Participatory research practices are increasingly being initiated between patients, caregivers, and researchers in traditional health research. We focus on the integration of Patient and Public Involvement and Engagement (PPIE) in health research in a setting where PPIE has become a strategic aim and examine institutional structures through the experience of patients and relatives invited into PPIE activities. Despite the increasing emphasis on PPIE to enhance research quality and healthcare outcomes in Denmark and internationally, our findings show that PPIE is currently located on the fringes of the research process. Consequently, researchers who are constrained by existing institutional structures and processes decide how to make use of patients' and relatives' input. Patients and relatives often feel valued for their unique perspectives in certain parts of the research process, and being part of research gives them unique insights into the healthcare institution. However, the strong institutional context and translocal relations end up shaping their input rather than their input actually shaping research. Through institutional ethnographic methods and the coproduction of the study with patients and relatives, we highlight the complex interplay and negotiation of roles between institutional demands and the personal experiences of being a patient or relative in a research collaboration. By understanding the experience of patients and relatives invited into PPIE activities and how those experiences are influenced, the study shows the importance of how PPIE is implemented within current research institutions by attending to the people who are incorporating it into their praxis as well as to the institution context. The insights gained from this study prompt a reconsideration of roles and legitimate contribution, if PPIE is to truly make a difference in research collaborations.

Various theoretical approaches have sought to account for the derogatory impact of ethnic slurs, paradigmatically exemplified by nouns such as 'Kike or 'Spic'. Content-based accounts of this derogatory impact hold that it owes to a slur's conventional content, e.g., semantic content or conventional implicature. Alternatives to such content-based accounts instead argue that the source of a slur's derogatory impact resides outside its content. According to one family of such alternative approaches, a slur's derogatory effect derives from facts about its use history, especially facts relating to its use by speakers with hateful views of the slur's targets. According to prohibitionism, another alternative to content-based accounts, the derogatory impact of using a slur arises from the presence of a social taboo prohibiting the term's use. This paper discusses how slurs denigrate, focusing primarily on certain multimorphemic slurs in Danish. These multimorphemic slurs, I argue, pose a previously unrecognized problem for history of use accounts. I also briefly argue against prohibitionism and accounts which hold that a slur's derogatory impact owes to its semantic content. After concluding that the derogatory impact of multimorphemic slurs in Danish cannot owe to history of use, taboo or semantic content, I argue that the evidence supports a conventional implicature account of how these terms denigrate.

Focus on patient and public involvement and engagement (PPIE) is increasing in health policy and research governance. PPIE is considered by some to be a democratic right, and by others to be a way to improve health care and research outcomes and implementation. Most recently, policy makers, funders and (clinical) research institutions are making PPIE a strategic requirement for health research urging researchers to invite patients and relatives into their research activities.Our study is based in a Danish university hospital where PPIE has been introduced as one of five strategic research goals. We investigated how researchers experienced this new practice and how their research practices connect to the wider context of the Danish health care system. Ten cases were studied during a year using observations, interviews, and document analysis. As our method of inquiry, we used institutional ethnography to look at researchers’ work from their perspective and to understand how PPIE practices are part of a larger institutional research culture reaching far beyond the individual. We found that current research culture has implications for the selection of patients and relatives and for what they are asked to do. Researchers who experienced that PPIE outcomes aided their existing research practices felt motivated. Researchers who engaged patients and relatives before it was a strategy, were ideologically driven and their approaches resulted in an increased diversity of inclusion and researcher assimilation.These findings add to the current knowledge on PPIE practices and help us understand that further development towards collaborative research practices require a change in key performance indicators and training and perhaps call for attention to our shared acceptance of knowledge generation in research.

Background The quality of care pathways that include transitions between healthcare settings may be increased by improving patients’ experiences of their care journey. Patients’ experiences can be explored through in-depth interviews, but valid and reliable patient-reported experience measures (PREMs) can be a useful and more cost-effective way of assessing patient-experienced quality. The aim of this study was to develop a valid, generic measure for assessment of PAtient-experience of Transitions in Healthcare settings, PATH. We evaluated the structural validity, internal consistency, and test-retest reliability of the PATH questionnaire in a Danish patient population with a range of diagnoses, comorbidities and diversity in age. Methods The PATH questionnaire was developed and tested through an iterative 3-step pilot-test and a comprehensive field-test. Results We found an 18-item version of PATH to be content valid and to have internal consistency and structural validity for a 2-factor solution with a single item scored separately. We found satisfactory test-retest reliability. Conclusions PATH is a generic, content valid, and reliable patient-reported experience measure for the assessment of patient-experienced quality in healthcare transitions. The PATH questionnaire is available for use in quality monitoring and quality improvement research, but we recommend further testing of its measurement properties alongside its practical application.

