This study seeks to understand, in the context of intersectional theory, the roles of family members in nursing home care. The unique social locus at which each person sits is the result of the intersection of gender, status, ethnicity and class; it is situational, shifting with the context of every encounter. A content analysis of 15 qualitative interviews with relatives of nursing home residents in Sweden was used to gain a perspective on the relationships between relatives and residents, relatives and (...) the nursing home as an institution, and relatives and the nursing home staff. We sought to understand these relationships in terms of gendered notions of the family and the residents, which are handed down from generation to generation and thus condition who and how relatives should be involved in care, and the ways in which relationships change as care moves from home to nursing home. It requires knowledge and awareness that the nursing home culture is based on intersectional power structures in order for relatives to be involved in nursing home care in alternative and individual ways. (shrink)

Cultural selection models aim to explain cultural phenomena as the products of a selective process, often characterising institutions, practices, norms or behaviours as adaptations. I argue that a lack of attention has been paid to the explanatory power of cultural selection frameworks. Arguments for cultural selection frequently depend on demonstrating only that selection models can in principle be applied to culture, rather than explicitly demonstrating the explanatory payoffs that could arise from their application. Understanding when and how cultural selection generates (...) powerful explanations is crucial to evaluating cultural selection, as well as realising its promised epistemic and practical benefits. I argue that the ability for cultural selection to explain ‘design without a designer’ is crucial to successful and powerful cultural selection explanations. I introduce the strategy of comparing cultural selection to goal-directed agent accounts in order to evaluate when cultural selection can provide distinctive explanatory payoffs, drawing on two case studies to illustrate the benefits of this strategy. I argue that a focus on phenomena which cannot be explained through intention or agency-based explanations in particular could provide a fruitful avenue to identifying the cases where cultural selection can be insightfully applied. (shrink)

Some cultural evolution researchers have argued for the importance of prestige bias as a systematic and widespread social learning bias, that structures human social learning and cultural transmission patterns. Broadly speaking, prestige bias accounts understand it as a bias towards copying ‘prestigious’ individuals. Prestige bias, along with other social learning biases, has been argued to pay a crucial role in allowing cumulative cultural selection to take place, thereby generating adaptations that are key to our success as a species. However, I (...) argue for skepticism about the plausibility and scope of a prestige bias account. I argue that although an account of prestige bias seems plausible or compelling on their face, it is committed to a particular view of the cognition underpinning the bias, and therefore to predictions regarding its flexibility and context-sensitivity. Given this, current empirical evidence gives us reason to doubt the explanatory value of a prestige bias account over a naive, goal-directed agent account. Additionally, the way that prestige is defined in empirical work is in tension with a general understanding of prestige, casting doubt upon its status as evidence of prestige bias. I examine two studies cited as evidence of prestige bias, arguing that in these cases we cannot clearly favour a prestige bias explanation over a goal-directed agent explanation. (shrink)

Moral distress (MD) has received considerable attention in the nursing literature over the past few decades. It has been found that high levels of MD can negatively impact nurses, patients, and their family and reduce the quality of patient care. This study aimed to investigate the potentially effective interventions to alleviate MD in critical care nurses. In this systematic review, a broad search of the literature was conducted in the international databases including PubMed/MEDLINE, Web of Science, and Scopus, as well (...) as Google Scholar search engine using keywords such as moral distress, intensive care unit, ICU, nurses, and critical care nurses from 1984, when the concept of MD was first introduced in the nursing literature, up to 29 October 2020. Studies focusing on the interventions for managing MD in critical care nurse were evaluated. The quality of eligible papers was assessed using the Joanna Briggs Institute (JBI) critical appraisal checklist. A total of 8 studies fulfilled the eligibility criteria. Three studies had RCT design and five studies had quasi-experimental design. All studies were conducted in the United States or Iran. Educational workshop, moral empowerment program, social work intervention, nursing ethics huddles, and multifaceted resiliency bundle intervention were effective interventions for managing of MD among critical care nurses. There is limited but promising research evidence evaluating the efficacy of educational interventions for managing of MD among critical care nurses. Although some positive results have been reported, there is limited generalizable evidence due to the variability of interventions. These findings highlight the need for further studies to validate the efficacy of these interventions or develop more potent and efficient interventions for reducing MD in critical care nurses. (shrink)

