Name der Zeitschrift: Semiotica Jahrgang: 2016 Heft: 209 Seiten: 249-275.

Journal Name: Semiotica - Journal of the International Association for Semiotic Studies / Revue de l'Association Internationale de Sémiotique Volume: 2013 Issue: 196 Pages: 353-364.

Background:Moral distress, moral sensitivity, and moral courage among healthcare professionals have been explored considerably in recent years. However, there is a paucity of studies exploring these topics among baccalaureate nursing students.Aim/objective:The purpose of this study was to explore the relationship between and among moral distress, moral sensitivity, and moral courage of undergraduate baccalaureate nursing students.Research design:The research employed a descriptive-correlational design to explore the relationships between and among moral distress, moral sensitivity, and moral courage of undergraduate nursing students.Participants and research (...) context:A total of 293 baccalaureate Filipino nursing students who have been exposed to various clinical areas participated in the study.Ethical considerations:Institutional review board approval was sought prior to the conduct of the study. Self-determination was assured and anonymity and confidentiality were guaranteed to all participants.Findings:Results indicate that a majority of the nursing students in the clinical areas encounter morally distressing situations that compromise quality patient care. However, despite the fact that they want to do what is in the best interest of their patients, their perception of being the inexperienced among the healthcare team drives the majority of them to ignore morally distressing situations to avoid conflict and confrontation. Another interesting finding is that 79.20% of the respondents hardly consider quitting the nursing profession even if they frequently encounter morally distressing situations. Analysis also shows associations between moral distress intensity and frequency ( r = 0.13, p < 0.05) and moral distress intensity and moral sensitivity ( r = 0.25, p < 0.05). The dimensions of moral courage are also related to both moral distress and moral sensitivity.Conclusion:Results of the study imply that moral distress is a reality among all healthcare professionals including nursing students and requires more consideration by nurse educators. (shrink)

Background:Nurses exposed to community health nursing commonly encounter situations that can be morally distressing. However, most research on moral distress has focused on acute care settings and very little research has explored moral distress in a community health nursing setting especially among nursing students.Aim:To explore the moral distress experiences encountered by undergraduate baccalaureate nursing students in community health nursing.Research design:A descriptive qualitative design was employed to explore the community health nursing experiences of the nursing students that led them to have (...) moral distress.Participants and research context:The study included 14 senior nursing students who had their course in Community Health Nursing in their sophomore year and stayed in the partner communities in their junior year for 6 and 3 weeks during their senior year.Ethical considerations:Institutional review board approval was sought prior to the conduct of the study. Self-determination was assured and anonymity and confidentiality were guaranteed to all participants.Findings:Nursing students are vulnerable and likely to experience moral distress when faced with ethical dilemmas. They encounter numerous situations which make them question their own values and ideals and those of that around them. Findings of the study surfaced three central themes which included moral distress emanating from the unprofessional behavior of some healthcare workers, the resulting sense of powerlessness, and the differing values and mindsets of the people they serve in the community.Conclusion:This study provides educators a glimpse of the morally distressing situations that often occurs in the community setting. It suggests the importance of raising awareness and understanding of these situations to assist nursing students to prepare themselves to the “real world,” where the ideals they have will be constantly challenged and tested. (shrink)

Strong non-maximalism holds that some truths require no ontological ground of any sort. Strong non-maximalism allows one to accept that some propositions are true without being forced to endorse any corresponding ontological commitments. We show that there is a version of truthmaker theory available—anti-aboutness truthmaking—that enjoys the dialectical benefits of the strong non-maximalist’s position. According to anti-aboutness truthmaking, all truths require grounds, but a proposition need not be grounded in the very thing(s) that the proposition is about. We argue that (...) if strong non-maximalism can be defended, then so can anti-aboutness truthmaking on the very same basis; one can enjoy the benefits of strong non-maximalism without giving up on the idea that truth is always grounded in being. (shrink)

The puzzle of material constitution can be expressed in at least two ways. First, how can the constituting object and the constituted object, which are materially and spatially coincident, be regarded as different objects? Second, how can the constituting object and the constituted object, which are qualitatively distinct, be regarded as identical objects? Monists argue that the constituting and constituted objects are identical since they are materially and spatially coincident and the property differences between then are simply differences in description, (...) perspective or context. In contrast, pluralists argue that the constituting and constituted objects are not identical even if they are materially and spatially coincident since they are qualitatively distinct. This paper proposes a solution to the puzzle of material constitution called ‘Fregean Monism’ (FM), and shows that it can better account for the property differences between the constituting and constituted objects without the need to regard them as two distinct objects. On the FM view, the puzzle of material constitution is partly a semantic puzzle and partly a metaphysical puzzle, and shows how a solution to the semantic part of the puzzle, based on the Fregean distinction between sense and reference, can yield a satisfactory solution to the metaphysical part of the puzzle. The key idea is that while the reference of a term picks out both the referent object and referent properties, the sense of the term determine which referent properties are picked out. (shrink)

