Relative Autonomy Research Articles

‘Trying to patch a broken system’: Exploring institutional work among care professions for interprofessional collaboration

Abstract There is a growing interest in understanding when and why interprofessional collaborations are well functioning, especially within healthcare systems. However, more knowledge is needed about how professionals affect and contribute to these collaborations when they engage in them. To address this shortcoming, this study aims to contribute to professional and organizational studies of interprofessional collaboration by providing novel insights into how professionals engage in and contribute to interprofessional collaborations. It builds on a theoretical perspective of examining professionals’ everyday collaboration practices through the interplay between temporal-oriented agency and institutional work. It applies this perspective to a case study of interprofessional collaboration between personal workers (PWs), nurses, and therapists in the home care sector in Denmark. Overall, the findings show that the professionals engaged in and contributed to the interprofessional collaboration by ‘trying to patch a broken system’. All three professional groups did this primarily by ‘adopting new practices to deal with inept institutionalized practices’ to maintain collaboration. Additionally, some PWs ‘failed to enact institutionalized practices’ to disrupt the collaboration, and some nurses and therapists ‘invented and established mechanisms’ to create new arrangements for the collaboration. Based on the findings, the study demonstrates that certain dimensions of agency are associated with certain types of institutional work. Furthermore, the study suggests that the interplay between agency and institutional work varies between professional groups, influenced by their relative autonomy.

Large-size gold–aluminum alloy cluster Al12Au60 stabilized by an encapsulating B12 icosahedron: a first-principles study

The investigation of novel clusters incorporating gold (Au) has attracted increasing attention due to their intriguing architecture and feasibility of experimental synthesis. In this study, a large-size gold–aluminum alloy cluster with icosahedral B12 as its core, specifically a B12@Al12Au60 cluster, is proposed and demonstrated to have remarkable stability as ascertained through first-principles calculations. The core–shell assembly, B12@Al12Au60, exhibiting I symmetry, is characterized by the incorporation of an icosahedral B12 motif within the outer shell of the Al12Au60 framework. By thorough analysis encompassing vibrational frequency and molecular dynamics simulations, the structural stability of the core–shell B12@Al12Au60 is investigated. The electronic characteristics are probed through adaptive natural density partitioning analysis, revealing the presence of 66 multi-center two-electron σ bonds distributed across the entirety of the core–shell configuration. Furthermore, scrutiny of distinct dimeric configurations composed of core–shell B12@Al12Au60 underscores their relative autonomy and potential prospects for applications within cluster-assembled materials.

An alternative planetary future? Digital sovereignty frameworks and the decolonial option

The frameworks of cyber, technology and data sovereignty have become some of the most influential alternative technological imaginaries. Developed by states and civil society groups, such frameworks are seducing a broad range of actors seeking to reassert their autonomy and self-determination in relation to digital technology and infrastructure. Against this backdrop, this article interrogates the alleged transformative character of digital sovereignty. Do these frameworks support alternative planetary futures, or do they involve a mere change in the actors who are privileging from the technological status quo? To answer this question, I examine the rhetoric and realisation of digital sovereignty frameworks by the Chinese state, the European Union (EU) and Latin American civil society in light of Walter Mignolo's decolonial option. The decolonial option gets inspiration from decolonial praxis and aims at enabling polycentric, noncapitalist and nonanthropocentric planetary futures. As I show, there is some degree of alignment between digital sovereignty frameworks and the decolonial option in the sphere of international politics, but less so in the world economy and the environment. While in some areas the formulations by the Chinese state and the EU can exacerbate coloniality, the Latin American civil society one constitutes a promising attempt at appropriating digital sovereignty from below and promoting peaceful forms of coexistence with the environment although needs further development.

