BackgroundThe advent of learning healthcare systems (LHSs) raises an important implementation challenge concerning how to request and manage consent to support secondary use of data in learning cycles, particularly research activities. Current consent models in Quebec were not established with the context of LHSs in mind and do not support the agility and transparency required to obtain consent from all involved, especially the citizens. Therefore, a new approach to consent is needed. Previous work identified the meta-consent model as a promising (...) alternative to fulfill the requirements of LHSs, particularly large-scale deployments. We elicited the public’s attitude toward the meta-consent model to evaluate if the model could be understood by the citizens and would be deemed acceptable to prepare for its possible implementation in Quebec.MethodsEight focus groups, with a total of 63 members of the general public from various backgrounds were conducted in Quebec, Canada, in 2019. Explicit attention was given to literacy levels, language spoken at home and rural vs urban settings. We assessed attitudes, concerns and facilitators regarding key components of the meta-consent model: predefined categories to personalized consent requests, a dynamic web-based infrastructure to record meta-consent, and default settings. To analyse the discussions, a thematic content analysis was performed using a qualitative software.ResultsOur findings showed that participants were supportive of this new approach of consent as it promotes transparency and offers autonomy for the management of their health data. Key facilitators were identified to be considered in the implementation of a meta-consent model in the Quebec LHSs: information and transparency, awareness campaigns, development of educational tools, collaboration of front-line healthcare professionals, default settings deemed acceptable by the society as well as close partnerships with recognized and trusted institutions.ConclusionsThis qualitative study reveals the openness of a sample of the Quebec population regarding the meta-consent model for secondary use of health data for research. This first exploratory study conducted with the public is an important step in guiding decision-makers in the next phases of implementing the various strategies to support access and use of health data in Quebec. (shrink)

The notion of affordance remains elusive, notwithstanding its importance for the representation of agency, cognition, and behaviors. This paper lays down a foundation for an ontology of affordances by elaborating the idea of “core affordance” which would serve as a common ground for explaining existing diverse conceptions of affordances and their interrelationships. For this purpose, it analyzes M. T. Turvey’s dispositional theory of affordances in light of a formal ontology of dispositions. Consequently, two kinds of so-called “core affordances” are proposed: (...) specific and general ones. Inspired directly by Turvey’s original account, a specific core affordance is intimately connected to a specific agent, as it is reciprocal with a counterpart effectivity (which is a disposition) of this agent within the agent-environment system. On the opposite, a general core affordance does not depend on individual agents; rather, its realization involves an action by an instance of a determinate class of agents. The utility of such core affordances is illustrated by examining how they can be leveraged to formalize other major accounts of affordances. Additionally, it is briefly outlined how core affordances can be employed to analyze three notions that are closely allied with affordances: the environment, image schemas, and intentions. (shrink)

In 2013, Bennett proposed a mereological theory in which the parthood relation is defined on the basis of two primitive relations: a is a part of b iff a fills a slot owned by b. However, this theory has issues counting how many parts an entity has. We explore the various counting problems and propose a new theory to solve them. Keeping the core idea of Bennett’s slots, this theory introduces mereological relations between slots. This theory enables us to solve (...) all known counting problems and to go beyond the limits of Bennett’s theory by theorising expected features of mereological theories: supplementation principles and mereological sum and fusion. The theory is illustrated on ontological issues on the nature of structural universals and informational entities. (shrink)

The ambiguities and overspecificities of prescription semantics along with their lack of standardization hinders the adoption of electronic prescriptions in some countries, limit data interoperabil...

Lee suggests a conceptualization of health data sharing not merely as an act of altruism, but as a gift. The difference is important, as the inscription of the latter in a social context inv...

