Background In May 2020, England moved to an opt-out organ donation system, meaning adults are presumed to be an organ donor unless within an excluded group or have opted-out. This change aims to improve organ donation rates following brain or circulatory death. Healthcare staff in the UK are supportive of organ donation, however, both healthcare staff and the public have raised concerns and ethical issues regarding the change. The #options survey was completed by NHS organisations with the aim (...) of understanding awareness and support of the change. This paper analyses the free-text responses from the survey. Methods The #options survey was registered as a National Institute of Health Research (NIHR) portfolio trial [IRAS 275992] 14 February 2020, and was completed between July and December 2020 across NHS organisations in the North-East and North Cumbria, and North Thames. The survey contained 16 questions of which three were free-text, covering reasons against, additional information required and family discussions. The responses to these questions were thematically analysed. Results The #options survey received 5789 responses from NHS staff with 1404 individuals leaving 1657 free-text responses for analysis. The family discussion question elicited the largest number of responses (66%), followed by those against the legislation (19%), and those requiring more information (15%). Analysis revealed six main themes with 22 sub-themes. Conclusions The overall #options survey indicated NHS staff are supportive of the legislative change. Analysis of the free-text responses indicates that the views of the NHS staff who are against the change reflect the reasons, misconceptions, and misunderstandings of the public. Additional concerns included the rationale for the change, informed decision making, easy access to information and information regarding organ donation processes. Educational materials and interventions need to be developed for NHS staff to address the concepts of autonomy and consent, organ donation processes, and promote family conversations. Wider public awareness campaigns should continue to promote the positives and refute the negatives thus reducing misconceptions and misunderstandings. Trial registration National Institute of Health Research (NIHR) [IRAS 275992]. (shrink)

Objectives To conduct an independent evaluation of the first phase of the Health Foundation’s Safer Patients Initiative (SPI), and to identify the net additional effect of SPI and any differences in changes in participating and non-participating NHS hospitals. Design Mixed method evaluation involving five substudies, before and after design. Setting NHS hospitals in the United Kingdom. Participants Four hospitals (one in each country in the UK) participating in the first phase of the SPI (SPI1); 18 control hospitals. Intervention The SPI1 (...) was a compound (multi-component) organisational intervention delivered over 18 months that focused on improving the reliability of specific frontline care processes in designated clinical specialties and promoting organisational and cultural change. Results Senior staff members were knowledgeable and enthusiastic about SPI1. There was a small (0.08 points on a 5 point scale) but significant (P<0.01) effect in favour of the SPI1 hospitals in one of 11 dimensions of the staff questionnaire (organisational climate). Qualitative evidence showed only modest penetration of SPI1 at medical ward level. Although SPI1 was designed to engage staff from the bottom up, it did not usually feel like this to those working on the wards, and questions about legitimacy of some aspects of SPI1 were raised. Of the five components to identify patients at risk of deterioration—monitoring of vital signs (14 items); routine tests (three items); evidence based standards specific to certain diseases (three items); prescribing errors (multiple items from the British National Formulary); and medical history taking (11 items)—there was little net difference between control and SPI1 hospitals, except in relation to quality of monitoring of acute medical patients, which improved on average over time across all hospitals. Recording of respiratory rate increased to a greater degree in SPI1 than in control hospitals; in the second six hours after admission recording increased from 40% (93) to 69% (165) in control hospitals and from 37% (141) to 78% (296) in SPI1 hospitals (odds ratio for “difference in difference” 2.1, 99% confidence interval 1.0 to 4.3; P=0.008). Use of a formal scoring system for patients with pneumonia also increased over time (from 2% (102) to 23% (111) in control hospitals and from 2% (170) to 9% (189) in SPI1 hospitals), which favoured controls and was not significant (0.3, 0.02 to 3.4; P=0.173). There were no improvements in the proportion of prescription errors and no effects that could be attributed to SPI1 in non-targeted generic areas (such as enhanced safety culture). On some measures, the lack of effect could be because compliance was already high at baseline (such as use of steroids in over 85% of cases where indicated), but even when there was more room for improvement (such as in quality of medical history taking), there was no significant additional net effect of SPI1. There were no changes over time or between control and SPI1 hospitals in errors or rates of adverse events in patients in medical wards. Mortality increased from 11% (27) to 16% (39) among controls and decreased from 17% (63) to 13% (49) among SPI1 hospitals, but the risk adjusted difference was not significant (0.5, 0.2 to 1.4; P=0.085). Poor care was a contributing factor in four of the 178 deaths identified by review of case notes. The survey of patients showed no significant differences apart from an increase in perception of cleanliness in favour of SPI1 hospitals. Conclusions The introduction of SPI1 was associated with improvements in one of the types of clinical process studied (monitoring of vital signs) and one measure of staff perceptions of organisational climate. There was no additional effect of SPI1 on other targeted issues nor on other measures of generic organisational strengthening. (shrink)

