Background:Nurses and nursing students appear vulnerable to moral distress when faced with ethical dilemmas or decision-making in clinical practice. As a result, they may experience professional dissatisfaction and their relationships with patients, families, and colleagues may be compromised. The impact of moral distress may manifest as anger, feelings of guilt and frustration, a desire to give up the profession, loss of self-esteem, depression, and anxiety.Objectives:The purpose of this review was to describe how dilemmas and environmental, relational, and organizational factors contribute (...) to moral distress in undergraduate student nurses during their clinical experience and professional education.Research design:The research design was a systematic literature review.Method:The search produced a total of 157 articles published between 2004 and 2014. These were screened with the assessment sheet designed by Hawker and colleagues. Four articles matched the search criteria (one quantitative study and three qualitative), and these were separately read and analyzed by the researchers. The process of review and analysis of the data was supervised by a colleague experienced in moral distress who provided an independent quality check.Ethical consideration:Since this was a systematic review, no ethical approval was required.Findings:From the analysis, it emerged that inequalities and healthcare disparities, the relationship with the mentor, and students’ individual characteristics can all impact negatively on the decisions taken and the nursing care provided, generating moral distress. All these factors condition both the clinical experience and learning process, in addition to the professional development and the possible care choices of future nurses.Conclusion:Few studies dealt with moral distress in the setting of nurse education, and there is a knowledge gap related to this phenomenon. The results of this review underline the need for further research regarding interventions that can minimize moral distress in undergraduate nursing students. (shrink)

Whitehead, in his famous book "Process and Reality", proposed a definition of point assuming the concepts of “region” and “connection relation” as primitive. Several years after and independently Grzegorczyk, in a brief but very interesting paper proposed another definition of point in a system in which the inclusion relation and the relation of being separated were assumed as primitive. In this paper we compare their definitions and we show that, under rather natural assumptions, they coincide.

Analyse : Concerne en grande partie la vie et l'oeuvre du pédagogue à Yverdon.

Whitehead, in his famous book Process and Reality, proposed a definition of point assuming the concepts of "region" and "connection relation" as primitive. Several years after and independently Grzegorczyk, in a brief but very interesting paper, proposed another definition of point in a system in which the inclusion relation and the relation of being separated were assumed as primitive. In this paper we compare their definitions and we show that, under rather natural assumptions, they coincide.

A main identifying factor of professions is professionals' willingness to comply with ethical and professional standards, often defined in a code of ethics and conduct. In a period of intense nursing mobility, if the public are aware that health professionals have committed themselves to the drawing up of a code of ethics and conduct, they will have more trust in the health professional they choose, especially if this person comes from another European Member State. The Code of Ethics and Conduct (...) for European Nursing is a programmatic document for the nursing profession constructed by the FEPI (European Federation of Nursing Regulators) according to Directive 2005/36/EC On recognition of professional qualifications , and Directive 2006/123/EC On services in the internal market, set out by the European Commission. This article describes the construction of the Code and gives an overview of some specific areas of importance. The main text of the Code is reproduced in Appendix 1. (shrink)

This paper is about a special version of PDL, proposed by Marcus Kracht, for reasoning about sibling ordered trees. It has four basic programs corresponding to the child, parent, left- and right-sibling relations in such trees. The original motivation for this language is rooted in the field of model-theoretic syntax. Motivated by recent developments in the area of semi-structured data, and, especially, in the field of query languages for XML (eXtensible Markup Language) documents, we revisit the language. This renewed interest (...) comes with a special focus on complexity and expressivity aspects of the language, aspects that have so far largely been ignored. We survey and derive complexity results, and spend most of the paper on the most important open question concerning the language: what is its expressive power? We approach this question from two angles: Which first-order properties can be expressed? And which second-order properties? While we are still some way from definitive answers to these questions, we discuss two first-order fragments of the PDL language for ordered trees, and show how the language can be used to express some typical (second-order) problems, like the boolean circuit and the frontier problem. (shrink)