Is the idea that the self‐determination of all citizens influences progress towards democracy not merely a dream that breaks itself against the hard historical reality of political societies? Is not the same fate reserved for all pedagogical innovations in democratic education that depend on this great dream? It is commonplace to assert this logic to demonstrate the inapplicability of the ideas of both democracy and of democratic education. Though this argument is prominent and recurring in the history of political and (...) educative ideas, in response we can ask ourselves if the gap between the ideal and the reality is effectively insuperable and must be considered an incontestable fact. The double objective of this article is to determine explicitly the meaning and extent of this gap in the context of democracy and of education and to demonstrate that this gap is neither static nor permanent, but is susceptible to being narrowed, from generation to generation. (shrink)

The COVID-19 pandemic has led governments worldwide to make ethically controversial decisions. As a result, healthcare professionals are facing several ethical dilemmas, especially in terms of healthcare services provided to senior citizens. Thus, the aim of this review is to identify and categorize ethical dilemmas as well as propose solutions regarding health care services for elderly individuals. A qualitative systematic review of the literature was undertaken in the first tier of the pandemic. All identified scientific and editorial articles published in (...) English or French between December 2019 and October 2021 were included. An article was excluded if it was commercial, did not address an issue in the care of the elderly or present any qualitative data. Article eligibility was determined through a process of triangulation among three independent reviewers. Initially, 69 articles met our inclusion criteria and were selected for this review. These studies can be divided into 2 distinct categories: scientific articles (17 studies) and expert opinion articles (52 articles). However, due to the large quantity of qualitative data that was extracted, only the results from the scientific literature are presented here. The analysis of the data of 17 studies has allowed the emergence of 2 main themes of ethical dilemmas: 1) access to care (3 subthemes: A) triage decisions for admission, B) access to the intensive care unit and C) vaccine allocation) and 2) infection control decisions (2 subthemes: (D) isolation and E) autonomy). Our results also revealed 4 categories of potential solutions to the encountered ethical dilemmas, namely, optimal protocols, enhanced communication, caregiver support and technological assistance (virtual team-based, AI). The ethical dilemmas that emerged from our results highlight the interest of a serious international discussion around the phenomena of ageism and its potential ethical implications for health care workers (be it under normal circumstances or exceptional circumstances such as those of a pandemic). We highly recommend that future research be undertaken to test the efficacy of the proposed solutions in providing age-friendly, dilemma-free health care and environments. (shrink)

The notion of transparency regularly comes up in discussions about the secondary uses of health data. Few studies, however, examine the impact of the presence or absence of transparency on members of the public. This literature review responds to this gap in the scientific literature. It is the result of a secondary analysis of 124 texts from an exploratory review on transparency, following the PRISMAS-ScR guidelines. The results help to identify negative or positive impacts and associate these with certain communication (...) components relating to secondary uses of health data. They also make it possible to identify the components associated with communication deemed transparent or opaque by stakeholders. Transparency, and more specifically continuity of communication, is strongly associated with increased trust and social acceptability, whereas members of the public generally perceive a lack of transparency negatively. This literature review also deepens our understanding of the potential negative impacts of transparent communication. (shrink)

In 1977 a seminal paper was published by Avinash Dixit and Joseph Stiglitz that revolutionized the modeling of imperfectly competitive markets. It launched what might be called the second monopolistic competition revolution, which has been far more successful than the first one, initiated by Edward Chamberlin and Joan Robinson in the 1930s. In this 2003 collection of essays experts in the fields of macroeconomics, international trade theory, economic geography, and international growth theory address the question of why the second revolution (...) was so successful. They also highlight what is missing, and look forward to the next step in the modeling of imperfectly competitive markets. The text includes a comprehensive survey of both monopolistic competition revolutions, and previously unpublished working papers by Dixit and Stiglitz that led to their famous 1977 paper. With contributions from Dixit, Ethier, Neary and Stiglitz amongst others, this collection will excite interest amongst researchers, advanced students and economists. (shrink)

This article is both an elaborated critique on the one-sided analysis of the misogynist nature of ballet as a cultural practice, and a contribution to a more embodied feminist theory. Based on empirical material, that was brought together by observing the body practices in ballet and listening to the life stories of dancers, the author explores the contradictions that the body in ballet provokes. In describing the embodied experiences ofprofessional ballet dancers she shows that ballet offers women the possibility to (...) transcend the discontinuity of body, mind and emotions. (shrink)

Originally published in Proceedings of the British Academy 60 (1974), 339-359.