BackgroundThe COVID-19 pandemic has created ethical challenges for intensive care unit (ICU) professionals, potentially causing moral distress. This study explored the levels and causes of moral distress and the ethical climate in Dutch ICUs during COVID-19.MethodsAn extended version of the Measurement of Moral Distress for Healthcare Professionals (MMD-HP) and Ethical Decision Making Climate Questionnaire (EDMCQ) were online distributed among all 84 ICUs. Moral distress scores in nurses and intensivists were compared with the historical control group one year before COVID-19. ResultsThree (...) hundred forty-five nurses (70.7%), 40 intensivists (8.2%), and 103 supporting staff (21.1%) completed the survey. Moral distress levels were higher for nurses than supporting staff. Moral distress levels in intensivists did not differ significantly from those of nurses and supporting staff. “Inadequate emotional support for patients and their families” was the highest-ranked cause of moral distress for all groups of professionals. Of all factors, all professions rated the ethical climate most positively regarding the culture of mutual respect, ethical awareness and support. “Culture of not avoiding end-of-life-decisions” and “Self-reflective and empowering leadership” received the lowest mean scores. Moral distress scores during COVID-19 were significantly lower for ICU nurses (p < 0.001) and intensivists (p < 0.05) compared to one year prior.ConclusionLevels and causes of moral distress vary between ICU professionals and differ from the historical control group. Targeted interventions that address moral distress during a crisis are desirable to improve the mental health and retention of ICU professionals and the quality of patient care. (shrink)

Dignity represents the essence of nursing care; hence, nurses are professionally responsible for promoting understanding about the promotion, provision, and preservation of every patient’s dignity, while considering contextual differences. The aim of this study was to explore the factors that influence, promote, or compromise patient dignity. A purposeful sample of 14 participants with hospitalization experience was chosen, and individual in-depth semi-structured interviews were conducted for data collection. Using inductive content analysis, the themes and subthemes related to factors influencing patients’ dignity (...) were explored: “persona” (“personal beliefs” and “personal characteristics”), “communication behaviors” (“verbal interaction,” “body language,” “compassionate behavior,” and “devoting enough time”), and “staff conduct” (“professional commitment,” “adequate human resources,” and “staff’s proficiency and competency”). The findings revealed that it is essential to expand nurses’ insights and knowledge about preserving patients’ dignity and the factors that influence these. Recognizing and focusing on these factors will help nurses to establish practical measures for preserving and promoting patients’ dignity and providing more dignified care at the bedside. (shrink)

BackgroundThe potential contribution of community engagement to addressing ethical challenges for international biomedical research is well described, but there is relatively little documented experience of community engagement to inform its development in practice. This paper draws on experiences around community engagement and informed consent during a genetic cohort study in Kenya to contribute to understanding the strengths and challenges of community engagement in supporting ethical research practice, focusing on issues of communication, the role of field workers in 'doing ethics' on (...) the ground and the challenges of community consultation.MethodsThe findings are based on action research methods, including analysis of community engagement documentation and the observations of the authors closely involved in their development and implementation. Qualitative and quantitative content analysis has been used for documentation of staff meetings and trainings, a meeting with 24 community leaders, and 40 large public and 70 small community group meetings. Meeting minutes from a purposive sample of six community representative groups have been analysed using a thematic framework approach.ResultsField workers described challenges around misunderstandings about research, perceived pressure for recruitment and challenges in explaining the study. During consultation, leaders expressed support for the study and screening for sickle cell disease. In community meetings, there was a common interpretation of research as medical care. Concerns centred on unfamiliar procedures. After explanations of study procedures to leaders and community members, few questions were asked about export of samples or the archiving of samples for future research.ConclusionsCommunity engagement enabled researchers to take account of staff and community opinions and issues during the study and adapt messages and methods to address emerging ethical challenges. Field workers conducting informed consent faced complex issues and their understanding, attitudes and communication skills were key influences on ethical practice. Community consultation was a challenging concept to put into practice, illustrating the complexity of assessing information needs and levels of deliberation that are appropriate to a given study. (shrink)

The relevance of the problem under study is due to the need to improve the practical skills and competencies of students in the course of training in order to prepare them for competition with other job seekers in employment. In this regard, this article is aimed at identifying the expediency of students’ participation in competitive selections and grants as a factor that creates conditions for effective practice-oriented learning. The leading method for the study of this problem is a pedagogical experiment, (...) which allows us to comprehensively consider the relationship between students’ participation in competitions and their further self-realization and development as young professionals. The article presents the results of monitoring the behavior of students who received an offer to participate in the university-wide competitive selection of student projects, implemented as part of the Program for Supporting Applied Research and Development of Students and Postgraduates of Petrozavodsk State University. The materials of the article can be useful for teaching staff in building a scheme for teaching students and services involved in the recruitment of personnel for large and medium-sized companies that require young professionals to have practical work skills, teamwork skills and creativity. (shrink)

Background A biobank is a structure which collects and manages biological samples and their associated data. The collected samples will then be made available for various uses. The sharing of those samples raised ethical questions which have been answered through specific rules. Thus, a Biobank functioning under tight ethical rules would be immensely valuable from a scientific and an economic view point. In 2009, Côte d’Ivoire established a biobank, which has been chosen to house the regional biobank of Economic Community (...) of West African States countries in 2018. To ensure optimal and efficient use of this biobank, the scientific community must be aware of its existence and its role. It was therefore necessary to evaluate the knowledge of laboratories staff on the role and activities of a biobank. Methods This descriptive study was done by questioning staff from laboratories working on human’s health, animals or plants. The laboratories were located in southern Côte d’Ivoire. Results A total of 205 people completed the questionnaire. Of these 205 people, 34.63% were biologists, 7.32% engineers, 48.78% technicians and 9.27% PhD students. The average length of work experience was 10.11 ± 7.83 years. In this study, 43.41% of the participants had never heard of biobanking. Only 48.78% of participants had a good understanding of the role of a biobank. Technicians and PhD students were less educated on the notion of biobank. Conclusion The level of knowledge of laboratory staff about biobanking needs to be improved. Training on the role, activities and interests of the biobank is important. (shrink)

