BackgroundIn the Canadian Alliance for Healthy Hearts and Minds (CAHHM) cohort, participants underwent magnetic resonance imaging (MRI) of the brain, heart, and abdomen, that generated incidental findings (IFs). The approach to managing these unexpected results remain a complex issue. Our objectives were to describe the CAHHM policy for the management of IFs, to understand the impact of disclosing IFs to healthy research participants, and to reflect on the ethical obligations of researchers in future MRI studies.MethodsBetween 2013 and 2019, 8252 participants (...) (mean age 58 ± 9 years, 54% women) were recruited with a follow-up questionnaire administered to 909 participants (40% response rate) at 1-year. The CAHHM policy followed a restricted approach, whereby routine feedback on IFs was not provided. Only IFs of severe structural abnormalities were reported.ResultsSevere structural abnormalities occurred in 8.3% (95% confidence interval 7.7–8.9%) of participants, with the highest proportions found in the brain (4.2%) and abdomen (3.1%). The majority of participants (97%) informed of an IF reported no change in quality of life, with 3% of participants reporting that the knowledge of an IF negatively impacted their quality of life. Furthermore, 50% reported increased stress in learning about an IF, and in 95%, the discovery of an IF did not adversely impact his/her life insurance policy. Most participants (90%) would enrol in the study again and perceived the MRI scan to be beneficial, regardless of whether they were informed of IFs. While the implications of a restricted approach to IF management was perceived to be mostly positive, a degree of diagnostic misconception was present amongst participants, indicating the importance of a more thorough consent process to support participant autonomy.ConclusionThe management of IFs from research MRI scans remain a challenging issue, as participants may experience stress and a reduced quality of life when IFs are disclosed. The restricted approach to IF management in CAHHM demonstrated a fair fulfillment of the overarching ethical principles of respect for autonomy, concern for wellbeing, and justice. The approach outlined in the CAHHM policy may serve as a framework for future research studies.Clinical trial registrationhttps://clinicaltrials.gov/ct2/show/nct02220582. (shrink)

Background:Despite the growing importance of spiritual care, the delivery of spiritual care is still an area of disagreement among healthcare providers.Objective:To develop a grounded theory about spiritual care delivery based on Iranian nurses’ perceptions and experiences.A grounded theory approach:A qualitative study using the grounded theory approach.Participants and research context:Data were collected through holding 27 interviews with 25 participants. The study setting was the Imam Khomeini Hospital Complex. Sampling was started purposively and continued theoretically. Data analysis was performed by the method (...) proposed by Strauss and Corbin.Ethical consideration:The study was approved by the Ethics Committee of Tarbiat Modares University and the agreement of the administrators of the study setting was got before starting the study.Results:The core category of the study was “Trust building” which reflected the nature of spiritual care delivery by nurses. Trust building was the result of eight main categories or strategies including creating a positive mentality at hospital admission, understanding patients in care circumstances, having a caring presence, adhering to care ethics, developing meaningful relationships, promoting positive thinking and energy, establishing effective communication with patients, and attempting to create a safe therapeutic environment. Poor interprofessional coordination negatively affected this process while living toward developing greater cognizance of divinity and adhering to the principles of professional ethics facilitated it. The outcome of the process was to gain a sense of partial psychological security.Conclusion:The “Trust building” theory can be used as a guide for describing and expanding nurses’ roles in spiritual care delivery, developing care documentation systems and clinical guidelines, and planning educational programs for nursing students and staff nurses. (shrink)

