Blockchain is one of the technologies that can support digital transformation in industries in many aspects. This sophisticated technology can provide a decentralized, transparent, and secure environment for organizations and businesses. This review article discusses the adoption of blockchain in the ports and shipping industry to support digital transformation. It also explores the integration of this technology into the current ports and shipping ecosystem. Besides, the study highlighted the situation of the supply chains management in ports and shipping domain as (...) a case study in this field. The investigated studies show that blockchain can be integrated into processes such as financial and document workflow. This review contributes to research by focusing on the adoption of blockchain in the ports and shipping industry to support digital transformation. It also aims to understand the existing port practice and map it with current tendencies based on blockchain. This study gives insight analysis to incorporate blockchain technology into ports and shipping processes globally. (shrink)

How patients and nurses experience the acute care psychiatric environment The concept of the therapeutic milieu was developed when patients’ hospitalizations were long, medications were few, and one‐to‐one nurse–patient interactions were the norm. However, it is not clear how the notion of ‘therapeutic milieu’ is experienced in American acute psychiatric environments today. This phenomenological study explored the experience of patients and nurses in an acute care psychiatric unit in the USA, by asking them, ‘What stands out to you about this (...) psychiatric hospital environment?’ Three figural themes emerged, contextualized by time, which was a source of stress to both groups: for patients there was boredom, and for nurses, pressure and chaos. Although they shared some themes, nurses and patients experienced them differently. For instance, nurses felt caged‐in by the Plexiglas‐enclosed nursing station, and patients felt caged‐in by the locked doors of the unit. The findings from this US study do not support the existence of the therapeutic milieu as described in the literature. Furthermore, although the nurse–patient relationship was yearned for by nurses, it was nearly absent from patients’ descriptions. The caring experienced by patients was mainly derived from interactions with other patients. (shrink)

Fluid socio-cultural ecologies that reflect historical events and their actors have led to particular religious groups being promoted or persecuted. This article explores how religiously minoritized youth are identified considering local and global contexts. I apply a phenomenological variant of ecological systems theory (PVEST) to understanding regularities and variations in development through a person-centered, relational, holistic lens that considers the intersection of multiple identities. Relatedly, I outline broad conceptual tools that center on how orientations to in-group vs out-group religious and (...) intersecting identities and related experiences align with a range of research methods to reflect such complexity. I suggest ways to study religious and spiritual influences of religiously minoritized youth that are specific to the faith tradition and particular youth’s circumstances in a holistic manner when these issues are a focal area of study, and when they emerge as relevant to other inquiries. Finally, I consider how understanding religiously minoritized youth, their peers, and mentors can be applied to educational, health care, and community settings to inform equitable practice and policy. (shrink)

A collection of personal narratives and essays, Living Professionalism is designed to help medical students and residents understand and internalize various aspects of professionalism. These essays are meant for personal reflection and above all, for thoughtful discussion with mentors, with peers, with others throughout the health care provider community who care about acting professionally.

Uchiyama et al. reveal how group-structured cultural variation influences measurements of trait heritability. We argue that understanding culture's influence on phenotypic heritability can clarify the impact of culture on genetic inheritance, which has implications for long-term gene–culture coevolution. Their analysis may provide guidance for testing our hypothesis that cultural adaptation is superseding genetic adaptation in the long term.

In this study, we elaborate connections among gender, structure, and practice to suggest how social structural relations shape social sexual practice and, in the process, reshape gender relations. Using survey data from a study of a community mobilization intervention, we investigate the connection between institutional arrangements and condom use practice in sexual encounters with commercial clients and intimate partners among 410 women engaged in sex trade in a semiurban town in southern India. Multinomial logistic regression analysis uncovers the effects of (...) 16 measures of gendered structural relations in three contexts—livelihood resources, household circumstances, and community mobilization intervention priorities. We compare women who practice either consistent or inconsistent condom use with both clients and partners with a reference group of women who practice consistent condom use with clients but not with partners. Results reveal the importance of household and community relations for consistent safer sex practice over and above the organization of sex trade. Our analysis advances gender theory in two interrelated ways: We contribute to gender theorizing in the implementation of health interventions, and to gender change more generally by thinking through possibilities emerging from recursive influences between reordered institutional configurations and altered expectations in interaction. (shrink)