Background:Prisons are contexts where nurses are required to have specific skills to ensure that, in a setting designed for the expiation of crime, prisoners receive the same type of care as anyone else. But this is not always the case, giving rise to ethical issues.Research questions:‘How do correctional nurses describe their working experience in prisons? What issues emerged?’Methodology:This is a qualitative descriptive study. Following purposive sampling, we conducted five focus groups. Thematic analysis was used to analyse the data.Participants and research (...) context:Our sample included 31 correctional nurses in seven prisons in Northern Italy.Ethical considerations:The scientific merit of this study was recognized by the Academic Board of the University of Genoa. Approval to conduct the study was obtained from the Liguria Regional Government that funded this study and from the Local Health Authority that was the prison nurses’ employer. Formal consent was obtained from all the nurses who volunteered to participate in this study.Findings:Five themes emerged from the focus groups: prisoners’ healthcare needs, negotiation between custody and care, satisfaction of working in prisons, obstacles to quality care and safety. ‘Manipulation’ was a transversal theme that emerged from all the focus groups.Discussion:The problems generated by the clash between prison security and nursing care priorities did not enable nurses to practice autonomously and provide the best possible to care prisoners, giving rise to ethical issues and moral distress. This in turn causes high nursing turnover rates that negatively impact continuum of care.Conclusion:In Italy, correctional nurses urgently require specific education interventions with the participation of all those who work in prisons. Interventions based on the post-modern concept of restorative nursing could offer prison nurses the opportunity to both resolve ethical issues and reduce moral distress. (shrink)

This paper considers the problem of assigning meanings to empty natural kind terms. It does so in the context of the Twin-Earth externalist-internalist debate about whether the meanings of natural kind terms are individuated by the external physical environment of the speakers using these terms. The paper clarifies and outlines the different ways in which meanings could be assigned to empty natural kind terms. And it argues that externalists do not have the semantic resources to assign them meanings. The paper (...) ends on a sceptical note concerning the fruitfulness of using the Twin-Earth setting in debates about the semantics of empty natural kind terms. (shrink)

ABSTRACTThe incorrect conceptualization and evaluation of reparations for colonial slave trade and slavery within the legal, as opposed to the political, domain, produces an interpretation of the demands in France that views them as morally absurd and politically deleterious. I’ll use Iris Marion Young’s distinction between a liability model and a social connection model of responsibility to suggest that the moral claim according to which we can be held responsible today for redressing the structural injustices inherited from slave trade and (...) slavery is not irrational, nor motivated by a political will to divide the body politic between blamed perpetrators and innocent victims. I’ll first analyze the difficulties posed by the liability model by focusing on a specific legal case, MIR and CMDP vs. French state. Then I’ll argue that using a political model of responsibility solves conceptual and normative issues and allows us to understand why, and to what extent, we are responsible for redressing the structural racial injustice that endures in French society. (shrink)

This study investigated how gender shapes the relationships between classroom environment, achievement goals and maths performance. Seventh-grade students (N?=?498) from five urban secondary schools filled in achievement goal orientations and classroom environment scales at the beginning of the second semester. Maths performance was assessed as an average grade four months later. The results indicated gender differences in the perception of teacher and peers support, achievement goals and maths performance. The effects of goal orientations, teacher and peers support on achievement were (...) moderated by gender. Furthermore, the interaction between classroom environment and performance goals on maths grades varied with gender. In the boys? sample, performance-avoidance goals interacted with teacher support, while in the girls? sample, performance-approach goals interacted with peers support in predicting maths grades. The educational implications of these gender differences are discussed. (shrink)

It is shown the complete equivalence between the theory of continuous (enumeration) fuzzy closure operators and the theory of (effective) fuzzy deduction systems in Hilbert style. Moreover, it is proven that any truth-functional semantics whose connectives are interpreted in [0,1] by continuous functions is axiomatizable by a fuzzy deduction system (but not by an effective fuzzy deduction system, in general).

The aim of this paper is to show what sorts of logics are required by externalist and internalist accounts of the meanings of natural kind nouns. These logics give us a new perspective from which to evaluate the respective positions in the externalist-internalist debate about the meanings of such nouns. The two main claims of the paper are the following: first, that adequate logics for internalism and externalism about natural kind nouns are second-order logics; second, that an internalist second-order logic (...) is a free logic—a second order logic free of existential commitments for natural kind nouns, while an externalist second-order logic is not free of existential commitments for natural kind nouns—it is existentially committed. (shrink)