To ensure ethical employee behavior, companies often utilize several forms of mostly one-way communication such as codes of conduct. The extent to which these efforts, in addition to informing about the company stance on ethics, are able to positively influence behavior is disputed. In contrast, research on business ethics communication and behavior indicates a relatively clear, positive link between open workplace dialogue about ethical issues and ethical conduct. In this article, I therefore address the question: What influences employee attitudes to (...) talking openly about ethical issues? Answers are proposed on the basis of focus group interviews with staff at the Denmark and Brazil affiliates of the global healthcare company Novo Nordisk. It was found that interest in discussing ethical issues was influenced by two main factors: employee conceptualizations of business ethics and the level of inter-collegial trust, credibility, and confidence. In this article, by examining these phenomena, I aim at providing insight that can both inform scholars in these fields as well as help managers in their attempts to promote open workplace dialogue about ethical issues. (shrink)

Mental health challenges appear to be extremely problematic among correctional service employees, affecting persons working in community, institutional, and administrative correctional services. Focusing specifically on giving voice to correctional workers employed by the Ontario Ministry of Community Services and Corrections, we shed light on their interpretations of the complexities of their occupational work and of how their work affects staff. We show that participants encounter barriers to treatment seeking, which they describe as tremendous, starting with benefits, wages, and shift (...) work. We let the voices of staff elucidate what is needed to create a healthier correctional workforce. Recommendations include more training opportunities and programs; quarterly, semi-annual, or annual appointments with a mental health professional who can assess changes in the mental health status of employees; off-site assessments to ensure confidentiality; and team building opportunities to reduce inter-personal conflict at work and increase moral by improving the work environment. (shrink)

Obtaining prospective written consent from women to participate in trials when they are experiencing an obstetric emergency is challenging. Alternative consent pathways, such as gaining verbal consent at enrolment followed, later, by obtaining written consent, have been advocated by some clinicians and bioethicists but have received little empirical attention. We explored women’s and staff views about the consent procedures used during the internal pilot of a trial, where the protocol permitted staff to gain verbal consent at recruitment. Interviews (...) with staff and participating women. Data were analysed thematically and interviews were cross-compared to identify differences and similarities in participants’ views about the consent procedures used. Women and some staff highlighted benefits to obtaining verbal consent at trial enrolment, including expediting recruitment and reducing the burden on those left exhausted by their births. However, most staff with direct responsibility for taking consent expressed extreme reluctance to proceed with enrolment until they had obtained written consent, despite being comfortable using verbal procedures in their clinical practice. To account for this resistance, staff drew a strong distinction between research and clinical care and suggested that a higher level of consent was needed when recruiting into trials. In doing so, staff emphasised the need to engage women in reflexive decision-making and highlighted the role that completing the consent form could play in enabling and evidencing this process. While most staff cited their ethical responsibilities to women, they also voiced concerns that the absence of a signed consent form at recruitment could expose them to greater risk of litigation were an individual to experience a complication during the trial. Inexperience of recruiting into peripartum trials and limited availability of staff trained to take consent also reinforced preferences for obtaining written consent at recruitment. While alternative consent pathways have an important role to play in advancing emergency medicine research, and may be appreciated by potential recruits, they may give rise to unintended ethical and logistical challenges for staff. Staff would benefit from training and support to increase their confidence and willingness to recruit into trials using alternative consent pathways. This qualitative research was undertaken as part of the GOT-IT Trial. Date of registration 26/03/2014. (shrink)

The aim of this study was to examine to what extent patients remained silent to the health care system after they experienced abusive or wrongful incidents in health care. Female patients visiting a women’s clinic in Sweden (n = 530) answered the Transgressions of Ethical Principles in Health Care Questionnaire (TEP), which was constructed to measure patients’ abusive experiences in the form of staff’s transgressions of ethical principles in health care. Of all the patients, 63.6% had, at some point, (...) experienced staff’s transgressions of ethical principles, and many perceived these events as abusive and wrongful. Of these patients, 70.3% had remained silent to the health care system about at least one transgression. This silence is a loss of essential feedback for the health care system and should not automatically be interpreted as though patients are satisfied. (shrink)

WHAT do we mean by saying that a being, God for example, is omniscient? One way of answering this question is to translate ‘God is omniscient’ into some slightly more formalised language than colloquial English, e.g. one with variables of a number of different types, including variables replaceable by statements, and quantifiers binding thes.

In June 2002, Arthur Andersen LLP became the first accounting firm in history to be criminally convicted. The repercussions were immense. From a position as one of the leading professional services firms in the world, with 85,000 staff in 84 countries and revenues in excess of $9 billion, Andersen effectively ceased to exist within a matter of months. Although Andersen’s conviction related specifically to a charge of obstructing justice, public attention focused on the audit relationship between Andersen and its (...) major client, Enron Corporation, particularly the actions (and inactions) that had allowed Enron to post spectacular year-on-year earnings and profit growth. As well as examining events leading up to the demise of Andersen, the case provides an opportunity to consider the broader controversy over accounting and corporate governance practices and, more generally, the pressures found within organisations that can foster unethical conduct. The case was prepared from public sources. (shrink)