BackgroundThe ARRIVE (Animal Research: Reporting of In Vivo Experiments) guidelines are widely endorsed but compliance is limited. We sought to determine whether journal-requested completion of an ARRIVE checklist improves full compliance with the guidelines.MethodsIn a randomised controlled trial, manuscripts reporting in vivo animal research submitted to PLOS ONE (March–June 2015) were randomly allocated to either requested completion of an ARRIVE checklist or current standard practice. Authors, academic editors, and peer reviewers were blinded to group allocation. Trained reviewers performed outcome adjudication (...) in duplicate by assessing manuscripts against an operationalised version of the ARRIVE guidelines that consists 108 items. Our primary outcome was the between-group differences in the proportion of manuscripts meeting all ARRIVE guideline checklist subitems.ResultsWe randomised 1689 manuscripts (control: n = 844, intervention: n = 845), of which 1269 were sent for peer review and 762 (control: n = 340; intervention: n = 332) accepted for publication. No manuscript in either group achieved full compliance with the ARRIVE checklist. Details of animal husbandry (ARRIVE subitem 9b) was the only subitem to show improvements in reporting, with the proportion of compliant manuscripts rising from 52.1 to 74.1% (X2 = 34.0, df = 1, p = 2.1 × 10−7) in the control and intervention groups, respectively.ConclusionsThese results suggest that altering the editorial process to include requests for a completed ARRIVE checklist is not enough to improve compliance with the ARRIVE guidelines. Other approaches, such as more stringent editorial policies or a targeted approach on key quality items, may promote improvements in reporting. (shrink)

This paper proposes a Cournot game organized by three competing firms adopting bounded rationality. According to the marginal profit in the past time step, each firm tries to update its production using local knowledge. In this game, a firm’s preference is represented by a utility function that is derived from a constant elasticity of substitution production function. The game is modeled by a 3-dimensional discrete dynamical system. The equilibria of the system are numerically studied to detect their complex characteristics due (...) to difficulty to get an explicit form for those equilibria. For the proposed utility function, some cases with different value parameters are considered. Numerical simulations are used to provide an experimental evidence for the complex behavior of the evolution of the system. The obtained results show that the system loses its stability due to different types of bifurcations. (shrink)