This article discusses the place of thematic coherence in various approaches to educational dialogue and proposes a unifying approach to the analysis of thematic coherence of classroom conversations based on research in educational dialogue, philosophy of language and recent advances in linguistic research on discourse structure. Addressing the same main question is crucial to preserving thematic coherence in a conversation and is considered a key criterion of quality in classroom dialogues across the field of research in dialogic teaching, e.g., in Alexander’s Dialogic Teaching, Michaels and colleagues’ Accountable Talk, and Mercer’s Interthinking. Nonetheless, a shared definition of thematic coherence is missing in the field. In order to provide such a conception, we propose a question centered approach to evaluating the thematic coherence of educational discourse. On this proposal, the thematic coherence of a conversation depends on how a conversational contribution relates to a conversation’s overall question under discussion. We show how this approach may be used to examine thematic coherence and incoherence and argue that the proposal’s focus on utterance level features of discourse has an advantage in helping researchers track how specific linguistic features of dialogue shape classroom conversations.

Introduction: EQ-5D is an internationally acknowledged tool for assessing health-related quality of life. Our aim was to examine how pragmatic dynamics may influence answers to the EQ-5D-5 L in items where the structure of answer options is disjunctive. Methods: We performed a 3-step linguistic analysis building on the seminal work of Grice, including (1) examination of the lexical meanings of the answer options, (2) considerations of how conversational maxims might affect the respondent's interpretation of compatible answer options under a single item, and (3) analysis of how the questionnaire's context might counteract the problem of omitted answer options by shifting the meaning of context-sensitive expressions. Results: All items with disjunctive answer options exhibit both compatibilities and omissions. In combination with the disjunctive form of answer options these features of the EQ-5D-5 L complicates the communicative task for respondents relying on conversational norms to identify the most suitable answers to the instrument's questions. Discussion: In items where answer options have a disjunctive structure, respondents relying on Gricean conversational maxims will have to depend on their individual understanding of fine-grained details concerning the questionnaire's purpose and may have to weigh how conflicting norms should be balanced. While such dynamics are likely to go undetected in cognitive interviews, linguistic analysis may help to identify them.

This study sought to explore the meaning that people with severe mental illnesses attribute to e-health solutions regarding user involvement and encounters with healthcare professionals. A qualitative design with a social phenomenological approach was applied, and data were collected via repeat interviews. Using a purposive sampling strategy, eight people with severe mental illness were interviewed two times between August 2021 to May 2022, at three different treatment sites in southern Denmark. To be included, participants needed to be 18-65 years of age, diagnosed with severe mental illness (schizophrenia, bipolar disorder, or depression), and using an e-health solution in collaboration with a health professional. The interviews lasted between 20 and 70 min and were audio recorded and then transcribed. The data were analysed with Braun and Clarke's 6-step thematic analysis. Participants experienced the use of an e-health solution as helpful for structuring their everyday lives, and e-health used together with healthcare professionals was considered to have a positive impact on the collaboration. The participants experienced feeling involved and in control when e-health solutions were used, which engaged them in their treatment. Furthermore, the participants found it important to have had some in-person meetings with healthcare professionals to build trust before the e-health solutions could be implemented successfully. E-health solutions used in collaboration with a trusted healthcare professional whom the participants had met in person tended to affect treatment engagement positively.

In both philosophical and linguistic research, the explicit cancelability test is widely used to distinguish semantic contents from conversational implicatures. Assuming a straightforward relation between semantic content and explicit cancelability, a researcher might think that: if the proposition p is expressed semantically by an utterance, then p is not explicitly cancelable. In this paper, however, I argue for two amendments to this assumption. First, following Jerrold Sadock, I argue that the semantic content of an ambiguous utterance may be explicitly cancelable. Against this widely accepted view, a recent paper by Arthur Sullivan argues that the ambiguity problem should be rejected. I respond to Sullivan’s arguments and argue that the ambiguity problem remains despite Sullivan’s objections. Second, I argue that there is also another type of case complicating the relation between semantic content and explicit cancelability. In some cases where an utterance of a sentence s semantically expresses the proposition that p , certain resources that speakers have available for metalinguistic communication may be employed to make p satisfy a sufficient condition for explicit cancelability, although s is not ambiguous. These two weaknesses of the explicit cancelability test have important implications for its diagnostic use.

