Background Genuine uncertainty on superiority of one intervention over the other is called equipoise. Physician-investigators in randomized controlled trials need equipoise at least in studies with more than minimal risks. Ideally, this equipoise is also present in patient-participants. In pediatrics, data on equipoise are lacking. We hypothesize that 1) lack of equipoise at enrolment among parents may reduce recruitment; 2) lack of equipoise during participation may reduce retention in patients assigned to a less favoured treatment-strategy. Methods We compared preferences of (...) parents/patients at enrolment, documented by a questionnaire, with preferences developed during follow-up by an interview-study to investigate equipoise of child-participants and parents in the BeSt-for-Kids-study. This trial in new-onset Juvenile Idiopathic Arthritis-patients consists of three strategies. One strategy comprises initial treatment with a biological disease-modifying-antirheumatic-drug, currently not standard-of-care. Semi-structured interviews were conducted with 23 parents and 7 patients, median 11 months after enrolment. Results Initially most parents and children were not in equipoise. Parents/patients who refused participation, regularly declined due to specific preferences. Many participating families preferred the biological-first-strategy. They participated to have a chance for this initial treatment, and would even consider stopping trial-participation when not randomized for it. Their conviction of superiority of the biological-first strategy was based on knowledge from internet and close relations. According to four parents, the physician-investigator preferred the biological-first-strategy, but the majority stated that she had no preferred strategy. In phase 2, preferences tended to change to the treatment actually received. Conclusions Lack of equipoise during enrolment did not reduce study recruitment, mainly due to the fact that preferred treatment was only available within the study. Still, when developing a trial it is important to evaluate whether the physicians’ research question is in line with preferences of the patient-group. By exploring so-called ‘informed patient-group’-equipoise, successful recruitment may be enhanced and bias avoided. In our study, lack of equipoise during trial-participation did not reduce retention in those assigned to a less favoured option. We observed a change for preference towards treatment actually received, possibly explained by comparable outcomes in all three arms. (shrink)

Group dynamics play an important role in the social interactions of both children and adults. A large amount of research has shown that merely being allocated to arbitrarily defined groups can evoke disproportionately positive attitudes toward one’s in-group and negative attitudes toward out-groups, and that these biases emerge in early childhood. This prompts important empirical questions with far-reaching theoretical and applied significance. How robust are these inter-group biases? Can biases be mitigated by behaviors known to bond individuals and groups together? (...) How can bonds be forged across existing group divides? To explore these questions, we examined the bonding effects of interpersonal synchrony on minimally constructed groups in a controlled experiment. In-group and out-group bonding were assessed using questionnaires administered before and after a task in which groups performed movements either synchronously or non-synchronously in a between-participants design. We also developed an implicit behavioral measure, the Island Game, in which physical proximity was used as an indirect measure of interpersonal closeness. Self-report and behavioral measures showed increased bonding between groups after synchronous movement. Bonding with the out-group was significantly higher in the condition in which movements were performed synchronously than when movements were performed non-synchronously between groups. The findings are discussed in terms of their importance for the developmental social psychology of group dynamics as well as their implications for applied intervention programs. (shrink)

This essay examines why the recent recognition of human rights violations against women, as exemplified by Amnesty International's 1995 report on women, remains bound to the limitations of traditional approaches to human rights. The essay argues that despite Amnesty International's commitment to incorporating violations against women into its activities, it nevertheless upholds questionable assumptions about the gendered subject, gender relations within the family, and the relationship between the family and the state.

Review of Timothy Brennan (2021) Places of Mind: A Life of Edward Said. London: Bloomsbury.

