BackgroundInformed consent as stipulated in regulatory human research guidelines requires volunteers to be well-informed about what will happen to them in a trial. However, researchers may be faced with the challenge of how to ensure that a volunteer agreeing to take part in a clinical trial is truly informed. This study aimed to find out volunteers’ comprehension of informed consent and voluntary participation in Human Immunodeficiency Virus (HIV) clinical trials during the registration cohort.MethodsWe conducted a qualitative study among volunteers who (...) were enrolled in the registration cohort of HIV clinical trials in Dar es Salaam, Tanzania. A purposive sampling strategy was used to obtain twenty study participants. The data were collected between June and September 2020 using a semi-structured interview guide. In-depth interviews were used to collect the data to obtain deep insights of the individual study participants on the comprehension of informed consent and participation in the clinical trial. A thematic analysis approach was used to analyze the data. Themes and subthemes were supported by the quotes from the participants.ResultsVolunteers described comprehension of informed consent from different perspectives. They reported that various components of the informed consent such as study procedure, confidentiality, risk and benefits were grasped during engagement meetings. Furthermore, the volunteers’ decision to participate in the registration cohort was voluntary. However, trial aspects such as health insurance, free condoms, and medical checkups could have indirectly influenced their reluctance to withdraw from the study.ConclusionEngagement meetings may increase the comprehension of informed consent among potential participants for HIV clinical trials. However, trial incentives may influence participation, and thus future research should focus on the challenges of giving incentives in the study. This will ensure comprehension and voluntary participation in the context of HIV clinical trials. (shrink)

In this case report, we describe a woman with advancing dementia who still retained decisional capacity and was able to clearly articulate her request for deactivation of her implanted cardiac pacemaker—a scenario that would result in her death. In this case, the patient had the autonomy to make her decision, but clinicians at an outside hospital refused to deactivate her pacemaker even though they were in unanimous agreement that the patient had capacity to make this decision, citing personal discomfort and (...) a belief that her decision seemed out of proportion to her suffering. We evaluated her at our hospital, found her to have decision-making capacity, and deactivated her pacer resulting in her death about 9 days later. While some clinicians may be comfortable discussing patient preferences for device deactivation in patients who are imminently dying, we can find no reports in the literature of requests for device deactivation from patients with terminal diagnoses who are not imminently dying. (shrink)

Studies have consistently shown that LGBTQ individuals are at increased risk for several mental and physical health challenges including suicidality. The relationship between religion and LGBTQ well-being in general and LGBTQ suicidality specifically has increasingly been the subject of scholarly investigation. This systematic review examines all peer-reviewed articles included in the EBSCO PsycInfo database since 2000 that examined the relationship between religiosity and LGBTQ suicide (50 studies in all). These studies reveal a complex relationship that is nuanced and, at times, (...) contradictory. Overall, 65% identified at least one religiosity-related predictor as a risk factor for LGBTQ suicidality, 41% identified at least one religiosity-related predictor as a protective factor against suicidality, while 53% found no associations between religiosity-related predictors and suicide risk. However, when specifically examining religious affiliation/denomination, salience, or beliefs and behaviors, typically, religiosity was either protective or unassociated with LGBTQ suicidality. This held particularly true for studies that had population-based samples, employed control variables and included comparison groups, thus enhancing their generalizability. The one religiosity-related predictor that was almost universally identified as a risk factor was when an individual felt conflicted between their religious and sexual-gender identities. (shrink)

More than 50 years ago, Bongard introduced 100 visual concept learning problems as a challenge for artificial vision systems. These problems are now known as Bongard problems. Although they are well known in cognitive science and artificial intelligence, only very little progress has been made toward building systems that can solve a substantial subset of them. In the system presented here, visual features are extracted through image processing and then translated into a symbolic visual vocabulary. We introduce a formal language (...) that allows representing compositional visual concepts based on this vocabulary. Using this language and Bayesian inference, concepts can be induced from the examples that are provided in each problem. We find a reasonable agreement between the concepts with high posterior probability and the solutions formulated by Bongard himself for a subset of 35 problems. While this approach is far from solving Bongard problems like humans, it does considerably better than previous approaches. We discuss the issues we encountered while developing this system and their continuing relevance for understanding visual cognition. For instance, contrary to other concept learning problems, the examples are not random in Bongard problems; instead they are carefully chosen to ensure that the concept can be induced, and we found it helpful to take the resulting pragmatic constraints into account. (shrink)

