Occupational health remains neglected in developing countries because of competing social, economic and political challenges. Ethical issues in the workplace related to the hazards and risks of becoming infected by Leishmania (Leishmania) mexicana , through the bite of naturally infected sand flies, is another area of concern that has been neglected as well. We report here the results of reviewing two entomological field studies carried out in our research center from 2003 to 2006. Eight students from our School of Biology (...) were invited to catch sand flies. A total of six of the eight (75%) developed a typical clinical picture of Localized Cutaneous Leishmaniasis (LCL) caused by L. (L.) mexicana . In this article we identify the ethical issues related to these kinds of studies and propose some guidelines for conducting them. (shrink)

Occupational health remains neglected in developing countries because of competing social, economic and political challenges. Ethical issues in the workplace related to the hazards and risks of becoming infected by Leishmania (Leishmania) mexicana, through the bite of naturally infected sand flies, is another area of concern that has been neglected as well. We report here the results of reviewing two entomological field studies carried out in our research center from 2003 to 2006. Eight students from our School of Biology were (...) invited to catch sand flies. A total of six of the eight (75%) developed a typical clinical picture of Localized Cutaneous Leishmaniasis (LCL) caused by L. (L.) mexicana. In this article we identify the ethical issues related to these kinds of studies and propose some guidelines for conducting them. (shrink)

Young children are prolific question-askers. The growing ubiquity of voice interfaces (e.g., Apple’s Siri, Amazon’s Alexa), as well as the availability of voice input in search fields, now make it possible for children to ask questions via Internet search when they are able to speak clearly, but before they have learned to read and write, typically between 3 and 6 years of age. The prevalence of voice search makes it important to understand children’s changing conceptions of digital devices as a (...) source of information and the role of technology-mediated question-asking in development. While limited research has focused on young children's use of voice interfaces, reviewing two related bodies of literature sheds light on how this use might unfold. This paper brings together studies of how children look for information, and of how they perceive and understand the informational and social roles of technology, drawing on human-computer interaction research. We conclude by highlighting lines of questioning for future work on younger children’s interaction through voice search. (shrink)

BackgroundThe psychological burden possibly deriving from not immediately undergoing radical treatment for prostate cancer could be a potential disadvantage of active surveillance, especially in the eve of some relevant clinical exams [i.e., re-biopsy, prostate-specific antigen test, and medical examination]. Even if it is known from the literature that the majority of PCa men in AS do not report heightened anxiety, there is a minority of patients who show clinically significant levels of anxiety after diagnosis. The present study aimed to investigate (...) if demographic, clinical, and psychological variables at the entrance in AS were associated with the risk of developing clinically significant PCa-related anxiety 2 months before the first re-biopsy and to offer psychological support to improve quality of life.Materials and MethodsA total of 236 patients participated in the PCa Research International: AS protocol and in PRIAS-QoL study. Demographic/clinical features, health-related QoL domains, coping with cancer, PCa-related anxiety [Memorial Anxiety Scale for PCa ], personality traits, and decision-making-related factors were assessed at T0. MAX-PC was also administered at T1. PCa-related anxiety at T1 was considered to be of clinical significance if the MAX-PC score was ≥1.5. Multivariable logistic regression coupled to bootstrap was used to detect factors associated with high levels of anxiety.ResultsThe median age was 64.4 years. Fifty-six patients reported MAX-PC total score above the cutoff. Three factors were associated with a high level of PCa anxiety at T1: anxious preoccupation [odds ratio = 4.36], extraversion, and prostate-related symptoms. Physical well-being was associated with a low PCa anxiety subscale ; neuroticism and functional well-being were associated with PSA anxiety. Neuroticism and helplessness/hopelessness were associated with fear of progression.ConclusionOnly a partial portion of the sample experienced significant levels of anxiety after 10 months. Psychological assessment should be routinely conducted to detect risk factors for increased anxiety, offering tailored psychological interventions aimed at promoting interpersonal awareness and emotional well-being. (shrink)

