Research from behavioural sciences shows that people reach decisions in a much less rational and well-considered way than was often assumed. The doctrine of informed consent, which is an important ethical principle and legal requirement in medical practice, is being challenged by these insights into decision-making and real-world choice behaviour. This article discusses the implications of recent insights of research on decision-making behaviour for the informed consent doctrine. It concludes that there is a significant tension between the often non-rational choice (...) behaviour and the traditional theory of informed consent. Responsible ways of dealing with or solving these problems are considered. To this end, patient decisions aids are discussed as suitable interventions to support autonomous decision-making. However, current PDAs demand certain improvements in order to protect and promote autonomous decision-making. Based on a conception of autonomy, we will argue which type of improvements are needed. (shrink)

BackgroundWork stress is a serious problem in primary education. Decades of research underline the importance of participatory, organizational-level work stress prevention approaches. In this approach, measures are planned to tackle causes of work stress in a participatory manner and implemented by a working group consisting of members of the organization. This approach can only be effective if the measures contain effective ingredients to decrease work stress risks and are successfully implemented. The aim of this paper is to present an outline (...) of a work stress prevention approach that is evaluated in primary education. To ensure the appropriateness of measures, a logic model of change is built as part of the risk assessment to facilitate the selection of appropriate measures. Progression on target behaviors as well as implementation factors are real-time monitored during implementation and fed back to the working groups, to provide the opportunity to adjust action plans when needed to optimize implementation.MethodsThe approach consists of five steps: preparation: installing an advisory board and working groups, risk assessment: inventory of work stress risks. In addition, a behavioral analysis is performed to build a logic model of change to facilitate selection of measures, action planning: conducting an action plan with appropriate measures, implementation: implementing the action plan. During implementation progression on target behaviors and implementation factors are monthly monitored and fed back to the working groups, and evaluation: effects of the approach are studied in a controlled trial with measurements at baseline, 1 year, and 2 years follow-up. A process evaluation is carried out using quantitative and qualitative data to study the implementation process of all steps of the work stress approach.DiscussionWe believe that building a logic model of change and real-time monitoring of implementation could be of added value to improve the success of the work stress prevention approach. With this study, we aim to provide more insights into work stress intervention research, especially in primary education.Clinical Trial RegistrationThe study is registered in Netherlands Trial Register. (shrink)

Background and aim With the increasing interest in lifestyle, health and consequences of unhealthy lifestyles for the healthcare system, a new kind of solidarity is gaining importance: lifestyle solidarity. While it might not seem fair to let other people pay for the costs arising from an unhealthy lifestyle, it does not seem fair either to punish people for their lifestyle. However, it is not clear how solidarity is assessed by people, when considering disease risks or lifestyle risks. The aim of (...) this study was to investigate the degree of solidarity with lifestyle as well as with other factors that are related to health outcomes—for example, old age—and the relation between this degree of solidarity and various characteristics. Methods This cross-sectional study is part of the Dutch longitudinal SMILE study. Data on the degree of solidarity with different lifestyles and old age, and the relation between the degree of solidarity and various demographic and other variables were obtained in a questionnaire survey. Results Solidarity with smokers and overweight people was moderate, as was solidarity with older people. Respondents were ambivalent about athletes. Respondents who were younger, male and highly educated, and those with a healthy lifestyle, a small social network, high quality of life and an internal locus of control, showed low solidarity. Conclusions Solidarity with an unhealthy lifestyle and old age is moderate and the degree of solidarity varies among the different subgroups. (shrink)

Background In the ethical and clinical literature, cases of parents who want treatment for their child to be withdrawn against the views of the medical team have not received much attention. Yet resolution of such conflicts demands much effort of both the medical team and parents. Objective To discuss who can best protect a child9s interests, which often becomes a central issue, putting considerable pressure on mutual trust and partnership. Methods We describe the case of a 3-year-old boy with acquired (...) brain damage due to autoimmune-mediated encephalitis whose parents wanted to stop treatment. By comparing this case with relevant literature, we systematically explored the pros and cons of sharing end-of-life decisions with parents in cases where treatment is considered futile by parents and not (yet) by physicians. Conclusions Sharing end-of-life decisions with parents is a more important duty for physicians than protecting parents from guilt or doubt. Moreover, a request from parents on behalf of their child to discontinue treatment is, and should be, hard to over-rule in cases with significant prognostic uncertainty and/or in cases with divergent opinions within the medical team. (shrink)

The editors of the JRE solicited short essays on the COVID‐19 pandemic from a group of scholars of religious ethics that reflected on how the field might help them make sense of the complex religious, cultural, ethical, and political implications of the pandemic, and on how the pandemic might shape the future of religious ethics.

