People living with chronic kidney disease (CKD) face an increased risk of severe outcomes such as hospitalization or death from COVID-19. COVID-19 vaccination is a vital approach to mitigate the risk ...and severity of infection in patients with CKD. Limited information exists regarding the factors that shape COVID-19 vaccine uptake, including health information-seeking behavior and perceptions, within the CKD population.
The objectives were to describe among CKD patients, (1) health information-seeking behavior on COVID-19, (2) their capacity to comprehend and trust COVID-19 information from different sources, and (3) their perceptions concerning COVID-19 infection and vaccination.
Cross-sectional web-based survey administered in British Columbia and Ontario from February 17, 2023, to April 17, 2023.
Chronic kidney disease G3b-5D patients and kidney transplant recipients (CKD G1T-5T) enrolled in a longitudinal COVID-19 vaccine serology study.
The survey consisted of a questionnaire that included demographic and clinical data, perceived susceptibility of contracting COVID-19, the ability to collect, understand, and trust information on COVID-19, as well as perceptions regarding COVID-19 vaccination. Descriptive statistics were used to present the data with values expressed as count (%) and chi square tests were performed with a significance level set at
≤ .05. A content analysis was performed on one open-ended response regarding respondents' questions surrounding COVID-19 infection and vaccination.
Among the 902 patients who received the survey via email, 201 completed the survey, resulting in a response rate of 22%. The median age was 64 years old (IQR 53-74), 48% were male, 51% were university educated, 32% were on kidney replacement therapies, and 57% had received ≥5 COVID-19 vaccine doses. 65% of respondents reported that they had sought out COVID-19-related information in the last 12 months, with 91% and 84% expressing having understood and trusted the information they received, respectively. Those with a higher number of COVID-19 vaccine doses were associated with having sought out (
=.017), comprehended (
< .001), and trusted (
=. 005) COVID-19-related information. Female sex was associated with expressing more concern about contracting COVID-19 (
= .011). Most respondents strongly agreed to statements regarding the benefits of COVID-19 vaccination. Respondents' questions about COVID-19 infection and vaccination centered on 4 major themes: COVID-19 vaccination strategy, vaccine effectiveness, vaccine safety, and the impact of COVID-19 infection and vaccination on kidney health.
This survey was administered within the Canadian health care context to patients with CKD who had at least 1 COVID-19 vaccine dose. Race/ethnicity of participants was not captured.
In this survey of individuals with CKD, COVID-19 information-seeking behavior was high and almost all respondents understood and trusted the information they received. Perceptions toward the COVID-19 vaccine and booster were mostly favorable.
Many nurses grieve when patients die; however, nurses’ grief is not often acknowledged or discussed. Also, little attention is given to preparing nurses for this experience in schools of nursing and ...in orientations to health care organizations. The purpose of this research was to explore obstetrical and neonatal nurses’ experiences of grieving when caring for families who experience loss after perinatal death. A visual arts-informed research method through the medium of digital video was used, informed by human science nursing, grief concepts, and interpretive phenomenology. Five obstetrical nurses and one neonatal intensive care nurse who cared for bereaved families voluntarily participated in this study. Nurses shared their experiences of grieving during in-depth interviews that were professionally audio- and videotaped. Data were analyzed using an iterative process of analysis-synthesis to identify themes and patterns that were then used to guide the editing of the documentary. Thematic patterns identified throughout the data were growth and transformation amid the anguish of grief, professional and personal impact, and giving–receiving meaningful help. The thematic pattern of giving–receiving meaningful help was made up of three thematic threads: support from colleagues; providing authentic, compassionate, quality care; and education and mentorship. Nurses’ grief is significant. Nurses who grieve require acknowledgment, support, and education. Supporting staff through their grief may ultimately have a positive impact on quality of work life and home life for nurses and quality of care for bereaved families.
Purpose of program:
Traditionally, peer review was a closed process conducted only by individuals working in the research field. To establish a more integrated and patient-centered approach, one of ...Canada’s largest kidney research networks (Can-SOLVE CKD) has created a Research Operations Committee (ROC) that includes patients as key members. The ROC represents one way for achieving meaningful patient-oriented research (POR).
Source of information:
Can-SOLVE CKD, a network created as part of the Canadian Institutes of Health Research (CIHR) Strategy for Patient-Oriented Research (SPOR).
Methods:
The ROC consists of patients, physicians, scientists, Indigenous partners, experts in research methodology, and a member of Can-SOLVE CKD’s operational team. On an annual basis, Can-SOLVE CKD’s research teams provide the ROC with a review package, which incorporates information from patient engagement check-in calls and surveys, the project’s knowledge translation plan and products, and a progress report written by the project team. The ROC evaluates the review package and provides feedback and recommendations accordingly.
Key findings:
The transparent nature of the process, regular feedback and review, along with an overt accountability and scoring system, has been embraced by both patients and researchers. As a result of the ROC process, the number of patient leads for each project has grown over a 3-year period and more researchers have received POR and cultural sensitivity training.
Limitations:
While anecdotal evidence suggests this approach is beneficial for achieving POR, formal mechanisms of evaluation are currently lacking.
Implications:
This ROC framework ensures patients are active contributors throughout the research process and could be adopted by other organizations to achieve a more patient-centered approach to research.