Employing a time-lagged sample of 371 North American individuals working full time in a wide range of industries, occupations, and levels, we contribute to research on employee outcomes of corporate social responsibility attributions as substantive or symbolic. Utilizing a mediated moderation model, our study extends previous findings by explaining how and why CSR attributions are related with work-related attitudes and subsequent individual performance. In support of our hypotheses, our findings indicate that the relationships between CSR attributions and individual performance are (...) mediated through person–organization fit and work-related attitudes. Additionally, when CSR is perceived as important, substantive CSR is positively related to, and symbolic CSR is negatively related to, perception of fit with the organization. These findings contribute toward our understanding of the complex effect CSR has on employees’ work outcomes. Practical implications and future research directions are discussed. (shrink)

ABSTRACTEvaluative conditioning procedures change people’s evaluations of stimuli that are paired with pleasant or unpleasant items. To test whether influence awareness allows people to resist such...

Šiame straipsnyje pateikiu naują prieštaravimą Chalmerso kertiniam argumentui prieš „B tipo“ fizikalistų privilegijuotą strategiją pagrindžiant aiškinimo spragą („fenomenalių sąvokų strategija“). Aš konkrečiai teigiu, kad antrasis kertinio argumento dėmuo neteisingai interpretuoja, kodėl zombiai negali patekti į mūsų episteminę situaciją sąmonės atžvilgiu. Zombiams negali būti būdingos tokios mentalinės būklės, kurias turime mes. Jeigu visi mūsų psichologiniai atributai yra būtina mūsų episteminės situacijos sąlyga, tai zombiai negali pasitarnauti kaip antrasis dilemos dėmuo. Kalbėdamas apie kontekstą, aš visų pirma trumpai aptariu susijusį argumentą, nukreiptą prieš (...) fizikalizmą, kurį taip pat naudojo D. Chalmersas – „suvokiamumo argumentą“. Aš akcentuoju kai kuriuos svarbiausius iššūkius šiam argumentui, kartu pateikdamas ir papildomų kritikos elementų. Galiausiai, glaustai panagrinėjęs panprotopsichizmą, aš svarstau, kas mūsų lauktų, jei priimtume Chalmerso argumentus. Prieinu išvadą, kad fenomenaliųjų konceptų strategija yra patikimas paaiškinimas, kodėl zombių suvokiamumas veikiausiai nereiškia jų metafizinės galimybės. (shrink)

In this paper I aim to discuss a fragment of Aristotle’s De Philosophia (fr. 21 Ross = Cic. N.D. ii, 44). After defending Cicero’s reliability as a source for the present fragment, I will focus on its contents, with particular reference to the similarities and differences between fr. 21 Ross and De Caelo A-B: my aim in this comparison is to identify two different astronomical systems underlying, on the one hand, the account of fr. 21 Ross and, on the other (...) hand, that given in the treatise. This shift of model is in my view the actual reason for the inconsistency between these accounts. Such an inconsistency might be explained in chronological terms: the last part of the paper, indeed, develops the hypothesis that De Philosophia Γ was written before 353–350bc, namely before Aristotle got acquainted with Eudoxus’ astronomical system. (shrink)

A Steiner triple system (STS) is a set S together with a collection B of subsets of S of size 3 such that any two elements of S belong to exactly one element of B. It is well known that the class of finite STS has a Fraïssé limit M_F. Here, we show that the theory T of M_F is the model completion of the theory of STSs. We also prove that T is not small and it has quantifier elimination, (...) TP2, NSOP1, elimination of hyperimaginaries and weak elimination of imaginaries. (shrink)

Attempting to steer moral philosophy away from abstract theorizing, Moral Disquiet and Human Life argues that moral philosophy should be a practical, rational, and argumentative engagement with reality, and that moral reflection should have direct effects on our lives and the world in which we live. Illustrating her discussion with vivid examples from literature, music, drama, and current events, the noted French philosopher Monique Canto-Sperber resumes the most ancient pursuit of philosophy: the examination of human life itself. What did (...) Socrates mean when he said that the unexamined life is not worth living? How can reflecting on one's existence incorporate human singularity, the contingency of events, the certainty of death, the presence of the past, or the irreversibility of time? Carefully analyzing and proposing answers to such questions, Moral Disquiet and Human Life eloquently calls for a redefinition of the task of moral philosophy and of its limits. (shrink)

