Background: The magnitude of bullying and harassment among psychiatrists is reportedly high, yet no peer-review published studies addressing this issue could be found. Therefore, it was decided to conduct a pilot study to assess the degree of the problem, the types of bullying/harassment and to provide some insights into the situation.Methods and Principal Findings: Following multiple focus group meetings, a yes/no response type questionnaire was developed to assess the degree and type of bullying and harassment experienced by psychiatrists. Over (...) a 3-month period the questionnaire was administered to a random sample of 60 psychiatrists. 57 out of the 60 psychiatrists reported harassment and bullying. Frequencies of the following response variables are presented in descending order: rumours 40% ; defamation 20% ; passing remarks 20% ; false accusations 15% ; threats 13.3% ; verbal abuse 13.3% ; unjustified complaints 13.3% ; promotion blocked 13.3% ; humiliation 13% ; bad reference given 10% ; credentials questioned 8.3% ; physical attacks 5% ; termination 5% ; derogatory remarks 1.7% and 1.7% were subjected to personal work. As a result of being subjected to harassment, 66.7% of the psychiatrists did not take any action, whereas 33.3% confronted the person they believed responsible. Asked whether the bullying and harassment caused distress, 18.3% of the psychiatrists did not report any effect, 30% reported mild distress, 40% moderate distress and severe distress was reported by 11.7%.Conclusions: It was concluded that the magnitude of bullying and harassment among psychiatrists may be quite high, as evidenced by this pilot study. There is a need for extensive systematic studies on this subject and to establish strategies to prevent and address this issue at a national and regulatory level. (shrink)

Einstein thought that quantum mechanics was incomplete because it was nonlocal. In this paper I argue instead that quantum theory is incomplete, even if it is nonlocal, and that relativity is incomplete because its minimal spatiotemporal structure cannot naturally accommodate such nonlocality. So, I show that relativistic pilot-wave theories are the rational completion of quantum mechanics as well as relativity: they provide a spatiotemporal ontology of particles, as well as a spatiotemporal structure able to explain quantum correlations.

This pilot study had two purposes: (1) to review recent Japanese nursing literature on nursing advocacy; and (2) to obtain data from nurses on advocacy. For the second purpose, 24 nurses at a nursing college in Japan responded to a questionnaire. The concept of advocacy, taken from the West, has become an ethical ideal for Japanese nurses but one that they do not always understand, or, if they do, they find it difficult to fulfil. They cite nursing leadership support (...) as necessary to enacting this role. Discussion on the meaning of and the rationale for advocacy in a society where goodness or badness is relative to social situations and its impact may reveal two parallel but overlapping views of morality. Such a situation would not only influence notions of advocacy but also possibly render them more complex. (shrink)

Although clinical ethics consultation is a high-stakes endeavor with an increasing prominence in health care systems, progress in developing standards for quality is challenging. In this article, we describe the results of a pilot project utilizing portfolios as an evaluation tool. We found that this approach is feasible and resulted in a reasonably wide distribution of scores among the 23 submitted portfolios that we evaluated. We discuss limitations and implications of these results, and suggest that this is a significant (...) step on the pathway to an eventual certification process for clinical ethics consultants. (shrink)

ABSTRACTIn this paper I argue that a remotely piloted aircraft pilot’s act of killing remotely, when it is done in the defense of another person, can be viewed as an act of sacrifice. This argument concludes from two premises. First, the RPA pilot faces psychological risk to self by carrying out such an action; second, the RPA pilot is motivated to some significant degree by something other than self-interest. Moreover, I challenge both the view that RPA represent (...) merely an incremental development in technology yielding an incremental expansion of the distance between the war-fighter and the target and the view that RPA is revolutionary in some fundamental sense. I instead argue that, based upon the natural geometric boundary imposed by the earth’s shape, RPA have maximized the physical distance between the war-fighter and the target and, over time, this fact will change, not only the psychological effects on the RPA pilot, but also the way we view killing and distance in general. When taken togethe... (shrink)