Both practitioners and scholars are increasingly interested in the idea of the human-centered organization. This term first appeared in the late 1950s and has gained attention in the last ten years. Awareness of the need for human-centeredness grew during the COVID-19 pandemic, in which many organizational leaders were compelled to focus on employee health, safety, and well-being. In this paper, we review and synthesize the rather fragmented scholarly and practitioner literature on human-centered organization (HCO) to develop an integrated definition and (...) framework. The 26 sources reviewed in depth indicate that the HCO construct is primarily utilized in two ways. First, human-centered design scholars and practitioners conceive of HCOs as employing human-centered design practices. The second discourse involves the humanistic management and culture literature, which conceives of HCOs as embodying humanistic values and cultures. After reviewing these separate discourses, we synthesize them in an integrated definition as well as framework of HCO. The framework starts from humanistic values such as dignity, well-being, and justice, which are pivotal in creating organizational practices characterized by a common good purpose, positive human experiences on the job, team structures to coordinate work, and participatory tools and approaches. (shrink)

This book argues that the Russian-British philosopher Isaiah Berlin should primarily be understood through British idealism. Though he adopted Kantian methodology and a view of people as purposive beings, he rejected the Idealists' monism and theories of positive liberty. Robert A. Kocis demonstrates how, like Michael Oakeshott and R. G. Collingwood, Berlin can be seen as a 'post-Idealist' thinker, invested in the implications of that rich tradition.

Maintaining that the existence of Moral Philosophy, as it is usually understood, rests on a mistake, Prichard undertakes to formulate our true attitude towards moral obligations. The right action does not depend upon either our own good or what is good. Obligations are underivative, immediate, and self‐evident, and therefore, we do not come to appreciate them through argument or a process of non‐moral thinking. The mistake on which Moral Philosophy rests, which links obligation to virtue or desire, parallels the mistake (...) underpinning the Theory of Knowledge. Like moral obligation, knowledge is immediate; it need not be vindicated or improved by additional knowledge. (shrink)

Shadows are intriguing phenomena. They do not have mass or energy. So, they are unable to have some basic characteristics of the objects of which they are shadows: they cannot move by themselves and they cannot experience the same kind of changes. At first sight, any theory of perception can skip this optical phenomenon or look at it only as a side-effect. Actually, in order to be seen objects must be illuminated and one of the consequences of this is that (...) they project a shadow over the surrounding space. Is that all? In this paper I will argue that, from a phenomenological point of view (or at least from a Husserlian oriented phenomenology), shadows, with their specific hyletic data, must be considered as an element of the process of constitution of spatial-temporal objectivities. In other words, shadows no less than other predicates, like extension or hardness, although in a different manner, belong to the a priori structure of those objectivities. This means that their ontological status is quite different from that of fictitious objects or hallucinations. To show this I will draw mainly in Husserl’s Lesson Thing and Space, from 1907, and other unpublished texts during Husserl’s lifetime, like the second volume of the Ideas and the Lesson of 1925 on Psychological Phenomenology. (shrink)

Ethical questions surrounding withdrawal of life support can be complex. When life support therapies are the result of a suicide attempt, the potential ethical issues take on another dimension. Duties and principles that normally guide clinicians’ actions as caregivers may not apply as easily. We present a case of attempted suicide in which decisions surrounding withdrawal of life support provoked conflict between a patient’s family and the medical team caring for him. We highlight the major unresolved philosophical questions and contradictory (...) normative values about suicide that underlie this conflict. Finally, we show how these considerations were practically applied to this particular case. (shrink)

In the present article, we review the theory and research on religious deconversion with a focus on adolescence and young adulthood. First, we present the relevant terminology (e.g. religious deconversion, religious disaffiliation, and religious deidentification) and statistical trends (e.g. the prevalence of religious Nones and Dones). We define religious deconversion as any movement away from religion. Religiosity decreases across adolescence and into young adulthood, and these developmental periods also have heightened rates of religious deidentification, at least in many Western cultures. (...) Second, we review the theory and research on processes, predictors, and outcomes of religious deconversion. Deconversion is discussed both in terms of individuals becoming less religious and possibly deidentifying from religion. In terms of processes of deconversion, we discuss various theoretical models and self-expressed reasons for deconversion. Religious deconversion tends to progress in phases, often initiated by religious and spiritual struggles. In terms of predictors, we identify predictors at the level of the individual (e.g. demographics, personality, norm-violating behavior, and dimensions of religiosity), family (e.g. parent and family religiosity, family dynamics such as parenting styles, and religious socialization), peers (e.g. peer religiosity and religious conversations with peers), religious communities (e.g. supportiveness, engagement, and dialogue), formal education, and social media. In line with developmental systems perspectives, religious deconversion is a complex and dynamic process involving numerous individual and contextual factors. In terms of outcomes of deconversion, we identify potential individual and relational outcomes that are considered both negative and positive. Finally, we outlined 10 promising future directions for research on religious deconversion. (shrink)

The article “Revive and Refuse: Capacity, Autonomy, and Refusal of Care After Opioid Overdose,” Marshall et al. (2024) highlights the critical issue of care after an opioid overdose. “Revive and Re...

