The brand personality of nonprofit service organizations is a focal cue for individuals engaging in pro-social behavior. However, the positive effect of brand personality on donors’ intention to engage pro-socially may be affected in cases in which NPOs provide monetary incentives to those donors. Relying on social exchange theory, the authors examine how monetary incentives and brand personality commonly affect the intention to donate and whether this effect varies based on the perceived trustworthiness of the NPO. The results of two (...) experimental studies show that branding and incentivizing decisions should not be developed independently because monetary incentives do indeed undermine the positive effects of brand personality on the intention to donate. However, the effectiveness of incentives varies with the perceived level of trust in the NPO: highly trusted NPO services are harmed by monetary incentives, whereas less-trusted NPOs may even benefit. (shrink)

This paper examines the ethical conundrum between a hospital's ethos of relieving distress, investigation and treatment, and its concurrent duties under English law to administer tests of decision-making capacity and safeguarding protection where it believes the patient may lack this capacity. Delirium, characterised by a precipitous decline in mental functioning exhibiting the shared symptomology of recoverable depressive disorders and terminal dementia, is not uncommon after emergency admission of elderly patients into acute medical hospital wards. The use of functional capacity testing (...) as a benchmark for decision-making capacity for post-discharge residence has been criticised as outdated, conceptually floored, subjective, lacking central guidance, transparent process, and accountability. A study of patient experience demonstrates the potential for hospital misuse of capacity testing, the failure of functional testing to differentiate decision making capacity from the disability of partial cognitive impairment, and how hospital capacity processes can interact and amplify patient pathology thereby decreasing recovery prospects. Prioritisation of mental capacity obligations above thorough investigation of emergent mental pathology and relief of patient anguish, results in extended detention in medical wards lacking bespoke facilities. Further understanding of patient experience is needed to inform policy with interventions tailored to avoid harm and increase wellbeing. (shrink)

This paper takes a novel approach to studying the existence and stability of Nash equilibria in N-firm Cournot–Bertrand oligopolies. First, we show that such games can be monotonically embedded into a game of strategic heterogeneity, so that each firm best responds to the choices of all other firms in a monotonic way. We then show that this monotonicity can be exploited to derive conditions which guarantee the existence of a unique, dominance solvable Nash equilibrium which is stable under all adaptive (...) dynamics. These conditions constitute a strict improvement over existing results in the literature. Finally, we examine the effect on these conditions resulting from additional firms entering the market. (shrink)

In this study the awake patient's intraoperative situation and experiences during regional anaesthetics and surgery are reflected upon by using the work of the French philosopher Maurice Merleau‐Ponty. Merleau‐Ponty's phenomenological idea of the body as being at the centre of the world highlights the patient's embodied position and bestows significance onto the body as a whole, as a lived body. A case, based on the findings from a previous interview study, is presented as a contextual starting point where a patient (...) goes from having a familiar body recognized as her own to having a partially anaesthetized body experienced as an unknown object. The intraoperative caring space is described in this context as the mutual ground where the awake patient and the nurse anaesthetist (NA) can interact to create meaning. The NA can act as the patient's bodily extension to bridge the gap between the patient's experiences and the situation. This calls for the NA's proximity and genuine presence in order to meet and understand the patient's awake experiences. Learning from the patient's situatedness gives information that is valuable for NAs to share with patients who are less experienced with this contextual situation. The challenge for the NA is not to perform routine‐based care, but to acknowledge every patient's lifeworld and uniqueness thus enabling the patient to move easily along the mind–body–world continuum. The core of intraoperative care is to provide support and promote well‐being of awake patients in the intraoperative environment. The use of a philosophical perspective is relevant for nurses who work in an intraoperative setting where patients undergo regional anaesthetics. This study shows how nursing research using phenomenological philosophy can help uncover new meanings known only to the patients living the experience. (shrink)

L’objectif de l’article est théorico-clinique. Autour des questions que posent les troubles de l’attachement, plusieurs référentiels théoriques sont analysés et mis en perspectives. L’éclairage théorique autorise une relecture de la symptomatologie. Il ouvre également des pistes intéressantes en ce qui concerne les questions que pose l’évaluation des pratiques. En suivant la position de D. Widlöcher (2000), la notion d’étayage permet une lecture dynamique des liens entre attachement et théorie des pulsions. Les perspectives thérapeutiques et plus particulièrement les questions posées par (...) les dispositifs novateurs dans le domaine des soins psychiques clôturent l’article. (shrink)

Storchak, Ehlis, and Fallgatter provide an extensive literature review on electrophysiological measurements, which indicate that general predictive deficits in self‐monitoring are associated with various positive symptoms in patients with schizophrenia.

