Purpose:To test the hypothesis that supernatural agents appear in nightmares and dreams in association with evidence of diminished agency within the dreamer/dream ego.Methods:Content analyses of 120 nightmares and 71 unpleasant control dream narratives.Results:We found that SAs overtly occur in about one quarter of unpleasant dreams and about half of nightmares. When SAs appear in a dream or nightmare they are reliably associated with diminished agency in the dreamer. Diminished agency within the dreamer occurs in over 90% of dreams that have (...) overt SAs. In about half of nightmare reports the SA appears suddenly with no clear emergence pattern. In some two thirds of unpleasant dreams, however, the SA emerged from a human character. The SA’s gender was indeterminate in most dreams with SAs but the SA communicated with the dreamer in 24% of nightmares and only 13% of unpleasant dreams. In most nightmares, the SA intended to harm the dreamer and in one third of nightmares the dreamer was the victim of physical agression by the SA. SA intentions in unpleasant dreams were more varied and actually benign in 13% of cases.Conclusion:Supernatural agents reliably appear in nightmares and unpleasant dreams in association with diminished agency in the dreamer. Diminished agency in an individual may facilitate supernatural agent cognitions. (shrink)

Firearm violence in the United States produces over 36,000 deaths and 74,000 sustained firearm-related injuries yearly. The paper describes the burden of firearm violence with emphasis on the disproportionate burden on children, racial/ethnic minorities, women and the healthcare system. Second, this paper identifies factors that could mitigate the burden of firearm violence by applying a blend of key ethical theories to support population level interventions and recommendations that may restrict individual rights. Such recommendations can further support targeted research to inform (...) and implement interventions, policies and laws related to firearm access and use, in order to significantly reduce the burden of firearm violence on individuals, health care systems, vulnerable populations and society-at-large. By incorporating a blended public health ethics to address firearm violence, we propose a balance between societal obligations and individual rights and privileges. (shrink)

Aspirations for global justice have, in the last two decades, found their most radical expressions in the context of global environmental governance and climate change. From Rio de Janeiro through Kyoto to Copenhagen, demands for international distributional justice, and especially North–South equity, have become a prominent aspect of international environmental negotiation. However, claims for international environmental and climate justice have generally been deployed in the form of instinctive gut reaction than as a closely argued concept. In this paper, I outline (...) the ways in which issues of international justice intertwine with notions of global environmental sustainability and the basic premises on which claims for North–South equity are entrenched. (shrink)

Preoperative informed consent is a legal and ethical requirement that ensures patients understand a procedure, its associated risks and benefits, alternative treatment options, and potential complications to make an informed decision about their care. This cross‐sectional study evaluated the informed consent process for major orthopaedic surgeries at a tertiary hospital in Nigeria. A self‐administered questionnaire was used to collect data from 120 adult participants. Results showed that many patients do not read the consent form before signing it, and surgeons do (...) not adequately explain the alternatives to surgery, potential risks, and available anaesthetic options. Higher‐educated patients are more likely to read the consent form. Surgeons performed well in explaining the nature of the condition and prognosis, the procedure's potential benefits, and answering patients' questions. The study emphasises the need to improve the informed consent process to ensure patients understand and can make rational decisions about their healthcare. (shrink)