Routinely, in Arriving at decisions on what treatments to recommend in intensive care wards, the moral presumption is that there is an intrinsic difference between the positive duty to save lives and the negative duty not to take lives. The discontinuation of treatment – say stopping chemotherapy or removing a ventilator – is thought of as a “negative” action, an allowing to die, not “positively”, say as an act of suicide by the patient, or a killing by the hospital (...) class='Hi'>staff. But the distinction between “positive” and “negative” here, despite its grave ethical import, is elusive and difficult to grasp firmly. St. Anselm of Canterbury was fond of citing the trickiness of the distinction between “to do” and “not to do”. In answer to the question “What's he doing?” we say “He's just sitting there.”, really meaning something negative: “He's not doing anything at all.” Sometimes the “negative” action is described in “positive” terms, or vice versa, and that makes one wonder if the distinction might be somehow trivial, a bit of jesuitry too insubstantial to bear much serious ethical weight. (shrink)

The main purpose of this study is to become acquainted with the educational institutions in Ottoman Empire during and after the 18th century. In this respect, special attention is given to which initiatives were taken in terms of education and which educational institutions were established during the aforementioned period. The need to comply with the West in terms of science, culture, reasoning, and technological advancements has led to the questioning of the current madrasah system. Upon revising the educational system of (...) the madrasah, which had difficulties in being productive and attaining to the necessities of the time, there have been initiatives primarily to establish and structure military schools. These attempts to reform education was intensively seen as from the early 18th century. The above-mentioned changes and progress have gained momentum with the Tanzimat era. It was observed that during this period, many schools were established beyond military; education levels were clarified and; females were given right to study. Similar to Tanzimat era during the first Constitutional Monarchy and Autocracy eras, positive contributions toward educational reforms were made. However, beginning from the middle of the second Constitutional Monarchy era, the economic and social complications that the state was going through had a negative impact on the educational system and the practicality of the educational institutions.Summary: Education has been the most important factor in determining the social, economic, and cultural level of a society. The level of development, which is the determinant of the superiority of the nations to each other over the world, varies according to the importance given to education. To be a pioneer in the scientific sense, to be able to have technological opportunities, to make people live more comfortable and peaceful, to have more power in the economic field and to ensure the continuity of the nation that depending on all these, it will be possible with the understanding of education that can read the time and future well. The fact that world states are superior to each other in different periods of history is directly related to their understanding of education. It can be said that in the centuries following the beginning of the new age, especially the Western nations have taken a more positive step at this subject. The changes in both mental and action spheres such as XVI. century Renaissance movements, XVIII. century enlightenment movement and finally the industrial revolution triggered the development in the scientific and technological field. In these periods the importance given to thinking and the freedom of thought has been the main factor of the progress in the scientific field. The European nations, which went beyond their religion-based bigotry and prioritized the free and secular understanding, have become superior to other nations of the world. However, it is not quite possible to say that in the same periods the Ottoman Empire was able to adapt with the same speed to such accelerations of change and development that placed in Europe. One of the main reasons for this situation and perhaps most importantly is that the educational concept in the Ottoman Empire remained within a static structure in the last centuries. In particular, the matters such as the madrasa being away from productivity, the limitation of the understanding of the science only with religious sciences, has led to the problem of inability to adapt to the rapid transformation that in Europe. The first steps towards eliminating this weakness noticed by the state executives over time has been taken through the improvement and transformation of the Ottoman educational institutions. It is possible to say that the first attempts as to these restructures of education, which is also called as Westernization or modernization by the educational historians, has begun in the period of Sultan III. Selim. In the context of the Nizam-ı Cedid movement, a number of positive initiatives in education, such as the improvement of madrasas, the opening of military schools and translation activities, constitute the core of the changes that will take place in later periods. Immediately afterwards, in the period of II. Mahmut, making the reading and writing education compulsory, opening of Western-style junior high school, establishing medical and vocational schools that provide education at higher education level are considered as positive innovations of the period. The time interval from the proclamation of the Tanzimat edict until the First Constitutional monarchy is the period in which the institutionalization and structuring towards education in the Ottoman Empire is at the highest level. Besides many educational institutions in this process where the ministry responsible for education and training is established and the regulation containing the arrangements regarding this field is put into force, one of the most important initiatives made is laying the foundations of the Dâr al-Fünûn (Ottoman University) which is considered as the first university in this land. The fact that many educational institutions established in this period that are the roots of today's educational institutions is important in terms of demonstrating the accuracy of the initiatives within the mentioned period. In Meşrutiyet (the First Constitutional Monarchy) and the subsequent period of Mutlakiyet (Autocracy), contributions were provided on previous positive structuring. However, the social and economic problems experienced in the country since the second half of II. Meşrutiyet (the 2nd Constitutional Monarchy) have been effective in the inability of continuing innovations towards education. In this study, the educational institutions established in the Ottoman Empire before and after the Tanzimat period were discussed. The aim is not just to reveal what these schools are. It was also aimed to emphasize which areas in which schools are required to be based on which needs, which obstacles are encountered during the change of mentality in education, regulatory activities foreseen to overcome obstacles and to what extent they have been successful. In this regard, the signals of change as to the structure of educational institutions, which could be the source of most of the republic period, started from the beginning of 1700s and continued until World War II period. During this period of more than a hundred years, the political periods related to the structure and functioning of the state have also been influential in the structuring of educational institutions. In fact, the Reorganization (Tanzimat) period, which is known as ‘reform’ in the mentioned process, is considered as the stage where the change and transformation concerning education is the most. It is seen that the process of westernization still continues even though it is not with the same acceleration in the Constitutional Monarchy and Autocracy periods after the Reorganization period. When looking at the facility of educational institutions in chronological order, it is determined that there is a dominated understanding that prioritizes to train military staff in the military field and to have a competent army with the technological possibilities of the time, in other words, to create a strong defence system against the foreign powers of the country. Indeed, for the first time in order to give technical information about modern military, Hendesehane opened and started to operate in İstanbul in 1734 by Mahmut I; Mühendishâne-i Bahrî-i Hümâyûn, the school of the first military maritime was opened in 1775 in order to provide modern education; Mühendishâne-i Berrî-i Hümâyun was founded in 1795 in Istanbul, in order to train artillery and military officer (military engineer); Mekteb-i Harbiye, which was opened in 1835 to train officers, and Menşe-i Küttab-ı Askeri, which was established to train military scribes, contributed to the contemporary construction of the army. In the mentioned period, the most important change outside the military area was in the health area. In this sense, in order to meet the medical doctor needs of the army, Tıbhâne-i Amire was established in 1827. In 1867, the first civilian medical school, Mekteb-i Tıbbiye-i Mülkiye, started education and training. Another important innovation movement for education was in the field of law. In this context, the School Law was established in 1880. In order to train competent staff in administrative staff, the schools of the Mekteb-i Mülkiye, the schools of teacher, the schools that enable women to do education, the improvement of schools that train the clergy and the regulations based on this take attention as educational activities carried out in the mentioned period. (shrink)