“I Prefer Eating Less Than Eating Healthy”: Drivers of Food Choice in a Sample of Muslim Adolescents

Adolescence is a time of significant change which is experienced differently across sociocultural contexts. Understanding drivers of food practice in adolescence is vital as these impact future health outcomes and can drive health inequality. This study investigates drivers of food choice in predominantly British–Asian, Muslim adolescents living in a deprived urban area of England. It identifies dominant drivers of food choice and their impact on health and wellbeing, and explores how Muslim adolescents from a low socioeconomic, British–Asian group understand and action autonomy in their food practices. PhotoVoice, a focussed ethnographical methodology where participants reflect on lived experience, was used to address the study aim. Participants (n = 21) were secondary school pupils aged 14–15 years, recruited from a school situated in an area of deprivation. Four overarching themes were developed from the qualitative data framework analysis: (1) food preference and other determinants of food choice; (2) concept, understanding and importance of health; (3) developing autonomy, skills, and independence; and (4) role of community, friends, and family in food practices. The adolescents were developing autonomy in relation to their food practices, whilst navigating a complex web of factors which were, in part, determined by their social class location and demographics. Participants understood the constituents of healthy eating. However, there was a perceived “effort” of being healthy, including additional time for preparing healthier food and sacrificing taste preferences. Parents, friends, and schools highly influence food choices, with adolescents preferring a broad palate of takeaway and convenience foods and would prefer to eat less of these “unhealthy” options than eat healthily.

'Someone must do it': multiple views on family's role in end-of-life care - an international qualitative study.

Family is a crucial social institution in end-of-life care. Family caregivers are encouraged to take on more responsibility at different times during the illness, providing personal and medical care. Unpaid work can be overburdening, with women often spending more time in care work than men. This study explored multiple views on the family's role in end-of-life care from a critical perspective and a relational autonomy lens, considering gender in a socio-cultural context and applying a relational autonomy framework. It explored patients, relatives and healthcare providers' points of view. This qualitative study was part of the iLIVE project, involving patients with incurable diseases, their relatives and health carers from hospital and non-hospital sites. Individual interviews of at least five patients, five relatives and five healthcare providers in each of the 10 participating countries using a semi-structured interview guide based on Giger-Davidhizar-Haff's model for cultural assessment in end-of-life care. Thematic analysis was performed initially within each country and across the complete dataset. Data sources, including researchers' field notes, were translated into English for international collaborative analysis. We conducted 158 interviews (57 patients, 48 relatives and 53 healthcare providers). After collaborative analysis, five themes were identified across the countries: family as a finite care resource, families' active role in decision-making, open communication with the family, care burden and socio-cultural mandates. Families were crucial for providing informal care during severe illness, often acting as the only resource. Patients acknowledged the strain on carers, leading to a conceptual model highlighting socio-cultural influences, relational autonomy, care burden and feminisation of care. Society, health teams and family systems still need to better support the role of family caregivers described across countries. The model implies that family roles in end-of-life care balance relational autonomy with socio-cultural values. Real-world end-of-life scenarios do not occur in a wholly individualistic, closed-off atmosphere but in an interpersonal setting. Gender is often prominent, but normative ideas influence the decisions and actions of all involved.

Источники мотивации и академических достижений студентов: роль родительского контроля и поддержки автономии

Background. The study examines the role of control and autonomy support as two of the most important factors in parenting. A scientific analysis of the consequences of parental control and support for autonomy is necessary both to deepen theoretical understanding of the role of autonomy in relations between parents and children and to develop sound practical recommendations. Objective. The goal is to analyse the direct and indirect (through academic motivation) links of autonomy support and parental control in childhood with the academic achievements of students. Study Participants. Russian university students (N = 281, MA = 19.8, SD = 2.01, 78% female). Methods. Parenting style in childhood (P-PASS), academic motivation, including scales of intrinsic motivation, extrinsic motivation and amotivation, and average academic performance were assessed. Results. The main hypothesis about the positive association between parental autonomy support in childhood and the academic achievements of students, mediated by intrinsic academic motivation, was confirmed. It has been shown that the controlling style is a predictor of external motivation and amotivation, which in turn are negatively related to intrinsic motivation. Conclusion. Results of the study indicate the important role of parental practices, differentiated within self-determination theory for the students’ (de) motivation and academic performance. In particular, the importance of autonomy support and the negative contribution of parental control are shown at much later stages of socialization, the stage of emerging adulthood.