El artículo que presentamos expone resultados de una investigación que tiene por objetivo construir conocimiento a partir de la implementación de la ley de la nueva educación pública en Chile. Desde un paradigma hermenéutico cualitativo, se ha recogido información a través del diseño de estudios de casos, múltiples y retrospectivos, en cinco Servicios Locales de Educación Pública. La dimensión empírica se centra en el análisis discursivo de documentos oficiales elaborados por los nombrados servicios, correspondientes a la primera fase del estudio. (...) La dimensión teórica y filosóficapolítica permiten discutir los resultados desde dos dimensiones que se vinculan entre sí: semiótica de la estructura y morfología de los documentos analizados, y por otra, el contenido de los mismos. Esto levanta cuatro categorías vinculadas con a) neoliberalismo como razón normativa y escala de valoración; b) la gestión como único objetivo en la lógica del new public management; c) burocracia homogenizadora de la rendición de cuentas; y d) la cuantificación como única lectura de la realidad, utilizándolo como discurso legitimador. El marco explicativo interpretativo desde las configuraciones subjetivas y de gobernanza institucional se alinean con las características del contexto neoliberal chileno, generando profundas contradicciones en la implementación de la ley. (shrink)

The article proposes a follow up contribution, possibly an almost final word, of our previous ones to the paleographical section of this journal – 2015 and 2022 especially but also 2018 – on the textual tradition of Aristotle’s Metaphysics. Based on Maas theory of Trennfehler, along the two latest decades, we collected and evaluated any possible counter arguments for the sake of a unified stemma codicum, topped by Π. We also add further details. As a result, Π is a fourth (...) century AD parchment manuscript. This unified Π stemma stands as an alternative to the previous two branched stemmas topped by two disconnected α and β without a single archetype (by Bernardinello 1970 and by Harlfinger 1979). One is recalled that those stemmas were ultimately based on Jaeger’s 1912, 1957 theory of the two versions of the Metaphysics, one which does not carry conviction since decades. As an alternative, according to our exploration and research on all the fourteen books of the Metaphysics, Π has been found to be the source not only of J, of E and of other alpha manuscripts (via J or via E) but of all extant Greek manuscripts of the Metaphysics, including Ab and the other representative of the so called β branch. This, without being identical, fits remarkably well with Marwan Rashed findings concerning the Greek exemplar of the Arabic tradition : one can figure the size, the columns layout, the capital scriptio continua handwriting of that exemplar, based on the magnificent Vatican ms. B (Vet. gr. 1219) of the Bible – possibly the earliest extant Greek manuscript of all the books of the Ancient and of the New Testament. Both as a proof and as a possible means for independent counter arguments, Laura Folli and Marco Ghione make available here fresh collations for two central books of the Metaphysics, Zeta and Eta. Variant readings from Ab (β) are thus contrasted with Π’s manuscripts : J, E. Eb is also being added as an early representative of the important delta group. Based on Paul Maas’ theory of errors, we are now in condition to face the crucial issue : does not Ab depend on the former and, if so, to what extent ? This helps to resolve any residual opacity or incertitude concerning the upper part of the stemma. As a consequence, manuscript sources for the text constitution of the Metaphysics are reduced to a very tight minimum : J, with its corrector J2 ; E’s first hand can be eventually taken into account. Other sources – including Ab and all so‑called β and δ manuscripts, are relevant, so far as our present knowledge goes, as sources for improvement and correction only. (shrink)

This paper is a reflection on an experiment undertaken during a Medical Ethics lecture delivered to a group of medical students in the UK as part of a project for a programme in Higher Education Practice. The aim of the project, following Paulo Freire’s idea of ‘liberating education,’ was to identify students’ ethical assumptions and biases in relation to a problem of resource allocation in healthcare, and their role in decision-making. The experiment showed the importance placed by medical students on (...) disputed values such as free will, desert, social worth and body image, and highlighted the difficulty and importance of bringing students’ process of moral decision-making to awareness in ethics teaching, in order to a) decrease the role of implicit bias in students’ decision making and b) allow students to decide whether they in fact agree with assumed values and ethical frameworks that influence their thinking. (shrink)