Decisions about targeting medical assistance in humanitarian contexts are fraught with dilemmas ranging from non-availability of basic services, to massive demographic and epidemiological shifts, and to the threat of insecurity and evacuations. Aid agencies are obliged, due to capacity constraints and competing priorities, to clearly define the objectives and the beneficiaries of their actions. That aid agencies have to set limits to their actions is not controversial, but the process of defining the limits raises ethical questions. In MSF, frameworks for (...) resource allocation are subject to constant reflection and reiteration, and perspectives are sought at all levels, from implementers at the programme level to the operational directors at headquarters. The perspectives of the programmes staff hold considerable weight as they have the knowledge and experience with particular communities to assess the degree of vulnerability and need, and are also the people who ultimately have to give explanations to beneficiaries when changes or closures are going to be instituted. Humanitarian agencies have a responsibility to ensuring that their workers are prepared to reflect on these dilemmas, and challenge the status quo when it costs lives. (shrink)

Caring for older persons is both rewarding and consuming. Work with older people in Finland has been shown to be more burdensome than in the other Nordic countries. The aim of this study was to try out a Finnish version of the Stress of Conscience Questionnaire (SCQ) and explore stress of conscience in staff caring for older persons in Finland. The data were collected from the nursing staff (n = 350) working with older people in health centre wards, (...) municipal and private nursing homes, and municipal and private dementia care units in Finland. It emerged clearly from the results that Finnish nursing staff mostly felt that they did not have enough time to provide good care to patients, and this gave them a troubled conscience. They also felt that the demanding work taxed their energy, a consequence being that they could not give their own families and loved ones the attention they would have liked. (shrink)

In his thesis Para uma Teoria Geral dos Homomorfismos (1944), the Portuguese mathematician José Sebastião e Silva constructed an abstract or generalized Galois theory, that is intimately linked to F. Klein’s Erlangen Program and that foreshadows some notions and results of today’s model theory; an analogous theory was independently worked out by M. Krasner in 1938. In this paper, we present a version of the theory making use of tools which were not at Silva’s disposal. At the same time, we (...) tried to keep in mind, so much as possible, the gist of his standpoint. (shrink)

The authors conducted a baseline survey of baccalaureate and graduate degree health humanities programs in the United States and Canada. The object of the survey was to formally assess the current state of the field, to gauge what kind of resources individual programs are receiving, and to assess their self-identified needs to become or remain programmatically sustainable, including their views on the potential benefits of program accreditation. A 56-question baseline survey was sent to 111 institutions with baccalaureate programs and 20 (...) institutions with graduate programs. Respondents were asked about three areas: (1) program administration (managing unit, paid director, faculty lines, paid staff, funding sources); (2) educational program (curricular structure, CIP code usage, completion rates); and (3) views on accreditation for the field. A clear majority of respondents agreed that some form of accreditation or consultation service could address resource and sustainability issues. Overall, the survey responses to staffing, curricular structure, and support suggest the need for developing a sustainable infrastructure for health humanities. (shrink)

It is frequently said that words like ‘now’, ‘then’, ‘ago’, ‘present’, ‘past’, ‘future’ and the various indications of tense, are ‘egocentric’ or ‘token-reflexive’ in character. I want to suggest, on the contrary, that the apparent egocentricity or token-reflexiveness of this class of expression is deceptive. It is perhaps not easy to see how on a point of this sort deception is possible, but a parallel case may make the position clearer.