IntroductionPalliative care is an emotionally and spiritually high-demanding setting of care. The literature reports on the main issues in order to implement self-care, but there are no models for the organization of the training course. We described the structure of training on self-care and its effects for a Hospital Palliative Care Unit.MethodWe used action-research training experience based mostly on qualitative data. Thematic analysis of data on open-ended questions, researcher’s field notes, oral and written feedback from the trainer and the participants (...) on training outcomes and satisfaction questionnaires were used.ResultsFour major themes emerged: “Professional role and personal feelings”; “Inside and outside the team”; “Do I listen to my emotions in the care relationship?”; “Death: theirs vs. mine.” According to participants’ point of view and researchers’ observations, the training course resulted in ameliorative adjustments of the program; improved skills in self-awareness of own’s emotions and sharing of perceived emotional burden; practicing “compassionate presence” with patients; shared language to address previously uncharted aspects of coping; allowing for continuity of the skills learned; translation of the language learned into daily clinical practices through specific facilitation; a structured staff’s support system for emotional experiences.DiscussionSelf-care is an important enabler for the care of others. The core of our intervention was to encourage a meta-perspective in which the trainees developed greater perspicacity pertaining to their professional role in the working alliance and also recognizing the contribution of their personal emotions to impasse experienced with patients. (shrink)

In the last decade, the financial underground markets evolved in a surprisingly way, around the world. Eastern Europe is a significant region, where illegal activities associated with the shadow economy became a real problem that affects the governments stability, the economical, political and social status. Due to the influence of old regimes and the current tolerance of the Eastern European nations, this underground corridors emphasize the risk of interfering with the financing platforms of international terrorism or organized crime.

Research indicates that nature offers many physical and mental health benefits, including restoration - or recovery from mental fatigue. However, questions remain about what exactly in one's environment is experienced as restorative and why. Bridging environmental aesthetics, environmental psychology and cultural studies, this study establishes a connection between landscape and mindscape as seen, for instance, in the ways in which an orderly environment is interpreted as an orderly state of mind and vice versa. Using data drawn from a qualitative survey (...) targeting expatriate Finns, the article mobilises content analysis to interpret the results and concludes that a 'favourite place' is aesthetically appealing, enables actions that are experienced as restorative and is as much an interpretation of a space as a physical place. (shrink)

The ongoing Coronavirus disease 2019 (COVID-19) pandemic is disrupting most specialized healthcare services worldwide, including those for high-risk newborns and their families. Due to the risk of contagion, critically ill infants, relatives and professionals attending neonatal intensive care units (NICUs) are undergoing a profound remodeling of the organization and quality of care. In particular, mitigation strategies adopted to combat the COVID-19 pandemic may hinder the implementation of family-centered care within the NICU. This may put newborns at risk for several adverse (...) effects, e.g., less weight gain, more nosocomial infections, increased length of NICU stay as well as long-term worse cognitive, emotional, and social development. This article aims to contribute to deepening the knowledge on the psychological impact of COVID-19 on parents and NICU staff members based on empirical data from the literature. We also provided evidence-based indications on how to safely empower families and support NICU staff facing such a threatening emergency, while preserving the crucial role of family-centered developmental care practices. (shrink)

La base conceptual de lo que sería más tarde desarrollado por las vanguardias artísticas fue colonizada por alemanes de pensamiento romántico e idealista, cuya dimensión utópica puede ser fácilmente reconocida en el «antiguo programa del idealismo alemán» (1796), un texto que consagró un pensamiento idealista, que clamó por una nueva racionalidad o una mitología de la razón de Hegel, la intuición intelectual de Schelling y la Humanidad de Schiller. Aunque este proyecto de emancipación desarrollado más tarde por la vanguardia ha (...) perdido su credibilidad para nosotros, todavía tenemos que investigar en qué medida el arte de hoy puede mantener una función social. Este artículo señala algunos conceptos idealistas a la luz de una filosofía del arte, y fue creado siguiendo las líneas esbozadas en la Crítica del juicio de Kant, que han contribuido a la historia de la «avanzada» del arte. (shrink)

L'articolo cerca di rispondere a questo interrogativo: quali sono le conseguenze del processo di individualizzazione sui legami sociali e sulla solidarietÀ? Esso porta, come alcuni autori hanno recentemente sostenuto, alla disgregazione sociale, alla ‘fine della societÀ', o possono essere rintracciate nuove forme di ricomposizione sociale? Il soggetto ‘individualizzato' č quindi un soggetto liberato e isolato nello stesso tempo, che č divenuto il perno dei destini del mondo? L'articolo sostiene una tesi diversa. Esso mette in luce alcuni caratteri della trasformazione attuale (...) che delineano varie forme di individualismo: individualismi sociali e asociali. Si cerca di mostrare che nuove forme di regolazione sociale stanno emergendo ovunque nel mondo globale. (shrink)