O cuidado em comunidades de pesca: reflexões sobre e para o currículo da Educação Infantil

ABSTRACT In Brazil, since the first decade of this century, there has been a concern as to outlining the meaning of care as a principle of the curriculum and the early childhood education policy. Based on references from philosophy and historical and sociological analyses, care is outlined as relationships and actions that have the other in mind and become constitutive of being, implying the constitution of each person. Between 2021 and 2022, we carried out post-doctoral research that sought to deepen the meanings of care to reflect on the early childhood education curriculum. The idea of the project was to consider care from the perspective of traditional populations and social movements. For this, we carried out an ethnography with a fishing community on the north coast of the state of Alagoas, Brazil. The study refutes notions that traditional people offer precarious care, as considered by the colonizer. In fact, it is just the opposite. Traditional peoples develop community care, implying greater freedom for children to move around community, and greater autonomy in relation to the demands of life and to act according to their curiosities. Subtle friendly relationships that are expressed in silence, economy of words and attention to gestures are at the basis of care. We consider that early childhood education curricula need to incorporate the different forms and meanings of caring for babies and children, and not subordinate social identities.

The robot butler: How and why should we study predictive algorithms and artificial intelligence (AI) in healthcare?

This article investigates how the PMHnet algorithm - an AI prognostication tool developed in Denmark to predict the one-year all-cause mortality risk for patients hospitalized with ischemic heart disease - was presented to cardiologists working in the hospital setting, and how they responded to this novel decision-support tool. Empirically, we draw upon ethnographic fieldwork in the Danish-led international research project, PM Heart, which since 2019 has developed the PMHnet algorithm and implemented the software into the electronic health record system in hospitals in Eastern Denmark (the Capital Region and Region Zealand). Paying careful attention to the hopes and concerns of cardiologists who will have to embrace and adapt to algorithmic tools in their everyday work of diagnosing and treating patients, we identify three analytical themes meriting attention when AI is implemented in healthcare: 1) the re-negotiation of agency and autonomy in human-algorithm relations, 2) accountability in algorithmic prognostication and 3) the complex relationship between association and causation actualized by predictive algorithms. From these analytical themes, we elicit methodological questions to guide future ethnographic explorations of how AI and advanced algorithms are put to use in the healthcare system, with what implications, and for whom. We conclude that local, qualitative investigations of how algorithms are used, embraced and contested in everyday clinical practice are needed in order to understand their implications - good and bad, intended and unintended - for clinicians, patients and healthcare provision.

Этнополитическое движение саамов в Арктическом регионе: от развития до стагнации

The ethnopolitical movement of the Sámi in the Arctic region is examined through significant events in its development, including during Russia’s special military operation in Ukraine. The author attempts to assess the current stage of the movement’s development and justify factors of its stagnation, proposing potential positive change scenarios based on the analysis of leading scholarly works in ethnopolitics and international relations, as well as open official internet resources of international organizations and periodical news publications. As a result, the author suggests considering five main stages in the development of the Sámi ethnopolitical movement against the backdrop of gradual formation of close international cooperation and cross-­border interaction among the countries where this indigenous Arctic people reside. It is identified that the collective West’s sanction policy against Russia negatively impacts the national consciousness of the Sámi people and the status of unity, which is unequivocally ignored by their own political leaders, leading the ethnopolitical movement to acute stagnation. This crisis is proposed to be seen as an opportunity to rethink the long historical journey of the Sámi towards relative political autonomy within the framework of pan-­Sámi policy.’