BackgroundObtaining informed consent for intravenous thrombolysis in acute ischemic stroke can be challenging, and little is known about if and how the informed consent procedure is performed by neurologists in clinical practice. This study examines the procedure of informed consent for intravenous thrombolysis in acute ischemic stroke in high-volume stroke centers in the Netherlands.MethodsIn four high volume stroke centers, neurology residents and attending neurologists received an online questionnaire concerning informed consent for thrombolysis with tissue-type plasminogen activator (tPA). The respondents were (...) asked to report their usual informed consent practice for tPA treatment and their considerations on whether informed consent should be obtained.ResultsFrom the 203 invited clinicians, 50% (n = 101) completed the questionnaire. One-third of the neurology residents (n = 21) and 21% of the neurologists (n = 8) reported that they always obtain informed consent for tPA treatment. If a patient is not capable of providing informed consent, 30% of the residents (n = 19) reported that they start tPA treatment without informed consent. In these circumstances, 53% of the neurologists (n = 20) reported that the resident under their supervision would start tPA treatment without informed consent. Most neurologists (n = 21; 55%) and neurology residents (n = 45; 72%) obtained informed consent within one minute. None of the respondents used more than five minutes for informed consent. Important themes regarding obtaining informed consent for treatment were patients’ capacity, and medical, ethical and legal considerations.ConclusionThe current practice of informed consent for thrombolysis in acute ischemic stroke varies among neurologists and neurology residents. If informed consent is obtained, most clinicians stated to obtain informed consent within one minute. In the future, a shortened information provision process may be applied, making a shift from informed consent to informed refusal, while still considering the patient’s capacity, stroke severity, and possible treatment delays. (shrink)

A partir de una encuesta por correo electrónico a estudiantes de Ingeniería en el SAI de la UAMA en un contexto de enseñanza remota forzado por la pandemia, se caracteriza la gestión de la docencia, desde la visión de los estudiantes, se realiza un diagnóstico de los aspectos relacionados. Es un estudio transversal con un análisis cualitativo y descriptivo de las respuestas. La gestión docente se ve afectada por factores inherentes al proceso, así como también por factores externos. Los resultados (...) obtenidos muestran que fue impactada fuertemente al realizarse el proceso totalmente vía remota especialmente, la comunicación e interacción alumno-profesor. (shrink)

Research on social influences often distinguishes between social and quality incentives to ascribe meaning to the value that popularity conveys. This study examines the neural correlates of those incentives through which popularity influences preferences. This research reports an functional magnetic resonance imaging experiment and a behavioral task in which respondents evaluated popular products with three focus perspectives; unspecified focus, focus on social aspects, and focus on quality. The results show that value derived with a social focus reflects inferences of approval (...) and reward value, and positively affects preferences. Value derived with a quality focus reflects inferences of quality and negatively affects preferences. This study provides evidence of two distinct inferential routes on both a neurological level, represented by different regions in the brain, and a behavioral level. These results provide the first evidence that a single popularity cue can in different ways influence the value derived from product popularity. (shrink)

In this study, we test a number of predictions concerning children's knowledge of the transitive Subject-Verb-Object (SVO) construction between two and three years on one child (Thomas) for whom we have densely collected data. The data show that the earliest SVO utterances reflect earlier use of those same verbs, and that verbs acquired before 2;7 show an earlier move towards adult-like levels of use in the SVO construction and in object argument complexity than later acquired verbs. There is not a (...) close relation with the input in the types of subject and object referents used, nor a close adherence to Preferred Argument Structure (PAS) before 2;7, but both early and late acquired verbs show a simultaneous move towards PAS patterns in selection of referent type at 2;9. The event semantics underpinning early transitive utterances do not straightforwardly fit prototype (high or inalienable) notions of transitivity, but rather may reflect sensitivity to animacy and intentionality in a way that mirrors the input. We conclude that children's knowledge of the transitive construction continues to undergo significant development between 2;0 and 3;0, reflecting the gradual abstraction and integration of the SVO and VO constructions, verb semantics, discourse pragmatics, and the interactions between these factors. These factors are considered in the context of a prototype for the transitive construction. (shrink)