Resumo: O objetivo deste artigo é, considerar o quarto paralogismo e a crítica kantiana a ele na versão da primeira edição da Crítica da razão pura, destacando o contexto do quarto paralogismo, a saber, o propósito e a estrutura dos paralogismos em geral. Procurarei mostrar que, ao contrário do que parece à primeira vista, o quarto paralogismo na sua primeira edição partilha da mesma estrutura dos demais e é equivalente à sua formulação na segunda edição da Crítica da razão pura. (...) Procurarei também mostrar que, ao levarmos em conta esse propósito e estrutura geral dos paralogismos partilhada pelo quarto paralogismo, podemos perceber que a crítica ao quarto paralogismo na primeira edição não é propriamente uma tentativa de prova da existência de objetos externos com base no caráter transcendentalmente interno dos objetos do sentido externo.Abstract:The aim of this paper is to examine Kant's criticism of the forth paralogism in the first edition of the Critique of pure reason, trying to highlight its context, i.e., the purpose and structure of the paralogisms in general. I intent to show that, contrary to what may seem on the face of it, the forth paralogism in the A edition shares the same structure of the first three and is equivalent to its new version on the B edition. I will also indicate that, taking into account these shared purpose and structure, we can see that Kant's criticism to the forth paralogism in the A edition is not exactly and attempt to prove the existence of outer objects based on his statement that empirically outer objects are transcendentally inner. (shrink)

The initial dilemma. I.1. The gradual rise of the Metaphysics. I.2. A bold contribution from textual history. I.3. A new perspective on late ancient commentaries. I.4. First philosophy or Metaphysics? I.5. Can tradition be ignored? II. ‘Being’ and οὐσία at the core of Aristotle’s theoretical research. II.1. Ontology as a science of ‘being’ in Aristotle: “What is X?” in the foreground. II.2. The first caveat: the copula function of Aristotle’s ‘being’. II.3. The definite article τό as quotation marks before the (...) flexed forms of ‘be’: τὸ ὄν, τὸ εἶναι, τὸ ἔστιν. II.4. Further explanations about Aristotle’s ‘being’. III. Οὐσία, the core of Aristotle’s theoretical philosophy. III.1. οὐσία and the criterion of pre‑eminence as Plato’s legacy. III.2. The dialectical roots of ontology. III.3. οὐσία from Zeta to Lambda. III.4. οὐσία as essence and οὐσία as substance. III.5. οὐσία as a syntactical core; the word’s etymology. III.6. οὐσία as the first sense of being in Aristotle’s first philosophy. III.7. Ontology as science, science of the science. IV. Historicizing: the semantic gap. IV.1. Editorial tradition: ontology and οὐσία as a fil rouge in the order of Metaphysics books. IV.2. οὐσία in the first century B.C. IV.3. οὐσία by Alexander of Aphrodisias. IV.4. Metaphysics and its purpose: the role of the Lambda book. IV.5. Being and οὐσία: a relationship lost over time. IV.6. The Aristotelian tradition as a way to cooperation. (shrink)

This paper investigates the influence of contrastive stress in resolving potential semantic ambiguities. The sentences under investigation contain the focus operator only. Sentences with only have three main properties: (a) some sentential element is typically in focus, (b) the speaker presupposes that a set of alternatives to the focus element (the contrast set) has previously been introduced in the context; and (c) the speaker makes the assertion that the focus element has some unique property which other members of the reference (...) set lack. Previous literature on focus has concluded that stress plays a role in the interpretation of only-sentences in many natural languages, including English (Rooth, 1992). In processing terms, this suggests that contrastive stress could immediately determine which NP bears the semantic focus (and therefore the NP that presupposes a contrast set in the context). On this scenario, the processing cost associated with contrastive stress should be no greater than the cost associated with neutral stress. There is, however, a theoretically motivated proposal that makes the opposite prediction (Reinhart, 1999). As we understand it, in this model the parser is expected calculate default stress first, with its associated interpretation, and only later reanalyze the sentence, if necessary, based on the contrastive stress pattern. Since in English the default stress falls on the last NP of the sentence, any deviation from this pattern will be more costly. In processing sentences with contrastive stress, the model implies that the parser first calculates the interpretation that is associated with the default stress pattern. In this regard, young children’s interpretation of sentences with stress and the focus operator only is of special interest. Because young children are in the throes of grammar formation, their behavior can reveal default strategies for sentence processing, as well as the extent to which the parser’s sensitivity to contrastive stress is universal, i.e., includes child languages.. (shrink)

