA Nanci Robinson notes, "most of us are certified... I wouldn't call an LPN a PN and leave out she's licensed." Passage of the Omnibus Budget Reconciliation Act of 1987 (OBRA 87), required each State to establish State-approved nurse aide training programs and establish requirements for nurse aide competency. Thus, I will refer to all the authors here as Certified Nursing Assistants (CNAs). I do wonder how significant of an issue these variations of titles are within the larger nursing assistant culture, and how it may contribute to disparities regarding pay schedules, duties, status, training and other relevant issues among all nursing assistants.In spite of problems, stressors, and other quality of life issues for CNAs, most of them spoke with pride and meaning regarding what was for many their "life's work," similar to what one might expect to find in other care giving occupations. Some spoke of a "love of the work," its "rewards" and "joys," [End Page 165] and the intense satisfaction of "making a difference" in patients' or residents' lives. These attitudes were not vague abstractions but were grounded throughout the narratives in rich examples of the affirming aspects of their work.It appears that much of the pleasure comes from what many refer to as the "hands on," "direct care," or "front line" nature of the work—often what other health professionals might view as things they would not want to do. And of course these other professionals—registered nurses, occupational therapists, and physicians—could make the same claim when describing the "hands-on" joys of their work. But the differences, it would seem, are profound between these other caregivers and CNAs. The CNA narratives report fundamentally intimate and often daily relationships with their clients/residents/patients. Danny Reed describes the "delight" he feels "in restoring dignity to every human in need of it regardless of cause," referring to himself as a "participant observer in a caring relationship," not as a "detached clinician." Many spoke directly... (shrink)

U Rusiji, dve decenije nakon urusavanja Sovjetskog Saveza, Staljinova popularnost je po anketama javnog mnjenja ogromna, posto se mnogi prisecaju nekadasnjeg ugleda zemlje i svog osecaja sigurnosti. Slicno tome, mnogi Srbi, koji su bili najveca grupa u bivsoj Jugoslaviji, s nostalgijom su gledali na vreme nacionalnog ponosa i materijalnog komfora. Nasuprot tome, potcinjene etnicke zajednice u isto to vreme osecale su frustraciju u teznji za nacionalnim ponosom. Svaki politicki poredak ima jednu pripovest sacinjenu od odabranih i povezanih dogadjaja koji promovisu (...) nacionalne interese. Iako se zavrsila oruzana borba, u bivsoj Jugoslaviji ostala je podeljenost koja je perpetuirana konkurentskim narativima o tome sta se i zbog cega dogodilo. U Rusiji,?nevidiljivi staljinizam? u porastu jos jednom je omalovazio iskustvo zrtava represije. Ovaj clanak pruza preliminarna razmatranja o razdvajanju narativa u Rusiji i Srbiji i pokusava da objasni jednu od kljucnih prepreki u pomirenju s prosloscu. (shrink)

Contemporary empiricism has attempted to ground its analysis of science in a falsificationism based in selection theory. This paper links these evolutionary epistemologies with commitments to certain epistemological and ontological assumptions found in the later work of K. Popper, D. Campbell, and D. Hull, I argue that their assumptions about the character of contemporary empiricism are part of a shared paradigm of epistemological explanation which results in unresolved tensions within their own projects. I argue further that their claim to be (...) doing a science of science is not defensible. Hull's selectionism is analyzed to show how this epistemological agenda has played itself out in late empiricism. I suggest some directions that Hull might take toward an historical epistemology. (shrink)

As feudalism made God the source and the justification of its particular social arrangements and the guarantor of their eternity, so the bourgeois/capitalist order that dissolved and supplanted feudalism has used nature , drawing science into its ideological orbit, using science to found the new era's dominant world-view. My complaint against the concept of nature that has thus been given God's work to do is that it does not present itself honestly as a religious notion. It covers its transcendental tracks (...) and dresses in secular clothes. The notion of nature that has been imposed on us and the notion of its laws pretend both to stand over and yet to lie within, and even to constitute, the physical, secular world. That pretence to both a transcendental and a secular status cannot be maintained for long under examination, and what is surprising is how little critical examination it has been given. (shrink)

Questions about perception remain some of the most difficult and insoluble in both epistemology and in the philosophy of mind. This controversial but highly accessible introduction to the area explores the philosophical importance of those questions by re-examining what had until recent times been the most popular theory of perception - the sense-datum theory. Howard Robinson surveys the history of the arguments for and against the theory from Descartes to Husserl. He then shows that the objections to the theory, (...) particularly Wittgenstein's attack on privacy and those of the physicalists, have been unsuccessful. He argues that we should return to the theory sense-data in order to understand perception. In doing so he seeks to overturn a consensus that has dominated the philosophy of perception for nearly half a century. (shrink)

Jenefer Robinson takes the insights of modern scientific research on the emotions and uses them to illuminate questions about our emotional involvement with the arts. Laying out a theory of emotion supported by the best evidence from current empirical work, she examines some of the ways in which the emotions function in the arts. Written in a clear and engaging style, her book will make fascinating reading for anyone interested in the emotions and how they work, as well as (...) anyone engaged with the arts and aesthetics. (shrink)

This paper examines a doctrine which David Lewis has called 'Humean Supervenience' (hereafter 'HS'), and a problem which certain imaginary cases seem to generate for HS. They include rotating perfect spheres or discs, and flowing rivers, imagined as composed of matter which is perfectly homogeneous right down to the individual points. Before considering these examples, I shall introduce the doctrine they seem to challenge.