My aim in this paper is to argue against the claim that agent causation is more fundamental than event causation. To accomplish this aim, I shall first briefly discuss the motivation behind agent causation. Second, I shall highlight the differences between agent causation and event causation. Third, I shall begin briefly with the weaker claim held by Timothy O’Connor and Randolph Clarke that there is no good reason to believe that event causation is more fundamental than agent causation. Fourth, I (...) shall discuss the stronger claim held by E. J. Lowe that agent causation is more fundamental than event causation, and raise objections against the various arguments Lowe advances for the stronger claim. To the extent that my objections against Lowe’s stronger claim succeed, they raise questions for O’Connor’s and Clarke’s weaker claim. (shrink)

Despite the entrenched acceptance of normal science in health care, it appears that authoritative, positivist, linear, risk averse, certainty-based thinking can only get us so far along the route of optimum health. This paper examines labor and childbirth as a paradigm case of a complex adaptive system (CAS) and offers the example of techniques used in a master-level course on normal childbirth to illustrate how maternity care clinicians can be introduced to complexity-based thinking through reflexive analysis of real life clinical (...) narratives. It suggests that these techniques might be used as a basis for answering the question, what is likely to work for this person, in this situation, given the range of evidence, and given their values and beliefs, my values and beliefs, and my clinical skills and knowledge? Topics discussed in this paper include complexity, pregnancy, and childbirth; mainstreaming complexity-focused decision making in maternity care; and using story in practice. In conclusion, complexity theory appears to offer a good explanatory model for pregnancy and childbirth, both in general, and for specific individuals. Future work in this area should examine the efficacy and limits to formal story telling in maternity care, with the aim of increasing optimal maternity care for mothers and babies, and for the staff and organizations that deliver the care. (PsycINFO Database Record (c) 2010 APA, all rights reserved). (shrink)

How can low-income, non-English-speaking parents become advocates, leaders, and role models in their children’s schools? _A Cord of Three Strands_ offers a close study of the Logan Square Neighborhood Association, a grassroots organization on the northwest side of Chicago, whose work on parent engagement has drawn national attention. The author identifies three elements—induction, integration, and investment—that together capture the dynamic and developmental nature of successful parent engagement. Writing with both optimism and urgency, author Soo Hong offers richly detailed portraits of (...) parents’ experiences and addresses the complex and sometime conflicting relationships among school, family, and community. (shrink)

In this essay, I aim to address the two related problems faced by ontological emergence and propose a solution. First, I shall briefly outline the concept of emergence, the distinction between ontological and epistemological emergence, as well as the distinction between synchronic and diachronic emergence, and focus mainly on synchronic ontological emergence. Second, I shall discuss the two related problems faced by synchronic ontological emergence—configurational forces and downward causation. Third, I shall present a solution to these problems—affirming ontological emergence but (...) denying vertical causation. Last, I shall address objections to the ontological emergence without vertical causation view. (shrink)

The past decade has seen a burgeoning of scholarly interest in conscientious objection in healthcare. While the literature to date has focused primarily on individual healthcare practitioners who object to participation in morally controversial procedures, in this article we consider a different albeit related issue, namely, whether publicly funded healthcare institutions should be required to provide morally controversial services such as abortions, emergency contraception, voluntary sterilizations, and voluntary euthanasia. Substantive debates about institutional responsibility have remained largely at the level of (...) first-order ethical debate over medical practices which institutions have refused to offer; in this article, we argue that more fundamental questions about the metaphysics of institutions provide a neglected avenue for understanding the basis of institutional conscientious objection. To do so, we articulate a metaphysical model of institutional conscience, and consider three well-known arguments for undermining institutional conscientious objection in light of this model. We show how our metaphysical analysis of institutions creates difficulties for justifying sanctions on institutions that conscientiously object. Thus, we argue, questions about the metaphysics of institutions are deserving of serious attention from both critics and defenders of institutional conscientious objection. (shrink)