The slogan that ‘the virus doesn’t discriminate’ has been belied by the emergence of stark and persistent disparities in rates of infection, hospitalisation, and death from Covid-19 between various social groups. I focus on two groups that have been disproportionately affected, and that have been constructed or designated as particularly ‘at-risk’ during the Covid-19 pandemic: racial or ethnic minorities and fat people. I trace the range of narratives that have arisen in the context of explaining these disparities, in both the (...) scientific literature and wider expert and public discourse. I show that the scientific and public narratives around these groups have differed significantly, revealing contested and competing conceptions of the basis of these categories themselves. These different conceptions have important impacts on the kinds of interventions that become possible or desirable. I show that in the case of racial or ethnic disparities, genetic narratives have been combatted by a strong focus on structural racism as a driver of pandemic inequalities. However, in the case of fatness, individualising and stigmatising narratives have dominated discussions. I suggest that, given racial or ethnic differences in prevalence of fatness, and scholarship casting anti-fatness as historically racialised, the stigmatisation of fatness disproportionately affects racial or ethnic minorities in terms of placing individual blame or responsibility for the increased burden of Covid-19 on these groups. Despite widespread acknowledgement of the role of structural racism in driving racial inequalities in the burden of Covid-19, anti-obesity rhetoric and research provides a ‘backdoor’ to placing blame on individuals from racial minorities. (shrink)

Background Moral distress is a complex and challenging issue in the nursing profession that can negatively affect the nurses’ job satisfaction and retention and the quality of patient care. This study focused on describing the resources and constraints, consequences, and interventions of moral distress in nurses. Methods In a literature review, an extensive electronic search was conducted in databases including PubMed, ISI, Scopus as well as Google Scholar search engine using the keywords including “moral distress” and “nurses” to identify resources, (...) constraints, consequences, and interventions about moral distress in nurses, from the earliest records up to 26 December 2020. The required data were extracted from 61 relevant studies by two independent reviewers. Results Resources and constraints in the occurrence of moral distress among nurses can be divided into three general categories including internal factors, clinical factors, and external factors. The consequences of moral distress on nurses and the medical system reduced moral sensitivity, development of psychological and physical health problems, and the intention to leave the profession. The potential effective interventions were the implementation of integrated communication programs, strengthening physician–nurse collaboration, nursing involvement in clinical decision-making and end-of-life issues, social support, using a resiliency bundle, interdisciplinary discussion, and promoting nurses’ ethical and communication skills. Conclusion There are a wide range of resources and constraints impacting moral distress in nurses that could lead to negative consequences. Further studies are necessary to identify, evaluate, and implement a range of potential effective interventions for the management of moral distress in nurses. (shrink)

In recent years, postgenomic research, and the fields of epigenetics and microbiome science in particular, have described novel ways in which social processes of racialization can become embodied and result in physiological and health-related racial difference. This new conception of biosocial race has important implications for philosophical debates on the ontology of race. We argue that postgenomic research on race exhibits two key biases in the way that racial schemas are deployed. Firstly, although the ‘new biosocial race’ has been characterized (...) as social race entering into biological processes, it is only particular aspects of social race that are taken to cross the biosocial boundary, resulting in a distorted view of the social component of biosocial race. Secondly, racial categories are assumed to be stable across time and space. This assumption is epistemically limiting, as well as indicating a reliance on a fixed racial ontology. However, the causal pathways for the embodiment of social race, and the different possible modes of embodiment, that postgenomic science is uncovering themselves present a challenge for fixed or static racial ontologies. Given these tensions, we argue that the emerging picture of a shifting landscape of entanglement between the social and the biological requires us to increase the complexity of our ontologies of race, or even embrace a deflationary metaphysics of race. (shrink)