The paper considers one of the most enigmatic problems of Wittgenstein`s Tractatus - the problem of solipsism. The authorś task is to reveal how the discussion of solipsism illuminates Wittgenstein`s metaphysical view in this treatise. Wittgenstein`s method is considered as one through which the status of what cannot be said is demonstrated. Wittgenstein has not embrased solipsism or idealism in the Tractatus, and neither has he rejected metaphysics as a whole. His attack has been directed against dogmatic philosophy and ethics, (...) against the effort to say what cannot be said in true/false propositions. The discussion of solipsism brings into philosophy the importance of metaphysical "I" as a transcendental limit of the world and language. Wittgenstein`s aim in the Tractatus has been twofold: a) to show the nonsensicality of philosophical, ethical, aesthetical propositions , b) to emphasize, that the inexpresibility of the higher is the most important thing in our lives. (shrink)

This comment proposes that Bullot & Reber's (B&R's) emphasis on historical and intentional knowledge expands the range of emotions that can be properly viewed as aesthetic states. Many feelings, such as anger, contempt, shame, confusion, and pride, come about through complex aesthetic meanings, which integrate conceptual knowledge, beliefs about the work and the artist's intentions, and the perceiver's goals and values.

For a theory T, we study relationships among IΔ n +1 (T), LΔ n+1 (T) and B * Δ n+1 (T). These theories are obtained restricting the schemes of induction, minimization and (a version of) collection to Δ n+1 (T) formulas. We obtain conditions on T (T is an extension of B * Δ n+1 (T) or Δ n+1 (T) is closed (in T) under bounded quantification) under which IΔ n+1 (T) and LΔ n+1 (T) are equivalent. These conditions depend (...) on Th Πn +2 (T), the Π n+2 –consequences of T. The first condition is connected with descriptions of Th Πn +2 (T) as IΣ n plus a class of nondecreasing total Π n –functions, and the second one is related with the equivalence between Δ n+1 (T)–formulas and bounded formulas (of a language extending the language of Arithmetic). This last property is closely tied to a general version of a well known theorem of R. Parikh. Using what we call Π n –envelopes we give uniform descriptions of the previous classes of nondecreasing total Π n –functions. Π n –envelopes are a generalization of envelopes (see [10]) and are closely related to indicators (see [12]). Finally, we study the hierarchy of theories IΔ n+1 (IΣ m ), m≥n, and prove a hierarchy theorem. (shrink)

Die Einordnung der Rechtsphilosophie als akademische Disziplin reicht vom reinen Grundlagenfach mit «Service-Funktion» für die praktischen Rechtswissenschaften über ein interdisziplinäres Verständnis, das die Bezüge zu anderen ...

Research involving transgender and gender diverse people (TGD) increased in the last years, mostly concerning healthcare associated to this population. Few studies dedicated their analysis to the impact of parental support on transgender people, even though this is an important aspect in creating a safe environment on which these individuals can build their identity. In addition, the link between family support, TGD identity and homelessness is not completely established. Thus, due to the specificities of the family context of TGD individuals, (...) the aim of this study is to investigate the association between family support and TGD in different moments of the process of gender affirmation. In addition, this study also aims to explore the relationship between a lack of social support and low self-esteem, home abandonment, and dwelling in the street. The survey was designed based on the TransPULSE project and was made available in electronic format. The sample was constituted of 423 TGD residents in two Brazilian states. A Structural Equation Model analysis suggested that the impact of gender affirmation status on homelessness was mediated by parental support, through self-esteem, and the need to move from home. The association between the status of the gender affirmation procedures, family support and self-esteem was significant and indicated that the further TGD individuals advanced in gender affirmation, the more self-esteem and family support they would have. The association between family support and self-esteem indicated that family support was associated with higher self-esteem. Low family support was associated with the willingness to move from home due to one’s TGD status and there was also a significant correlation between low self-esteem and the willingness to move from home due to one’s TGD status. Finally, homelessness was associated with the willingness to move with a large effect size. Limitations include the sample that was constituted by individuals with Internet access and who had more contact with TGD communities. The findings indicate directions for interventions involving TGD people and their families, considering the parental relationship as a critical variable to improve TGD quality of life in the process of gender affirmation. (shrink)

Dutch Book Arguments. B is susceptibility to sure monetary loss (in a certain betting set-up), and F is the formal role played by non-Pr b’s in the DBT and the Converse DBT. Representation Theorem Arguments. B is having preferences that violate some of Savage’s axioms (and/or being unrepresentable as an expected utility maximizer), and F is the formal role played by non-Pr b’s in the RT.