As clinicians, this case1 raises both personal and professional challenges. A key issue is who carries legal parental responsibility for the difficult decisions that may be required around life-sustaining care in baby T. Medicolegally, we understand that the surrogate mother holds legal parental responsibility for baby T until this can be transferred to the intended parents.2 But this process can take many months to complete, after the birth of baby. As M is now critically ill and unable to engage in (...) any discussion around the care of her baby, who becomes the legal guardian of the baby, for complex decision making that involves either reorientation of care away from intensive care with the inevitable consequence of death in this extremely premature baby, or continuing this life-sustaining treatment with a high likelihood for major neonatal morbidity and longer term disability? Does it pass onto one of the IPs as the genetic father, or does this responsibility fall on the neonatal consultant managing the baby in intensive care? And if an antenatal surrogacy agreement had existed, is it legally binding for inclusion of the IPs perspectives in the decision-making, especially if our medical decision making turns out to be at discord with the beliefs and wishes of the IPs for baby T? Box 1 ### Current surrogacy proceedings in the UK.2 6–8 The Law Commission UK5 is currently reviewing the decision on whether legal parenthood to intended parents can be effected immediately at the time of birth of the baby. Parental orders. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 9.1 (2002) 93-96 [Access article in PDF] Phenomenological Methods in Psychiatry:A Necessary First Step M. Gupta and L. Rex Kay Keywords: behavior, empathy, human science, methodology, natural science, phenomenology. WE ARE GRATEFUL to the journal for prviding the opportunity for exchange and discussion of some of the themes raised in our paper, "The impact of phenomenology on North American psychiatric assessment" and we are pleased (...) to be able to reply to the two excellent commentaries by McMillan and Morley. Both McMillan and Morley question the prospect of employing phenomenology and its methods in psychiatric assessment, and in psychiatric practice more generally. McMillan questions the utility of such a step, and Morley is pessimistic about its feasibility. We shall address each author's concerns in turn.Initially, let us restate the aims of our paper to contextualize our arguments and those made in the commentaries. First, we sought an understanding of what is meant by North American psychiatrists, working within the DSM framework, when they refer to the phenomenological approach to psychiatric assessment. To elucidate this meaning, we compared the contemporary North American usage to a small number of definitions of phenomenology, particularly those definitions that were, and are now, applied to clinical psychiatric work. Contrary to McMillan's suggestion, we did not intend to state definitively what should or should not count as phenomenological, but rather to compare North American psychiatric assessment to what typically has counted as phenomenological. Second, we sought to examine phenomenology's influence on North American psychiatric practice, particularly psychotherapy.Morley argues that such influences usually exemplify the inappropriate appending of phenomenology to psychiatric practice rather than true integration of different paradigms. Although we do not disagree with this general contention, we will argue that the deployment of phenomenological methods in psychiatric assessment is a necessary first step toward the kind of integration he proposes.McMillan makes two related but unintegrated points. First, he argues that objective, behavioral data are phenomenological, according to his broad definition of the term. Second, he proposes that, if the behavioral and the phenomenological are different, we are better off staying with the behavioral when it comes to psychiatric nosology. Let us consider these two points in succession.McMillan seeks to broaden Jasper's definition of phenomenology to include objective observations [End Page 93] as phenomenological. To this end, he distinguishes methods from aims. He summarizes Jasper's definition of phenomenology as "an empirical method for investigating 'individual psychic experience (p 55)" and claims that this is a statement of aim or objectives. He then urges us to "consider the merits of different phenomenological methodologies in terms of their success in achieving this objective" whether or not they utilize "all the methods" of phenomenology. This is much like saying that if we treat waving one's hand as a method for greeting someone, we are then free to treat the objective of the wave as one of greeting someone, and then say that anything that serves as a greeting is, by definition, a "wave." Whatever else McMillan's objective observations are, he has not convinced us that they are phenomenological, anymore than we are likely to convince you that a kiss on the lips is really just a wave.Nonetheless, it is worthwhile seeing what McMillan does with this argument. He tells us that we can "read the first-person experience from behavior in a fairly accurate and informative way." He uses the example of a father gazing at his young child and notes that it is not unreasonable to infer that he is experiencing loving and nurturing feelings. It is, indeed, not unreasonable to draw such an inference. But it is far more reasonable to infer that the father is experiencing a cacophony of feelings, including, but not limited to, love, concern, anxiety, pride, envy, hope, and sadness (Stern 1995, 18-58). If we are able to distinguish which of these feelings is dominant at any given moment—which we are—and if we are also able to track subtle shifts in such feelings... (shrink)

What kind of relationship subsists between an “organism” and a “monas dominans »? In some texts, Leibniz claims that the soul « actuat » the organic body and in the late debate with Stahl he describes the « monas dominans » as a « monas actuatrix ». But how does the monas « actualize » the organic body ? and what implies the semantic of the word « agere » here used by Leibniz ? Is it also possibile to describe (...) this event in terms of « whole/part » relationship ? The aim of this paper is to sketch out the status quaestionis of the topic by discussing some of the most recent studies. More specifically to propose an interpretation of the « monas dominans » as the « nota distinguens » of the whole organism. (shrink)