The current methods in psychoanalytic studies of God images and representations have focused almost exclusively on individual, internal processes. This article examines how psychological anthropologists go about formulating symbolic representations of deity in their research, in comparison with the object relations method of God- representations. Drawing on Melford Spiro's integrative proposal for interpreting the mental and collective representations in religious symbol systems, this paper proposes that there is a need for a comprehensive model of the representational process in the Eastern (...) world in order to suit its cultural traditions. The author uses both theoretical and historical materials as well as personal narrative throughout its entirety to balance the two in a mutual and coherent flow of understanding. Noting the culturally patterned interactions with culturally postulated God-symbols, the object relations method of God- representations will be utilized to probe how God is both created and found on a collective level as well as individual level. (shrink)

The aim of this paper is to situate the early Indian (Nikāya) Buddhist notion of karmic causation within the mental causation discourse in the Western analytic tradition, which concerns causal transactions involving mental events, such as desires, beliefs, and intentions, whether the transactions are between mental events, or between mental events and physical events. Karmic causation involves actional causes, in concert with non-actional causes, and their experiential effects on the actor, in concert with non-experiential effects. The problems generated by karmic (...) causation in Buddhism overlap with those generated by mental causation in the Western analytic tradition. They include how the mental aspects relate to the physical aspects of the self, sense perception, and action, as well as how the mental and physical aspects of an actional cause relate to the experiential and non-experiential aspects of an effect on the actor. -/- To make sense of mental causation, it is crucial to understand a cluster of associated concepts such as causation, the self, sense perception, and action. Similarly, to make sense of karmic causation, it is crucial to understand a cluster of associated concepts such as dependent arising (paṭiccasamuppāda), the fivefold laws of nature (pañca-niyāma), the five aggregates (pañca-khandha), the six sense bases (Saḷayatana), action (karma), and results (vipāka). I shall discuss these concepts under the headings of causation, the self, sense perception, and action before I move on to address karmic causation in the context of the mental causation debate. (shrink)

Clinical ethics consultation service remains undeveloped in developing countries. It is recognised that its introduction poses challenges. Malaysia, a multicultural society with diverse religions, values and perceptions further complicate the introduction of formal clinical ethics consultation service. Clinicians attending a national congress workshop completed a Strengths–Weaknesses–Opportunities–Threats analysis. The aim was to gain insight into clinician’s expectations and promote initiatives leading to the introduction of clinical ethics consultation service. Clinicians agree that clinical ethics consultation service can improve quality of care, reduce (...) healthcare costs and advocate for patients and providers. The analysis highlighted constraints in sufficient critical mass of relevant expertise and restricted opportunities for training. The opportunities lie in education, curriculum development and availability of dedicated proponents. Cultural barriers, limited resources, lack of awareness, differenc... (shrink)

Xunzi's philosophy provides a rich resource for understanding how ethical relationships between humans and nature can be articulated in terms of harmony. In this paper, I build on his ideas to develop the concept of reciprocal harmony, which requires us to reciprocate those who make our lives liveable. In the context of the environment, I argue that reciprocal harmony generates moral obligations towards nature, in return for the existential debt that humanity owes towards heaven and earth. This can be used (...) as a normative basis for an environmental ethic that enables humanity and nature to flourish together. (shrink)

The combination of decreased genotyping costs and prolific social media use is fueling a personal genetic testing industry in which consumers purchase and interact with genetic risk information online. Consumers and their genetic risk profiles are protected in some respects by the 2008 federal Genetic Information Nondiscrimination Act (GINA), which forbids the discriminatory use of genetic information by employers and health insurers; however, practical and technical limitations undermine its enforceability, given the everyday practices of online social networking and its impact (...) on the workplace. In the Web 2.0 era, employers in most states can legally search about job candidates and employees online, probing social networking sites for personal information that might bear on hiring and employment decisions. We examine GINA's protections for online sharing of genetic information as well as its limitations, and propose policy recommendations to address current gaps that leave employees? genetic information vulnerable in a Web-based world. (shrink)