Since the 1970s, estrogen have sometimes been used in adolescent girls to reduce very tall adult expected height. Worries about long-term effects have led to a proposal to link treatment data with cancer registers. How should one deal with informed consent for such a study? We designed a qualitative study with semi-structured telephone interviews. From 1200 women who were to be followed-up in cancer registers, we randomly selected 22 women. Major themes were a wish to be involved and a positive (...) attitude to the proposed register research. The women did not express worry after reading the study protocol, but did convey considerable frustration that this research had not been initiated earlier. Active consent was not seen as crucial. We found strong interest in a high participation rate and a concern over missing data. The selection of information and consent or the decision to go ahead without consent in register follow-up is a delicate balancing act. Study participants wish to be contacted, but acknowledge the primary goal of answering important questions. Our study provides support for safeguarding privacy in epidemiological linkage studies and in follow-up of medical treatment without losing the scientific value by requesting for informed consent. (shrink)

Background Despite its negative impact on patients and nurses, the use of restraint in somatic health care continues in many settings. Understanding the reasons and justifications for the use of restraint among nurses is crucial in order to manage this challenge. Aim To understand nurses’ justifications for restraint use in neurosurgical care. Research design A qualitative, descriptive design was used. Data were analysed with inductive qualitative content analysis. Participants and research context Semi-structured interviews with 15 nurses working in three neurosurgical (...) departments in Sweden. Ethical considerations Approved by The Regional Ethics Committee, Stockholm, Sweden. Findings The analysis resulted in three categories. The category Patient factors influencing restraint use describes patient factors that trigger restraint, such as a diminished decision-making competence, restlessness, and need for invasive devices. The category Specific reasons for justifying restraint describes reasons for restraining patients, such as restraint being used for the sake of the patient or for the sake of others. The category General reasoning in justifying restraint describes how nurses reason when using restraint, and the decision to use restraint was often based on a consequentialist approach where the nurses’ weighed the pros and cons of different alternatives. Discussion Nurses with experience of restraint use were engaged in a constant process of justifying and balancing different options and actions. Restraint was considered legitimate if the benefit exceeded the suffering, but decisions on which restraint measures to use and when to use them depended on the values of the individual nurse. Conclusion How nurses reason when justifying restraint, why they use restraint, and who they use restraint on must be considered when creating programs and guidelines to reduce the use of restraint and to ensure that when it is used it is used carefully, appropriately, and with respect. (shrink)

Restraint is regularly used in somatic healthcare settings, and countries have chosen different paths to regulate restraint in somatic healthcare. One overarching problem when regulating restraint is to ensure that patients with reduced decision-making capacity receive the care they need and at the same time ensure that patients with a sufficient degree of decision-making capacity are not forced into care that they do not want. Here, arguments of justice, trust in the healthcare system, minimising harm and respecting autonomy are contrasted (...) with different national regulations. We conclude that a regulation that incorporates an assessment of patients’ decision-making capacity and considers the patient’s best interests is preferable, in contrast to regulations based on psychiatric diagnoses or regulations where there are no legal possibilities to exercise restraint at all in somatic care. (shrink)

In Victoria, Australia, the law regulating abortion was reformed in 2008, and a clause was introduced requiring doctors with a conscientious objection to abortion to refer women to another provid...

In "Implementing Expanded Prenatal Genetic Testing: Should Parents Have Access to Any and All Fetal Genetic Information?," Bayefsky and Berkman argue in favor of establishing three categorie...

It is shown that the nonrecursive predecessors of a 1-generic degree $ are all 1-generic. As a corollary, it is shown that the 1-generic degrees are not densely ordered.

Le suivi psychologique d’une femme dans la cinquantaine est l’occasion de saisir les effets du corps malade et vieillissant sur la vie psychique. Suite à une atteinte somatique bénigne mais surchargée d’enjeux du féminin et du maternel, Toni apprend une infidélité de son mari et elle s’effondre. Les auteures interrogent comment le psychologue d’orientation psychanalytique peut entendre la souffrance contemporaine du corps et l’actualité du désamour et leurs déterminations inconscientes. Les faits somatiques et de la scène conjugale sont une porte (...) d’entrée pour revisiter des événements passés, leur charge affective et pour dénouer un contrat narcissique conjugal autour de la performance et de la réussite. (shrink)