Background:Forgiveness has the potential to resolve painful feelings arising from nurse–patient conflicts. It would be useful to evaluate direct and indirect important factors which are related to forgiveness in order to design interventions that try to facilitate forgiveness.Aim/objective:The purpose of this study was to evaluate the intermediating role of empathy in the cultural competence–forgiveness association among nurses using structural equation modeling.Research design:The research applied a cross-sectional correlational design.Participants and research context:The study included 380 nurses eight hospitals in southern Iran.Ethical considerations:The (...) Ethics and Research Committee of Birjand University of Medical Sciences approved the study protocol. The voluntary nature of participation was explained consent was obtained from participants, and anonymity was guaranteed.Findings:Most of the participants were married and female and fell in the 20- to 30-year-old category. Most of them (89.5%) had a working experience of 1–10 years. The proposed model showed that nurses’ empathy intermediated the association between nurses’ cultural competence and forgiveness which has fitted the data acceptably (root mean square error approximation = 0.070; comparative fit index = 0.993; goodness-of-fit index = 0.983; and χ2/df = 2.85).Conclusion:Empathy skills and cultural competence training were essential for interventions aimed at increasing the tendency to forgive patients. In such interventions, planners should aim at increasing nurses’ cultural competence in order to enhance their empathy toward patients, which can, in turn, lead to a greater wish to forgive patients. (shrink)

The reflections that follow are written by Roisin Winston, Zoe Carletide, Naomi McLeod and Bahar Mustafa. These four young women outline their experience of feminism and in so doing suggest ways in which the Next Generation are thinking about ‘feminism’ and its relevance to their modern day lives. Topics discussed include sexuality, cultural differences, sex education, rape, and how the face of feminism is changing or needs to change. Thoughts range from a belief that the word ‘feminism’ has too (...) many negative connotations and thus it seems the term, and therefore the movement, is restricted by the glass ceiling which it aims to fight. Another view is that ‘Feminism,’ like any movement, will remain as relevant as it always has been until no person of any gender is coerced or compelled to act, think, feel or endure anything which has reductive gender inequality at its core. (shrink)

PurposeCancer can be a burden on the relationship and even lead to relationship dissolution. Previous studies about the impact of cancer on close relationships almost exclusively involve cancer patients. So far, little is known about the views of spouses. Therefore, this study focuses on partners or ex-partners of cancer patients.MethodsIn this cross-sectional study, N = 265 partners or ex-partners of cancer patients are examined regarding a possible separation, the reasons for separation and the influence of the cancer on the relationship. (...) In addition, predictors of separation and the positive or negative perception of the impact of cancer on the relationship were investigated.ResultsThe separation rate was marginally lower than in the general population in Germany. The most frequent reason for separation was the death of the cancer patient, followed by relationship problems, and the cancer disease itself. Among those who were separated, 57.4% reported that cancer contributed to the separation. On average, the influence of cancer on relationship dissolution is indicated with 82.9%. Also, for those who stayed together, 83.7% reported an impact of the cancer on the relationship, of which 55.9% reported a negative impact. Logistic regressions indicated that higher levels of depression were associated with greater odds of a more negative perception of the influence of cancer on the relationship, whereas a more satisfied relationship tended to be associated with a more positive perception. Those who had no psychological treatment in the past, lower anxiety levels and lower relationship satisfaction had an increased risk of separation. Overall, relationship satisfaction was significantly lower than in the general population in Germany.ConclusionIn particular, psychological factors such as depression and anxiety as well as relationship satisfaction appear to be factors influencing separation and the perception of the influence of cancer on the relationship as positive or negative. Therefore, it seems to be reasonable to consider these aspects in the psychosocial support and also to include the partners in order to achieve a stable and satisfied relationship which has a positive effect on health and psychological well-being. (shrink)

We begin by distinguishing computationalism from a number of other theses that are sometimes conflated with it. We also distinguish between several important kinds of computation: computation in a generic sense, digital computation, and analog computation. Then, we defend a weak version of computationalism—neural processes are computations in the generic sense. After that, we reject on empirical grounds the common assimilation of neural computation to either analog or digital computation, concluding that neural computation is sui generis. Analog computation requires continuous (...) signals; digital computation requires strings of digits. But current neuroscientific evidence indicates that typical neural signals, such as spike trains, are graded like continuous signals but are constituted by discrete functional elements (spikes); thus, typical neural signals are neither continuous signals nor strings of digits. It follows that neural computation is sui generis. Finally, we highlight three important consequences of a proper understanding of neural computation for the theory of cognition. First, understanding neural computation requires a specially designed mathematical theory (or theories) rather than the mathematical theories of analog or digital computation. Second, several popular views about neural computation turn out to be incorrect. Third, computational theories of cognition that rely on non-neural notions of computation ought to be replaced or reinterpreted in terms of neural computation. (shrink)

