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Moral distress as a reason for ethics consultation is common, but perceived or real racism is underrecognized as a potential cause. The consultation requested in this case was nominally for moral distress, but elements of cultural misunderstanding and culturally relevant value conflicts rapidly became apparent. Cultural concordance between the ethics consultant and the patient’s family enhanced communication and allowed the medical care team to change their perspective on interactions they had observed and previously considered to be belittling between family members and staff. This led to a broadening of medically permissible options being considered and ultimately resulted in a discharge plan that was acceptable and welcome by both the patient’s family and the ICU staff. Further discussion of reasons why greater diversity in ethics consultation members may be helpful.
This chapter examines Darwin’s analysis of emotional expression. It is widely accepted that Darwin wrote Expression to refute Sir Charles Bell’s theory that God created humans with special muscles to express their emotions. However, scholars have overlooked the fact that Bell developed his theory to refute Erasmus Darwin’s associationist analysis of emotional expression, inspired by David Hartley, and that Charles Darwin defends his grandfather’s analysis against Bell’s objections. I demonstrate that Charles’s defense of Erasmus’s associationist theory, which denies that expressions occur for the sake of communicating emotions, explains Charles’s puzzling reluctance to claim that expressions evolved to serve as signals in communication.
Clinical ethics prides itself on communication, collaboration, interdisciplinary cooperation and mediation. But what happens when all those skills and efforts fail? This chapter describes a difficult situation fraught with clinical uncertainty and complicated by an unbridgeable cultural divide that left the clinical parties feeling as if they failed the patient. This case demonstrates that sometimes there is no real closure, no understanding, and no sense of having been helpful. These are the kinds of cases that haunt us.
This study examined public attitudes and experiences in using the Internet for first aid guidance in real-life medical emergencies.
Methods
The study involved: (1) an analysis of YouTube comments (n = 6,786) on first aid videos using latent Dirichlet allocation topic modeling; (2) a survey of completers of an online Basic Life Support course (n = 731).
Results
Topic modeling of social media comments revealed users’ frustration with unskippable advertisements, reflecting a collective perception of online videos as a source of immediate advice on first aid in real-life emergencies. According to the survey data, 14.6% of respondents sought online first-aid instructions during a real-life emergency. An additional 8.9% reported similar experiences among friends or relatives. Of those who searched for advice, 90.7% found and implemented instructions. Most respondents showed readiness to attempt this in future as they believe it could be lifesaving.
Conclusions
The existing public demand for, and continued use of, the Internet as a source of advice on first aid, the risks arising from laypeople’s reliance on information of questionable quality, and the potential usefulness of authoritative digital guidance for instances where other means of assistance are unavailable constitute an intricate public health issue that requires attention and comprehensive solutions.
This chapter provides brief conclusions drawing together the threads of the story and its wider analysis, the political and religious context, its transnational significance and the insights a single document and event have provided. Returning to some of the themes raised in the introduction, reflects on the role of truth and secrecy amid the practicalities for ministers of upholding an ideological cause.
Chapter 5 explores the importance of the communication of news and information through correspondence, but also the problems of its interception and betrayal. Couriers faced the risk of violence and incarceration, particularly at times of diplomatic tension, and strategies of concealment could be quite sophisticated to counter this, such as the use of ciphers, pseudonyms and other methods. Nevertheless, the dangers to which Tivinat and other couriers were exposed was considerable, their detention was a frequent occurrence, as was that of Huguenots carrying books and papers, as shown in cases drawn from the Conciergerie in Paris. Consideration is given to the importance of correspondence as a source for both contemporaries and historians. The news content of the letters carried by Tivinat is discussed in detail, revealing concerns with events both international and domestic. Connections between the letters and those found in other circumstances, such as on the body of the prince of Condé and in the English State Papers, are made, identifying Regnard/Changy as their author and the complexity of the network in which he operated.
This chapter introduces the interrogation document and associated letters around which the book is based and summarises the structure of the book and the content of its chapters. Emphasises the European-wide context of the Huguenot network that is revealed as well as the circumstances of the French religious wars c. 1567–1571. Engages with the relevant historiographical themes, including studies of correspondence and communication, diplomacy, intelligence-gathering and espionage, and confessional and transnational connections. Addresses the sub-themes of truth and secrecy and how these provide the backdrop for the clandestine confessional activities to be explored, particularly through the participation of Huguenot ministers. Investigates what we are able to reconstruct about the man, Jean Tivinat, who was arrested for and interrogated about his role in carrying the correspondence and the circumstances of his incarceration at the château of Dieppe.
Chapter 1 provides a detailed analysis of the interrogation document and what it reveals to us about, and as far as possible what can be verified regarding, Tivinat’s activities as a merchant and courier operating between France and England. The process of interrogation and the interests of the interrogator are also explored. In particular, examines Tivinat’s relationship with the household of the cardinal of Châtillon and identifies those to whom and from whom the letters were sent and the clandestine world in which these contacts were made. Other contemporary examples of similar interceptions are discussed to establish how typical or otherwise this case is and what they collectively tell us about the frequency and precarity of such communication. Above all, the necessity of identifying Tivinat’s supplier, Changy, is emphasised and undertaken at length, establishing that he was Hugues de Regnard, a Huguenot minister with well-established and widespread transnational connections with Calvinist church and noble leaders in several countries.