Originally published in Proceedings of the British Academy 60 (1974), 339-359.

As has been widely observed, histories of feminism have often been conceived via notions of generation where feminism is positioned as a kind of familial property, a form of inheritance and legacy which is transmitted through generations. Thus feminism and its history have been imagined as following a familial mode of social reproduction. Despite the dominance of this model, it has nonetheless been subject to critique, not least because of its reliance on teleological and progressive notions of history. Judith Roof, (...) for example, has called for new conceptualizations of temporality in an attempt to decouple histories of feminism from a generational model. This need to move away from a generational model is also underscored by what commentators such as Angela McRobbie have identified as a dispersal of feminism – a broad-scale circulation of feminist values in popular culture – as well as by the emergence of a certain kind of reflexivity whereby past and current feminist practices are increasingly subject to critique. For McRobbie such developments are understood as part of the articulation of a post-feminism in which feminism can no longer be passed on as it is positioned as having already passed away. However, in this article via an exploration of recent accounts of the passing of feminism it is suggested that what allows for a declaration of this passing is an attachment to feminism as a particular way of knowing as well as to a particular arrangement of the social. Indeed, it will be suggested that recent histories of feminism and commentaries on the state of contemporary feminism are driven not only by generational logics but also by these attachments – attachments which lose and fix both feminism and women in time. (shrink)

The paper distinguishes versions of the 'Agency theory of causation' and defends some of them against the charge of circularity.

This work analyses the complex and contentious issues of mutual affection and codependency in relationships between Korean ‘comfort women’ and Japanese soldiers during World War II. Drawing on a combination of interviews and published resources, it explores the groups’ perceptions of one another within the framework of ‘traumatic bonding’. Despite traumatic violence and stark inequalities, this article finds nuanced contributions from the parties involved. For the soldiers, the relationships provided a form of emotional relief from the violence of war and (...) from the oppression they themselves were subjected to by those of superior rank within the military hierarchy, while the women often sought kindness and protection from the military men with whom they had formed relationships. However, underneath the yearning for human connection, these relationships were highly complex and deeply affected by the overarching power dynamics of gender and the racialised colonial hierarchy. (shrink)

Women from post-socialist countries started migrating to Turkey in the second half of the 1990s to work in the domestic work sector. Migrant domestics have formed their niche as live-in caregivers, due to the disinclination of the existing local labour power to work in the care sector. Yet, the employer mothers, besides asking their live-in workers to tend their children, often demand that they also do the daily chores in the home, purposely leaving the heavy cleaning to their Turkish domestics. (...) This way, live-in migrant domestics are promoted from the status of foreign employees to fictitious family members, to eventually embody `the ideal housewife'. (shrink)

The article addresses the gendered implications of Covid-19 in the Global South by paying attention to the intersectional pre-existing inequalities that have given rise to specific risks and vulnerabilities. It explores various aspects of the pandemic-induced ‘crisis of social reproduction’ that affects women as the main caregivers as well as addressing the drastic increase of various forms of gender-based violence. Both, in addition to growing poverty and severely limited access to resources and health services, are particularly devastating in marginalized and (...) vulnerable communities in the Global South. The article looks at specific regions and countries to illustrate wider challenges faced by LGBTQ populations, ethnic minorities, domestic workers, migrants and sex workers. Against the background of these gendered intersectional challenges, the article then moves to discuss feminist initiatives and mobilizations to deal with the crisis in specific local contexts as well as nationally, regionally and transnationally. It concludes by highlighting a number of visions, tensions and dilemmas faced by feminists in the Global South that will need to be taken into consideration in terms of transnational feminist solidarities. (shrink)