BackgroundIn cancer care, do not resuscitate orders are common in the terminal phase of the illness, which implies that the responsible physician in advance decides that in case of a cardiac arrest neither basic nor advanced Coronary Pulmonary Rescue should be performed. Swedish regulations prescribe that DNR decisions should be made by the responsible physician, preferably in co-operation with members of the team. If possible, the patient should consent, and significant others should be informed of the decision. Previous studies have (...) shown that physicians and nurses can experience ethical dilemmas in relation to DNR decisions, but knowledge about what ethical reasoning they perform is lacking. Therefore, the aim was to describe and explore what ethical reasoning physicians and nurses apply in relation to DNR-decisions in oncology and hematology care.MethodsA qualitative, descriptive and explorative design was used, based on 287 free-text comments in a study-specific questionnaire, answered by 216 physicians and nurses working in 16 oncology and hematology wards in Sweden. Comments were given by 89 participants.ResultsThe participants applied a situation-based ethical reasoning in relation to DNR-decisions. The reasons given for this were both deontological and utilitarian in kind. Also, expressions of care ethics were found in the material. Universal rules or guidelines were seen as problematic. Concerning the importance of the subject, nurses to a higher extent underlined the importance of discussing DNR-situations, while physicians described DNR-decisions as over-investigated and not such a big issue in their daily work.ConclusionThe study revealed that DNR-decisions in oncology and hematology care gave rise to ethical considerations. Important ethical values described by the participants were to avoid doing harm and to secure a peaceful and “natural” death with dignity for their dying patients. A preference for the expression “allow for natural death” instead of the traditional term “do not resuscitate” was found in the material. (shrink)

Cloud computing (ClC) has become a more popular computer paradigm in the preceding few years. Quality of Service (QoS) is becoming a crucial issue in service alteration because of the rapid growth in the number of cloud services. When evaluating cloud service functioning using several performance measures, the issue becomes more complex and non-trivial. It is therefore quite difficult and crucial for consumers to choose the best cloud service. The user's choices are provided in a quantifiable manner in the current (...) methods for choosing cloud services. Hence, this study attempts to achieve this objective through construction. decision-making framework so-called cloud services evaluator (CSsEv). The main indicator and its sub-indicators are formed as nodes at levels(n) in tree soft sets (TSSs). Thereafter Single Value Neutrosophic Sets (SVNSs) as branch of neutrosophic sets which conjunction with the Multi-Criteria Decision Making (MCDM) technique to facilitate analysis and evaluation process for the available Cloud services providers. Hence, entropy is employed to obtain indicators and sub_indicators weights and Complex Proportional Assessment utilizes these weights to facilitate the decision process of selecting optimal ClSPs. (shrink)

Le projet révolutionnaire s'est largement identifié à un projet pédagogique, qui déborde de beaucoup les dispositifs scolaires pour s'attacher à une véritable conversion : du sujet au citoyen, de l'homme enchaîné à l'homme libre, du vieil homme à l'homme régénéré. Au coeur de cet ouvrage, on trouvera l'essai consacré à cette entreprise, dont Saint-Just a défini l'ambition ("faire des hommes ce qu'on veut qu'ils soient") et Mirabeau le possible délire : "Avec des moyens appropriés, on pourrait passionner les hommes pour (...) une organisation sociale entièrement absurde, injuste et cruelle". Toutes les études qui accompagnent ce texte central éclairent à leur manière la tentative utopique, magnifique et désespérée, de maîtriser à la fois l'événement et la durée, l'individu et le collectif, l'opinion réfléchie et l'opinion spontanée. Se dessine ainsi le vrai sujet de cet ensemble, que traitaient déjà La Fête révolutionnaire (1976) et L'École de la France (1984) : l'entrée, avec la volonté d'instituer l'homme aussi bien que le citoyen, dans notre culture démocratique. (shrink)

La France a longtemps passé pour le pays des femmes. Elle a pourtant la réputation d'être aussi celui d'un féminisme timoré qui a tardé plus qu'ailleurs à asseoir ses conquêtes. D'où vient cette timidité? C'est ce paradoxe qu'explore le livre de Mona Ozouf, en donnant à entendre "les mots des femmes", ceux qu'elles ont choisis elles-mêmes pour décrire la féminité.