This article attempts to fill a gap in International Relations literature on East Asian security. ‘East Asia’ appears to be mostly an indeterminate conceptual construct, allowing scholars to look selectively at those aspects and areas that could justify their security thesis, albeit security dynamics in the region are all too difficult to comprehend and predict. This problem has been frequently pointed out in IR literature, but its methodological implications and suggestions have neither been appropriately illuminated nor been systematically offered, and (...) the main solution commonly found in the literature was the tautological one of ‘better defining’ the region. As an alternative, this article suggests that one needs to tighten geographical focus and differentiate the subjects of analysis. When it comes to the study of East Asian security, one needs to aim to develop specific and differentiated generalizations as opposed to generalizations of a broad character. To showcase the fact that research outcomes can be more determinate when the target of analysis is more focused and specified, this article takes Northeast Asian security as an example and challenges the so-called ‘peaceful East Asia’ thesis, one of the mainstream perspectives on East Asian security. This article ultimately argues that while apprehending East Asian security dynamics through delimiting the scope of analysis and circumscribing the subjects of investigation is often deemed to be a modest enterprise―in particular, in terms of generalizability―the merits are substantial: research outcomes will be able not only to give us a truer mapping of the real world, but also bring us closer to building knowledge which satisfies the scientific criterion of ‘falsifiability.’Export citation Request permission. (shrink)

A number of artificial intelligence systems have been proposed to assist users in identifying the issues of algorithmic fairness and transparency. These AI systems use diverse bias detection methods from various perspectives, including exploratory cues, interpretable tools, and revealing algorithms. This study explains the design of AI systems by probing how users make sense of fairness and transparency as they are hypothetical in nature, with no specific ways for evaluation. Focusing on individual perceptions of fairness and transparency, this study examines (...) the roles of normative values in over-the-top platforms by empirically testing their effects on sensemaking processes. A mixed-method design incorporating both qualitative and quantitative approaches was used to discover user heuristics and to test the effects of such normative values on user acceptance. Collectively, a composite concept of transparent fairness emerged around user sensemaking processes and its formative roles regarding their underlying relations to perceived quality and credibility. From a sensemaking perspective, this study discusses the implications of transparent fairness in algorithmic media platforms by clarifying how and what should be done to make algorithmic media more trustable and reliable platforms. Based on the findings, a theoretical model is developed to define transparent fairness as an essential algorithmic attribute in the context of OTT platforms. (shrink)

In the real-world complex product design process, task allocating is an ongoing reactive process where the presence of unexpected design change is usually inevitable. Therefore, reallocating is necessary to respond to design change positively as a procedure to repair the affected task plan. General reallocating literature addressed the reallocating versions with fixed executing time. In this paper, a multi-objective reallocation model is developed with a feasible assumption that the task executing time is controllable. To illustrate this idea, a compressing executing (...) time strategy is proposed in CPD process, where the executing time can be controlled with a non-linear compression cost. When design change occurs during the executing, task-resource reallocating is required to absorb the interference effects. Reallocating implies an increase in design cost and system instability; the proposed method CETS can address this issue effectively. CETS considers three objectives: completing time, stability, and change-adaptation cost. An adaptive multi-objective hybrid genetic algorithm and tabu search is developed to solve this mathematical method. The computational results of specific simulation examples verify the superiority. It shows that CETS is sensitive to design change, and the proposed algorithm AMOGATS can be effective to achieve the allocating by coordinating the objective consistency. (shrink)

According to the expressive view of voting, a voter derives expressive utility from casting a vote. We present two possible sources of expressive utility: social interaction with voters having the same political preferences, and interestingness of the election. First, it has been suggested that a voter's expressive utility may increase when there are more voters having the same political preference. We extend this line of study and test the hypothesis that a voter's expressive utility increases as the number of voters (...) having the same political preferences increases in the local community, where interaction occurs more frequently with others than it does with others in distant communities. Second, we propose and test the other hypothesis, that voters’ expressive utility is larger when the election is more interesting. Using 2008 parliamentary election data from Korea, where the election consists of both 245 single-member districts and only one nationwide district for proportional representatives, we find supporting evidence for these two arguments: the turnout rate is significantly and positively related to the share of proportional representation votes for the largest party in each single-member district; the turnout rate is also significantly and positively related to the number of polls for single-member district election conducted by major broadcasting companies, which we use as a proxy variable for interestingness of the election. (shrink)

This study viewed students majoring in public relations as prospective public relations practitioners and explored their perceptions about corporate social responsibility (CSR) as their job attraction condition. The results showed that the students perceived CSR to be an important ethical fit condition of a company. One of the significant findings is that CSR can be an effective reputation management strategy for prospective employees, particularly when a company’s business is suffering. In examining the effect of CSR efforts on attitudinal and behavioral (...) outcomes, person–organization (P–O) fit appeared to serve as a mediator between CSR performances and organizational attractiveness. (shrink)