The concept of sustainability was developed in response to stakeholder demands. One of the key mechanisms for engaging stakeholders is sustainability disclosure, often in the form of a report. Yet, how reporting is used to engage stakeholders is understudied. Using resource dependence and stakeholder theories, we investigate how companies within the same industry address different dependencies on stakeholders for economic, natural environment, and social resources and thus engage stakeholders accordingly. To achieve this objective, we conducted our research using qualitative research (...) methods. Our findings suggest that the resource dependencies on different stakeholders lead to development of different stakeholder relationships and thus appropriate resources within the company to execute engagement strategies that are informing, responding, or involving. Our research explains why diversity exists in sustainability disclosure by studying how it is used to engage stakeholders. We find that five sustainability reporting characteristics are associated with the company’s stakeholder engagement strategy: directness of communication, clarity of stakeholder identity, deliberateness of collecting feedback, broadness of stakeholder inclusiveness, and utilization of stakeholder engagement for learning. Our study develops the literature by providing insight into companies’ choices of stakeholder engagement strategy thus explaining diversity in sustainability reporting based on the characteristics and relationships with specific stakeholders. (shrink)

We study the sources of resistance to change among firms in the Canadian petroleum industry in response to a shift in societal level logics related to corporate environmental performance. Despite challenges to its legitimacy as a result of poor environmental performance, the Canadian petroleum industry was divided as to how to respond, with some members ignoring the concerns and resisting change (i.e., laggards) while others took action to ensure continued legitimacy (i.e., leaders). We examine why organizations within the same institutional (...) field responded differently, delaying the industry response. We found that one population of firms was aligned with increasing pressures from its stakeholders for improved environmental performance, and the other was influenced by local cultural, political, and economic ideals less demanding of environmental actions. Our results reveal that several factors both at the institutional field level and the organizational level affected how these two populations reacted to a changing societal logic. Implications for theory, practice, and future research are discussed. (shrink)

Deciphering nonhuman communication – particularly nonhuman vocal communication – has been a longstanding human quest. We are, for example, fascinated by the songs of birds and whales, the grunts of apes, the barks of dogs, and the croaks of frogs; we wonder about their potential meaning and their relationship to human language. Do these utterances express little more than emotional states, or do they convey actual bits and bytes of concrete information? Humans’ numerous attempts to decipher nonhuman systems have, however, (...) progressed slowly. We still wonder why only a small number of species are capable of vocal learning, a trait that, because it allows for innovation and adaptation, would seem to be a prerequisite for most language-like abilities. Humans have also attempted to teach nonhumans elements of our system, using both vocal and nonvocal systems. The rationale for such training is that the extent of success in instilling symbolic reference provides some evidence for, at the very least, the cognitive underpinnings of parallels between human and nonhuman communication systems. However, separating acquisition of reference from simple object-label association is not a simple matter, as reference begins with such associations, and the point at which true reference emerges is not always obvious. I begin by discussing these points and questions, predominantly from the viewpoint of someone studying avian abilities. I end by examining the question posed by Premack: do nonhumans that have achieved some level of symbolic reference then process information differently from those that have not? I suggest the answer is likely “yes,” giving examples from my research on Grey parrots. (shrink)

Este trabajo analiza el papel de los suidos en la ritualidad protohistórica japonesa, tomando como base la aparición de una serie de restos óseos de estos animales en contextos rituales y/o con indicios de consumo ritual, especialmente en los periodos Jōmon (ca. 10,500-300 a.n.e.) y Yayoi (1,000-900 a.n.e.-250-300 d.n.e.),. Pero antes de entrar de lleno en la problemática de estos ejemplares, es necesario realizar una retrospectiva del papel de dichos animales en el archipiélago japonés desde la Prehistoria, así como de (...) la propia domesticación del cerdo en el continente asiático y su difusión por Asia Oriental hasta llegar a las islas japonesas. A este respecto, hay que tener en cuenta que existen tres ámbitos de estudio diferenciado en lo referente a los suidos en el archipiélago japonés: Hokkaidō, el archipiélago de las Ryūkyū y las islas de Kyūshū Honshū y Shikoku. (shrink)

Philosophers are apt to assume that impartial thinking is both possible and desirable. This article, originating in a very definite doubt of this assumption, is an attempt at an examination of the problem.