LetTbe a recursive theory in the language of first order Arithmetic. We prove that ifTextends: (a) the scheme of parameter free Δ1-minimization (plusexp). or (b) the scheme of parameter free Π1-induction, then there are no Σ1-maximal models with respect toT. As a consequence, we obtain a new proof of an unpublished theorem of Jeff Paris stating that Σ1-maximal models with respect toIΔ0+expdo not satisfy the scheme of Σ1-collectionBΣ1.

It has recently been argued that normative considerations play an important role in causal cognition. For instance, when an agent violates a moral rule and thereby produces a negative outcome, she will be judged to be much more of a cause of the outcome, compared to someone who performed the same action but did not violate a norm. While there is a substantial amount of evidence reporting these effects, it is still a matter of debate how this evidence is to (...) be interpreted. In this paper, we engage with the three most influential classes of explanations, namely, (a) the Norm‐Sensitive Cognitive Process View, (b) the Normative Concept View, and (c) the Pragmatics View. We will outline how these theories explain the empirical results and in what ways they differ. We conclude with a reflection on how well these strategies do overall and what questions they still leave unanswered. (shrink)

In recent years, the conjunction of far-right agendas with those of the anti-vax movement has spread disbelief in science and turned the reinforcement of individualism into a way to erode the social fabric. In this text, by means of a review of specialized literature, we propose to discuss the strengthening of vaccine citizenship, a phenomenon that involves not only the construction of citizenship but also trust in scientific knowledge. Two are the axes of our analysis: a) civic education to address (...) vaccine hesitancy and refusal, and b) the importance of cooperation between Citizenship Education and Scientific Education for the development of critical thinking and the ability to assess the effects of scientific knowledge on society. To identify studies that have investigated the social nature of vaccination-related decisions and practices and those that have identified ways in which educational processes have been able to strengthen vaccine citizenship, we used bibliographic and documentary research as methodological strategies. As final recommendations, we suggest that the praxis involved in vaccine citizenship requires Citizenship Education for its realization to demand scientific literacy, just as Scientific Education requires scientific knowledge’s commitment to global citizenship so that it can be transformed into practice and action in the real world. (shrink)

In this article, we report a study in which 109 research-active mathematicians were asked to judge the validity of a purported proof in undergraduate calculus. Significant results from our study were as follows: (a) there was substantial disagreement among mathematicians regarding whether the argument was a valid proof, (b) applied mathematicians were more likely than pure mathematicians to judge the argument valid, (c) participants who judged the argument invalid were more confident in their judgments than those who judged it valid, (...) and (d) participants who judged the argument valid usually did not change their judgment when presented with a reason raised by other mathematicians for why the proof should be judged invalid. These findings suggest that, contrary to some claims in the literature, there is not a single standard of validity among contemporary mathematicians. (shrink)

This paper investigates the status of the fragments of Peano Arithmetic obtained by restricting induction, collection and least number axiom schemes to formulas which are $${\Delta_1}$$ provably in an arithmetic theory T. In particular, we determine the provably total computable functions of this kind of theories. As an application, we obtain a reduction of the problem whether $${I\Delta_0 + \neg \mathit{exp}}$$ implies $${B\Sigma_1}$$ to a purely recursion-theoretic question.