Stakeholder theory contends that organizations owe an obligation to other stakeholder groups that extends beyond shareholders. This study uses stakeholder theory to examine which groups public relations practitioners and journalists attend to as well as which attributes—legitimacy, power, and urgency—they highlight. Content analysis of press releases and news stories found that the stakeholder most frequently mentioned in both press releases and newspapers was the shareholder group. Both press releases and news stories focused more on legitimacy than power or urgency for (...) all stakeholders except government. The findings support criticisms that, in general, business news and corporate communications concentrate on the interests of shareholders. The ethical implications from the perspective of stakeholder theory are discussed. (shrink)

The aim of this paper is to explore the role of ethical climate on the relationship between the paternalistic leadership and team identification at the team level. In contrast to the prior studies which tended to focus on ethical climate as a whole dimension, this paper further classified the domain of construct into the categories of egoism, benevolence, and principle using a sample from 143 teams in Mainland China and Taiwan. Hierarchical regression results showed that the average paternalistic leadership had (...) a significant impact on the team identification at the team level. Moreover, the results indicated that the ethical climate of benevolence fully mediated while the ethical climate of egoism partially mediated the relationship between authoritarian leadership and team identification. Also, the ethical climates of benevolence and principle had a partial mediating effect on the relationship between benevolent leadership and team identification as well as moral leadership and team identification, respectively, but the ethical climate of egoism did not play a significant role. The major findings, theoretical contributions, practical implications, and the limitations were discussed. (shrink)

Several ethicists have defended the use of responsibility-based criteria in healthcare rationing. Yet in this article we outline two challenges to the implementation of responsibility-based healthcare rationing policies. These two challenges are, namely, that responsibility for past behavior can diminish as an agent changes, and that blame can come apart from responsibility. These challenges suggest that it is more difficult to hold someone responsible for health related actions than proponents of responsibility-sensitive healthcare policies suggest. We close by discussing public health (...) policies that could function as an alternative to contentious, responsibility-sensitive rationing policies. (shrink)

ObjectiveThis study explores the relationship between physical exercise and school adaptation of junior middle school students and constructs a chain intermediary model through the intermediary role of psychological resilience and sports learning motivation.MethodsUsing the stratified cluster sampling method, 930 junior middle school students in Anhui Province were measured in group psychology by using the physical exercise rating scale, adolescent psychological resilience scale, physical learning motivation scale and school adaptation scale. The statistical software SPSS 23.0 and process plug-in were used for (...) statistical processing, and the common method deviation test was carried out by Harman single-factor control method. Finally, the bootstrap sampling test method and process plug-in were used to test the significance of intermediary effect.Results The direct prediction effect of physical exercise on school adaptation is remarkable ; psychological resilience and sports learning motivation are the intermediary variables of the relationship between physical exercise and school adaptation; psychological resilience and sports learning motivation play a chain mediation role in the relationship between physical exercise and school adaptation. The intermediary effect is composed of three indirect effects: physical exercise → psychological resilience → school adaptation, physical exercise → physical learning motivation → school adaptation, physical exercise → psychological resilience → physical learning motivation → school adaptation.ConclusionsPhysical exercise can directly improve the school adaptation of junior middle school students, which can also affect junior middle school students’ school adaptation indirectly through psychological resilience or sports learning motivation, and it can influence school adaptation through the chain mediation of psychological resilience and sports learning motivation. (shrink)

Taking the formal analogies between black holes and classical thermodynamics seriously seems to first require that classical thermodynamics applies in relativistic regimes. Yet, by scrutinizing how classical temperature is extended into special relativity, I argue that the concept falls apart. I examine four consilient procedures for establishing the classical temperature: the Carnot process, the thermometer, kinetic theory, and black-body radiation. I argue that their relativistic counterparts demonstrate no such consilience in defining the relativistic temperature. As such, classical temperature doesn’t appear (...) to survive a relativistic extension. I suggest two interpretations for this situation: eliminativism akin to simultaneity, or pluralism akin to rotation. (shrink)

Conventional wisdom holds that the von Neumann entropy corresponds to thermodynamic entropy, but Hemmo and Shenker (2006) have recently argued against this view by attacking von Neumann's (1955) argument. I argue that Hemmo and Shenker's arguments fail due to several misunderstandings: about statistical-mechanical and thermodynamic domains of applicability, about the nature of mixed states, and about the role of approximations in physics. As a result, their arguments fail in all cases: in the single-particle case, the finite particles case, and the (...) infinite particles case. (shrink)