One of the core problems with engineering ethics education is perceptual. Although ethics is meant to be a central component of today’s engineering curriculum, it is often perceived as a marginal requirement that must be fulfilled. In addition, there is a mismatch between faculty and student perceptions of ethics. While faculty aim to communicate the nuances and complexity of engineering ethics, students perceive ethics as laws, rules, and codes that must be memorized. This paper provides some historical context to better (...) understand these perceptual differences, and suggests that curriculum constraints are important contributing factors. Drawing on the growing scholarship of student engagement approaches to pedagogy, the paper explores how students can be empowered to effect change in the broader engineering curriculum through engineering ethics. The paper describes a student engagement approach to pedagogy that includes students as active participants in curriculum design—a role that enables them to critically reflect about why ethics is a requirement. Including students in the process of curriculum design leads students to reframe ethics as an integrative tool with the capacity to bring together different engineering departments and build bridges to non-engineering fields. This paper argues that students can and should play an active and important role in relocating ethics from the periphery to the core of the engineering curriculum. (shrink)

We have identified a sample of 53 societies outside of the classical Himalayan and Marquesean area that permit polyandrous unions. Our goal is to broadly describe the demographic, social, marital, and economic characteristics of these societies and to evaluate some hypotheses of the causes of polyandry. We demonstrate that although polyandry is rare it is not as rare as commonly believed, is found worldwide, and is most common in egalitarian societies. We also argue that polyandry likely existed during early human (...) history and should be examined from an evolutionary perspective. Our analysis reveals that it may be a predictable response to a high operational sex ratio favoring males and may also be a response to high rates of male mortality and, possibly, male absenteeism. Other factors may contribute, but our within-polyandry sample limits analysis. (shrink)

Big Ideas for Little Kids includes everything a teacher, a parent, or a college student needs to teach philosophy to elementary school children from picture books. Written in a clear and accessible style, the book explains why it is important to allow young children access to philosophy during primary-school education. Wartenberg also gives advice on how to construct a "learner-centered" classroom, in which children discuss philosophical issues with one another as they respond to open-ended questions by saying whether they agree (...) or disagree with what others have said. (shrink)

The aim of this study is to explore how nurses perceive patient participations of patients over 75 years old undergoing hemodialysis treatment in dialysis units, and of their next of kin. Ten nurses told stories about what happened in the dialysis units. These stories were analyzed with critical discourse analysis. Three discursive practices are found: (1) the nurses’ power and control; (2) sharing power with the patient; and (3) transferring power to the next of kin. The first and the predominant (...) discursive practice can be explained with an ideology of paternalism, in which the nurses used biomedical explanations and the ethical principle of benefice to justify their actions. The second can be explained with an ideology of participation, in which the nurses used ethical narratives as a way to let the patients participate in the treatment. The third seemed to involve autonomous decision-making and the ethical principle of autonomy for the next of kin in the difficult end-of-life decisions. (shrink)

Scientometrics has found many applications in describing, explaining and predicting the scientific status of researchers, educational and research groups, universities, organizations and countries in various national and international arenas. By studying the scientific products of different countries, their status in the production of science can be evaluated. Present study was conducted using a scientometrics approach and using co-word analysis and social network analysis (SNA) to investigate relationships in the field of know­ledge organization. In this regard, research indexed in web of (...) science on the topic of “know­ledge organization” has been analyzed using software including VOSviewer, Gephi, Publish or Perish. The findings of the study show that the most frequently used topics and words are know­ledge organization and classification. Also, the most valuable subject areas were identified based on the maps drawn using the closeness and centrality of indexes, taxonomy, ontology and know­ledge organization systems. Co-authorship analysis revealed that the co-authorship network is discrete and has low-density, with a total of 12,491 citations in all articles. Also, the most prolific author is Hjorland, followed by Smiraglia and Dahlberg. using the co-word map of know­ledge organization, policymakers can plan appropriately through the know­ledge of the research and thematic status of know­ledge organization. (shrink)

