This article deals with nurses’ ethical concerns raised by the consequences of changes in governmental and institutional policies on nursing practice and patient care. The aims of this project were to explore perspectives of registered nurses who provide or manage direct patient care on policies that affect nursing and patient care, and to provide input to policy makers for the development of more patient-centred policies. Four focus groups were conducted with a total of 36 registered nurse participants. The project team (...) identified major themes that emerged in the analysis of transcripts of the focus group discussions. The four major themes were: effects of policy focused on cost containment, effects on quality of care, effects on patient education and access to needed services, and effects on nurses and nursing. The participants identified primarily negative effects of changes in national health policy and legislation that influence institutional policies on patient care and nursing practice. The effects of identified policy changes raised concerns about meeting nurses’ ethical obligations to patients and families. Participants specified key points for consideration by legislators and other policy makers. They viewed nurses who are involved in direct patient care as a critical resource for legislators and other policy makers in the development of public and institutional policies that affect nursing and patient care. (shrink)

The purpose of this paper is to describe the nature of dental practice and to identify some recent innovations which have effect on cost containment in dentistry. The first of these innovations is dental insurance or prepaid dental services. Dental insurance has only recently emerged as a significant economic factor. The chronic and prevalent nature of dental disease mandates that the management of these programs incorporate insurance devices which limit demand and utilization. These devices amount to cost containment measures. The (...) second factor to be discussed is advertising. Advertising has been foisted on the dental profession by recent rulings of the Federal Trade Commission in an effort to promote competition. The Reagan administration, despite a market oriented approach to health care, had attempted to blunt some of the FTC actions. Advertising, nevertheless, has the potential to stimulate competition and restrain price escalation. The third factor includes a discussion of alternative delivery systems. These commercially oriented dental enterprises have the potential to compete with established practices as well as increase the demand for services. (shrink)

The study explores the challenges UK-based institutional investors face when trying to monitor investee companies and influence their social, environmental, and governance practices. Consistent with previous research, I find that misalignment of interests within the investment chain and dispersed ownership are factors which inhibit investor activism. However, other underexplored challenges include lack of investee company transparency and investor experience in activism, as well as low client demand for engagement and internal conflicts of interest. The results contribute to the literature on (...) institutional investor activism by using direct empirical evidence to systematically discuss the challenges to stewardship. Given the intensification of media and regulatory attention on shareholders in the post-global financial crisis era, coupled with investors’ growing awareness and practice of stewardship, the research opens new avenues for enquiry which go beyond the on-going debate about the monitoring versus short-termism roles of institutional investors. (shrink)

In vitro fertilisation ‘add-ons’ are therapeutic or diagnostic tools developed in an endeavour to improve the success rate of infertility treatment. However, there is no conclusive evidence that these interventions are a beneficial or effective adjunct of assisted reproductive technologies. Additionally, IVF add-ons are often implemented in clinical practice before their safety can be thoroughly ascertained. Yet, patients continue to request and pay large sums for such additional IVF tools. Hence, this essay set out to examine if it is ethical (...) to provide IVF add-ons when there is no evidence of a benefit if the patient requests it. In order to determine what is ethical—namely, morally good and righteous, the question was considered in relation to three key values of medical ethics—autonomy, beneficence and non-maleficence. It was determined that providing IVF add-ons might be morally acceptable in specific circumstances, if true informed consent can be given, there is a potential of cost-effective physiological or psychological benefit and the risk of harm is minimal, particularly with regard to the unborn child. (shrink)

