Background: Compassion fatigue is recognized as impacting the health and effectiveness of healthcare providers, and consequently, patient care. Compassion fatigue is distinct from “burnout.” Reliable measurement tools, such as the Professional Quality of Life scale, have been developed to measure the prevalence, and predict risk of compassion fatigue. This study reviews the prevalence of compassion fatigue among healthcare practitioners, and relationships to demographic variables. Methods: A systematic review was conducted using key words in MEDLINE, PubMed, and Ovid databases. Data were (...) extracted from a total of 71 articles meeting inclusion criteria, from studies measuring compassion fatigue in healthcare providers using a validated instrument. Quantitative and qualitative data were extracted and compiled by three independent reviewers into an evidence table that included basic study characteristics, study strength and quality determination, measurements of compassion fatigue, and general findings. Meta-analysis, where data allowed, was stratified by Professional Quality of Life version, heterogeneity was quantified, and pooled means were reported with 95% confidence interval. A table of major study characteristics and results was created. Ethical consideration: This paper contains no primary data obtained directly from research participants. Data obtained from previously published resources have been acknowledged within references. Psychological distress, particularly compassion fatigue, can be insidious, no health profession is immune, and may significantly impact the ability to provide care. Results: A total of 71 studies were included. Compassion fatigue was reported across all practitioner groups studied. Relationships to most demographic variables such as years of experience and specialty were either not statistically significant or unclear. Variability in reporting of Professional Quality of Life results was found. Interpretation: Compassion fatigue exists across diverse practitioner groups. Prevalence is highly variable, and its relationship with demographic, personal, and/or professional variables is inconsistent. Questions are raised about how to mitigate compassion fatigue. (shrink)

This article discusses the new reproductive technology of egg freezing in the context of existing literature on gender, medicalization, and infertility. What is unique about this technology is its use by women who are not currently infertile but who may anticipate a future diagnosis. This circumstance gives rise to a new ontological category of “anticipated infertility.” The author draws on participant observation and a qualitative analysis of scientific, mainstream, and marketing literature to identify and compare the representation of two different (...) candidates for egg freezing: women with cancer and healthy young women. Although both populations experience anticipated infertility, their dichotomous portrayals as appropriate candidates are demonstrative of gender norms linking women to motherhood. Egg freezing is a concise illustration of how the medicalization of women’s bodies and bodily processes masks a host of cultural anxieties about aging, illness, reproduction, and risk. (shrink)

Michael A. Petersa and Fazal Rizvib aBeijing Normal University, Beijing, PR China; bMelbourne University, Melbourne, Australia Our minds are still racing back and forth, longing for a return to ‘no...

Case-based instruction is a stable feature of ethics education, however, little is known about the attributes of the cases that make them effective. Emotions are an inherent part of ethical decision-making and one source of information actively stored in case-based knowledge, making them an attribute of cases that likely facilitates case-based learning. Emotions also make cases more realistic, an essential component for effective case-based instruction. The purpose of this study was to investigate the influence of emotional case content, and complementary (...) socio-relational case content, on case-based knowledge acquisition and transfer on future ethical decision-making tasks. Study findings suggest that emotional case content stimulates retention of cases and facilitates transfer of ethical decision-making principles demonstrated in cases. (shrink)

When applied in the health sector, AI-based applications raise not only ethical but legal and safety concerns, where algorithms trained on data from majority populations can generate less accurate or reliable results for minorities and other disadvantaged groups.

Cases have been employed across multiple disciplines, including ethics education, as effective pedagogical tools. However, the benefit of case-based learning in the ethics domain varies across cases, suggesting that not all cases are equal in terms of pedagogical value. Indeed, case content appears to influence the extent to which cases promote learning and transfer. Consistent with this argument, the current study explored the influences of contextual and personal factors embedded in case content on ethical decision-making. Cases were manipulated to include (...) a clear description of the social context and the goals of the characters involved. Results indicated that social context, specifically the description of an autonomy-supportive environment, facilitated execution of sensemaking processes and resulted in greater decision ethicality. Implications for designing optimal cases and case-based training programs are discussed. (shrink)

This letter addresses the editorial decision to publish the article, “Research on group differences in intelligence: A defense of free inquiry” (Cofnas, 2020). Our letter points out several critical problems with Cofnas's article, which we believe should have either disqualified the manuscript upon submission or been addressed during the review process and resulted in substantial revisions.