The notion that curse tablets were used to cause harm whereas amulets were used to provide protection is a misleading oversimplification. Curse tablets have often been removed from the category of religion and consigned to the illusive one of magic. However, the existence of those tablets designated as prayers for justice illustrates that the desires which drove curse tablet creation were varied. To ascertain to what extent the use of curse tablets and amulets fitted in with polis religion, different aspects of them are examined, such as the ritualistic nature of their creation, their use of formulaic inscriptions and evidence for their use, or lack of use, of reciprocity. Examples of amulets and curse tablets are presented from the fourth century BCE through to the second century CE and from a large geographical scope. Examples from across the Greek world illustrate a paradoxical unity and sense of religious community amongst those who engaged in these practices. The incredibly personal nature of the inscriptions on curse tablets and the wearing of amulets provides an insight into Greek religious practice at an individual level.
How did Huguenots stay connected in the 16th-century? And how did they maintain clandestine religious and political networks across Europe? Beginning with the chance discovery of an intriguing interrogation document, concerning correspondence to be smuggled from France to England hidden in a basket of cheese, this study explores the importance of truth and secrecy within Huguenot information networks. Penny Roberts provides new insights into the transnational operation of agents: fanning out from confessional conflicts in Normandy to incorporate exiles in England, scholars and diplomats in Germany, the Swiss cantons and the Netherlands, and spy networks operating between France and Scotland. Above all, this study uncovers the primary role played by Huguenot ministers in maintaining and nurturing these connections at considerable danger to themselves, mobilising secrecy in the service of truth. As a result, Huguenot Networks provides greater understanding of confessional connections within Reformation Europe, demonstrating how these networks were sustained through the efforts of those whose contribution often remains hidden.
The 14-item Body-Related Disclosure Scale (BRDS; Greer, Campione-Barr, & Lindell, 2015) can be administered in person or online to adolescents and young adults (ages 10-25 years) in the context of any close relationship (e.g., mother-child, father-child, siblings, friends, romantic partners) and is free to use in any setting. This chapter first discusses the development of the BRDS and then provides evidence of its psychometrics. More specifically, the Body-Related Disclosure Scale has been found to have a 2-factor structure within confirmatory factor analyses to include a positively-valence sub-scale and a negatively-valanced subscale. Internal consistency reliability supports the use of the BRDS. Next, this chapter provides the BRDS items in their entirety, instructions for administering the BRDS to participants, the item response scale, and the scoring procedure. Logistics of use, such as permissions, copyright, and contact information, are provided for readers.
Several neurotransmitter systems play a key role in decision-making. The serotonergic system plays a neuromodulatory role, and is very widely connected, influencing a very wide variety of behaviours including sleep, mood, sexual behaviour, eating and memory. The norodrenergic system has a key connection to the prefrontal cortex, which we know is vital in decision-making. Noradrenaline also has a role in sleep. The dopaminergic system is important for working memory, novelty-seeking and attention. All of these contribute to decision-making.
Patients’ involvement in the decision-making process is essential for shared decision-making and optimal patient-centered care. However, when there are concerns about a patient’s cognition and judgmen, the complexity of providing patient-centered care increases. It is often necessary to evaluate patients’ decision-making capacity (DMC) to determine whether they are able to make a particular decision or whether to rely on their previously expressed wishes or the patient’s caregivers.
Methods
In this article, we present a case of an older adult with colon cancer who presented to the emergency room.
Results
We describe how multidisciplinary care can enhance the evaluation of DMC and improve quality of care for older patients with advanced cancer.
Significance of results
Multidisciplinary discussions and good communication skills are essential for navigating these complex situations, reducing potential harm and maximizimizing quality of life.
An effective communication seemed to be crucial in all the cancer care phases, like diagnosis, prognosis, and treatment options.
Objectives
To analyze and interpret structured and open-ended questionnaire responses, focusing on the communication of bad news in onco-hematology: health care professionals’ attitudes, communication methods, and perceived stress levels.
Methods
By employing a free Large Language Model, we identified and summarized the main emotions and perspectives shared by professionals.
Results
A total of 221 Italian nurses and physicians employed in onco-hematology field were enrolled. The analysis revealed key emotional themes, offering insights into the professionals’ emotional states and coping mechanisms when delivering difficult news.
Significance of results
Data highlighted the duality of emotions experienced by nurses when delivering bad news – balancing professional composure with emotional distress, underscoring the critical role of empathy, team support, and adequate preparation in helping nurses navigate these challenging conversations.
This chapter reconstructs the relationship between the Gospel of Truth’s author and his intended audience, arguing that its author ensures its rhetorical effectiveness by his use of keywords and vivid imagery.