Цивилизация и культура в XXI веке. Диалог, конвергенция или конфронтация? (Коммуникативный аспект)

. It seems to us that although each of the concrete historical forms of culture functions within "its" civilization, genetically, structurally and functionally, art always retains its spiritual and creative "redundancy" in relation to its civilization, and its signs precisely characterize culture in relation to civilization from the side of its relative autonomy and creativity freedom.
 The orientation of civilization towards the means of life, the immediate practical interests and values due to its focus on the development, use of natural conditions of life, external life are complemented in any particular society, "enlightened" by the appeal of culture, and especially art to internal life, expressing the boundlessness of the "claims of the human spirit".
 Layers of psychic reality are available for artistic reflection. And it is no coincidence, apparently, that in scientific research on this issue we sometimes see more references to the works of artists than to the actual scientific works. The same thing happens with objective reality, and on the borders of the unknown, the infinite. The requirement of reliability, verifiability, and the necessary axiomatization of knowledge complicates the formation and institutionalization of a hypothetical idea in science, requires overcoming the existing paradigm and corresponding empirical confirmations. Otherwise, the unknown is explicated in art. It enters into it in the full scope of uncertainty and improbability.
 If technical civilization builds its relations with the natural universe, realizing the principles of consumption and subjugation of nature, subordination to man, as if for the benefit of man, then culture, and above all art, cultivate our attitude to nature, which is based on disinterested contemplation, reverence, reverent admiration as the highest and most perfect form of creation, which is for a person, an eternal source of creative inspiration. Unlike the anthropocentrism of civilization, art is characterized by environmentalism and the desire for universal unity with nature, its pantheistic perception.

Relational Autonomy in Teacher Education: Deepening Teacher Quality through Indigenous and Decolonizing Education

Drawing from transnational and critical studies in Indigenous and decolonizing education, this paper argues for relational autonomy as a key dimension of teacher quality. Bridging feminist critiques of autonomy and Indigenous and decolonial conceptions of personhood, it defines relational autonomy as the personal and social factors that allow individuals to take principled action to benefit their communities when applied to teacher education, relational autonomy helps us understand that good teachers are those who ably support students while transmitting a love of learning, an ethic of care, and a sense of responsibility. The article summarizes the strengths of relational autonomy. The article concludes by discussing how relational autonomy might enrich and decolonize efforts to conceptualize, administer, and evaluate teacher preparation programs going forward.

PREPARING FOR ADVANCING ILLNESS AND END OF LIFE WITH DEMENTIA

Abstract Dementia involves coping with advancing illness that involves cognitive and functional decline. Also decision-making capacity diminishes, which implies that preparing for a future and taking opportunities to exercise individual and relational autonomy is particularly relevant in the case of dementia. Engaging the person with dementia and family caregivers meaningfully in formal or informal advance care planning conversations may require addressing specific challenges. Health care providers often lack time or are reluctant to broach these conversations. Often conversations are delayed even in institutional long-term care settings as residents, their family caregivers and care providers may all view advance care planning as uncomfortable and difficult to initiate. Special support for health care providers to develop skills, confidence and taking initiative is needed. This symposium presents about new, large qualitative and quantitative studies with contributions from the UK and Canada, and international work. It addresses preparing for an uncertain future through advance care planning and decision making about future care and treatment which may include conversations about the end of life. We present and evaluate tools to support the process across settings.

TEMPORAL ORGANIZATION OF ORAL ENGLISH AND GERMAN RELIGIOUS SERMONS (THEOLINGUISTIC APPROACH)