ObjectiveThis pilot study aimed to evaluate the efficacy of a digital cognitive behavioral therapy in patients with cancer experiencing sleep problems.MethodsA total of 57 participants aged 25–65 years were randomly assigned to three groups—21 participants to a dCBT program, 20 participants to an app-based attentional control program, and 16 participants to a waitlist control group—and evaluated offline before and after the program completion. Of the 57 participants, there were a total of 45 study completers, 15 participants in each group. (...) The dependent variables were sleep quality scores, measured by the Pittsburgh Sleep Quality Index and health-related quality of life scores, measured using the Short-Form 36, and attentional bias scores from a dot-probe computer task.ResultsFor both the intention-to-treat and study-completers analyses, a significant increase supported by a large effect size was found in the quality of sleep score of the HARUToday Sleep group compared to both the app-based attentional control and the waitlist control group. However, no significant changes were found in the quality of life and attentional bias scores.ConclusionOur results suggest that the HARUToday Sleep app has the potential to serve as an intervention module to enhance the sleep quality of patients with cancer experiencing sleep problems. (shrink)

Background This pilot study evaluated the speaking book ‘What it means to be part of a clinical trial’. The book aims at empowering populations with information on their rights and responsibilities when enrolled in clinical research. Wide publication of the book—at significant cost—is anticipated. It is important that the book is evaluated within the communities for whom it is intended, and the necessary changes (if any) are made, before translation and large-scale publication takes place. Objective The objective of the (...) study was to measure the efficacy and ease of use of the book. Methods Participants were recruited from a catering company. Participants were questioned on their knowledge of clinical trials and were then given the book. Instructions for use of the book were given to one group (‘experimental’ group). The other group (‘control’ group) was not given any instructions. A week later, the investigators returned, repeated the knowledge questions and asked ‘ease of use’ questions. Results A two-way repeated measure of covariants showed a statistically significant positive increase in knowledge of clinical trials among the intervention group (p=0.02). Results for the control group displayed trends that were not statistically significant. Percentage analysis of ‘ease of use’ questions proved that the book is easy to use, although some changes would be beneficial. Conclusion This study revealed that the speaking book is easy to use. It significantly increased knowledge of clinical trials among the study sample if instructions on use of the book were provided. (shrink)

The representation of a quantum system as the spatial configuration of its constituents evolving in time as a trajectory under the action of the wave-function, is the main objective of the de Broglie–Bohm theory. However, its standard formulation is referred to the statistical ensemble of its possible trajectories. The statistical ensemble is introduced in order to establish the exact correspondence between the probability density on the spatial configurations and the quantum distribution, that is the squared modulus of the wave-function. In (...) this work we explore the possibility of using the pilot wave theory at the level of a single Bohm’s trajectory, that is a single realization of the time dependent configuration which should be representative of a single realization of the quantum system. The pilot wave theory allows a formally self-consistent representation of quantum systems as a single Bohm’s trajectory, but in this case there is no room for the Born’s rule at least in its standard form. We will show that a correspondence exists between the statistical distribution of configurations along the single Bohm’s trajectory and the quantum distribution for a subsystem interacting with the environment in a multicomponent system. To this aim, we present the numerical results of the single Bohm’s trajectory description of the model system of six confined planar rotors with random interactions. We find a rather close correspondence between the coordinate distribution of one rotor, the others representing the environment, along its trajectory and the time averaged marginal quantum distribution for the same rotor. This might be considered as the counterpart of the standard Born’s rule when the pilot wave theory is applied at the level of single Bohm’s trajectory. Furthermore a strongly fluctuating behavior with a fast loss of correlation is found for the evolution of each rotor coordinate. This suggests that a Markov process might well approximate the evolution of the Bohm’s coordinate of a single rotor and, under this condition, it is shown that the correspondence between coordinate distribution and quantum distribution of the rotor is exactly verified. (shrink)

Objective: To pilot informed consent materials developed for Aboriginal parents in a vaccine trial, and evaluate their design and the informed consent process.Methods: Cross sectional quantitative and qualitative survey of 20 Aboriginal and 20 non-Aboriginal women in Alice Springs. Information about the proposed research was presented to Aboriginal participants by an Aboriginal researcher, using purpose designed verbal, visual, and written materials. Non-Aboriginal participants received standard materials developed by the sponsor. Questionnaires were used to evaluate recall and understanding immediately and (...) five days later. Qualitative analysis of Aboriginal participants’ interviews was performed.Results: There were no differences between the groups in understanding of diseases prevented by the vaccine, the potential risks of participating, or the voluntary nature of participation. Most Aboriginal participants had difficulty with the concept of a “licensed” versus “unlicensed” vaccine. The non-Aboriginal group had a good understanding of this. Aboriginal participants identified the use of the flipchart, along with a presentation by a doctor and Aboriginal health worker, as preferred delivery modes. Group presentations were preferred rather than one-on-one discussions. The use of the questionnaire posed considerable methodological difficulties.Conclusions: A one-off oral presentation to Aboriginal participants is unlikely to produce “informed consent”. Key but unfamiliar concepts require identification and particularly considered presentation. (shrink)