The discourse on CRS began late in Spain. Its permeation into political institutions also began later than in many Western countries. The Spanish government neither contributed nor reacted to the green paper Corporate social responsibility. A business contribution sustainable development, published by the European Commission in 2002. However, the publication of this document gave the definitive impulse for the start of the Spanish debate on CSR. After this initial impulse, the debate rapidly developed into a consolidated field of discourse. This (...) field is the object of the present paper. Here, we seek to elaborate on a concept of corporate social citizenship viewed as a "field of discourse", which is being produced by an epistemic community, at Spanish yet also at a global level. Thus, we seek to depict the contours of the Spanish discourse on CSR, researching its evolution over the last 5 years. We focus on its main actors, the central topics on its agendas, the conflicts that are appearing, and how they are being dealt with. In order to in to achieve these objectives, we focus primarily on the transcription of 61 speeches made by different stakeholders at the Spanish Parliament during 2005. This initiative of the Spanish Parliament is unique of its kind. A special sub-commission was created to discuss the role that Spanish public institutions should play regarding corporate social responsibility. Sixty-one experts from different areas (academia, business, trade unions, and NGOs) were invited to present their views on CSR. Members of the sub-commission had the opportunity to discuss with these experts the nature, limits, results and evolution of CSR, seeking with special interest their opinions on the role that the Spanish Government should play in the consolidation of CSR in Spain. The thesis of this paper is that through an exhaustive analysis of the transcriptions of these interventions at the Spanish Parliament, we can identify who constitutes the Spanish epistemic community on CSR. We can also trace the main contours of this field of discourse, to identify the main actors in its development (particularly, of course, on the binding point between CRS and government) and the main issues discussed, as well as the "hot topics". The presentation will also locate the uniqueness of this debate generated in parliament within the context of the wider Spanish debate on CSR. (shrink)

Clarke and Beck discuss in their sections on congruency and confounds literature that has challenged the claim that the approximate number system represents numerical content. We argue that the propositions put forward by these studies aren't that far from the indirect model of number perception suggested by C&B.

The red tape and delays around research ethics and governance approvals frequently frustrate researchers yet, as the lesser of two evils, are largely accepted as unavoidable. Here we quantify aspects of the research ethics and governance approvals for one interview- and questionnaire-based study conducted in England which used the National Health Service procedures and the electronic Integrated Research Application System. We demonstrate the enormous impact of existing approvals processes on costs of studies, including opportunity costs to focus on the substantive (...) research, and suggest directions for radical system change. We have recorded 491 exchanges with 89 individuals involved in research ethics and governance approvals, generating 193 pages of email text excluding attachments. These are conservative estimates. The exchanges were conducted outside IRAS, expected to be the platform where all necessary documents are provided and questions addressed. Importantly, the figures exclude the actual work of preparing the ethics documentation. We propose six areas of work to enable system change: 1. Support the development of a broad range of customised research ethics and governance templates to complement generic, typically clinical trials orientated, ones; 2. Develop more sophisticated and flexible frameworks for study classification; 3. Link with associated processes for assessment, feedback, monitoring and reporting, such as ones involving funders and patient and public involvement groups; 4. Invest in a new generation IT infrastructure; 5. Enhance system capacity through increasing online reviewer participation and training; and 6. Encourage researchers to quantify the approvals processes for their studies. Ethics and governance approvals are burdensome for historical reasons and not because of the nature of the task. There are many opportunities to improve their efficiency and analytic depth in an age of innovation, increased connectivity and distributed working. If we continue to work under current systems, we are perpetuating, paradoxically, an unethical system of research approvals by virtue of its wastefulness and impoverished ethical debate. (shrink)

Background: Altering components of ecological momentary assessment measures to better suit the purposes of individual studies is a common and oftentimes necessary step. Though the inherent flexibility in EMA has its benefits, no resource exists to provide an overview of the variability in how convergent constructs and symptoms have been assessed in the past. The present study fills that gap by examining EMA measurement design for mood and anxiety symptomatology.Methods: Various search engines were used to identify 234 relevant studies. Items (...) administered, data collection schedules, response scales, data collection platforms, and psychometric properties were extracted.Results: Study designs varied greatly in all aspects across the identified papers. Over 4,600 extracted items were qualitatively analyzed, resulting in the identification of 12 themes. The most EMA items focused on affect, with categories such as “happiness” and “tension” appearing most frequently. We provide all of our data extraction in the format of an open-source database.Limitations: Despite our best attempts to include as much of the relevant literature as possible, this review and the accompanying database are not exhaustive, but can easily be built upon to include other, newer studies.Conclusions: The fact that the affect theme featured both positive and negative emotional constructs highlights the dichotomous focus on valence and affect within the literature surrounding anxious and depressive symptomatology. We hope that our database will act as a helpful design decision-making resource for researchers studying this kind of symptomatology in the future.Systematic Review Registration: PROSPERO. (shrink)