Grey parrots do not acquire referential English labels when tutored with videotapes displayed on CRT screens if socially isolated, reward for attempted labels is possible, trainers direct birds’ attention to the monitor, live video feed avoids habituation or one trainer repeats labels produced on video and rewards label attempts. Because birds learned referential labels from live tutor pairs in concurrent sessions, we concluded that video failed because input lacked live social interaction and modeling. Recent studies, however, suggest that standard CRT (...) monitor flickering could instead have prevented learning. Using an LCD monitor, we found that eliminating flickering did not enable birds to learn from video under conditions of limited social interaction. Results emphasize the role of social interaction in referential label learning and may generalize to other systems. (shrink)

Grey parrots do not acquire referential English labels when tutored with videotapes displayed on CRT screens if socially isolated, reward for attempted labels is possible, trainers direct birds’ attention to the monitor, live video feed avoids habituation or one trainer repeats labels produced on video and rewards label attempts. Because birds learned referential labels from live tutor pairs in concurrent sessions, we concluded that video failed because input lacked live social interaction and modeling. Recent studies, however, suggest that standard CRT (...) monitor flickering could instead have prevented learning. Using an LCD monitor, we found that eliminating flickering did not enable birds to learn from video under conditions of limited social interaction. Results emphasize the role of social interaction in referential label learning and may generalize to other systems. (shrink)

Explaining the transition from nonhuman to human behavior is a major scientific problem. Penn et al. argue for discontinuous evolution; they review many relevant papers but miss some that disagree with their stance. Given the shifting ground on which Penn et al.'s theories are based, and the likelihood of future studies providing additional information on continuities, a more open approach to continuity is warranted.

The field of animal-computer interfaces has a longer history than one might at first suppose. In this Introduction, I first discuss some of the early attempts to integrate computers into the study of animal cognition, communication, and behavior and how they provided the groundwork for subsequent research in nonhuman-computer interfaces. I then summarize the various contributions to this special issue, emphasizing how they provide a snapshot into the current state of the field. I close by emphasizing the value of this (...) work but also by suggesting some potential pitfalls of which we must also be aware. (shrink)

Grâce aux nombreuses sources littéraires dont il dispose, l'auteur retrace la vie d'Irène la Sevastokratorissa, épouse du Sevastokator Andronic, second fils de Jean II Comnène. Il tente surtout d'éclaircir quelques zones d'ombres, comme la raison de son emprisonnement depuis l'accession au trône de son beau-frère Manuel Ier Comnène , et d'élucider les causes du danger qu'elle représentait pour Manuel, qui semblerait être lié à sa famille ou à son origine géographique.

The study of animal behavior, and particularly avian behavior, has advanced significantly in the past 50 years. In the early 1960s, both ethologists and psychologists were likely to see birds as simple automatons, incapable of complex cognitive processing. Indeed, the term “avian cognition“ was considered an oxymoron. Avian social interaction was also seen as based on rigid, if sometimes complicated, patterns. The possible effect of social interaction on cognition, or vice versa, was therefore something almost never discussed. Two paradigm shifts—one (...) concerning animal cognition and one concerning social interaction—began to change perceptions in, respectively, the early 1970s and 1980s, but only more recently have researchers actively investigated how these two areas intersect in the study of avian behavior. The fruits of such intersection can be seen in the various papers for this special issue. I provide some brief background material before addressing the striking findings of current projects. In some cases, researchers have adapted early classic methods and in other cases have devised new paradigms, but in all instances have demonstrated avian capacities that were once thought to be the exclusive domain of humans or at least nonhuman primates. Keywords: avian cognition; avian social learning; avian observational learning; avian communication. (shrink)

The study of animal behavior, and particularly avian behavior, has advanced significantly in the past 50 years. In the early 1960s, both ethologists and psychologists were likely to see birds as simple automatons, incapable of complex cognitive processing. Indeed, the term “avian cognition” was considered an oxymoron. Avian social interaction was also seen as based on rigid, if sometimes complicated, patterns. The possible effect of social interaction on cognition, or vice versa, was therefore something almost never discussed. Two paradigm shifts—one (...) concerning animal cognition and one concerning social interaction—began to change perceptions in, respectively, the early 1970s and 1980s, but only more recently have researchers actively investigated how these two areas intersect in the study of avian behavior. The fruits of such intersection can be seen in the various papers for this special issue. I provide some brief background material before addressing the striking findings of current projects. In some cases, researchers have adapted early classic methods and in other cases have devised new paradigms, but in all instances have demonstrated avian capacities that were once thought to be the exclusive domain of humans or at least nonhuman primates. Keywords: avian cognition; avian social learning; avian observational learning; avian communication. (shrink)