ObjectivesThe breast cancer stigma affects Health-related quality of life, while general resilience resources, namely, sense of coherence, social support, and coping skills, are thought to alleviate this effect. The study aimed to explore the mediating/moderation role of GRRs in the relationship between stigma and HRQoL and its dimensions in Iranian patients with breast cancer.MethodsIn this cross-sectional study, Stigma Scale for Chronic Illness 8-item version, SOC-13, Medical Outcome Survey- Social Support Scale, Brief COPE, and Functional Assessment of Cancer Therapy-Breast were investigated (...) in a convenience sample of Iranian women with confirmed non-metastatic breast cancer. Following the establishment of correlations using Pearson’s correlation, single and parallel mediation analysis and moderation analysis were conducted to determine the extent to which each GRR might be impacted by stigma or decrease the adverse impact of stigma on HRQoL.ResultsAn analysis of 221 women with the mean age of 47.14 showed that stigma was negatively correlated to all HRQoL’s dimensions, SOC, social support, and the bulk of coping skills. In the single mediation analysis, stigma affected all facets of SOC, all subscales of social support, and positive reframing, which partially reduced breast cancer HRQoL. Stigma affects general HRQoL through damaging meaningfulness, social support, and positive reframing. Meaningfulness was marked as the most impacted GRR in terms of all domains of HRQoL. In parallel mediation, reduced meaningfulness, total social support, and positive reframing were highlighted as the pathways of diminished breast cancer HRQoL. Moderation analysis indicated the higher levels of humor, behavioral disengagement, and use of instrumental support behaviors to be functional in protecting different dimensions of HRQoL, while the results were mixed for venting, especially in patients with mastectomy surgery.ConclusionWhile GRRs may be impacted by stigma, they exert a relatively small protective effect against the impact of stigma on HRQoL. This study provides some novel findings, but longitudinal studies are needed to further verify these before any causal conclusion or recommendations for health policy can be drawn. (shrink)

В статье философия характеризуется на основе дискурсной парадигмы анализа: как текст, интеллектуальная деятельность и коммуникация. Характеризуются два равнозначных аспекта философского дискурса - когнитивный и коммуникативный. Обсуждается феномен философских контроверз, специфика философского спора, выразительные (знаковые) средства философского дискурса, роль мировоззренческого дискурса в современной общественно-политической ситуации в стране.

Background: Despite an increase in health research conducted in Africa, there are still inadequate human resources with research ethics training and lack of local long-term training opportunities in research ethics. A research ethics training program named United States-Mali Research Ethics Training Program (US-Mali RETP) was established through a partnership between the George Washington University Milken Institute School of Public Health (GWSPH), USA and University of Sciences, Techniques & Technologies of Bamako (USTTB), to address the critical need for improved bioethics training, (...) leadership, and policy in Mali. Methods: The aims of the capacity building programme are achieved by leveraging US and Africa-based expertise to strengthen research ethics education and capacity through: (1) intensive faculty development to design ethics training curricula; (2) development of a research ethics specialization within the existing Masters of Public Health program (MPH); and (3) establishing professional development courses through short-term training workshops and webinars to address research and professional needs in ethics. Results: The program will strengthen USTTB’s capacity of research ethics by training at least 15 MPH students over 5 years to prepare the next generation of ethics researchers. During the first two years of the program, a new ethics training curricula was developed, two cohorts of Master’s students were enrolled, and a series of webinars and workshops were conducted with participation of Malian and international researchers. Conclusions: US-Mali RETP will promote a sustainable bioethics enterprise at USTTB, and enable dissemination of research ethics training to increase health research capacity in Mali. (shrink)

Many writers in various fields--philosophy, religion, literature, and psychology--believe that the question of the meaning of life is one of the most significant problems that an individual faces. In The Meaning of Life, Second Edition, E.D. Klemke collects some of the best writings on this topic, primarily works by philosophers but also selections from literary figures and religious thinkers. The twenty-seven cogent, readable essays are organized around three different perspectives on the meaning of life. In Part I, the readings assert (...) and defend the theistic view that without the existence of God--or faith in God--life has no significance or purpose. In Part II the selections deny this thesis, defending instead the humanistic alternative--that life has or can have meaning and worth without any theistic beliefs or commitment. In the final group of readings, contributors ask if the question of the meaning of life is in itself legitimate and significant. The volume also includes an introduction by the editor and a selected bibliography. This new edition adds essays by A. J. Ayer, Hazel Barnes, William Lane Craig, Owen Flanagan, Antony Flew, Thomas Nagel, Kai Nielsen, Philip L. Quinn, Arthur Schopenhauer, and Walter T. Stace. The only anthology of its kind, The Meaning of Life, Second Edition, is ideal for courses in introduction to philosophy and human nature. It also provides an accessible and stimulating introduction to the subject for general readers. (shrink)