Human health is inextricably linked to the state of the environment, making it important to find ways to raise children’s interests in the topics of human health and the environment in which they live. The Goal 4 of the 2030 Agenda addressing quality education offers a guideline on how it is necessary to provide education for sustainable development directed to promoting sustainable lifestyles. The research results show that students show a greater interest in human health topics compared to environmental topics. (...) Boys in grade 6, compared to girls, show a statistically significantly higher interest in environmental topics, the ones related to energy. Girls generally show a statistically significantly higher interest in environmental topics compared to boys. Therefore, in the educational system in general, including the subjects of Science and Biology, it is necessary to find methods of active and exploratory learning that will increase students’ interest in environmental topics that are not currently perceived as particularly interesting. (shrink)

We critically address current theories of figurative language, focusing on the role of literal or compositional meaning in the interpretation of non-literal expressions, including idioms and metaphors. Specifically, we formulate and discuss the processing hypothesis that compositional meaning may either facilitate or impede the recovery or construction of the intended figurative meaning depending on multiple factors, and in particular, on the expression’s decomposability and on the “strength” of semantic relations between the compositional and figurative meanings. As a case study, we (...) consider research on processing and acquisition of figurative expressions in highly verbal individuals with autism spectrum disorder in comparison to neuro-typical individuals, and examine the factors that may account for the observed comprehension deficits in the ASD group. Based on this evidence, we discuss some of the strategies employed by language users in processing non-compositional or non-literal expressions, and we highlight implications for research on natural language comprehension and processing systems in the domain of figurative meaning. (shrink)

BackgroundHumanitarian crises and emergencies, events often marked by high mortality, have until recently excluded palliative care—a specialty focusing on supporting people with serious or terminal illness or those nearing death. In the COVID-19 pandemic, palliative care has received unprecedented levels of societal attention. Unfortunately, this has not been enough to prevent patients dying alone, relatives not being able to say goodbye and palliative care being used instead of intensive care due to resource limitations. Yet global guidance was available. In 2018, (...) the WHO released a guide on‘Integrating palliative care and symptom relief into the response to humanitarian emergencies and crises’—the first guidance on the topic by an international body.AimsThis paper argues that while a landmark document, the WHO guide took a narrowly clinical bioethics perspective and missed crucial moral dilemmas. We argue for adding a population-level bioethics lens, which draws forth complex moral dilemmas arising from the fact that groups having differential innate and acquired resources in the context of social and historical determinants of health. We discuss dilemmas concerning: limitations of material and human resources; patient prioritisation; euthanasia; and legacy inequalities, discrimination and power imbalances.ImplicationsIn parts of the world where opportunity for preparation still exists, and as countries emerge from COVID-19, planners must consider care for the dying. Immediate steps to support better resolutions to ethical dilemmas of the provision of palliative care in humanitarian and emergency contexts will require honest debate; concerted research effort; and international, national and local ethical guidance. (shrink)

In the famous account of his two-year experiment of a simple life away from the distractions of society, Walden, or Life in the Woods, Henry David Thoreau wrote that "a man who has at length found something to do will not need to get a new suit to do it in; for him the old will do, that has lain dusty in the garret for an indeterminate period."1 Since its first publication in 1854, Walden has had as many critics as (...) adherents, and until now, Thoreau's attempt at a life of self-sufficiency in harmony with nature has divided views. Despite this, the above quote embodies a dilemma that is as salient in the current crisis of our unsustainable model of fashion consumption as it was in the nineteenth century, when the... (shrink)

2018 marked the centenary of Georg Simmel’s death, coinciding with the publication of several monographs dealing with his oeuvre and legacy. The four monographs discussed here deal with Simmel from the perspective of scholars who have specialized in cultural and sociological theory and/or philosophy whilst addressing the intellectual and social challenges of our times. These problems, questions and even anxieties are beyond those Simmel ever knew or could have envisioned, despite his extraordinary capacity to detect tendencies and to analyse potentialities (...) in his own present. (shrink)

It is commonly accepted – not only in the philosophical literature but also in daily life – that ignorance is a failure of some sort. As a result, a desideratum of any ontological account of ignorance is that it must be able to explain why there is something wrong with being ignorant of a true proposition. This article shows two things. First, two influential accounts of ignorance – the Knowledge Account and the True Belief Account – do not satisfy this (...) requirement. They fail to provide a satisfying normative account of the badness of ignorance. Second, this article suggests an alternative explanation of what makes ignorance a bad cognitive state. In a nutshell, ignorance is bad because it is the manifestation of a vice, namely, of what Cassam calls “epistemic insouciance”. (shrink)