It is widely accepted that knowledge of certain of one's own mental states is authoritative in being epistemically more secure than knowledge of the mental states of others, and theories of ...self-knowledge have largely appealed to one or the other of two sources to explain this special epistemic status. The first, 'detectivist', position, appeals to an inner perception-like basis, whereas the second, 'constitutivist', one, appeals to the view that the special security awarded to certain self-knowledge is a conceptual matter. I argue that there is a fundamental class of cases of authoritative self-knowledge, ones in which subjects are consciously thinking about their current, conscious intentional states, that is best accounted for in terms of a theory that is, broadly speaking, introspectionist and detectivist. The position developed has an intuitive plausibility that has inspired many who work in the Cartesian tradition, and the potential to yield a single treatment of the basis of authoritative self-knowledge for both intentional states and sensation states.
The purpose of this research was to uncover the structure of the lived experience of living with changing expectations from the perspectives of women with high-risk pregnancies. The researchers' ...nursing theoretical perspective is the humanbecoming theory and the Parse research method was used. For the participants, living with changing expectations is foreboding disquietude arising with arduous restrictions, while envisioning the yearned-for with mitigating nurturing engagements. Findings enhance the theory of humanbecoming as well as enhance understanding of the experience of living with changing expectations. Recommendations for future research and practice are discussed.
Knowing Our Own Minds Wright, Crispin; Smith, Barry C; Macdonald, Cynthia
1998, 1998-10-15
eBook
Self-knowledge is the focus of considerable attention from philosophers: Knowing Our Own Minds gives a much-needed overview of current work on the subject, bringing together new essays by leading ...figures. Knowledge of one's own sensations, desires, intentions, thoughts, beliefs, and other attitudes is characteristically different from other kinds of knowledge: it has greater immediacy, authority, and salience. The contributors examine philosophical questions raised by the distinctive character of self-knowledge, relating it to knowledge of other minds, to rationality and agency, externalist theories of psychological content, and knowledge of language. Together these original, stimulating, and closely interlinked essays demonstrate the special relevance of self-knowledge to a broad range of issues in epistemology, philosophy of mind, and philosophy of language.
The Metaphysics of Mental Causation MacDonald, Cynthia; MacDonald, Graham
The Journal of philosophy,
11/2006, Volume:
103, Issue:
11
Journal Article
Peer reviewed
Open access
A debate has been raging in the philosophy of mind for at least the past two decades. It concerns whether the mental can make a causal difference to the world. A look at this debate is presented.
From An Explanation of America: LAIR Robert Pinsky ? Inexhaustible, delicate, as if Without source or medium, daylight Undoes the mind; the infinite, Empty actual is too bright, Scattering to where ...the road Whispers, through a mile of woods … Later, how quiet the house is: Dusk-like and refined, The sweet Phoebe-note Piercing from the trees; The calm globe of the morning, Things to read or to write Ranged on a table; the brain A dark, stubborn current that breathes Blood, a deaf wadding, The hands feeding it paper And sensations of wood or metal On its own terms. Trying to read I persist a while, finish the recognition By my breath of a dead giant's breath-- Stayed by the space of a rhythm, Witnessing the blue gulf of the air.
Octavio Paz has long been known for his brilliant essays as well as for his poetry. Through the essays, he has sought to confront the tensions inherent in the conflict between art and society and to ...achieve a unity of their polarities. The Siren and the Seashell is a collection of Paz’s essays, focusing on individual poets and on poetry in general. The first five poets he treats are Latin American: Sor Juana Inés de la Cruz, Rubén Darío, José Juan Tablada, Ramón López Velarde, and Alfonso Reyes. Then there are essays on Robert Frost, e. e. cummings, Saint-John Perse, Antonio Machado, and Jorge Guillén. Finally, there are Paz’s reflections on the poetry of solitude and communion and the literature of Latin America. Each essay is more than Paz’s impressions of one person or issue; each is the occasion for a wider discussion of cultural, historical, psychological, and philosophical themes. The essays were selected from Paz’s writing between 1942 and 1965 and provide an overview of the development of his thinking and an exploration of the ideas central in his works.
In this paper I outline and defend an introspectionist account of authoritative self-knowledge for a certain class of cases, ones in which a subject is both thinking and thinking about a current, ...conscious thought. My account is distinctive in a number of ways, one of which is that it is compatible with the truth of externalism—the view that the contents of subjects' intentional states are individuation-dependent on factors external to their minds. It is thus decidedly anti-Cartesian, despite being introspectionist. My argument proceeds in three stages. A virtue of the position I develop is that the epistemic features on which it is based also apply to sensations and to non-episodic intentional states, to the extent that one has authoritative knowledge of them. However, despite the appeal to analogies with observable properties of objects of perception, the account is not a 'perceptual' model of such knowledge in the sense that those such as Shoemaker, Burge and others have in mind. Because the features on which the analogy is based are abstract and general, they are not tied to cases of observation alone. Those who appeal to such phenomena as 'intellectual experience' (Burge, "Proceedings of the Aristotelian Society", 96, 91—116, 1996) or 'intellectual intuition' (Bealer, "Philosophical perspectives", Cambridge, MA: Basil Blackwell, 29—55, 1999) in their accounts of authoritative self-knowledge may well appeal to such features. This, amongst other factors, distinguishes the position from other introspectionist ones in a way that makes it immune to standard objections to perceptual models of self-knowledge.
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