A well known theorem proved by J. Paris and H. Friedman states that BΣn +1 is a Πn +2-conservative extension of IΣn . In this paper, as a continuation of our previous work on collection schemes for Δn +1-formulas , we study a general version of this theorem and characterize theories T such that T + BΣn +1 is a Πn +2-conservative extension of T . We prove that this conservativeness property is equivalent to a model-theoretic property relating Πn-envelopes and (...) Πn-indicators for T . The analysis of Σn +1-collection we develop here is also applied to Σn +1-induction using Parsons' conservativeness theorem instead of Friedman-Paris' theorem.As a corollary, our work provides new model-theoretic proofs of two theorems of R. Kaye, J. Paris and C. Dimitracopoulos : BΣn +1 and IΣn +1 are Σn +3-conservative extensions of their parameter free versions, BΣ–n +1 and IΣ–n +1. (shrink)

Background A team-based approach has been advocated for advance care planning in nursing homes. While nurses are often put forward to take the lead, it is not clear to what extent other professions could be involved as well. Objectives To examine to what extent engagement in advance care planning practices (e.g. conversations, advance directives), knowledge and self-efficacy differ between nurses, care assistants and allied care staff in nursing homes. Design Survey study. Participants/setting The study involved a purposive sample of 14 (...) nursing homes in Flanders, Belgium. Nurses, care assistants and allied care staff (e.g. social workers, physical therapists) completed a survey. Ethical considerations The study was approved by the University Hospital of Brussels (B.U.N. 143201834759), as part of a cluster randomized controlled trial (clinicaltrials.gov NCT03521206). Results One hundred ninety-six nurses, 319 care assistants and 169 allied staff participated (67% response rate). After adjusting for confounders, nurses were significantly more likely than care assistants to have carried out advance care planning conversations (odds ratio 4; 95% confidence interval 1.73–9.82; p < 0.001) and documented advance care planning (odds ratio 2.67; 95% confidence interval 1.29–5.56; p < 0.001); differences not found between allied staff and care assistants. Advance care planning knowledge total scores differed significantly, with nurses (estimated mean difference 0.13 (score range 0–1); 95% confidence interval 0.08–0.17; p < 0.001) and allied staff (estimated mean difference 0.07; 95% confidence interval 0.03–0.12; p < 0.001) scoring higher than care assistants. We found no significant differences regarding self-efficacy. Discussion While nursing home nurses conducted more advance care planning conversations and documentation than allied care staff and care assistants, these two professional groups may be a valuable support to nurses in conducting advance care planning, if provided with additional training. Conclusions Allied care staff and care assistants, if trained appropriately, can be involved more strongly in advance care planning to enhance relational and individual autonomy of nursing home residents, alongside nurses. Future research to improve and implement advance care planning should consider this finding at the intervention development stage. (shrink)

Being in a romantic relationship is characterized by a high degree of intimacy and affective involvement. Affective behavior indicates the emotional content in couple interactions and therefore promotes an understanding of the evolution of romantic relationships. When couples are also parents, their affective behavior reflects their romantic and coparental bonds. In this paper, we present an observation of parent couples’ affective behavior during a coparenting conflict discussion task to document whether and how much it improved during couple therapy. Two contrasting (...) cases of affective behavior change are included. Observational coding of affective behavior within pre- and post-intervention coparenting conflict discussion tasks was carried out to compute means and CIs for each partner in both cases. In addition, the partners’ coparental and romantic satisfaction were evaluated through validated self-report questionnaires in pre- and post-intervention assessments; this helped document whether the partners’ coparental and romantic satisfaction were dissimilar between the two cases. Finally, a clinical analysis of both cases was realized with the contribution of the therapists to investigate possible differences within therapy sessions. Statistical analyses revealed negative means of affective behavior for couple A in the pre-intervention assessment and positive means in the post-intervention assessment. Partners from couple B had negative means of affective behavior in the pre- and post-intervention assessments. Results concerning coparental and romantic satisfaction differed: Couple A’s coparental satisfaction slightly increased and the romantic satisfaction somewhat decreased, whereas couple B’s coparental satisfaction remained stable and the romantic satisfaction slightly increased between the pre- and post-intervention assessments. The clinical analysis revealed that the interactional quality of couple A slightly improved within therapy sessions and that both partners succeeded in working together as coparents, notwithstanding their romantic distress. Couple B conveyed coparental distress and exhibited poor interactional quality throughout therapy sessions (e.g., repeated criticism and contempt). This study contributes to enriching the more traditional empirical research methods in the field of couple psychotherapy, as it takes into account microlevel affective changes within parent couples’ interactions in addition to self-reported data. Furthermore, the analysis of therapy sessions supports the importance of working with affective behavior in couple therapy. (shrink)