In lieu of an abstract, here is a brief excerpt of the content:Summaries and CommentsElizabeth C. Shaw, Staff*, and James ChamberlainBAGGINI, Julian. The Great Guide: What David Hume Can Teach Us about Being Human and Living Well. Princeton, N.J.: Princeton University Press, 2021. 319 pp. Cloth, $24.95; paper, $19.95Throughout this engaging and accessible book, Julian Baggini encourages his readers to treat the life and works of David Hume as a "model of how to live." Baggini presents summaries of Hume's (...) most famous philosophical arguments, along with biographical details about Hume's life, but always with the aim of learning from Hume about living well. He also discusses his own visits to several locations of importance to Hume.Over the course of The Great Guide, Baggini suggests many "Humean maxims and aphorisms" related to the good life. Some are drawn from Hume's own writings, such as the maxim that "the greatest part of mankind float betwixt vice and virtue." Others are arrived at by considering aspects of Hume's own life and character, including his failings. For example, after considering Hume's racism, Baggini clearly has his own admiration for Hume in mind when he suggests the maxim "never slavishly follow even the greatest minds, for they too have prejudices, weaknesses, and blind spots."Baggini begins by describing those parts of Edinburgh and southern Scotland that Hume would have known in his youth. He recounts the young Hume's rejection of religious belief and of the Stoic project of attempting to find happiness by making oneself independent of others. However, Baggini notes, Hume never rejected the racist views he expressed in his essay "Of National Characters." Baggini argues that, although we should condemn Hume's views, we should treat his possession of these views primarily as evidence of the extent to which we are all socially conditioned. In Baggini's view, Hume's empiricist commitments are such that, were he to be alive today, experience would lead him to reject racism. Baggini thus aims to excuse Hume, at least somewhat, without excusing his racism.In chapter 2, Baggini follows Hume to La Flèche, in France's Loire valley, where Hume wrote most of his Treatise of Human Nature. As well as providing an account of Hume's time there, Baggini summarizes Hume's arguments about miracles, reason, and causation. He approvingly [End Page 809] notes Hume's skeptical conclusions concerning miracles, which he takes to demonstrate Hume's insistence on philosophizing only about the world as it really is. Baggini treats Hume's conclusions about cause and effect as significantly less skeptical. Although he observes that some scholars deny this, Baggini understands Hume to assert that causation is a "real power." His is a clear and helpful introduction to Hume's arguments concerning cause and effect, but readers of the relevant passages might hope for a little more discussion of what certainly appear to be Hume's skeptical claims about causal powers.Chapter 3 examines Hume's arguments about free will and personal identity, via a discussion of the complex factors which shaped his identity as a man of letters. Baggini observes Hume's sociability and his satisfaction in his success. He also commends Hume's broad-minded approach to philosophy and his willingness to write a wide variety of essays and, eventually, historical works.In chapter 4, Baggini discusses Hume's relationship with Paris. Returning to the topic of Hume's broad understanding of philosophy, Baggini argues that many of Hume's greatest insights were psychological ones. By comparing Hume's views on religion with the fervent atheism of the French philosophes, Baggini admiringly stresses Hume's moderation and his denial of any knowledge about "the ultimate ground of being." Since Hume believed he knew no more about the origins of the universe than anyone else, Baggini argues, he was able to develop friendships with and respect for moderate religious thinkers, as many philosophes were not. However, Baggini also suggests that Hume's "conservative instincts" sometimes led him astray, as where he "broadly endorsed the patriarchal attitudes of his time."Chapter 5 begins with an account of the dispute between Hume and Jean-Jacques Rousseau, which then forms the background for a discussion... (shrink)

Muslim scholars have defined ethics as enduring traits and characteristics in the individual that cause actions appropriate to those traits to be issued spontaneously without the need for human thought and reflection. Islamic ethics state the rightness or wrongness of these attributes within the framework of Islamic concepts, while the concepts of Islamic work ethics deal with the functioning of the framework of Islamic concepts in the form of human work activities in various organisations. Furthermore, work ethics can be effective (...) in the organisation when it can shape the culture of the organisation. Research shows that Islamic work ethics have a significant relationship with various individual, professional and organisational factors. The purpose of this study is to investigate the relationship between Islamic work ethics and organisational culture. The statistical population of this research consists of 1500 Muslim staff of 30 service organisations (financial, educational, medical and hotel organisations) in Moscow, Russia, in 2021, of which 306 people have been selected as statistical samples using Krejcie and Morgan's sample size table. Data analyses were performed by statistical software, Statistical Package for the Social Sciences (SPSS). The results of this study confirm the significant and positive relationship between Islamic work ethics and organisational culture among the Muslim Russian staff (β = 0.53; T = −8.65). CONTRIBUTION: This study examines the relationship between Islamic work ethics and organisational culture in Russia and has expanded the results of previous studies conducted in other contexts. (shrink)