The article is dedicated to exploring the temporal organization of texts in Anglican and Lutheran sermons, which are an integral part of worship in their respective churches. The study of homiletic and theolinguistic literature, along with an examination of the compositional features of the analysed sermons, has allowed for the identification of four compositional parts present in both types of sermons (theme manifestation, citation, interpretation, conclusion). Each part is characterized by relative semantic and structural autonomy, serving specific pragmatic purposes. The research material, consisting of oral English and German sermons, underwent perceptual, auditory, and instrumental analysis. A comprehensive auditory and instrumental analysis of the temporal characteristics of the preachers’ speech allows the conclusion that there is unity not only in the pragmatic directives of preachers in the two most widespread Protestant traditions but also in the prosodic structure of oral sermons. Among the integral temporal parameters at the perceptual level, pauses and contrasting tempo play a leading role in creating the influential effect of sermons. Regarding integral objective temporal parameters, common patterns in the temporal organization of the introductory and main parts of the text are identified. Differentiating features include significant differences between Anglican and Lutheran sermons in the concluding part. Lutheran sermons demonstrate relatively stable use of a normal tempo with a tendency toward slowing down, while Anglican sermons exhibit contrasting use of both slowed and accelerated tempo, creating a “broken” rhythm of articulation that enhances the influential effect of this part of the sermon. Based on the identified integral temporal means involved in the construction of the analysed texts, it can be stated that Anglican and Lutheran sermons belong to the same type of homiletic discourse.

Why Pashukanis was right: Abstraction and form in The General Theory of Law and Marxism

The area of Marxism and law has long been considered marginalised. However, hand in hand with the renaissance of Marxist theory in recent decades, neglect has finally been put to rest. As Marxists increasingly explore the connections between rights, law, democracy and capitalism, one text in particular has taken centre stage: The General Theory of Law and Marxism, published by E. B. Pashukanis in 1924. This article seeks to make three contributions to the field of Marxism and law. First, by proposing that Pashukanis’s polemic is best understood as a critique of a spectrum between formalism and instrumentalism, containing both differences and similarities, it rectifies the way in which these concepts most often either have been discussed at a too general level or been defined too narrowly. Second, by addressing the conceptions of abstraction and form in the General Theory, it reconstructs the concept of the legal form according to the spirit of Pashukanis’s thought to supersede the limits of the formalism–instrumentalism spectrum, despite the unevenness found in the letter of his text. Third, regarding the reconstruction of the concept of the legal form, it demonstrates how objections against Pashukanis’s focus on the sphere of circulation at the cost of production, his exclusion of inequalities of race and gender, and his structuralist, consequentialist or instrumentalist biases, which reduces the space for agency, processes and the relative autonomy of politics, ideology and law, can be reconsidered and challenged.

Cultural and technical progress in a sociogenetic perspective

The correlation of cultural and technical progress is considered as a manifestation of subject-active and behavioral principles in sociogenesis. Both factors of the sociogenetic process have relative autonomy, uniting in the systemic organization of society. The relevance of addressing the essence of cultural progress, which manifests itself in sociogenesis as the development of specific universal principles of behavior, appearing as the universal foundations of morality, is pointed out.

Reluctant Republic: A Positive Right for Older People to Refuse AI-Based Technology

Societies in the global North face a future of accelerated ageing. In this context, advanced technology, especially that involving artificial intelligence (AI), is often presented as a natural counterweight to stagnation and decay. While it is a reasonable expectation that AI will play important roles in such societies, the manner in which it affects the lives of older people needs to be discussed. Here I argue that older people should be able to exercise, if they so choose, a right to refuse AI-based technologies, and that this right cannot be purely negative. There is a public duty to provide minimal conditions to exercise such a right, even if majorities in the relevant societies disagree with skeptical attitudes towards technology. It is crucial to recognize that there is nothing inherently irrational or particularly selfish in refusing to embrace technologies that are commonly considered disruptive and opaque, especially when the refusers have much to lose. Some older individuals may understandably decide that they indeed stand to lose a whole world of familiar facts and experiences, competencies built in decades of effort, and autonomy in relation to technology. The current default of investigating older people’s resistance to technology as driven by fear or exaggerated emotion in general, and therefore as something to be managed and extinguished, is untenable.