The idea of a role in nursing that includes expertise in ethics has been around for more than 30 years. Whether or not one subscribes to the idea that nursing ethics is separate and distinct from bioethics, nursing practice has much to contribute to the ethical practice of healthcare, and with the strong grounding in ethics and aspiration for social justice considerations in nursing, there is no wonder that the specific role of the nurse ethicist has emerged. Nurse ethicists, expert (...) in nursing practice and the application of ethical theories and concepts, are well positioned to guide nurses through complex ethical challenges. However, there is limited discussion within the field regarding the specific job responsibilities that the nurse ethicist ought to have. The recent appearance of job postings with the title “nurse ethicist” suggest that some healthcare institutions have identified the value of a nurse in the practice of ethics and are actively recruiting. Discomfort about the possibility of others defining the role of the nurse ethicist inspired this paper (and special issue). If the nurse ethicist is to be seen as an integral part of addressing ethical dilemmas and ethical conflicts that arise in healthcare, then nurse ethicists ought to be at the forefront of defining this role. In this paper, we draw upon our own experiences as nurse ethicists in large academic healthcare systems to describe the essential elements that ought to be addressed in a job description for a nurse ethicist practicing in a clinical setting linked to academic programs. Drawing upon our experience and the literature, we describe how we perceive the nurse ethicist adds value to healthcare organizations and teams of professional ethicists. (shrink)

Kant holds that the a human subject's free causation, as well as the deliberations and decision preceeding it, are literally timeless. This paper tries to defend this doctrine of timeless agency by first distinguishing three senses of "cause", then showing the relationship between cause and time-determination in the theoretical philosophy, and finally relating the timelessness of free agency to the status of the representations of perception. The result is that whereas agency has no time in isolation, it may borrow enough (...) time for its purposes from the theoretical realm. Kant meint, daß die freie Verursachung durch ein menschliches Subjekt, genauso wie die Überlegungen und die Entscheidung, die ihr vorausgehen, buchstäblich zeitlos sind. Der Beitrag versucht, diese Lehre von einem zeitlosen Handeln zu verteidigen. Zunächst wird zwischen drei verschiedenen Bedeutungen von "Ursache" unterschieden. Dann wird die Beziehung zwischen Ursache und Zeitbestimmung in der theoretischen Philosophie dargestellt. Schließlich wird die Zeitlosigkeit freien Handelns mit dem Status der Gegenstände der Wahrnehmung in eine Beziehung gesetzt. Das Ergebnis ist, daß das Handeln, während es für sich selbst betrachtet keine Zeit hat, für seine Zwecke doch genügend Zeit aus der theoretischen Sphäre entlehnen kann. (shrink)

Interpretations of the quantum mechanical formalism true to the spirit of scientific realism satisfy not only principles of scientific realism but also principles of causality that guide realist constructions. Formally, such interpretations are hidden variables theories and are commonly believed to be ruled out by the most recent no-hidden-variables argument expressed by Bell's theorem. This dissertation investigates the possibility of constructing indeterministic hidden variables theories in light of Bell's result. A pair of arguments in the literature lead to the conclusion (...) that there is no generality to be gained in moving to the stochastic case. The author uses limitations on measurements discovered by Wigner as the basis for a response to both. Proofs of the existence of the limitations are analyzed and it is shown that, contrary to claims in the literature, we cannot always assume that measurements subject to the limitations are perfectly revealing and, therefore, that the assumption of strict anti-correlations, an assumption crucial to one of those arguments, is unjustified in the Bell case. The author suggests how Bell's 1971 inequality must be modified to incorporate these limitations . This result is used against the second argument, due to Fine, which relies on Bell's 1971 inequality. A thought experiment due to Jarrett is reviewed and it is argued that the independence assumptions incorporated into hidden variables theories are not without additional and controversial assumptions about causality related to constraints imposed by the special theory of relativity. The author concludes that Bell's theorem tells us nothing about determinism or special relativity but does tell us that there can be no interpretation of quantum mechanics that does not violate either one of three principles of scientific realism or one of three traditional principles of causality. (shrink)

Although the focus of "Globalizing Democracy and Human Rights" is practical, Gould does not shy away from hard theoretical questions, such as the relentless debate over cultural relativism, and the relationship between terrorism and democracy.