BackgroundThe consent process for a genetic study is challenging when the research is conducted in a group stigmatized because of beliefs that the disease is familial. Podoconiosis, also known as 'mossy foot', is an example of such a disease. It is a condition resulting in swelling of the lower legs among people exposed to red clay soil. It is a very stigmatizing problem in endemic areas of Ethiopia because of the widely held opinion that the disease runs in families and (...) is untreatable. The aim of this study was to explore the impact of social stigma on the process of obtaining consent for a study on the genetics of podoconiosis in Southern Ethiopia.MethodsWe adapted a rapid assessment tool validated in The Gambia. The methodology was qualitative involving focus-group discussions (n = 4) and in-depth interviews (n = 25) with community members, fieldworkers, researchers and staff of the Mossy Foot Treatment and Prevention Association (MFTPA) working on prevention and treatment of podoconiosis.ResultsWe found that patients were afraid of participation in a genetic study for fear the study might aggravate stigmatization by publicizing the familial nature of the disease. The MFTPA was also concerned that discussion about the familial nature of podoconiosis would disappoint patients and would threaten the trust they have in the organization. In addition, participants of the rapid assessment stressed that the genetic study should be approved at family level before prospective participants are approached for consent. Based on this feedback, we developed and implemented a consent process involving community consensus and education of fieldworkers, community members and health workers. In addition, we utilized the experience and established trust of the MFTPA to diminish the perceived risk.ConclusionThe study showed that the consent process developed based on issues highlighted in the rapid assessment facilitated recruitment of participants and increased their confidence that the genetic research would not fuel stigma. Therefore, investigators must seek to assess and address risks of research from prospective participants' perspectives. This involves understanding the issues in the society, the culture, community dialogues and developing a consent process that takes all these into consideration. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:An Exposition of The Divine Names, The Book of Blessed Dionysius by Thomas AquinasMichael J. Rubin, Elizabeth C. Shaw, and Staff*AQUINAS, Thomas. An Exposition of The Divine Names, The Book of Blessed Dionysius. Translated and edited with an introduction by Michael A. Augros. Merrimack, N.H.: Thomas More College Press, 2021. xxv + 549 pp. Cloth, $65.00The profound influence that Pseudo-Dionysius had on Aquinas’s thought, especially in his (...) metaphysics of participation and his apophatic theology, has been known for some time now, thanks to the excellent work of such scholars as Fran O’Rourke. One would therefore think that Aquinas’s Exposition of the Divine Names (his only commentary on the works of Pseudo-Dionysius) would have been translated a lot sooner. This delay is assuredly due not just to the difficulty of translating this work but also to a certain embarrassment felt by Thomists over Aquinas’s sincere belief that the “Dionysius” who wrote the Divine Names was the Areopagite whose conversion at the teaching of St. Paul is mentioned in the Acts of the Apostles. That the author calling himself “Dionysius” was in fact a theologian writing in the fifth or sixth centuries has been well established by modern scholarship. Hence, Thomists may have felt tempted to discount or at least pass over the influence of this author on Aquinas since it is discomfiting to think that the Church’s greatest theologian accorded such authority to an imposter.Michael Augros tackles these concerns head-on in the excellent introduction to his new translation of the Divine Names commentary. First, Augros points out that in past centuries a pseudonym was usually not an act of forgery but, rather, a way of concealing the author’s identity, which an early Christian theologian might well decide to do either out of humility or out of a desire “to avoid provoking certain prejudices” in those who disagreed with him in contemporary theological disputes. Moreover, it is likely that the work was never intended for the general public (who could easily mistake the pseudonym as genuine) but, rather, was written for those “already initiated in a particular Neoplatonic school of Christian theology,” who would recognize the author as being “one of their own” but without knowing his precise identity. Finally, in taking the particular name of “Dionysius,” the author of the Divine Names was indicating his intention for the work: Just as the biblical Dionysius was a Greek philosopher who converted to Christianity, so the works of Pseudo-Dionysius [End Page 345] are an attempt to reconcile Greek philosophy with the Christian faith.It therefore seems likely, as Augros observes, that Aquinas would still have accorded a great deal of respect to the Divine Names even if he had learned the truth of the author’s identity. The work would not have had the same deuterocanonical authority for him that comes with being written by a direct disciple of St. Paul himself, but “the inherent cogency, coherence, and beauty” of Pseudo-Dionysius’s theology would have been the same. Hence, Pseudo-Dionysius would surely have earned from Aquinas the “docile attitude” appropriate “for a philosopher and theologian of the first order, such as Boethius.”That Aquinas was right to see the author of the Divine Names as a master philosopher and theologian becomes evident when one dives into the text itself, in which Aquinas sees a truly dazzling order, both externally and internally. According to Aquinas, the Divine Names discusses those truths about God of which there are intelligible likenesses in creatures, such as goodness or wisdom, whereas the truths about God of which there are sensible likenesses (for example, “when God is called a lion, or a rock”) are treated by Pseudo-Dionysius in The Symbolic Theology; meanwhile, in the lost or fictional work The Divine Characteristics, Dionysius claims to have treated those truths about God (such as the Trinity) that cannot be known through any likenesses in creatures.Aquinas finds a still more intricate order within the Divine Names itself. Since this work is dedicated to “the divine names by which the processions of God to creatures are manifested,” the plan of the work... (shrink)

In this article I would like to express my personal ideas and points of view about strike action, which I think many colleagues will share. I am a qualified paediatric nurse, currently working in the central operating theatre of a university hospital in Germany. At the same time, I am also finishing my studies in health care sciences. Apart from two short protest strikes, I have not taken part in any strike, because there have not been any during my whole (...) professional career at the hospitals where I have worked. I am personally deeply convinced that strikes are important and are a good and useful tool, in particular to protest against ‘rationalizations’, which so far have led only to lower salaries and fewer jobs for nurses, and have brought no improvement in the conditions for staff or patients. (shrink)

In this article I would like to express my personal ideas and points of view about strike action, which I think many colleagues will share. I am a qualified paediatric nurse, currently working in the central operating theatre of a university hospital in Germany. At the same time, I am also finishing my studies in health care sciences. Apart from two short protest strikes, I have not taken part in any strike, because there have not been any during my whole (...) professional career at the hospitals where I have worked. I am personally deeply convinced that strikes are important and are a good and useful tool, in particular to protest against ‘rationalizations’, which so far have led only to lower salaries and fewer jobs for nurses, and have brought no improvement in the conditions for staff or patients. (shrink)

The case study method offers a hands-on inquiry based method for teaching leadership traits. With this in mind, the case study method is used to provide opportunities for middle school students to analyze a situation and the actions of the case study charactcrs and to identify leadership behaviors. The use of the case study method allows instructors to teach character education to this group of middle school students by promoting the use of critical thinking skills through small group discussions and (...) reflections. The staff is confident by using this method that the students are able to analyze, discuss, and draw conclusions for discussions in small groups. (shrink)