This work has been selected by scholars as being culturally important, and is part of the knowledge base of civilization as we know it. This work was reproduced from the original artifact, and remains as true to the original work as possible. Therefore, you will see the original copyright references, library stamps (as most of these works have been housed in our most important libraries around the world), and other notations in the work. This work is in the public domain (...) in the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work. As a reproduction of a historical artifact, this work may contain missing or blurred pages, poor pictures, errant marks, etc. Scholars believe, and we concur, that this work is important enough to be preserved, reproduced, and made generally available to the public. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)

Because factory-farmed meat production inflicts gratuitous suffering upon animals and wreaks havoc on the environment, there are morally compelling reasons to become vegetarian. Yet industrial plant agriculture causes the death of many field animals, and this leads some to question whether consumers ought to get some of their protein from certain kinds of non factory-farmed meat. Donald Bruckner, for instance, boldly argues that the harm principle implies an obligation to collect and consume roadkill and that strict vegetarianism is thus immoral. (...) But this argument works only if the following claims are true: all humans have access to roadkill, roadkill would go to waste if those who happen upon it don’t themselves consume it, it’s impossible to harvest vegetables without killing animals, the animals who are killed in plant production are all-things-considered harmed by crop farming, and the best arguments for vegetarianism all endorse the harm principle. As I will argue in this paper, each claim is deeply problematic. Consequently, in most cases, humans ought to strictly eat plants and save the roadkill for cats. (shrink)

This chapter introduces and defends a pragmatist model of aesthetic disagreement that avoids many of the philosophical puzzles generated by the traditional, semantic, approach. Mainstream philosophical inquiry into aesthetic disagreement begins with a rather innocuous assumption: to understand what’s going on we must first explain what disputants are saying, which involves identifying the meaning of the relevant expressions or determining how aesthetic claims could be true. However, this task brings with it a new host of semantic and epistemic puzzles and (...) fails to vindicate the central role aesthetic disagreements occupy in our aesthetic lives more generally. Further, it isn’t clear how settling the meaning of aesthetic expressions bears on everyday aesthetic disagreements. Paying attention to what we do in an aesthetic disagreement will give us a better chance at identifying what matters for determining what we say. (shrink)

Introduction , Sophie Gibb 1. Mental Causation , John Heil 2. Physical Realization without Preemption , Sydney Shoemaker 3. Mental Causation in the Physical World , Peter Menzies 4. Mental Causation: Ontology and Patterns of Variation , Paul Noordhof 5. Causation is Macroscopic but not Irreducible , David Papineau 6. Substance Causation, Powers, and Human Agency , E. J. Lowe 7. Agent Causation in a Neo-Aristotelian Metaphysics , Jonathan D. Jacobs and Timothy O’Connor 8. Mental Causation and Double Prevention , (...) Sophie Gibb 9. The Identity Theory as a Solution to the Exclusion Problem , David Robb 10. Continuant Causation, Fundamentality, and Freedom , Peter Simons 11. There is no Exclusion Problem , Steinvor Tholl Arnadottir and Tim Crane. (shrink)

An adequate theory of rights ought to forbid the harming of animals to promote trivial interests of humans, as is often done in the animal-user industries. But what should the rights view say about situations in which harming some animals is necessary to prevent intolerable injustices to other animals? I develop an account of respectful treatment on which, under certain conditions, it’s justified to intentionally harm some individuals to prevent serious harm to others. This can be compatible with recognizing the (...) inherent value of the ones who are harmed. My theory has important implications for contemporary moral issues in nonhuman animal ethics, such as the development of cultured meat and animal research. (shrink)