This article aims at showing the potentiality of Transcendent Theosophy in the creation of peace and denial of religious violence. Belief in Necessary Being that is identical to beauty and perfection is one of the central issues in Islamic philosophy, particularly Mulla Sadra’s Transcendent Theosophy. This belief has different stages, the highest one of which is a love-based sense of humbleness before God who is the source of beauty. Thus, faith in the thought of Mulla Sadra is one of the (...) aesthetic categories. Surrender to such a Being leads to love in him and his effects. Thus, in Transcendent Theosophy, love in God is followed by the love in people. This love is associated with the sense of responsibility and the effort for the realisation of people’s rights. In the final part of the article under the title ‘Mulla Sadra and Confrontation of Two Types of Religious Understanding’, through the analysis of Mulla Sadra’s dialogue with a religious radical, we have criticised the discourse of religious violence and concluded that Transcendent Theosophy is a defender of human rights and a pioneer of peace and a despiser of religious violence. The most important finding of this study is that according to Mulla Sadra, religious radical interpretations are the source of the emergence of religious violence, and the solution to this problem is the promotion of rational and conscious religiosity. The method used in this research is of descriptive-analytic type.Contribution: The article brought to fore the potentiality of Islamic philosophy for the realisation of peace and the denial of religious violence. The authors analytically studied Mulla Sadra’s pacifist foundations in order to ascertain its relation with non-violence towards humans. The main contribution of this article is that the teachings of Transcendent Theosophy are very useful for creating peaceful coexistence between human beings. (shrink)

Background: Discrimination and injustice are big obstacles in nurses’ way to socialization and are among the major clinical challenges faced by nurses. Workplace discrimination is associated with such negative consequences as stress, fatigue, demoralization, loss of professional commitment, tension and conflicts at work, and resignation. A review of literature shows that not much research has been dedicated to workplace discrimination in nursing. Objective: This study aims to investigate nurses’ perception of workplace discrimination. Method: This cross-sectional study was conducted in the (...) hospitals affiliated with a university of medical sciences in the largest city in the south of Iran in 2019. The participants consisted of 597 nurses who were selected through stratified random sampling. Data were collected using a researcher-made workplace discrimination questionnaire and analyzed in SPSS v. 21. Findings: The mean of the nurses’ workplace discrimination scores was found to be 102.57 ± 14.5, which is considered as moderate. The nurses’ mean scores for the dimensions of vertical and horizontal discrimination, consequences of discrimination, and unfair promotion were moderate. As for the two other dimensions of workplace discrimination, namely, gender discrimination and cultural-organizational discrimination, the participants’ mean scores were low. There was a significant relationship between the nurses’ workplace discrimination mean score on the one hand and their employment status and work experience on the other. However, the nurses’ workplace discrimination mean score was not found to correlate with their level of education, marital status, and gender. Ethical consideration: This study has been approved by the ethics committee of the university. All the participants had signed the written informed consent form before participation. Conclusion: Hospital managers should take measures to reduce discrimination and establish organizational justice to raise nurses’ morale and improve the quality of their performance as caregivers. (shrink)

Neurofibromatosis type 1 is associated with peripheral and central nervous system tumors. It is noteworthy that the regions in which these tumors frequently arise are the optic pathways and the brainstem. Thus, we decided to trace the procedure of diffusion Magnetic Resonance Imaging alterations along with Short-Wavelength Automated Perimetry examinations of the OPs after surgery and chemotherapy over 1 year, which enabled us to evaluate chemotherapy's efficacy in an NF1 patient with an OP tumor. In this study, a 25-year-old woman (...) with NF1 and left optic radiation glioma underwent surgery to remove the glioma. Immunohistochemistry revealed a Pilocytic Astrocytoma WHO grade I. Post-operation chemotherapy done using nine treatment cycles of administering Temozolomide for 5 days every 4 weeks. Applying the region of interest differential tractography method and SWAP four times every 3 months allowed us to follow the patient's visual acuity alterations longitudinally. The differential deterministic tractography method and statistical analyses enabled us to discover the white matter tracts anisotropy alterations over time. Furthermore, statistical analyses on the SWAP results along time illustrated possible alterations in visual acuity. Then, we could compare and associate the findings with the SWAP examinations and patient symptoms longitudinally. Statistical analyses of SWAP tests revealed a significant improvement in visual fields, and longitudinal differential tractography showed myelination and dense axonal packing in the left OR after 1 year of treatment. In this study, we examined an old hypothesis suggesting that chemotherapy is more effective than radiotherapy for NF1 patients with OP gliomas because of the radiation side effects on the visual field, cognition, and cerebrovascular complications. Our longitudinal clinical case study involving dMRI and SWAP on a single NF1-OPG patient showed that chemotherapy did not suppress the OP myelination over time. However, it should be noted that this is a clinical case study, and, therefore, the generalization of results is limited. Future investigations might focus on genetic-based imaging, particularly in more cases. Further, meta-analyses are recommended for giving a proper Field Of View to researchers as a subtle clue regarding precision medicine. (shrink)