Artificial intelligence (AI) national strategies provide countries with a framework for the development and implementation of AI technologies. Sixty countries worldwide published their AI national strategies. The majority of these countries with more than 70% are developed countries. The approach of AI national strategies differentiates between developed and developing countries in several aspects including scientific research, education, talent development, and ethics. This paper examined AI readiness assessment in a developing country (Palestine) to help develop and identify the main pillars of (...) the AI national strategy. AI readiness assessment was applied across education, entrepreneurship, government, and research and development sectors in Palestine (case of a developing country). In addition, it examined the legal framework and whether it is coping with trending technologies. The results revealed that Palestinians have low awareness of AI. Moreover, AI is barely used across several sectors and the legal framework is not coping with trending technologies. The results helped develop and identify the following five main pillars that Palestine’s AI national strategy should focus on: AI for Government, AI for Development, AI for Capacity Building in the private, public and technical and governmental sectors, AI and Legal Framework, and international Activities. (shrink)

Can we engineer conceptual change? While a positive answer to this question would be exciting news for philosophy, there has been a growing number of pessimistic voices in the literature. This paper resists this trend. Its central aim is to argue not only that conceptual engineering is possible but also that it is not even distinctively hard. In order to achieve this, we will develop a novel approach to conceptual engineering that has two key components. First, it proposes a reorientation (...) of the conceptual engineering project away from fixing conceptual defects and towards bringing about conceptual innovation. Second, it offers a new account of when conceptual engineering is successful in terms of etiological functions. We then turn to the reasons that have motivated various forms of pessimism about conceptual engineering and show that, on our novel approach, none of them stands up to scrutiny. (shrink)

One central debate in recent literature on epistemic normativity concerns the epistemic norm for action. This paper argues that this debate is afflicted by a category mistake: strictly speaking, there is no such thing as an epistemic norm for action. To this effect, I introduce a distinction between epistemic norms and norms with epistemic content; I argue that while it is plausible that norms of the latter type will govern action in general, epistemic norms will only govern actions characteristically associated (...) with delivering epistemic goods. (shrink)

In this groundbreaking book, psychiatrist and ethicist Mona Gupta analyzes the basic assumptions of Evidence-based medicine (EBM), and critically examines their applicability to psychiatry. Highlighting ethical tensions between psychiatry and EBM, she asks the controversial question - should psychiatrists practice evidence-based medicine at all?

French historian Mona Ozouf argues that French feminism lacks the rancor and resentment of its counterpart in America and explains why this placid brand of feminism is uniquely French. Ozouf portrays ten French women of letters whose lives span the period from the eve of the French Revolution to the resurgence of the feminist movement in the late 20th century.

While religious pluralism is often regarded as a defining aspect of western liberal democracies, the mix of different religious and cultural identities has raised specific challenges for liberal de...

Scientific evidence is crucial in a burgeoning number of litigated cases, legislative enactments, regulatory decisions, and scholarly arguments. Evaluating Scientific Evidence explores the question of what counts as scientific knowledge, a question that has become a focus of heated courtroom and scholarly debate, not only in the United States, but in other common law countries such as the United Kingdom, Canada and Australia. Controversies are rife over what is permissible use of genetic information, whether chemical exposure causes disease, whether future (...) dangerousness of violent or sexual offenders can be predicted, whether such time-honored methods of criminal identification have any better foundation than ancient divination rituals, among other important topics. This book examines the process of evaluating scientific evidence in both civil and criminal contexts, and explains how decisions by nonscientists that embody scientific knowledge can be improved. (shrink)

This article develops and defends a full account of the nature and normativity of resistance to evidence, according to which resistance to evidence is an instance of input-level epistemic malfunctioning. At the core of this epistemic normative picture lies the notion of knowledge indicators, as evidential probability increasing facts that one is in a position to know; resistance to evidence is construed as a failure to uptake knowledge indicators.