Many factors are known to influence experiences in bereavement. With a growing focus on public health approaches to bereavement support, it is important to further understand factors which healthcare workers (HCW) can influence regarding bereavement experiences for families. The study aim was to describe the experience of people bereaved following a death in Sydney Local Health District (SLHD), with particular focus on people’s awareness and experience of available supports and the perceived impact of healthcare interactions on bereavement experiences.
Methods
The study used semi-structured qualitative interviews (n = 15) to explore the experiences of bereaved people. These were recorded, transcribed, and analyzed using a Reflexive Thematic Analysis approach.
Results
Themes were generated showing the ways in which healthcare and bereavement experiences are mediated by personal interactions; that information and its delivery are central to shaping experiences; and the impacts of healthcare and government system issues on experiences of care and access to support. Attention to these factors may positively impact end-of-life care and subsequent bereavement experiences.
Significance of results
It is illuminating to consider the results in light of proposed public health approaches to bereavement. Our findings assist in understanding the role that HCWs have in supporting preparation for death, providing care with the potential to prevent negative bereavement outcomes, and offering short-term bereavement support. This is key in planning models that acknowledge the essential role HCWs play within public health approaches to bereavement support. Findings can inform education and training in healthcare, with a focus on approaches that affirm dignity and positive relationships, ensure sensitive and timely information provision, and enhance skilled communication. Recommendations can support policy and system improvements to enhance bereavement outcomes.
Pediatric cancer survivors are at increased risk for neurocognitive challenges that can impact academic achievement and attainment. Educational supports via accommodations or special education can promote better outcomes for these youth; however, barriers often stand in the way of appropriate supports being implemented. Neuropsychological evaluation reports highlight a child’s neurocognitive strengths and needs, but an additional tool to assist parents and educators in understanding the extent to which a child’s neurocognitive needs are addressed by their educational supports may help ensure appropriate supports.
Method:
The present study piloted a novel neurocognitive needs-to-educational supports alignment rubric in a referred sample of pediatric survivors of cancer, bone marrow transplant, and cancer predisposition syndromes (i.e., neurofibromatosis).
Results:
Inter-rater reliability across disciplines was satisfactory. Among school-aged patients who were attending public school (n = 90), mean needs-to-supports alignment was 20.3%, indicating that on average, referred patients were receiving minimal classroom supports addressing identified neurocognitive needs. Among the 42.9% with a formal support plan, proportion of needs met by a support rose to only 47%, indicating that in spite of some recognition of patient needs, supports remain inadequate to the breadth of patient needs.
Conclusions:
This alignment tool can assist parents and educators in better tailoring a child’s educational supports to meet their needs, serve as a communication tool between healthcare and education teams, and provide a quantitative metric for evaluating educationally focused interventions (e.g., school liaison programming) in youth with a variety of chronic health conditions and developmental disabilities.
Kant’s thoughts on language as a practical tool of what he would call “pragmatic formation” in his pedagogical writings are often overlooked. If anything, Kant is read from selected passages of his third Critique as being opposed to the arts of oratory and persuasion. This chapter will canvas Kant’s supposed animosity to the persuasive employment of language – rhetoric, in a term – and detail the complexity that lies behind Kant’s reaction to language as a tool of action among moral agents. Drawing upon his anthropological lectures and writings, as well as his religious and aesthetics work, I will argue that Kant leaves space in his system for a moralized, and moralizing, use of persuasive language in human community. Language use can draw upon inclinations and desires in an agent, and thereby compromise their autonomy. Yet there are ways that Kant speaks of or hints at that use language in ways that move us to be free. Kant’s aesthetics also allows room for vivid presentations as a way to make clear to one’s listener what one already knows in a nonmanipulative manner; these presentation styles are tied in with Kant’s religious thought, as well as with the western rhetorical tradition in general.
The USA as a prison where Black people are confined inside a barbed wire of stereotypes – an idea memorably articulated by Malcolm X in 1963 – is influentially explored in works by Amiri Baraka, Etheridge Knight, and Reginald Dwayne Betts, a three-man mini-tradition within prison writing. Circumstances leading to Baraka’s experience of solitary confinement (memorably chronicled in his 1979 poem “AM/TRACK”) are the subject of the first third of the chapter. Etheridge Knight, who in prison forged his own poetic path out of tools provided partly by Malcolm and Baraka, is the subject of the next third. The Knight-inspired Reginald Dwayne Betts, a lawyer-poet who was incarcerated as a teenager, is the focus of the rest of the chapter (except for a brief examination of Baraka’s son, Ras, a significant political leader). All four men articulate secrets of survival in the coils of carceral culture and model alternative ways of imagining justice.
The importance of effective communication between the adults in the lives of children and young people has gained prominence in theory, policy and practice, and throughout the different contexts in which students participate. In educational contexts throughout the world, it has been well established that the best outcomes occur for children and youth when the adults in their lives come together to support them. Communication is at the core of interaction and provides the building blocks for positive relationships to emerge and develop. Such relationships enhance learning and support students, their families and teachers to recognise and reach their full potential. The field of communication offers some sound insight into effective communication between adults, including different models that aid in developing a better understanding about the complex nature of communication in education-based settings.