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When orders of worth clash: Negotiating legitimacy in situations of moral multiplexity
How is moral legitimacy established in pluralist contexts where multiple moral frameworks co-exist and compete? Situations of moral multiplexity complicate not only whether an organization or practice is legitimate but also which criteria should be used to establish moral legitimacy. We argue that moral legitimacy can be thought of as the property of a dynamic dialogical process in which relations between moral schemes are constantly (re-)negotiated through dynamic exchange with audiences. Drawing on Boltanski and Thévenot's 'orders of worth' framework, we propose a process model of how three types of truces may be negotiated: transcendence, compromise, antagonism. While each can create moral legitimacy in pluralistic contexts, legitimacy is not a binary variable but varying in degrees of scope and certainty
Mutually orthogonal latin squares with large holes
Two latin squares are orthogonal if, when they are superimposed, every
ordered pair of symbols appears exactly once. This definition extends naturally
to `incomplete' latin squares each having a hole on the same rows, columns, and
symbols. If an incomplete latin square of order has a hole of order ,
then it is an easy observation that . More generally, if a set of
incomplete mutually orthogonal latin squares of order have a common hole of
order , then . In this article, we prove such sets of
incomplete squares exist for all satisfying
A study protocol to develop and test an e-health intervention in follow-up service for intensive care survivors' relatives
Background: The negative impact on long-term health-related outcomes among relatives of critically ill patients in the intensive care unit (ICU) has been well described. High-quality ICU specialized follow-up care, which is easily accessible with digital innovation and which is designed by and with relevant stakeholders (i.e., ICU patients' relatives and nurses), should be considered to reduce these impairments in the psychological and social domains. Aim: The programme's aim is to develop and test an e-health intervention in a follow-up service to support ICU patients' relatives. Here, the protocol for the overall study programme will be described. Study Design: The overall study comprises a mixed-methods, multicentre research design with qualitative and quantitative study parts. The study population is ICU patients' adult relatives and ICU nurses. The main outcomes are the experiences of these stakeholders with the newly developed e-health intervention. There will be no predefined selection based on age, gender, and level of education to maximize diversity throughout the study programme. After the participants provide informed consent, data will be gathered through focus groups (n = 5) among relatives and individual interviews (n = 20) among nurses exploring the needs and priorities of a digital follow-up service. The findings will be explored further for priority considerations among members of the patient/relative organization (aiming n = 150), which will serve as a basis for digital prototypes of the e-health intervention. Assessment of the intervention will be followed during an iterative process with investigator-developed questionnaires. Finally, symptoms of anxiety and depression will be measured with the 14-item Dutch version of the ‘Hospital Anxiety and Depression Scale’, and symptoms of posttraumatic stress will be measured with the 21-item Dutch version of the ‘Impact of Events Scale-Revised’ to indicate the effectiveness of digital support among ICU patients' relatives. Relevance to Clinical Practice: The e-health intervention to be developed during this research programme can possibly bridge the gap in integrated ICU follow-up care by providing relevant information, self-monitoring and stimulating self-care among ICU patients' relatives
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