In their letter to the Editor in this issue, Kolstoe and Carpenter challenge a core aspect of our recently published case study of research approvals [BMC Medical Ethics 20:7] by arguing that we conflate research ethics with governance and funding processes. Amongst the key concerns of the authors are: 1) that our paper exemplifies a typical conflation of concepts such as governance, integrity and ethics, with significant consequences for claims around the responsibility and accountability of the organisations involved; 2) that, (...) as a consequence of this conflation, we misrepresent the ethics review process, including in fundamental aspects such as the ethics approval-opinion distinction; 3) that it is difficult to see scope for greater integration of processes such as applying for funding, research approvals, Patient and Public Involvement, etc., as suggested by us. Here we present an alternative point of view towards the concerns raised. (shrink)

This study describes Raden Panji Natarata's thoughts as a humanist, poet and religious scholar who thinks that the concepts of Javanese Sufism and Islamic Sufism are two contradictory ideas. Raden Panji Natarata describes his ideas through the medium of têmbang macapat (Javanese song) in a classic Javanese literature entitled Sêrat Bayanullah. Sêrat Bayanullah, which is used as a source of data for this research, is a collection of the Pura Mangkunegaran library, Surakarta, with catalogue number A-393. The scope of this (...) study focuses on Raden Panji Natarata's thoughts on the nature of life, which include the concepts of human creation, human death, and the after-death union of the servant with God. To obtain objective and comprehensive research results, the researchers used a qualitative descriptive research paradigm by applying hermeneutic theory. The results showed that Raden Panji Natarata's thoughts about the nature of life did not go beyond the limits of monotheism, while other poets tended to acculturate Javanese Sufism thoughts, which sometimes were not in line with the teachings of monotheism. CONTRIBUTION: As an academic contribution, this research is expected to enrich and preserve the repertoire of local research literature with Sufism nuances and their relationship with the thoughts of Sufi experts. Differences in perspective is natural, and the most important thing is mutual respect for differing opinions for the sake of creating harmony in life. (shrink)

Dans la genese de sa constitution, la philosophie n'a pu faire l'economie d'une confrontation avec la musique qui fournissait aux anciens Grecs les schemes fondamentaux de la culture. De cette confrontation Platon est le temoin. Scindant la musique, il privilegie l'Harmonique, qui en est la partie theorique, sans toutefois lui reconnaitre la titre de science supreme. Correlativement, il condamne comme dysharmonie, tumulte fracassant et perturbateur de l'ordre cosmique, l'harmonie chromaticiste dont il s'emploie, non sans paradoxe, a decrire le detail. Par (...) cette lecture en filigrane des Dialogues de Platon, l'auteur se propose de reconstruire la pensee qui procede de l'harmonie chromaticiste et de montrer son importance dans l'elaboration de la philosophie fondatrice. Au carrefour des disciplines du savoir antique, ce livre s'adresse non seulement aux philosophes, mais aussi a tous ceux qui, musiciens ou stylisticiens, s'interessent a la forme musicale. (shrink)

Languages around the world differ in terms of the number of adnominal and pronominal demonstratives they require, as well as the factors that impact on their felicitous use. Given this cross-linguistic variation in deictic demonstrative terms, and the features that determine their felicitous use, an open question is how this is accommodated within bilingual cognition and language. In particular, we were interested in the extent to which bilingual language exposure and practice might alter the way in which a bilingual is (...) using deictic demonstratives in their first language. Recent research on language attrition suggests that L2 learning selectively affects aspects of the native language, with some domains of language competence being more vulnerable than others. If demonstratives are basic, and acquired relatively early, they should be less susceptible to change and attrition. This was the hypothesis we went on to test in the current study. We tested two groups of native Spanish speakers, a control group living in Spain and an experimental group living in Norway using the Memory game paradigm. Contra to our expectations, the results indicate a significant difference between the two groups in use of deictic terms, indicative of a change in the preferred number of terms used. This suggests that deictic referential systems may change over time under pressure from bilingual language exposure. (shrink)