Roots, Cogwheels and Clouds: A Tale of Encounters In her first book The Illusion of Freedom published in 2006 and in The Age of Gluttony published in 2010 Yıldız Silier focused on the notions of freedom and happiness respectively. This last book on justice completes her trilogy. Instead of taking injustices as a discourse on victimization, she focuses on the life experiences of resisting subjects and collates them through semi fictional tales, letters and diaries. The concrete, material foundations of injustices (...) are exposed in the Roots. The Cogwheels, puts forward what happens when the rebellions fail and the Clouds predict what would have happened if the rebellions had succeeded. Through these three axes, the past (the lost possibilities), the present (dystopia) and the future (utopia) are merged. -/- Those that resist the dictator in the country of animals, peasant risings in the 14th century England, women’s rebellion during the witch hunts in the 16th century Italy, 18th century slave riots in the plantations of West Indies and in workers’ rebellion in the 21st century in a Chinese factory that produces tablets and mobile phones; these are the main subjects of these semi fictional tales. In the second part of the book on “the meeting of old class mates” five friends having different political views discuss “what will happen to our country?” and uncompromising conflicts appear. The last part of the book includes three essays on the Gezi rebellion, Pontecorvo’s film Burn and Calvino’s book Invisible Cities. (shrink)

Kapitalizm, bireysel özgürlüğün son durağı mı? Liberal kuramcılar diyor ki: "Serbest piyasa ekonomisi, belki eşitlik, kardeşlik ve adalet sağlayamıyor ama hiç olmazsa özgürlüğü garanti altına alıyor." Özgürlüğün, tüketicilerin marka seçme özgürlüğüne ya da soyut vatandaşların eşit yasal haklarına indirgenemeyeceğini düşünüyorsak, liberalizmin ilk eleştirmenlerinden Rousseau ve Marx'ın alternatif özgürlük anlayışlarından hâlâ öğreneceğimiz çok şey var. Çoğumuz, ya özgürlüğü kuralsızlık olarak tanımlayıp, mutlak özgürlüğün hiçbir toplumda var olamayacağını düşünüyoruz, ya da özgürlüğü "özel alan" içindeki serbestliğe indirgeyip, kendimizi özgür hissetmenin özgür olmak için (...) yeterli olduğuna inanıyoruz. Peki, ya Rousseau'nun iddia ettiği gibi ayağımızdaki zincirleri halhal zannedip çiçeklerle süslüyorsak? Özgürleşmenin ilk adımı, şu anda neden özgür olmadığımızı kavramaktan geçiyor. Modern toplumda içine düştüğümüz "özgürlük yanılsaması"nı açıklayan Rousseau ve Marx, özgürlüğün ihtiyaçlarla ilişkisine dair iki farklı tez öne sürüyor. Rousseau'ya göre, uygarlık, arzuları ve bağımlılıkları artırdıkça toplumlar yozlaşır ve insanlar farkına varmadan özgürlüklerini kaybeder. Özgürlüğün koşulu "yapay arzular"dan kurtularak yetenekler ve ihtiyaçlar arasında denge kurulmasıdır. Oysa Marx'a göre özgürleşme ancak ihtiyaçların artması ve insancıllaşmasıyla mümkündür. Bütün ihtiyaçlarımızı para ihtiyacına indirgeyen "meta fetişizmi"nden kurtulma mücadelesi, yabancılaşmanın aşılmasının da önünü açar. Bu kitap, "Biz kimiz? Nereden geldik? Nereye gidiyoruz? Nasıl özgürleşebiliriz?" sorularının peşine düşen herkesi düşünsel bir yolculuğa davet ediyor. (shrink)