Background and objectives: This systematic review aimed to investigate the experiences and opinions of people with mental illness regarding the role of telemedicine in their treatment. Methods: To be eligible, studies were required to include people between 18 and 65 years of age with mental illness, defined as depression, anxiety, bipolar disorder, schizophrenia, or personality disorder. It was further required that the patients' experiences of the telehealth solutions were reported. Between April 5, 2020, and June 29, 2020 (renewed November 10, 2021), the CINAHL electronic database was searched. Using the OVID search engine, Embase, MEDLINE, and PsycINFO were likewise searched; gray literature was retrieved from Scopus. The included studies were critically appraised using the CASP checklists.Results: Seventeen studies were included. Treatment provided via telehealth technology offered people with mental illness insights and skills that helped them cope better in everyday life. The patient-therapist relationship was improved where the parties collaborated. Furthermore, gaining control of one's mental health by using an app and following one's development empowered people with mental illness, leading to greater involvement in treatment. Conclusions: Engaging people with mental illness in decisions concerning the use of telehealth technology is essential. It is likewise important that both people with mental illness and health professionals have access to help with the implementation of technology, and that telehealth solutions function as a supplement rather than a substitute for face-to-face treatment.(c) 2022 The Author(s). Published by Elsevier Espana, S.L.U. on behalf of Asociacion Universitaria de Zaragoza para el Progreso de la Psiquiatria y la Salud Mental. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

The International Journal of Integrated Care (IJIC) is an online, open-access, peer-reviewed scientific journal that publishes original articles in the field of integrated care on a continuous basis.IJIC has an Impact Factor of 2.913 (2021 JCR, received in June 2022)The IJIC 20th Anniversary Issue was published in 2021.

The SF-36 is a commonly used tool for measuring health status in a general population. Despite the overall moderate to high validity scores, certain communicative dynamics of the questionnaire deserve attention. Our aim was to examine how pragmatic dynamics, semantic context-sensitivity and epistemic reflection may influence answers to the SF-36. We applied a three-step Gricean analysis, including identification of the items in which pragmatic dynamics are most likely to have a significant effect, examination of how Gricean maxims might affect the answers given to the items identified, and assessment of whether the combined influence of linguistic context-sensitivity and pragmatic norms is benign. We found that the pragmatic dynamics of scalar implicatures are crucial to the interpretation of answer options but generally benign to its purpose. Regarding context, we raised concerns about the answer option 'Ved ikke' (Don't know); rather than representing a neutral midpoint, the answer is compatible with both a positive and a negative answer option. Whereas scalar implicatures are helpful to the purpose of SF-36, other contextual effects appear to be more worrisome. However, since pragmatic norms of communication, semantic context-sensitivity, and attention to epistemic error possibilities can all be expected to shape answers to the SF-36, we think that all three factors belong in a description of how the questionnaire works.

Purpose The SF-36 is a commonly used tool for measuring health status in a general population. Despite the overall moderate to high validity scores, we believe that certain communicative dynamics of the questionnaire deserve more careful attention. Our aim was to examine how pragmatic dynamics and epistemic reflection may influence answers to the SF-36. Methods We applied a three-step Gricean analysis, which included identification of the items in which pragmatic dynamics are most likely to have a significant effect, examination of how Gricean maxims might affect the answers given to the items identified, and finally, assessment of whether the combined influence of linguistic context-sensitivity and pragmatic norms is benign. Results Items 6, 9a, 10 and 11a–d were included in the analysis. Regarding these items, our analysis showed that the pragmatic dynamics of scalar implicatures are crucial to the interpretation of answer options. In addition, we raised concerns specifically about the answer option ‘Ved ikke’; rather than representing a neutral midpoint, the answer is compatible with both a positive and a negative answer option. Nonetheless, we found that the communicative dynamics of the questionnaire are mostly benign. Conclusion Compared to the significance of scalar implicatures, the potential effects of epistemic reflection that we identified are minor because they concern only items with a ‘Don’t know’ answer option. However, we raised the concern that attention to epistemic error possibilities might prompt respondents to opt for a ‘Don’t know’ answer despite having evidence supporting a different answer. Therefore, although pragmatic norms of communication are far more significant than attention to epistemic error possibilities in shaping answers to the SF-36, we think that both factors belong in a description of how the questionnaire works.