Comparison Between Indonesian and German Regional Autonomy in Relation to the Government System

The purpose of this study is to explain the comparison between the regional autonomy of Indonesia and Germany concerning the system of government adopted by the two countries. Regional autonomy in a country, both in Indonesia and in Germany, has the same goal, namely to give authority to regional governments in managing internal affairs in their respective regional domains. However, the differences in the government systems adopted by the two countries have resulted in differences in the structure and implementation of the regional autonomy system in the two countries. The theories used in discussing this research are the theory of federalism, the theory of decentralization, and the theory of constitutionalism. The research method used in this research is normative legal research, namely research that examines document studies using various secondary data such as court decisions, laws, and regulations, legal theory, and can be in the form of opinions of scholars. In addition, this study also uses the comparative legal research method, namely a research methodology conducted by comparing the legal systems of two or more different countries or jurisdictions. The comparison of the regional autonomy of Indonesia and Germany is related to the difference in the system of government adopted by the two countries where Indonesia has a government system called the Unitary State of the Republic of Indonesia (NKRI) while Germany has a federal government system called the Federal Republic of Germany (RFJ). This resulted in a different regional autonomy between Indonesia and Germany. In Indonesia, there are restrictions on local governments to regulate their internal affairs whereby the supreme power rests with the central government while the states in Germany have greater authority in managing their internal affairs

How clinicians can respond when family members question a proxy/surrogate's judgment and decisional capacity

Many state laws specify procedures for determining surrogate or proxy decision-makers for end-of-life care in the absence of an advance directive, living will, or other designation. Some laws also set forth criteria that the decision-maker must follow when making medical decisions for an incapacitated patient and determining whether to withdraw life-sustaining treatment. This article provides analysis of a medical ethics case on the question of how to address family allegations that the proxy decision-maker suffers from dementia and is unable to make decisions for the patient. Cases such as this involve interwoven legal and ethical considerations including: how to address concerns that the proxy is making questionable or unreasonable decisions, how to evaluate the proxy's decisional capacity, strategies for enhancing communication, and standards for removing a proxy. This article suggests that “surrogacy ladders” in state law serve not only as a procedural mechanism, but also protect important ethical values such as tiers of moral authority for decision-making, relational autonomy, and privacy.

Housing Financialization and the State, in and Beyond Southern Europe: A Conceptual and Operational Framework

ABSTRACT This article sets out a conceptual/operational framework designed to analyse how the state has enabled, promoted and shaped housing financialization. We build on the systematic analysis of literature and legislation in Portugal, Spain, Italy and Greece, thereby providing an overview of housing financialization in Southern Europe. We identify six modes of housing financialization (mortgage debt, mortgage securitization, social rented housing, market rental housing, housing companies, “not-for-housing housing”), characterized by relative autonomy and specific mechanisms, plus a number of cross-cutting dimensions. Our conceptual/operational framework allows to systematically inquiry whether the state has passively adapted to global transformations or shaped these transformations in turn, therefore advancing two main contributions: first, contributing to a more precise conceptualization of the mechanisms of housing financialization; and, second, providing operational instruments to explore state action and policy in housing financialization beyond Southern Europe.

Non-binary gender identity expression in the workplace and the role of supportive HRM practices, co-worker allyship, and job autonomy

In this paper, we shed light on how non-binary people express their gender identity in the workplace by drawing on self-discrepancy and self-verification theories. We argue that non-binary workers may experience a discrepancy between their actual and ideal expression of their gender identity at work and be motivated to prevent this due to a desire for others to see them as they see themselves. A mixed quantitative/qualitative survey of 160 non-binary workers in the UK and USA reveals that there are various ways non-binary workers express their gender identity at work via physical appearance and clothing, gestures and language, posture and movement, and other communication signals. However, most non-binary workers may perceive a moderate level of discrepancy between their current and ideal-future expression of their gender identity at work. We find that such discrepancies are less likely to occur when organizations promote supportive gender identity related HRM practices (such as flexible dress code and pronoun policies), co-worker allyship, and job autonomy. Overall, we contribute to knowledge about how non-binary people view their gender identity expression at work and what HR practitioners, managers, and co-workers can do to support them.