Purpose Telemedicine has been advancing for decades and is more indispensable than ever in this unprecedented time of the COVID-19 pandemic. As shown, eHealth appears to be effective for routine management of chronic conditions that require extensive and repeated interactions with healthcare professionals, as well as the monitoring of symptoms and diagnostics. Yet much needs to be done to alleviate digital inequalities that stand in the way of making the benefits of eHealth accessible to all. The purpose of this paper (...) is to explore the recent shift in healthcare delivery in response to the COVID-19 pandemic towards telemedicine in healthcare delivery and show how this rapid shift is leaving behind those without digital resources and exacerbating inequalities along many axes. Design/methodology/approach Because the digitally disadvantaged are less likely to use eHealth services, they bear greater risks during the pandemic to meet ongoing medical care needs. This holds true for both medical conditions necessitating lifelong care and conditions of particular urgency such as pregnancy. For this reason, the authors examine two case studies that exemplify the implications of differential access to eHealth: the case of chronic care diseases such as diabetes requiring ongoing care and the case of time-sensitive health conditions such as pregnancy that may be compromised by gaps in continuous care. Findings Not only are the digitally disadvantaged more likely to belong to populations experiencing greater risk – including age and economic class – but they are less likely to use eHealth services and thereby bear greater risks during the pandemic to meet ongoing medical care needs during the pandemic. Social implications At the time of writing, almost 20% of Americans have been unable to obtain medical prescriptions or needed medical care unrelated to the virus. In light of the potential of telemedicine, this does not need to be the case. These social inequalities take on particular significance in light of the COVID-19 pandemic. Originality/value In light of the COVID-19 virus, ongoing medical care requires exposure to risks that can be successfully managed by digital communications and eHealth advances. However, the benefits of eHealth are far less likely to accrue to the digitally disadvantaged. (shrink)

Virtues are acquirable, so if intellectual humility is a virtue, it’s acquirable. But there is something deeply problematic—perhaps even paradoxical—about aiming to be intellectually humble. Drawing on Edward Slingerland’s analysis of the paradoxical virtue of wu-wei in Trying Not To Try (New York: Crown, 2014), we argue for an anti-individualistic conception of the trait, concluding that one’s intellectual humility depends upon the intellectual humility of others. Slingerland defines wu-wei as the “dynamic, effortless, and unselfconscious state of mind of a person (...) who is optimally active and effective” (Trying Not to Try, 7). Someone who embodies wu-wei inspires implicit trust, so it is beneficial to appear wu-wei. This has led to an arms race between faking wu-wei on the one hand and detecting fakery on the other. Likewise, there are many benefits to being (or seeming to be) intellectually humble. But someone who makes conscious, strategic efforts to appear intellectually humble is ipso facto not intellectually humble. Following Slingerland’s lead, we argue that there are several strategies one might pursue to acquire genuine intellectual humility, and all of these involve commitment to shared social or epistemic values, combined with receptivity to feedback from others, who must in turn have and manifest relevant intellectual virtues. In other words, other people and shared values are partial bearers of a given individual’s intellectual humility. If this is on the right track, then acquiring intellectual humility demands epistemic anti-individualism. (shrink)

The assumption of materialism Howard Robinson believes is false.

Gossip is often serious business, not idle chitchat. Gossip allows those oppressed to privately name their oppressors as a warning to others. Of course, gossip can be in error. The speaker may be lying or merely have lacked sufficient evidence. Bias can also make those who hear the gossip more or less likely to believe the gossip. By examining the social functions of gossip and considering the differences in power dynamics in which gossip can occur, we contend that gossip may (...) be not only permissible but virtuous, both as the only reasonable recourse available and as a means of resistance against oppression. (shrink)

Medical students may fear that their training leeches away the caring attitudes which attracted them to medicine. Some research suggests they are right. The medical school has a duty to support and encourage their values, but the reverse may happen. Students are taught about legal consent but not ethical consent. They may see or participate in concealment of medical mistakes and learn to practise deceit. The use of unconscious females for gynaecology teaching may encourage the wrong attitudes to patients. Trainee (...) GPs may learn that the doctors' rights are more important than those of the patient. Measuring patients' views should be included in research protocols. (shrink)

Criminal Law Conversations provides an authoritative overview of contemporary criminal law debates in the United States. This collection of high caliber scholarly papers was assembled using an innovative and interactive method of nominations and commentary by the nation's top legal scholars. Virtually every leading scholar in the field has participated, resulting in a volume of interest to those both in and outside of the community. Criminal Law Conversations showcases the most captivating of these essays, and provides insight into the most (...) fundamental and provocative questions of modern criminal law. (shrink)