The current study is a pilot trial to examine the effects of a nonelective, classroom-based, teacher-implemented, mindfulness meditation intervention on standard clinical measures of mental health and affect in middle school children. A total of 101 healthy sixth-grade students (55 boys, 46 girls) were randomized to either an Asian history course with daily mindfulness meditation practice (intervention group) or an African history course with a matched experiential activity (active control group). Self-reported measures included the Youth Self Report (YSR), a (...) modified Spielberger State-Trait Anxiety Inventory, and the Cognitive and Affective Mindfulness Measure –Revised. Both groups decreased significantly on clinical syndrome subscales and affect but did not differ in the extent of their improvements. Meditators were significantly less likely to develop suicidal ideation or thoughts of self-harm than controls. These results suggest that mindfulness training may yield both unique and non-specific benefits that are shared by other novel activities. (shrink)

This article presents original empirical data generated from the Crown Prosecution Service (CPS) Pilot Evaluation of pre-trial witness interviewing (PTWI) in England and Wales. Section 1 introduces the PTWI Pilot and describes the methodological strengths and limitations of our qualitative socio-legal study. Forming the richly documented empirical core of the article, Sections 2–5 identify the principal considerations which seemed to influence case selection for Pilot interviews. An overlapping collection of evidentiary, strategic and circumstantial factors encouraged prosecutors to (...) resort to PTWI, whilst other, countervailing considerations were apprehended as disincentives. Assessments of witness credibility were central to prosecutors’ attempts to balance these competing factors. Section 6 concludes by underlining the potential of qualitative socio-legal studies to promote more nuanced understandings of criminal process, and by extension to make practical contributions to evidence-based criminal procedure reform. (shrink)

Background/ObjectiveSocial skills are essential in adolescence, both for their relational dimension and for their influence on other areas of adolescent life, so it is essential to include Social skills in the formal education of students.MethodThis paper presents the results of an experimental mixed factorial design pilot study in which an Interpersonal Skills Training Program for Adolescents was applied. The convenience sample consisted of 51 adolescents. An evaluation was carried out before and after the intervention, using the CEDIA and SAS-A (...) questionnaires.ResultsThe mixed factorial ANOVA show significant differences in the overall measures and in most of the subscales of both questionnaires, indicating that PEHIA is effectiveness, at least in the short term.ConclusionsThe results obtained in assertiveness, interpersonal relationships and public speaking suggest that the program is feasible and shows promising results in reducing anxiety. However, a larger scale study should be conducted. (shrink)

The de Broglie–Bohm pilot-wave theory provides an illuminating candidate solution to the philosophical problems that plague orthodox quantum theory. But the pilot-wave theory also has the potential to be of practical use to, for example, quantum chemists and condensed matter physicists who study many-body problems. In particular, the proprietary pilot-wave concept of the “conditional wave function” provides a novel perspective on and justification for a standard approach to many-body quantum systems in which the N-particle wave function is (...) replaced by N single-particle wave functions. Moreover, this uniquely Bohmian “small entanglement approximation” can be understood as the most basic level in a hierarchy of well-defined approximation schemes. Here we explain all of this theoretical background and then explore several of these approximation schemes numerically in the context of a simple toy model system. (shrink)

The idea of obtaining a pilot-wave quantum theory on a lattice with discrete time is presented. The motion of quantum particles is described by a \-distributed Markov chain. Stochastic matrices of the process are found by the discrete version of the least-action principle. Probability currents are the consequence of Hamilton’s principle and the stochasticity of the Markov process is minimized. As an example, stochastic motion of single particles in a double-slit experiment is examined.