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Jesus Becoming Jesus, Volume 2, A Theological Interpretation of the Gospel of John: Prologue and the Book of Signs by Thomas G. WeinandyDaniel A. KeatingJesus Becoming Jesus, Volume 2, A Theological Interpretation of the Gospel of John: Prologue and the Book of Signs by Thomas G. Weinandy, O.F.M. Cap. (Washington, DC: Catholic University of America Press, 2021), xviii + 484 pp.This is an unusual biblical commentary. By his (...) own account, Fr. Weinandy had set out to write a fully orbed systematic theology. While in the process of giving a "respectful nod to Scripture" as a prelude to his systematic study, he found himself caught up and engrossed in the biblical text—and never managed to extricate himself. Changing course, he decided to write "a theological or doctrinal interpretation of the New Testament." Volume 1 of this effort covers the Synoptic Gospels (2018). In this second volume, Weinandy turns his attention to the Fourth Gospel, his aim being "to discern the theological and doctrinal content of John's Gospel" (x).Perhaps the most unusual quality of this study is the complete absence of any secondary literature. Though the author has read commentaries on the Gospels, both ancient and modern, he chose not to consult any other scholars (or ecclesiastical writers) in composing this doctrinal commentary. Given his focused aim—a theological and doctrinal study of the Gospels—he wanted to avoid getting caught up in contemporary scholarly exegetical debates. And so there are no footnotes to secondary sources (a thing probably welcome to many readers).Weinandy alerts the reader at the start concerning his particular approach to this study of the Gospels. Fascinated throughout his career as a systematic theologian with the notion of "act" (and especially with God as "pure act"), he approaches the Gospel narratives primarily from the perspective of Jesus's actions. Specifically, he intends to explore how Jesus "enacts" [End Page 738] his name, "YHWH-Saves," through the saving mysteries revealed in the narrative of the Gospels. Thus the title of his multi-volume work, "Jesus Becoming Jesus," serves as the overarching theological theme of the entire effort. This is how he explains his methodology of "act" and "enactment" in his first volume: "Jesus more and more becomes Jesus in act through his saving acts; he becomes more and more the Savior. He definitively becomes Jesus-in-act with the actions of his saving death and resurrection, which will find completion when Jesus comes in glory at the end of time" (xix). With such attention given to Jesus's actions, Weinandy admits that Jesus's teaching does not receive the same attention. It is not that he ignores Jesus's words, but they function primarily as pointers to Jesus's acts.And yet in another sense, the endpoint of this commentary is to show the Trinity-in-act. "The Father is fatherhood fully in act; the Son is sonship fully in act; and the Holy Spirit is love fully in act. This threefold perichoretic act is the one God fully in act" (xiv). As Jesus progressively enacts his name and identity, so too are the Father and the Spirit revealed according to the "acts" that reflect their hypostatic identities. A consistent feature of this commentary is the sustained attention given to how the Father and the Spirit are involved in the saving actions of Jesus, the Word made flesh. Congruent with this view of the Trinity's perichoretic act, Weinandy often adopts what might be called a "perichoretic syntax," whereby he presents a single reality from the distinct perspectives of the divine persons, restating the same truth in mutually enhancing ways. This grammatical-syntactical style of the commentary is admirably suited to its theme.If we are looking for parallels to this theological-doctrinal approach in the Christian tradition, the commentaries on the Gospel of John by Cyril of Alexandria and Thomas Aquinas come to mind. Like Weinandy, they each work through the Gospel text passage by passage, explaining the meaning of each section, but they are characterized by an overarching doctrinal concern: to present the entirety of the Christian faith through the words of John's Gospel and to... (shrink)

Throughout history, the nature and mystery of death has captivated artists, scientists, philosophers, physicians, and theologians. This eerie chronology ventures right to the borderlines of science and sheds light into the darkness. Here, topics as wide ranging as the Maya death gods, golems, and séances sit side by side with entries on zombies and quantum immortality. With the turn of every page, readers will encounter beautiful artwork, along with unexpected insights about death and what may lie beyond."--Publisher's description.