Context: The idea for this article sprang from a desire to revive a conversation with the late Ernst von Glasersfeld on the heuristic function - and epistemological status - of forms of ideations that resist linguistic or empirical scrutiny. A close look into the uses of humor seemed a thread worth pursuing, albeit tenuous, to further explore some of the controversies surrounding the evocative power of the imaginal and other oblique forms of knowing characteristic of creative individuals. Problem: People generally (...) respond to humor, i.e., they are inclined to smile at things they find funny. People like to crack jokes, make puns, and, starting at age two, human infants engage in pretense or fantasy play. Research on creativity, on the other hand, has mostly scorned the trickster within. Cognitivists in particular are quick to relegate wit, whimsy, and even playfulness to the ranks of artful or poetic frivolities. Method: We use the emblems of the craftsman, the trickster, and the poet to highlight some of the oblique ways of knowing by which creative thinkers bring forth new insights. Each epitomizes dimensions intrinsic to the art of “possibilizing.” Taken together, they help us better understand what it means to be playful beyond curious, rigorous beyond reasonable, and why this should matter, even to constructivists! Results: The musings characteristic of creative individuals speak to intelligent beings’ ability to use glitches intentionally or serendipitously as a means to open up possibilities; to hold on to a thought before spelling it out; and to resist treating words or images as conventional and arbitrary signs regardless of their evocative power. To fall into nominalism, Bachelard insisted, is a poet’s nightmare! Implications: Psyche is image, said Jung, and when we feel alive we rely on the imaginal to guide our reason. Note that image is not here to be understood as a picture in the head or a photographic snapshot of the world. The imaginal does not represent, it brings forth what we understand beyond words. It does not lock us into a single mode. Instead, it is a call to be mindful, in Ellen Langer’s sense: in the present, mentally alert, and on the outlook for our psyche’s own surprising wisdom (sagacity. Constructivist content: Debates on the heuristic function and epistemological status of oblique ways of knowing have long occupied constructivist scholars. I can only guess whether my uses of Jung’s imaginal or Bachelard’s anti-nominalism would have amused or exasperated Ernst! I do know that, on occasion, Ernst the connoisseur, bricoleur, and translator allowed the rationalist-within to include the poet’s power to evoke as a legitimate form of rationality. He himself has written about oblique knowing as legit! (shrink)

In recent discussions, it has been argued that a theory of animal rights is at odds with a liberal abortion policy. In response, Francione (1995) argues that the principles used in the animal rights discourse do not have implications for the abortion debate. I challenge Francione’s conclusion by illustrating that his own framework of animal rights, supplemented by a relational account of moral obligation, can address the moral issue of abortion. I first demonstrate that Francione’s animal rights position, which grounds (...) moral consideration in sentience, is committed to the claim that a sentient fetus has a right to life. I then illustrate that a fully developed account of animal rights that recognizes the special obligations humans have to assist animals when we cause them to be dependent and vulnerable through our voluntary actions or omissions is committed to the following: a woman also has a special obligation to assist a sentient fetus when she causes it to be dependent and vulnerable through her voluntary actions or omissions. From these considerations, it will become evident that a fully developed and consistent animal rights ethic does in fact have implications for the abortion discussion. (shrink)

In The Case for Animal Rights, Tom Regan argues that although all subjects-of-a-life have equal inherent value, there are often differences in the value of lives. According to Regan, lives that have the highest value are lives which have more possible sources of satisfaction. Regan claims that the highest source of satisfaction, which is available to only rational beings, is the satisfaction associated with thinking impartially about moral choices. Since rational beings can bring impartial reasons to bear on decision making, (...) Regan maintains that they have an additional possible source of satisfaction that nonrational beings do not have and, consequently, the lives of rational beings turn out to have greater value.. (shrink)