Zusammenfassung Lebensweltliche Bedingungen können sich als Barrieren in Hinblick auf die Durchführung einer von den Patient*innen gewählten – beispielsweise onkologischen – Therapie erweisen und den Therapieerfolg gefährden. Solche lebensweltlichen Herausforderungen lassen sich als Schichten sozialer Vulnerabilität begreifen. In dieser Arbeit wird untersucht, ob es geboten ist, herausfordernde soziale Lebensbedingungen von Patient*innen systematisch bei Therapieentscheidungen zu berücksichtigen. Hierfür wird der Befähigungsansatz nach Martha Nussbaum herangezogen, der die Achtung der Patient*innenautonomie mit der Möglichkeit der Unterstützung durch Dritte zusammenbringt. Anschließend werden anhand des (...) Schichten-Konzeptes von Florencia Luna Vorschläge dafür formuliert, wie soziale Vulnerabilitäten in der Praxis erfasst werden könnten. Obwohl die Überlegungen zum vorliegenden Text aus Beobachtungen der onkologischen Behandlungssituation heraus entstanden sind, lassen sie sich auch auf andere Therapiefelder, die lange Behandlungsdauern mit regelmäßigen Anwesenheiten verlangen, übertragen. Die vorliegende Untersuchung kommt zu dem Ergebnis, dass die ethische Pflicht besteht, lebensweltliche Faktoren in gemeinsame Therapieentscheidungen miteinzubeziehen und den Patient*innen ggf. Unterstützung anzubieten, um den Zugang zu der von ihnen gewählten Therapie zu ermöglichen. (shrink)

Opinion leaders are informal leaders who have the ability to influence others' decisions about adopting new products, practices or ideas. In the healthcare setting, the importance of translating new research evidence into practice has led to interest in understanding how opinion leaders could be used to speed this process. Despite continued interest, gaps in understanding opinion leadership remain. Agent‐based models are computer models that have proven to be useful for representing dynamic and contextual phenomena such as opinion leadership. The purpose (...) of this paper is to describe the work conducted in preparation for the development of an agent‐based model of nursing opinion leadership. The aim of this phase of the model development project was to clarify basic assumptions about opinions, the individual attributes of opinion leaders and characteristics of the context in which they are effective. The process used to clarify these assumptions was the construction of a preliminary nursing opinion leader model, derived from philosophical theories about belief formation. (shrink)

Qualitative validation consists in showing that a model is able to mimic available observed data. In population level biological models, the available data frequently represent a group status, such as pool testing, rather than the individual statuses. They are aggregated. Our objective was to explore an approach for qualitative validation of a model with aggregated data and to apply it to validate a stochastic model simulating the bovine viral-diarrhoea virus (BVDV) spread within a dairy cattle herd. Repeated measures of the (...) level of BVDV-specific antibodies in the bulk-tank milk (total milk production of a herd) were used to summarise the BVDV herd status. First, a domain of validation was defined to ensure a comparison restricted to dynamics of pathogen spread well identified among observed aggregated data (new herd infection with a wide BVDV spread). For simulations, scenarios were defined and simulation outputs at the individual animal level were aggregated at the herd level using an aggregation function. Comparison was done only for observed data and simulated aggregated outputs that were in the domain of validation. The validity of our BVDV model was not rejected. Drawbacks and ways of improvement of the approach are discussed. (shrink)

General practitioners (GPs) have to negotiate a range of challenges when they suspect child abuse or neglect. This article details findings from a Delphi exercise that was part of a larger study exploring the conflicts of interest that arise for UK GPs in safeguarding children. The specific objectives of the Delphi exercise were to understand how these conflicts of interest are seen from the perspectives of an expert panel, and to identify best practice for GPs. The Delphi exercise involved four (...) iterative rounds with questionnaires completed by an expert panel. Results from each round were distilled and findings sent to panel members until consensus was reached. Panel members shared insights regarding their understanding of conflicts of interest in relation to GPs and safeguarding children and responses when conflicts of interests arise. Findings suggested a broader understanding of conflicts of interest (intrapersonal, interpersonal, interprofessional and interagency), the importance of professional judgement in uncertain situations when both action and inaction have potentially negative consequences and the importance of trust. The Delphi exercise was an effective means to bring together a wide range of professional and disciplinary perspectives on a complex topic. Findings caution against the oversimplification of the conceptual and practical issues, emphasise the importance of professional judgement, and support the development of open and trusting relationships with families and among professionals in health and social care agencies. (shrink)

Les femmes mariées restent gouvernées par les hommes qui en attendent un travail domestique ménager, culturel, social, et sexuel. La famille reste oppressive pour les femmes. Patriarcat et capitalisme sont deux systèmes d’oppression distincts. Partout, et pas seulement dans le capitalisme, le travail ménager est fait par les femmes gratuitement et obligatoirement, parfois par des domestiques qu’il faut tout de même contrôler. La hiérarchie entre les hommes et les femmes reste admise, car elle est héritée du passé. Les femmes continuent (...) de s’autosacrifier quand il faut partager au sein de la famille. (shrink)