A picture which reflects the contradictions of our era: Glutton adults, who are always bored and constantly demand new toys and hungry children who have grown untimely. Completely different lives in the same world: Those in the display windows and those in the garbage... This picture is the starting point of the Age of Gluttony. -/- Silier who uses a plain and fluent language, starts from a story of Kafka and touches upon the reasons of obedience to authorities, the internal (...) fears that hinder freedom and issues related with the “meaning of life”. She then proceeds by searching answers to new questions: How does the fetishism of happiness encourage individualism and prevent the flourishing of individuality? Taking inspiration from Kant, Marx, Mill and Sartre can we form a conceptual frame for critical and objective ethical values? -/- What are the different accounts of individuality that lay at the foundations of Marx’s goal of overcoming alienation and existentialists’ yearning for authenticity? How does postmodernism confuse different conceptions of “reason” and “progress”, to charge the Enlightenment as guilty for the crimes and devastation caused by capitalism? How were women transformed through history from goddess to pariah by being domesticated? Can motherhood experiences be saved from the oppressive effects of “motherhood ideology” and have a liberating potential? What kind of link exists between narcissistic individuals who relate freedom with the absence of rules and limits and the ideology of consumerism, which redefines gluttony as a virtue? As greedy companies which rule the world shape both consumers and employers in their image, how does the “irrational” system at the basis of “deformed” and alienated individuals become naturalised and invisible? (shrink)

Substance use disorders (SUDs) constitute a growing global health crisis, yet many limitations and challenges exist in SUD treatment research, including the lack of objective brain-based markers for tracking treatment outcomes. Electroencephalography (EEG) is a neurophysiological technique for measuring brain activity, and although much is known about EEG activity in acute and chronic substance use, knowledge regarding EEG in relation to abstinence and treatment outcomes is sparse. We performed a scoping review of longitudinal and pre-post treatment EEG studies that explored (...) putative changes in brain function associated with abstinence and/or treatment in individuals with SUD. Following PRISMA guidelines, we identified studies published between January 2000 and March 2022 from online databases. Search keywords included EEG, addictive substances (e.g., alcohol, cocaine, methamphetamine), and treatment related terms (e.g., abstinence, relapse). Selected studies used EEG at least at one time point as a predictor of abstinence or other treatment-related outcomes; or examined pre- vs. post-SUD intervention (brain stimulation, pharmacological, behavioral) EEG effects. Studies were also rated on the risk of bias and quality using validated instruments. Forty-four studies met the inclusion criteria. More consistent findings included lower oddball P3 and higher resting beta at baseline predicting negative outcomes, and abstinence-mediated longitudinal decrease in cue-elicited P3 amplitude and resting beta power. Other findings included abstinence or treatment-related changes in late positive potential (LPP) and N2 amplitudes, as well as in delta and theta power. Existing studies were heterogeneous and limited in terms of specific substances of interest, brief times for follow-ups, and inconsistent or sparse results. Encouragingly, in this limited but maturing literature, many studies demonstrated partial associations of EEG markers with abstinence, treatment outcomes, or pre-post treatment-effects. Studies were generally of good quality in terms of risk of bias. More EEG studies are warranted to better understand abstinence- or treatment-mediated neural changes or to predict SUD treatment outcomes. Future research can benefit from prospective large-sample cohorts and the use of standardized methods such as task batteries. EEG markers elucidating the temporal dynamics of changes in brain function related to abstinence and/or treatment may enable evidence-based planning for more effective and targeted treatments, potentially pre-empting relapse or minimizing negative lifespan effects of SUD. (shrink)