DNR decisions are frequently made in oncology and hematology care and physicians and nurses may face related ethical dilemmas. Ethics is considered a basic competence in health care and can be understood as a capacity to handle a task that involves an ethical dilemma in an adequate, ethically responsible manner. One model of ethical competence for healthcare staff includes three main aspects: being, doing and knowing, suggesting that ethical competence requires abilities of character, action and knowledge. Ethical competence can be (...) developed through experience, communication and education, and a supportive environment is necessary for maintaining a high ethical competence. The aim of the present study was to investigate how nurses and physicians in oncology and hematology care understand the concept of ethical competence in order to make, or be involved in, DNR decisions and how such skills can be learned and developed. A further aim was to investigate the role of guidelines in relation to the development of ethical competence in DNR decisions. Individual interviews were conducted with fifteen nurses and sixteen physicians. The interviews were analyzed using thematic content analysis. Physicians and nurses in the study reflected on their ethical competence in relation to DNR decisions, on what it should comprise and how it could be developed. The ethical competence described by the respondents related to the concepts being, doing and knowing. In order to make ethically sound DNR decisions in oncology and hematology care, physicians and nurses need to develop appropriate virtues, improve their knowledge of ethical theories and relevant clinical guidelines. Ethical competence also includes the ability to act upon ethical judgements. Continued ethical education and discussions for further development of a common ethical language and a good ethical working climate can improve ethical competence and help nurses and physicians cooperate better with regard to patients in relation to DNR decisions, in their efforts to act in the best interest of the patient. (shrink)

This work is a manifesto for epistemic independence: the independence of good thinking from practical considerations. It presents a functionalist account of the normativity of assertion in conjunction with an integrated view of the normativity of constative speech acts.

ABSTRACTSeveral philosophers have inquired into the metaphysical limits of conceptual engineering: ‘Can we engineer? And if so, to what extent?’. This paper is not concerned with answering these questions. It does concern itself, however, with the limits of conceptual engineering, albeit in a largely unexplored sense: it cares about the normative, rather than about the metaphysical limits thereof. I first defend an optimistic claim: I argue that the ameliorative project has, so far, been too modest; there is little value theoretic (...) reason to restrict the project to remedying deficient representational devices, rather than go on a more ambitious quest: conceptual improvement. That being said, I also identify a limitation to the optimistic claim: I show that the ‘should’ in ameliorative projects suffers from a ‘wrong-kind-of-reasons’ problem. Last but not least, I sketch a proposal of normative constraining meant to address both the above results. The proposal gives primacy to epistemic constraints: accordingly, a concept should be ameliorated only insofar as this does not translate into epistemic loss. (shrink)

Emergency teams facing critical adversity situations often feel questioned in their professional roles as conscientious rescuers, leading to feelings of threats as a kind of stress experience. According to the stress-as-offence-to-self theory, perceptions of insufficiency and disrespect trigger threats by frustrating underlying needs. In this study, we explored threats in the context of a CAS by investigating the activation of threat triggers during the action and postaction phases of teamwork, and evaluating the mediating role of needs. In a multitask experiment, (...) student teams experienced a controllable mission, followed by a CAS mission in a computer simulation task. After the CAS, teams received negative feedback. We measured threats, the activation of insufficiency and disrespect triggers, and the frustration of needs. While insufficiency triggers were activated in the CAS but not in the non-CAS, disrespect triggers were activated by situation-nonspecific and situation-specific feedback but not by no feedback. Furthermore, the results of mediation models indicated the presence of the postulated need-based mechanism between triggers and threats. Our study highlights that the action and postaction phases of a CAS pose a variety of risks for experiencing threats. As individuals cope with these risks, needs are important mediators. (shrink)

This paper has two aims. The first is critical: I identify a set of normative desiderata for accounts of justified belief and I argue that prominent knowledge first views have difficulties meeting them. Second, I argue that my preferred account, knowledge first functionalism, is preferable to its extant competitors on normative grounds. This account takes epistemically justified belief to be belief generated by properly functioning cognitive processes that have generating knowledge as their epistemic function.

When in the business of offering an account of the epistemic normativity of belief, one is faced with the following dilemma: strongly externalist norms fail to account for the intuition of justification in radical deception scenarios, while milder norms are incapable to explain what is epistemically wrong with false beliefs. This paper has two main aims; we first look at one way out of the dilemma, defended by Timothy Williamson and Clayton Littlejohn, and argue that it fails. Second, we identify (...) what we take to be the problematic assumption that underlies their account and offer an alternative way out. We put forth a knowledge-first friendly normative framework for belief which grants justification to radically deceived subjects while at the same time acknowledging that their false beliefs are not epistemically good beliefs. (shrink)