It’s generally taken to be established that no local hidden-variable theory is possible. That conclusion applies if our world is a _thread_, where a thread is a world where particles follow trajectories, as in Pilot-Wave theory. But if our world is taken to be a _set_ of threads locality can be recovered. Our world can be described by a _many-threads_ theory, as defined by Jeffrey Barrett in the opening quote. Particles don’t follow trajectories because a particle in our world (...) is a set of _elemental_ particles following different trajectories, each in a thread. The “elements” of a superposition are construed as subsets in such a way that a particle in our world only has definite position if all its set-theoretic elements are at corresponding positions in each thread. Wavefunction becomes a 3D density distribution of particles’ subset measures, the stuff of an electron’s “probability cloud”. Current Pilot-Wave theory provides a non-relativistic dynamics for the elemental particles (approximated by Many Interacting Worlds theory). EPR-Bell nonlocality doesn’t apply because the relevant measurement outcomes in the absolute elsewhere of an observer are always in superposition. (shrink)

In this pilot qualitative study 13 clinical bioethicists from across Canada were interviewed about their experiences of conflicts of interest and/or conflicting interests in their professional roles. The interviews generated five composite cases. Participants reported being significantly impacted by these experiences both personally and professionally.

The COVID-19 pandemic has highlighted the difficult task of balancing access to misinformation with respect for patient decision-making. Due to its innate antagonism, the paradigm of “physician paternalism” versus “patient autonomy” may not adequately capture the clinical relationship. The authors hypothesized that most patients would, in fact, prefer significant physician input as opposed to unopinionated information when making medical decisions. There is a lack of empirical data corroborating this in the United States. To that end, a survey was distributed to (...) 650 individuals through Amazon Mechanical Turk, of which 499 responses met pre-determined quality criteria. Most respondents believed their doctor's insight would be better than their own if injured or gravely ill. When asked to affirm preferences separately, a significantly higher proportion of respondents preferred guidance from their doctor when making medical decisions compared to being presented with unopinionated information ( p < 0.001). Encouragingly, 93.1% believed that the doctor's primary goal was their health. When asked directly to compare physician guidance to unopinionated information, 69.1% respondents stated they would prefer physician guidance. We found a consistent association between educational/economic background and affirmative responses ( p < 0.001), suggesting particular attention should be paid to patients that are disadvantaged with respect to these demographic factors. The belief in a shared goal, and a consistent preference for physician input, suggests that patients endorse a more collaborative view of the clinical dynamic than is suggested by the paternalism-autonomy paradigm. This pilot study suggests physicians should not be afraid to communicate conviction with regard to treatment decisions. (shrink)

This second paper reports on a small ethnographic study of Argentine psychiatrists. A carefully selected group of six psychiatrists currently practicing in Buenos Aires participated in an in-depth semi-structured interview. The transcripts of the interviews were coded and a thematic analysis method was applied to construct a local theory of the professional values constructed by Argentine psychiatrists, and the circumstances in which such values were constructed. Our analysis indicated that Argentine psychiatrists constructed a number of values, frequently perceived as obligations (...) to their professional group and the needs of their patients. The two main strategies employed by Argentine psychiatrists were the diagnostic act and advocacy. We also identify that these values emerge in the context of recent broad historical and cultural inl uences upon the profession of psychiatry in Argentina, and the Argentine population in general. (shrink)

The strange story of the von Neumann impossibility proof is recalled, and the even stranger story of later impossibility proofs, and how the impossible was done by de Broglie and Bohm. Morals are drawn.

The position underlying this article is that while pilots are not strictly required to justify moving in the direction of a basic income system, nevertheless they can play several useful functions in the debate. These include rebutting common preconceptions, for instance that basic income will make people ‘lazy’, indicating non-monetary benefits such as improved health and wellbeing, and testing how a basic income might best be introduced in a given region, country or city. In that context the article goes on (...) to present 19 guiding principles for the design, implementation and evaluation of basic income pilots, with examples of selected experiments and pilots past and present. (shrink)

Intellectual property in biotechnology invention provides important incentives for research and development leading to advances in genetic tests and treatments. However, there have been numerous concerns raised regarding the negative effect patents on gene sequences and their practical applications may have on clinical research and the availability of new medical tests and procedures. One concern is that licensing policies attempting to capture for the benefit of the licensor valuable rights to downstream research results and products may increase the financial risks (...) and cliniinish potential payoffs of — and therefore motivation for — performing downstream research and development. In addition, very broad patent claims allowed by the U.S. Patent and Trademark Office, the sheer growth in patents claiming genetic sequences, and threats of overlapping patents create a veritable minefield for researchers in both academia and industry. The concern is that research may be stifled because of the high cost and hassle of negotiating access. (shrink)