Humans can recollect past events in details and/or know that an object, person, or place has been encountered before. During the last two decades, there has been intense debate about how recollection and familiarity are organized in the brain. Here, we propose an integrative memory model which describes the distributed and interactive neurocognitive architecture of representations and operations underlying recollection and familiarity. In this architecture, the subjective experience of recollection and familiarity arises from the interaction between core systems and an (...) attribution system. By integrating principles from current theoretical views about memory functioning, we provide a testable framework to refine the prediction of deficient versus preserved mechanisms in memory-impaired populations. The case of Alzheimer's disease is considered as an example because it entails progressive lesions starting with limited damage to core systems before invading step-by-step most parts of the model-related network. We suggest a chronological scheme of cognitive impairments along the course of AD, where the inaugurating deficit would relate early neurodegeneration of the perirhinal/anterolateral entorhinal cortex to impaired familiarity for items that need to be discriminated as viewpoint-invariant conjunctive entities. The integrative memory model can guide future neuropsychological and neuroimaging studies aiming to understand how such a network allows humans to remember past events, to project into the future, and possibly also to share experiences. (shrink)

John MacFarlane has recently argued that his brand of truth relativism provides the best solution to the puzzle of future contingents: assertions about the future that express propositions that are metaphysically neither necessary nor impossible. In this paper, we show that even if we grant all of the metaphysical, semantic and pragmatic assumptions in terms of which MacFarlane sets and aims to solve the puzzle, his truth relativism is not apt to solve the problem of future contingents. We argue that (...) the theory fails to vindicate the intuition that future contingent propositions are neither true nor false, leaving the theory open to a charge of Reductio. We show that these problems cannot be answered while preserving the core tenets of truth relativism. (shrink)

The article will argue that, despite Will Kymlicka’s claims to the contrary, the concept of ‘multicultural toleration’ implicitly entails an essentialist concept of groups, which amounts to holding a negative ‘permission’, power-loaded conception of toleration and not a positive liberal ‘respect’ conception. This seems contradictory to the general goal of Kymlicka’s multiculturalism. This article will then argue that multicultural toleration is not a satisfactory concept, neither from a conceptual point of view (it is incoherent) nor from a practical point of (...) view (it disregards important aspects of political life). Nonetheless, multiculturalism poses the question of toleration at the correct level of group relations. This article will try to sustain the double requirement of, on one hand, trying to place toleration in a collective frame and, on the other, refusing the essentialist concept of groups used by multiculturalism. The way out of this difficulty can be found in a critical ‘non-domination’ conception of toleration. (shrink)

IntroductionDignity therapy is brief psychotherapy targeting psychological and existential suffering among patients with a life-limiting illness. Studies have been conducted on the use of DT by healthcare professionals. In Italy, the current legislation defines that any form of psychotherapy may be performed exclusively by psychotherapists. Consequently, this intervention is unlikely to be used by other healthcare professionals. Herein, we will describe a training on DT not as a psychotherapy intervention but as a narrative intervention for non-psychotherapists health care professionals. Finally, (...) we will explore the potential enablers/barriers as experienced by palliative care physicians and nurses.MethodsThe study was conducted in the Psycho-Oncology Unit within the Cancer Research Hospital of Reggio Emilia. It consisted of an exploratory qualitative case study. Data were collected employing observations and interview data and thematically analyzed.ResultsThe training was attended by six physicians and ten nurses and took place during two-afternoon sessions for 10 h. Two participants put their training into practice and administered DT under the supervision of a psychotherapist. Data analysis highlighted five overarching themes relating to the training experience and direct use of DT, namely, time required, psychological skills, patient’s disease awareness, patient’s life history, and distinguishing DT from Advance Care Planning.ConclusionPalliative care professionals found DT to be a valuable non-pharmacological hospital-based intervention to address the person beyond the patient and his clinical conditions. In our experience, considering that in Italy, psychotherapy is an intervention that psychotherapists can only perform, it can help organize different training on DT for psychotherapists and other healthcare professionals. (shrink)

What is the relation of risk to negativity? Is it possible to think a notion of the negative that doesn't exclude the other via inclusion? These two questions are at the heart of Massimo Donà's discussion of immunity. Drawing on Roberto Esposito's genealogy of immunity in community, Donà shows how immunity depends upon a paradox of separation that brings the common and the immune closer together. After sketching the relation of immunity to the notion of polemos, Donà argues that the (...) immune subject, by including the other, negates itself so that the other becomes the true self. The essay closes with a series of reflections on how to think negation and immunity together through pregnancy; a negation that affirms a nonsubstitutive or alternative way of being. (shrink)