IntroductionThe objectives of this study are to assess and compare differences in the intensity, frequency, and overall severity of moral distress among a diverse group of healthcare professionals.MethodsParticipants from within Baylor Health Care System completed an online seven-point Likert scale (range, 0 to 6) moral distress survey containing nine core clinical scenarios and additional scenarios specific to each participant’s discipline. Higher scores reflected greater intensity and/or frequency of moral distress.ResultsMore than 2,700 healthcare professionals responded to the survey (response rate 18.14 (...) percent); survey respondents represented multiple healthcare disciplines across a variety of settings in a single healthcare system. Intensity of moral distress was high in all disciplines, although the causes of highest intensity varied by discipline. Mean moral distress intensity for the nine core scenarios was higher among physicians than nurses, but the mean moral distress frequency was higher among nurses. Taking into account both intensity and frequency, the difference in mean moral distress score was statistically significant among the various disciplines. Using post hoc analysis, differences were greatest between nurses and therapists.ConclusionsMoral distress has previously been described as a phenomenon predominantly among nursing professionals. This first-of-its-kind multidisciplinary study of moral distress suggests the phenomenon is significant across multiple professional healthcare disciplines. Healthcare professionals should be sensitive to situations that create moral distress for colleagues from other disciplines. Policy makers and administrators should explore options to lessen moral distress and professional burnout that frequently accompanies it. (shrink)

Machine learning algorithms may radically improve our ability to diagnose and treat disease. For moral, legal, and scientific reasons, it is essential that doctors and patients be able to understand and explain the predictions of these models. Scalable, customisable, and ethical solutions can be achieved by working together with relevant stakeholders, including patients, data scientists, and policy makers.

This article considers the theme of discernment in the tradition of Ignatian spirituality emanating from the Spiritual Exercises of St Ignatius of Loyola, the founder of the Society of Jesus. After a brief introduction which addresses the central problematic of bad influences that manifest themselves as good, the article turns to the life and work of two Jesuits, the 16th C English missionary to India, Thomas Stephens and the 20th C French historian and cultural critic, Michel de Certeau. Both kept (...) up a constant dialogue with local culture in which they sought authenticity in their response to ‘events’, whether a hideous massacre which shaped the pastoral commitment and writing of Stephens in the south of the Portuguese enclave of Goa or the 1968 student-led protests in Paris that so much affected the thinking of de Certeau. Very different in terms of personal background and contemporary experience, they both share in a tradition of discernment as a virtuous response to what both would understand as the ‘wisdom of the Spirit’ revealed in their personal interactions with ‘the other’. (shrink)

Biographical essays explore the careers of two major early photographers, Joseph-Philibert Girault de Prangey and William James Stillman. in addition, portfolios with works by Maxime Du Camp, John Beasley Greene, Francis Frith, Robert Macpherson, Adolphe Braun and others testify to the strength and consistency of other early photographers who captured the antique worlds around the Mediterranean."--BOOK JACKET.

Purpose Algorithms are in the mainstream media news on an almost daily basis. Their context is invariably artificial intelligence and machine learning decision-making. In media articles, algorithms are described as powerful, autonomous actors that have a capability of producing actions that have consequences. Despite a tendency for deification, the prevailing critique of algorithms focuses on ethical concerns raised by decisions resulting from algorithmic processing. However, the purpose of this paper is to propose that the ethical concerns discussed are limited in (...) scope and suggest that it is not clear what concerns dominate the debate. Design/methodology/approach The paper uses a systematic mapping study approach to review articles appearing in leading UK national papers from the perspective of the ethical concerns over a period of one year. The articles are categorised using a widely cited framework detailing a taxonomy of ethical concerns. The UK context is important because of UK public policy initiatives around AI. Findings The research presented in this paper contributes the first systematic mapping study of articles appearing in leading UK national papers from the perspective of widely accepted ethical concerns such as inscrutable evidence, misguided evidence, unfair outcomes and transformative effects. Originality/value The research presented in this paper contributes the first systematic mapping study of articles appearing in leading UK national papers from the perspective of the ethical concerns. The UK context is important because of UK public policy initiatives around AI. To review the media content from the perspective of ethical concerns, this paper uses the synthesised conceptual map of ethical concerns developed by Mittelstad et al. Given the dominance of that framework, this paper’s contribution is also an important instantiation and experimental validation of using that conceptual map. (shrink)