Background Institutional review board (IRB) expertise is necessarily limited by maintaining a manageable board size. IRBs are therefore permitted by regulation to rely on outside experts for review. However, little is known about whether, when, why, and how IRBs use outside experts.Methods We conducted a national survey of U.S. IRBs to characterize utilization of outside experts. Our study uses a descriptive, cross-sectional design to understand how IRBs engage with such experts and to identify areas where outside expertise is most frequently (...) requested.Results The survey response rate was 18.4%, with 55.4% of respondents reporting their institution’s IRB uses outside experts. Nearly all respondents who reported using outside experts indicated they do so less than once a month, but occasionally each year (95%). The most common method of identifying an outside expert was securing a previously known subject matter expert (83.3%). Most frequently, respondents sought consultation for scientific expertise not held by current members (69.6%). Almost all respondents whose IRBs had used outside experts reported an overall positive impact on the IRB review process (91.5%).Conclusions Just over half of the IRBs in our sample report use of outside experts; among them, outside experts were described as helpful, but their use was infrequent overall. Many IRBs report not relying on outside experts at all. This raises important questions about what type of engagement with outside experts should be viewed as optimal to promote the highest quality review. For example, few respondents sought assistance from a Community Advisory Board, which could address expertise gaps in community perspectives. Further exploration is needed to understand how to optimize IRB use of outside experts, including how to recognize when expertise is lacking, what barriers IRBs face in using outside experts, and perspectives on how outside expert review impacts IRB decision-making and review quality. (shrink)

Development and targeting efforts by academic organizations to effectively promote research integrity can be enhanced if they are able to collect reliable data to benchmark baseline conditions, to assess areas needing improvement, and to subsequently assess the impact of specific initiatives. To date, no standardized and validated tool has existed to serve this need. A web- and mail-based survey was administered in the second half of 2009 to 2,837 randomly selected biomedical and social science faculty and postdoctoral fellows at 40 (...) academic health centers in top-tier research universities in the United States. Measures included the Survey of Organizational Research Climate (SORC) as well as measures of perceptions of organizational justice. Exploratory and confirmatory factor analyses yielded seven subscales of organizational research climate, all of which demonstrated acceptable internal consistency (Cronbach’s α ranging from 0.81 to 0.87) and adequate test–retest reliability (Pearson r ranging from 0.72 to 0.83). A broad range of correlations between the seven subscales and five measures of organizational justice (unadjusted regression coefficients ranging from 0.13 to 0.95) document both construct and discriminant validity of the instrument. The SORC demonstrates good internal (alpha) and external reliability (test–retest) as well as both construct and discriminant validity. (shrink)

This article is an attempt to develop a measure of ethical sensitivity to racial and gender intolerance that occurs in schools. Acts of intolerance that indicate ethically insensitive behaviors in American schools were identified and tied to existing professional ethical codes developed by school-based professional organizations. The Racial Ethical Sensitivity Test consists of 5 scenarios that portray acts of racial intolerance and ethical insensitivity. Participants viewed 2 videotaped scenarios and then responded to a semistructured interview protocol adapted from Bebeau and (...) Rest. After a 2-week interval, this procedure was repeated. Stability of the REST across time was determined by using the overall test-retest coefficient. Internal as well as interrater consistency was also calculated for each scenario. Overall findings indicate promise for the REST as a reliable measure to assess racial and ethnic sensitivity. (shrink)

Liao and Carbonell argue that medical devices are often not merely biased, but rather materialize oppression through the perpetuation of oppression into the present and future (Liao and Carbonell 2...

Group sex among men who have sex with men may be understood as a ‘radical’ practice insofar as it transgresses dominant social discourses around appropriate sexual relations—prioritizing heteronormative, monogamous and risk‐averse sex. These practices are generally defined as steeped in risk, most commonly due to the potential for transmitting human immunodeficiency virus and sexually transmitted infections and accompanied by the possibility of legal and social repercussions. Our ethnographic research study explored the desires, practices and contexts of group sex participants (n (...) = 10) within a popular group sex party destination located in the United States. We employ a poststructuralist perspective (utilizing the work of Deleuze and Guattari) to understand group sex events with the pretext that bodies have no inherent ethics, meaning or essence: they are ‘bodies without organs’. We identify group sex as a form of boundary play, in which participants pursue new limits to what their bodies can do but within a carefully constructed environment that establishes norms of interaction meant to secure trust and safety between participants. A variety of risk reduction practices are shown to be promoted and honoured within these eventful sexual(ized) spaces. The application of poststructuralist concepts of ‘boundary play’ and ‘bodies without organs’ helped to depict the construction and navigation of pleasure, safety and risk among group sex participants. (shrink)

ABSTRACTDepression is associated with increased emotional response to stress. This is especially the case during the developmental period of adolescence. Cognitive reappraisal is an effective emotion regulation strategy that has been shown to reduce the impact of emotional response on psychopathology. However, less is known about whether cognitive reappraisal impacts the relationship between depressive symptoms and emotional responses, and whether its effects are specific to emotional reactivity or emotional recovery. The current study examined whether cognitive reappraisal moderated the relationship between (...) depressive symptoms and trait or state measures of emotional reactivity and recovery. A community sample of 127 adolescents, at an age of risk for depression, completed self-report measures of trait emotional responding and depressive symptoms. In addition, they completed an in vivo social stress task and were assessed on state emotional reactivity and recove... (shrink)