Human Research Ethics Committee (HREC) reviewers often provide similar feedback across applications, which suggests that the problem lies in researcher awareness of key issues rather than novel, unsolvable challenges. If common problems can be addressed before lodgement by applicants referencing clear evidence-based supports (e.g., FAQs on common application shortcomings), it would improve efficiency for HREC members and expedite approvals. We aim to inform such supports by analysing the patterns in the most frequent feedback made by HREC members during review processes. (...) We collected every instance (N = 4,195) of feedback made on N = 197 ‘low-risk’ protocols by all HREC staff (N = 16) at one institution over the course of a full year (2019). Reflexive thematic analysis to identify themes (and content analysis to determine relative frequency) revealed that the top three themes are consistent with existing literature: Consent, Administrative, and Methodological concerns. However, we identified important new themes that are not captured in previous research, including ‘Risk to Researchers’, ‘Commercial benefit, scope and scale’, ‘Diversity’ (covering issues of cultural sensitivity, language and accessibility), as well as fair right to a complaints process. Our thorough exploration of information-rich primary data marks an important methodological improvement over previous studies and offers a theoretical contribution to understanding themes that have heretofore been overlooked in the ethics review process. By identifying the common challenges experienced in HREC review we can better inform tailored supports to applicants (by extension reducing workload burdens on HREC systems) and reduce their perceived barriers to engaging in challenging but meaningful research. (shrink)

Background Currently there is increasing recognition of the need for research in developing countries where disease burden is high. Understanding the role of local factors is important for undertaking ethical research in developing countries. We explored factors relating to information and communication during the process of informed consent, and the approach that should be followed for gaining consent. The study was conducted prior to a family-based genetic study among people with podoconiosis (non-filarial elephantiasis) in southern Ethiopia. Methodology/Principal Findings We adapted (...) a method of rapid assessment validated in The Gambia. The methodology was entirely qualitative, involving focus-group discussions and in-depth interviews. Discussions were conducted with podoconiosis patients and non-patients in the community, fieldworkers, researchers, staff of the local non-governmental organisation (NGO) working on prevention and treatment of podoconiosis, and community leaders. We found that the extent of use of everyday language, the degree to which expectations of potential participants were addressed, and the techniques of presentation of information had considerable impact on comprehension of information provided about research. Approaching podoconiosis patients via locally trusted individuals and preceding individual consent with community sensitization were considered the optimal means of communication. Prevailing poverty among podoconiosis patients, the absence of alternative treatment facilities, and participants' trust in the local NGO were identified as potential barriers for obtaining genuine informed consent. Conclusions Researchers should evaluate the effectiveness of consent processes in providing appropriate information in a comprehensible manner and in supporting voluntary decision-making on a study-by-study basis. (shrink)

The paper considers the intellectual computer mathematics system InparSolver, which is designed to automatically explore and solve basic classes of computational mathematics problems on multi-core computers with graphics accelerators. The problems of results reliability of solving problems with approximate input data are outlined. The features of the use of existing computer mathematics systems are analyzed, their weaknesses are found. The functionality of InparSolver, some innovative approaches to the implementation of effective solutions to problems in a hybrid architecture are described. Examples (...) of applied usage of InparSolver for processes mathematical modeling in various subject areas are given. Nowadays, new more complex objects and phenomena in many subject areas are constantly emerging, which are subject to mathematical research on a computer. This encourages the development of new numerical methods and technologies of mathematical modeling, as well as the creation of more powerful computers for their implementation. With the advent and constant development of supercomputers of various architectures, the problems of their effective use, expansion of tasks range should be solved, ensuring the reliability of computer results and increasing the level of intellectual information support for users ‒ specialists in various fields. Today, the issues of solving these problems are given special attention by many specialists in the fields of information technology and parallel programming. The world's leadingscientists in the field of computer technology see the solution to the problems of efficient usage of modern supercomputers in algorithmic software creation that easily adapts to different computer architectures with different types of memory and coprocessors, supports efficient parallelism on millions of cores etc. In addition, improving the efficiency of high-performance computing on modern supercomputers is provided by their intellectualization, transferring to the computer to perform a significant part of the functions. The industry of development and usage of intelligent computer technologies is one of the main directions of science and technology development in modern society. (shrink)

Before taking this book with the seriousness which at least parts of it deserve, it is necessary to dispose of a criticism which is basically frivolous but has already been made too often to be ignored. “Contemporary British Philosophy”—the title conjures up the names that everyone is currently bandying about ; and then you find with a jolt that you are being served with fare by such cooks as Ewing, Findlay, Kneale, Mabbott, Price, and—of all people—Paton. People, clearly, who for (...) the most part wouldn’t even pretend to be “contemporary” in the ordinary use of this word, and who indeed in these very papers subject the real “contemporary” philosophers to endless sniping and sharp-shooting. Almost the only contributor one can imagine wishing to be thought “contemporary” is Ryle; and even he—well, did Freud really think of himself as a Freudian? Ayer might be put up as another exception, but that would be shallow— there's no one so completely and hopelessly out of date as the conductor of the bandwagon that's just gone past. Even from the point of view of crass physical age, the baby of this bunch , works out at about 43. (shrink)

The economic and social essence of the current revolution in science and technology taking place under the conditions of socialism is that it shapes new societal needs and at the same time creates the conditions for satisfying them.