While it is common in social epistemology, philosophy of education, and sociology to speak of theoretical knowledge, the concept of theoretical knowledge used in ordinary discourse has not been properly examined, and its relations to other types of knowledge remain unclear. This paper argues that this ordinary language notion of theoretical knowledge has a distinct meaning different from the meanings of terms for other knowledge types, e

While Moorean paradoxes with ‘know’ and epistemic ‘certain’ are distinct, sentences of both types are infelicitous to assert. Jason Stanley and Timothy Williamson both purport to explain these data based on their respective accounts of epistemically appropriate assertion. Stanley claims that his Epistemic Certainty Norm of Assertion provides a unified account of the observed infelicity, while Williamson explains it by supplementing the Knowledge Norm of Assertion with further assumptions about the relation between knowledge and certainty. In this paper, I argue that neither of these explanations succeeds. I then suggest that a unified account of Moorean paradoxes with ‘know’ and epistemic ‘certain’ may be provided by modifying Stanley’s Epistemic Certainty Norm.

According to the widely endorsed Knowledge Account of Assertion, the epistemic requirements on assertion are captured by the Knowledge Norm of Assertion, which requires speakers only to assert what they know. This paper proposes that in addition to the Knowledge Norm there is also an Epistemic Propositional Certainty Norm of Assertion, which enjoins speakers only to assert p if they believe that p on the basis of evidence which makes p an epistemic propositional certainty. The paper explains how this propositional certainty norm accounts for a range of data related to the practice of assertion and defends the norm against general objections to certainty norms of assertion put forward by Duncan Pritchard, John Turri, and Timothy Williamson, by drawing on linguistic theories about epistemic modals and gradable predicate semantics. Together these considerations show that the prospects of a certainty account of assertion are much more promising than is usually assumed.

This chapter surveys the work on epistemic norms of action, practical deliberation, and assertion. In doing so, it is considered how these norms are interrelated. If there are important similarities between the epistemic norms of action and assertion, these may have important ramifications for how we should think about asserting. Thus, the chapter indicates how thinking about assertions as a speech act might benefit from a broader action theoretic setting. In consequence, we begin by considering the epistemic norms of action and practical deliberation on the market. On this basis we proceed to considering the epistemic norms of assertion. Finally, we consider their interrelation and wider ramifications.

The third-person belief ascription, Marie believes that the contract is in the cabinet, may engender two interpretations: (1) It neutrally describes what is on Marie's mind and (2) it offers indirect evidence about reality, committing the speaker to the cabinet as the most likely location. The circumstances that lead to the evidential interpretation are at present not well documented in the case of belief verbs. In the case of belief-dependent verbs with and without embedding clause syntax, for example, Marie says that the contract is in the archive, and Marie is lookingfor the contract in the archive, it has been claimed that they eschew the evidential interpretation altogether. We explore the influence of the pragmatic context on the third-person, present tense and first-person, past tense use of the verbs, believe, say, and look for. In three experiments that manipulated the discourse context, 258 adults rated written vignettes. Regardless of the verb and the tense, when presented in discourse contexts without prior shared knowledge of the location of the object in question, the belief ascription was interpreted as indirect evidence. The results illuminate the border area between semantics and pragmatics, particularly regarding evidential uses of belief and belief-dependent verbs.

Despite general agreement within philosophy that peer review is indispensable, its fairness and reliability is often questioned. This article suggests that such worries can to a large extent be met by adopting the practice that reviews as well as earlier versions of papers are made publicly available when the final version of a paper is published. This suggestion combines the advantages of transparency with the merits of anonymity of reviewers. While there are obstacles to this suggestion, the article argues that it would be worthwhile to implement it because it can help map patterns of conduct and secure confidence in the fairness and reliability of review procedures and journal editing within philosophy.