Physicians anecdotally report inquiring about incarcerated patients’ crimes and their length of sentence, which has potential implications for the quality of care these patients receive. However, there is minimal research on how a physician’s awareness of their patient’s crimes/length of sentence impacts physician behaviours and attitudes. We performed regression modelling on a 27-question survey to analyse physician attitudes and behaviours towards incarcerated patients. We found that, although most physicians did not usually try to learn of their patients’ crimes, they often (...) became aware of them. We observed associations between awareness of a patient’s crime and poor physician disposition towards their patients and between physicians’ poor dispositions and lower reported quality of care. These associations suggest that awareness of a patient’s crime may reduce quality of care by negatively impacting physicians’ dispositions towards their patients. Future quantitative and qualitative studies, for example, involving physician interviews and direct patient outcome assessments, are needed to confirm these findings and further uncover and address hurdles incarcerated patients face in seeking medical care. (shrink)

Research about the Olympic Games has primarily focused on preparing athletes for competition. Less attention has been paid to the post-Olympic-phase and athlete well-being during this time. This study explored Australian Olympic athletes’ experiences following the conclusion of the 2016 Rio Olympic Games, including the factors that may have contributed to or challenged their well-being during this time. Eighteen athletes participated in semi-structured interviews and thematic analysis revealed that when Olympic performance appraisal met prior expectations, when athletes planned for a (...) return to work or study, and when support from a variety of sources was readily available, this positively influenced athletes’ well-being during the POP. When these factors were not in place, more challenging post-Games experiences were present, and well-being was compromised. The findings contribute to the broader literature on elite athlete well-being and at an applied level, may be used to inform targeted programs that focus on supporting athletes after an Olympic campaign. (shrink)

The examination of the complex cell biology of the human malaria parasite Plasmodium falciparum usually relies on the time‐consuming generation of transgenic parasites. Here, metabolic labeling and click chemistry are employed as a fast transfection‐independent method for the microscopic examination of protein S‐palmitoylation, an important post‐translational modification during the asexual intraerythrocytic replication of P. falciparum. Applying various microscopy approaches such as confocal, single‐molecule switching, and electron microscopy, differences in the extent of labeling within the different asexual developmental stages of P. (...) falciparum and the host erythrocytes over time are observed. (shrink)

Previous studies have shown a robust bias to express the goal path over the source path when describing events. Motivated by linguistic theory, this study manipulated the causal structure of events and measured the extent to which adults and 3.5- to 4-year-old English-speaking children included the goal and source in their descriptions. We found that both children's and adults’ encoding of the source increased for events in which the source caused the motion of the figure compared to nearly identical events (...) in which the source played no such causal role. However, a goal bias persisted overall for both causal and noncausal motion events. These findings suggest that although the goal bias in language is highly robust, properties of the source influence its likelihood of being encoded in language, thus shedding light on how properties of an event can influence the mapping of event components into language. (shrink)

Much experimental evidence shows that minimally counterintuitive concepts, which violate one intuitive ontological expectation of domain-specific natural kinds, are remembered as well as or better than intuitive concepts with no violations of ontological expectations, and much better than maximally counterintuitive concepts with more than one violation of ontological violations. It is also well established that concepts rated as high in imagery, are recalled better than concepts that are low in imagery. We conducted three studies to test whether imagery levels affected (...) recall rates of intuitive, minimally counterintuitive, and maximally counterintuitive concepts. In study 1, we obtained imagery level ratings for 48 three-word items. In study 2, we used the ratings obtained in study 1 in a 2 × 3 recall task in which imagery was manipulated along with counterintutiveness. High imagery items were recalled significantly better than low imagery items for intuitive and maximally counterintuitive items but not for minimally counterintuitive items. Study 3, replicated the findings from study 2 in a 2 × 2 study using a larger number of intuitive and minimally counterintuitive items. In both studies, High imagery items were recalled significantly better than low imagery items for intuitive but not for minimally counterintuitive items. Thus, minimally counterintuitive concepts appear insulated from imagery effects on recall. (shrink)

In this issue, we present two symposia on recent, influential books which have already sparked important research in philosophy and psychology. A common characteristic of these two very different b...