The aim of this study was to investigate the effects of Islam as a religion and culture on Turkish women’s health. The study included 138 household members residing in the territory of three primary health care centers in Turkey: Güzelbahçe, Fahrettin Altay and Esentepe. Data were collected by means of a questionnaire prepared by a multidisciplinary team that included specialists from the departments of public health, psychiatric nursing and sociology. We found that the women’s health behavior changed from traditional to (...) rational as education levels increased, and that religious and traditional attitudes and behaviors were predominant in the countryside, especially practices related to pregnancy, delivery, the postpartum period, induced abortion and family planning. One of the most important prerequisites for the improvement of women’s health is that nurses should know the religious practices and culture of the society for which they provide care, so that their efforts to protect and improve women’s health will be effective. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Helping a Muslim Family to Make a Life–and–Death Decision for Their Beloved Terminally Ill FatherBahar BastaniI live in a city in the Midwest with a population of around two million people. There are an estimated 2,000 Iranians living in this city, the vast majority of which belong to Shia sect of Islam. [End Page 190] However, the vast majority is also not very religious. Over the past two decades (...) that I have been living in this city, professionally in the capacity of a physician and university faculty at a school of medicine, and socially as one of the community leaders with a particular role in religious matters, I have acquired the trust of my community. Following one of my yearly routine travels to my homeland, Iran, I had just returned to work when I received a phone call from one of the Iranian community members. He informed me that his father was very ill and was hospitalized, and that the physicians had introduced the idea of stopping life support. The family was experiencing a significant emotional, moral and religious dilemma as to whether they could consent to this. I was requested by the patient’s children to help them make the right decision.I requested that the oldest son, who had called me, to ask the three other siblings and their mother to be present at the bedside of the patient that night, so that we could discuss the matters face–to–face. That same night, all requisite family members and myself gathered at the bedside of this 88–year–old husband and father, who had developed multi–organ failure, which commenced with an infection following a heart valve replacement, followed by bacteremia and sepsis. Moreover, the patient was hypotensive, had developed respiratory failure requiring intubation and artificial ventilation, and had also developed hematologic coagulation abnormalities secondary to sepsis. Because of the sepsis, hypotension, and multiple drugs, including antibiotics and vasopressors, his kidneys had also failed, and there was a need to start hemodialysis if his life was to be maintained. After speaking with the intensive care physicians who were taking care of this elderly gentleman, it became clear to me that further care was futile, and there was absolutely no hope for him to recover from his multiple organ failure. I presented all the facts that I had acquired to the family members, and expressed my own viewpoint that I agreed with those physicians and that further care of their beloved, terminally ill husband and father was futile and only extended his dying. My assurances made it easier for the family members, particularly for his four sons who were present, to come to the decision to withdraw life support. After I informed the intensive care physicians of the family’s decision, the patient was heavily sedated with morphine, and the intravenous fluids, antibiotics, vasopressors, and the ventilator machine were all stopped. Over the next several minutes, the patient developed agonal breathing, his blood pressure dropped to zero, and his heart stopped. During the last few minutes of his life, I held the hands of the family members, we all prayed Islamic prayers to bless his soul while departing from his body. The next day, I supported the family with funeral services that included the Islamic prayers for the dead, the ceremonial religious washing of the body of the deceased, and the ceremonial religious burial.The dilemma that this family faced was multi-factorial: (1) the children had spent all of their adult life in America, and were unfamiliar with Islamic end of life and funeral traditions; (2) they had been asked by their father’s physicians to make a decision regarding the withdrawal of life support, which posed a moral and ethical dilemma; (3) they did not know whether it was religiously acceptable to withdraw life support; and (4) they did not know what type of funeral service would be acceptable to the religious beliefs of their deceased father.My presence as a trusted community leader, physician and religious leader was reassuring to the family members that the decision to stop life support for their loved one with a terminal illness and multiple organ... (shrink)

The primary aim of this study is to clarify the authorship trends, collaboration patterns, and impact factors in business ethics literature by looking at articles published between 1960 and 2015 in four leading business ethics journals: Business and Society, Business Ethics: A European Review, Business Ethics Quarterly, and the Journal of Business Ethics. This study showed the growth type of business ethics literature, authorship trends, collaboration patterns, authors' productivity evolved by subperiods and journals, and authors' dominance factor by subperiods and (...) journals. After providing an evaluation of the results of the study, the authors discuss the study's limitations and suggestions for future research. (shrink)