Despite the emphasis on dialogue and argumentation in educational settings, still not much is known about how best we can support learners in their interthinking, reasoning, and metadialogic understanding. The goal of this classroom intervention study is to explore the degree of students’ dialogicity and its possible increase during a learning programme implementing dialogic and argument-based teaching goals and principles. In particular, we focus on how students from 5 to 15 years old engage with each other's ideas, and whether/how this (...) engagement is influenced by lesson and classroom setting factors. The participants were 4208 students distributed in preprimary, primary, and secondary classrooms of five countries (UK, Portugal, Germany, Spain, and Cyprus). Findings suggest that there is a consistent increase with age for some high-dialogicity moves, and students behave more dialogically in whole-class discussions rather than small-group activities. (shrink)

Investigating the theoretical and empirical relationships between transparency and trust in the context of surveillance, this volume argues that neither transparency nor trust provides a simple and self-evident path for mitigating the negative political and social consequences of state surveillance practices. Dominant in both the scholarly literature and public debate is the conviction that transparency can promote better-informed decisions, greater oversight, and restore trust damaged by the secrecy of surveillance. The contributions to this volume challenge this conventional wisdom by considering (...) how relations of trust and policies of transparency are modulated by underlying power asymmetries, socio-historical legacies, economic structures, and institutional constraints. They study trust and transparency as embedded in specific socio-political contexts to show how, under certain conditions, transparency can become a tool of social control that erodes trust, while mistrust-rather than trust-can sometimes offer the most promising approach to safeguarding rights and freedom in an age of surveillance. The first book addressing the inter-relationship of trust, transparency, and surveillance practices, this volume will be of interest to scholars and students of surveillance studies as well as appeal to an interdisciplinary audience given the contributions come from political science, sociology, philosophy, law, and civil society. (shrink)

Researchers in science education have converged on the view that argumentation can be an effective intervention for promoting knowledge construction in science classrooms. However, the impact of such interventions may be mediated by individuals’ task goals while arguing. In argumentative discourse, one can distinguish two overlapping but distinct kinds of activity: dispute and deliberation. In dispute the goal is to defend a conclusion by undermining alternatives, whereas in deliberation the goal is to arrive at a conclusion by contrasting alternatives. In (...) this study, we examine the impact of these discourse goals on both content learning and argument quality in science. (shrink)

Pionnière dans la pénalisation du viol en 1980, la France a été en eurocrime qu’aurait entraîné l’unanimité dans l’acceptation de la nouvelle définition proposée par la Commission européenne. L’absence de consentement devient finalement pour tous le critère principal, et de nombreux pays ont aligné récemment leur législation avec la directive européenne. Sur le droit à l’avortement, la convergence est moins sensible, plusieurs pays mettent d’importantes restrictions. La constitutionnalisation de la liberté d’avorter et de sa garantie en France va peut-être conduire (...) à son inscription dans les droits humains. (shrink)

Objective—To identify and describe the current state of clinical ethics support services in the UK.Design—A series of questionnaire surveys of key individuals in National Health Service (NHS) trusts, health authorities, health boards, local research ethics committees and health professional organisations. Interviews with chairmen/women of clinical ethics committees identified in the surveys.Setting—The UK National Health Service.Results—Responses to the questionnaires were received from all but one NHS trust and all but one health authority/board. A variety of models of clinical ethics support were (...) identified including twenty formal clinical ethics committees (CECs). A further twenty NHS trusts expressed an intention to establish a CEC within the next twelve months. Most CECs in the UK have been in existence less than five years and are still defining their role. The chairmen identified education of committee members and contact with other ethics committees as important requirements for committee development. Problems were identified around lack of support for the committee and with raising the profile of the committee within the institution. There has been little evaluation of clinical ethics support services either in the UK or in other countries with longer established services. What evaluation has occurred has focused on process rather than outcome measures.Conclusions—Clinical ethics support services are developing in the UK. A number of issues have been identified that need to be addressed if such support services are to develop effectively. (shrink)

Kline's evolutionary analysis of teaching provides welcome reframing for cross-species comparisons. However, theory based on competition cannot explain the transmission of human cultural elements that were collectively created. Humans evolved in a cultural niche andteaching-learningcoevolved to transmit culture. To study human cultural variation in teaching, we need a more articulated theory of this distinctively human engagement.

The meaning of life and man's alienation from himself and his natural environment is examined in brief selections, illustrated with photographs, from the works of Albert Schweitzer.