In the past decade, the Norwegian government has emphasized user participation as an important goal in the care of mentally ill patients, through governmental strategic plans. At the same time, the governmental documents request normalization of psychiatric patients, including the re‐socialization of psychiatric patients back into society outside the psychiatric hospital. Milieu therapy is a therapeutic tool to ensure user participation and re‐socialization. Based on an ethnographic study in a long‐term psychiatric ward in a psychiatric hospital, we identified how staff (...) tried to implement user participation in their milieu‐oriented therapy work. We have identified three major tensions and challenges in implementing user participation in milieu‐therapeutic work. First, it is difficult to implement individual‐based user participation and at the same time take collective house rules and codes of conduct into consideration. Second, user participation proved a difficulty when patients’ viewpoints challenged staff judgements on proper conduct and goals for which patients might aim. Third, user participation becomes a challenge when trying to establish relationships based on equality when using milieu therapy in a biomedical hierarchical hospital structure. These tensions and challenges are seen in light of paradoxical political frames and demands on one side, and milieu therapy as a complex tradition anchored in different ideologies on the other. (shrink)

We consider questions related to the rigidity of the structure R, the PTIME-Turing degrees of recursive sets of strings together with PTIME-Turing reducibility, pT, and related structures; do these structures have nontrivial automorphisms? We prove that there is a nontrivial automorphism of an ideal of R. This can be rephrased in terms of partial relativizations. We consider the sets which are PTIME-Turing computable from a set A, and call this class PTIMEA. Our result can be stated as follows: There is (...) an oracle, A, relative to which the PTIME-Turing degrees are not rigid . Furthermore, the automorphism can be made to preserve the complexity classes DTIMEA for all k 1, or to move any DTIMEA for n 2. From the existence of such an automorphism we conclude as a corollary that there is an oracle A relative to which the classes DTIME are not definable over R. We carry out the corresponding partial relativization for the many-one degrees to construct an oracle, A, relative to which the PTIMA-many-one degrees relative to A have a nontrivial automorphism, and one relative to which the lattice of sets in PTIMEA under inclusion have a nontrivial automorphism. The proof is phrased as a forcing argument; we construct the set A to meet a particular collection of dense sets in our notion of forcing. Roughly, the dense sets will guarantee that if A meets these sets and we split A into two pieces, A0 and A1, in a simple way, and then switching the roles of A0 and A1 in all computations from A will produce an automorphism of the ideal of PTIMA-degrees below A. We force A0 and A1 to have different PTIME-Turing degree; this will then make the automorphism nontrivial. An appropriately generic set A is constructed using a priority argument. (shrink)

In “Non-invasive prenatal testing for ‘non-medical’ traits: Ensuring consistency in ethical decision-making,” Bowman-Smart et al. (2023) lay out arguments both for and against the potential use of...

Bayefsky and Berkman argue in favor of evidence-based policy development for expanded prenatal genetic testing. They propose to identify what kinds of information pregnant persons, their par...

Biobanks correspond to different situations: research and technological development, medical diagnosis or therapeutic activities. Their status is not clearly defined. We aimed to investigate human biobanking in Europe, particularly in relation to organisational, economic and ethical issues in various national contexts. Data from a survey in six EU countries were collected as part of a European Research Project examining human and non-human biobanking. A total of 147 institutions concerned with biobanking of human samples and data were investigated by questionnaires and (...) interviews. Most institutions surveyed belong to the public or private non-profit-making sectors, which have a key role in biobanking. This activity is increasing in all countries because few samples are discarded and genetic research is proliferating. Collections vary in size, many being small and only a few very large. Their purpose is often research, or research and healthcare, mostly in the context of disease studies. A specific budget is very rarely allocated to biobanking and costs are not often evaluated. Samples are usually provided free of charge and gifts and exchanges are the common rule. Good practice guidelines are generally followed and quality controls are performed but quality procedures are not always clearly explained. Associated data are usually computerised. Biobankers generally favour centralisation of data rather than of samples. Legal and ethical harmonisation within Europe is considered likely to facilitate international collaboration. We propose a series of recommendations and suggestions arising from the EUROGENBANK project. (shrink)

Harvey and Gurvir’s Law is a bill proposed to the Legislative Assembly of Ontario (Canada) to reduce stigma and bias associated with Down syndrome, by developing and disseminating quality information about Down syndrome in the context of prenatal testing.

In order to support the professional development of high school preservice teachers during their initial university training as reflective practitioners an innovative educational design was placed in a classroom management course. With this design, inspired by the principles of the learning community (Brown, 1994), has assisted students to develop a collective discourse on their professional practice through their own issues in the secondary classroom management and their concerns during a five weeks internship. We make the assumption that the participation in (...) the development of a collective discourse on professional practice allows students to not only reflect on their practice, but also to gain significant professional learning. Thus, our study focuses on student engagement in the development of collective discourse and actions enabling them to advance it. (shrink)