In this study, the relationship between adolescents' perception of God, forgiveness inclination and anger was examined. For this purpose, it was determined whether the perception of God, forgiveness inclination, the trait anger and anger expression styles of the adolescents studying in different educational institutions differ according to demographic variables and the relationship between the adolescents' perception of God, forgiveness inclination and anger was determined. The sample of the study consists of 596 10th grade students studying in different types of high (...) schools in the city center of Ankara. The Demographic Information Form, The Forgiveness Inclination Scale, The God Perception Scale, The Trait Anger and Anger Expression Style Scale were used as data collection tools. The obtained data were analyzed with the unrelated samples t test when the scale scores of the two-category variables were normally distributed and with the Mann-Whitney U test when there was no normal distribution. For variables with more than two categories, the analysis of variance (ANOVA) was used in cases where the scale scores were normally distributed, and the Kruskal-Wallis H test was used in cases where the normal distribution could not be determined. As a result of the research, statistically significant differences were found in the scores of the sub-dimensions of the scales applied according to the demographic variables. In addition between the Forgiveness Inclination Scale distancing sub- dimension and trait anger, anger-out dimensions; It was determined that there was a positive, moderately statistically significant relationship between the forgiveness inclination scale revenge sub- dimension and trait anger, anger-in, anger-out dimensions. The findings were discussed in the light of the literature. (shrink)

In recent years, issues of childhood obesity, unsafe toys, and child labor have raised the question of corporate responsibilities to children. However, business impacts on children are complex, multi-faceted, and frequently overlooked by senior managers. This article reports on a systematic analysis of the reputational landscape constructed by the media, corporations, and non-government organizations around business responsibilities to children. A content analysis methodology is applied to a sample of more than 350 relevant accounts during a 5-year period. We identify seven (...) core responsibilities that are then used to provide a framework for enabling businesses to map their range of impacts on children. We set out guidelines for how to identify and manage the firm’s strategic responsibilities in this arena, and identify the␣constraints that corporations face in meeting such responsibilities. (shrink)

Sosyal politikalar dezavantajlı gruplara fayda sağlamak amacıyla oluşturulmaktadır. Ancak bazı durumlarda bu politikalara duyulan güven düzeyinin düşük olması bir takım olumsuz sonuçlar doğurabilmektedir. Zihinsel engelli çocuğa sahip ebeveynlerin yaşadıkları ölüm kaygısı bu olumsuz sonuca bir örnek teşkil etmektedir. Bu noktadan hareketle çalışmada zihinsel engelli çocuğu olan annelerin sosyal politikalara duydukları güvenin çocuklarından önce ölme kaygısına etkileri araştırılmıştır. Araştırmada yalnızca zihinsel engelli çocuğu anneler ile görüşülmesinin temel sebebi, Türkiye İstatistik Kurumu (2011) verilerine göre zihinsel engelli çocuğun bakımını yüksek bir oranla (%81) (...) annelerin üstlenmesidir. Ayrıca ülkemizde engel türlerinin oranları incelendiğinde, yine Türkiye İstatistik Kurumu (TÜİK, 2011) verilerine göre en büyük grubu %29,2 ile zihinsel engelliler teşkil etmektedir.Çalışmada Kasım 2017 - Ocak 2018 tarihleri arasında, İstanbul ilinde ikamet eden beş anne ile yapılan ve yarı yapılandırılmış görüşme formu ile elde edilen verilerden ulaşılan bulgular sunulmuştur. Görüşmeler esnasında ses kaydı alınmış, sonra yazıya geçirilmiş ve ardından sorular temelinde oluşturulan başlıklar altında veriler değerlendirilmiştir. Sosyal politikalara güven eksikliğinin zihinsel engelli çocuğu olan annelerin ölüm kaygılarının nedenleri arasında olduğu; çocuklarından önce ölme korkusu nedeniyle de “Çocuğumu benden sonraya bırakma Allah’ım” diye dua ettikleri tespit edilmiştir. Kaygı veren bu durumun temel sebepleri üzerinde durulmuş, sosyal politikalar ile ilişkisi incelenerek sorunun çözümü ve giderilmesi için çeşitli öneriler getirilmiştir. (shrink)