The purpose of this paper is to suggest that the current conversation about the relationship between capitalism and the poor assumes a story about business that is shopworn and outmoded. There are assumptions about business, human behavior, and language that are no longer useful in the twenty first century. Business needs to be understood as how we cooperate together to create value and trade. It is fundamentally about creating value for stakeholders. Human beings are not solely self-interested, but driven by (...) meaning, purpose, and the ability to cooperate. And, language is best understood as a tool, rather than a source of representation. Business and capitalism with these new assumptions can be realized by large and small businesses as not just about money and profits but as the creation of meaning within a prophetic framework. (shrink)

Against the backdrop of cultural and political ideals, this article highlights both the significance of mental health nursing in meeting population needs and the regulatory barriers that may be impeding its ability to adequately do so. Specifically, we consider how ambiguous notions of ‘proficiency’ in nurse education—prescribed by the regulator—impact the development of future mental health nurses and their mental health nursing identity. A key tension in mental health practice is the ethical‐legal challenges posed by sanctioned powers to restrict patients' (...) freedom at the same time as the desire (and obligation) to promote patients' self‐determined recovery. The genericism of the UK's Future Nurse Standards do little to prepare mental health nurses to navigate the tensions that ensue. This has consequences for nurses and patients alike, as both risk experiencing the distress and dissonance that attends giving or receiving poor care. We argue that more needs to be done to enable mental health nurses to define and articulate the nuances of the profession as part of becoming critical, thoughtful and confident practitioners. Educators can contribute to this mission by aligning curriculum, pedagogy and assessment to create meaningful opportunities for mental health nursing students to engage with the complexities of mental health nursing practice. Without this, the credibility of the profession will continue to be questioned; its future uncertain. (shrink)

Storytelling, art and craft can be considered aesthetic expressions of identities. Kalahari identities are not fixed, but fluid. Research with present-day Kalahari People regarding their artistic expression and places where it has been, and is still, practised highlights that these expressions are informed by spirituality. This article explores this idea via two Kalahari case studies: Water Stories recorded in the Upington, Kakamas area, as well as research on a specific rock engraving site at Biesje Poort near Kakamas. The importance of (...) the Kalahari People’s spiritual beliefs as reflected in these case studies and its significance regarding their identities and influence on social change and/or community development projects is discussed. The article thus highlights ways in which spirituality can be considered in relation to social change projects that are characterised by partnerships between local community, non-government and tertiary education representatives and researchers and that highlight storytelling as an integral part of people’s spirituality. (shrink)

Social signaling models predict that subtle variation in climatic temperature induces systematic changes in expressed cognition. An experiment showed that perceived room temperature was associated with variability in self-descriptions, social reactions of others, and desiring differing types of social networks. The findings reflect the tendency to inflate capacity demonstrations in warmer climates as a result of the social networking opportunities they enable.

Previous studies have shown a robust bias to express the goal path over the source path when describing events (“the bird flew into the pitcher,” rather than “… out of the bucket into the pitcher”). Motivated by linguistic theory, this study manipulated the causal structure of events (specifically, making the source cause the motion of the figure) and measured the extent to which adults and 3.5‐ to 4‐year‐old English‐speaking children included the goal and source in their descriptions. We found that (...) both children's and adults’ encoding of the source increased for events in which the source caused the motion of the figure compared to nearly identical events in which the source played no such causal role. However, a goal bias persisted overall for both causal and noncausal motion events. These findings suggest that although the goal bias in language is highly robust, properties of the source (such as causal agency) influence its likelihood of being encoded in language, thus shedding light on how properties of an event can influence the mapping of event components into language. (shrink)

Background Design thinking is a tool for generating and exploring ideas from multiple stakeholders. We used DT principles to introduce students to the ethical implications of organ transplantation. Students applied DT principles to propose solutions to maximise social justice in liver transplant allocation. Methods A 150 min interactive workshop was integrated into the longitudinal ethics curriculum. Following a group didactic on challenges of organ donation in the USA supplemented by patient stories, teams of students considered alternative solutions to optimise fairness (...) of organ distribution and ethical implications of changing the current model. Facilitators led students through DT steps of empathy, defining the team’s point of view, ideating on potential solutions, prototyping a specific idea and testing the idea through oral presentation, with questions and answers by peers and faculty. The curriculum was evaluated with presurveys and postsurveys including quantitative and open-ended items. Results 100 first year medical students participated. Before the session, 75.3% of students had no practical experience with DT. Following participation, students reported an increased understanding of the current liver transplant allocation system and an increased appreciation of shortcomings of the current organ allocation system. After the session, 73.8% of students felt that DT could be used to approach complex health system problems. Discussion Students participating in a DT workshop displayed improved knowledge and attitudes toward organ transplantation and DT. In this pilot study, DT showed promise as a student-led approach emphasising collaboration and creativity in ethics curricula in medical education. (shrink)

In another tumultuous term of the United States Supreme Court in 2022-2023 a series of critical cases implicate instant and forthcoming changes in multiple fronts that collectively shift the national public health law and policy environment.