A prefrontal control system that is less mature than the limbic reward system in adolescence is thought to impede self-regulatory abilities, which could contribute to poor dietary choices and obesity. We, therefore, aimed to examine whether structural morphology of the prefrontal cortex and the amygdala are associated with dietary decisions and obesity in children and adolescents. Seventy-one individuals between the ages of 8–22 years participated in this study; each participant completed a computer-based food choice task and a T1- and T2-weighted (...) structural brain scans. Two indices of obesity were assessed, including age- and sex-specific body mass index and waist-to-height ratio. The behavioral task included rating 60 food stimuli for tastiness, healthiness, and liking. Based on each participant’s self-ratings, 100 binary food choices were then made utilizing a computer mouse. Dietary “self-control” was calculated as the proportion of trials where the individual chose the healthier food item over the total number of trials. Cortical thickness and amygdala subnuclei volumes were quantified using FreeSurfer 6.0 and CIT168 atlas, respectively. We found that WHtR was negatively associated with the thickness of bilateral superior frontal, left superior temporal, right insula, and right inferior temporal regions. We also found WHtR to be positively associated with the volume of the central nucleus region of the amygdala, after adjusting for the hemisphere, age, sex, and intracranial volumes. A similar data pattern was observed when BMIz was used. Moreover, we found that across all participants, thinner right superior frontal cortex and larger left CEN volumes predicted lower dietary self-control. These results suggest that differential development of the PFC and amygdala relate to obesity and dietary self-control. Further longitudinal studies are merited to determine causal relationships among altered PFC to amygdala neural circuitry, dietary self-control, and obesity. (shrink)

Halin in 1965 proved that if a graph has [Formula: see text] many pairwise disjoint rays for each [Formula: see text] then it has infinitely many pairwise disjoint rays. We analyze the complexity of this and other similar results in terms of computable and proof theoretic complexity. The statement of Halin’s theorem and the construction proving it seem very much like standard versions of compactness arguments such as König’s Lemma. Those results, while not computable, are relatively simple. They only use (...) arithmetic procedures or, equivalently, finitely many iterations of the Turing jump. We show that several Halin-type theorems are much more complicated. They are among the theorems of hyperarithmetic analysis. Such theorems imply the ability to iterate the Turing jump along any computable well ordering. Several important logical principles in this class have been extensively studied beginning with work of Kreisel, H. Friedman, Steel and others in the 1960s and 1970s. Until now, only one purely mathematical example was known. Our work provides many more and so answers Question 30 of Montalbán’s Open Questions in Reverse Mathematics in 2011. Some of these theorems including ones in Halin in 1965 are also shown to have unusual proof theoretic strength as well. (shrink)

In both academic literature and the media, financial conflicts of interest in human subjects research have come center-stage. The cover of a recent edition of Time magazine features a research subject in a cage with the caption human guinea pigs, signifying perhaps that human research subjects are no more protected from research abuses than are laboratory animals. That magazine issue highlights three well-publicized cases of human subjects research violations that occurred at the University of Oklahoma, the University of Pennsylvania, and (...) Johns Hopkins University.At St. John Medical Center in Tulsa, Oklahoma, a study that was co-sponsored by the University of Oklahoma Health Sciences Center investigated an experimental vaccine for malignant melanoma. In that case, the chair of the university's institutional review board — the committee within each medical institution charged with ethics review of human research projects undertaken at that institution — and the dean of the University's College of Medicine allegedly concealed from both the IRB and the United States Food and Drug Administration a report by an outside consulting firm that had found severe deficiencies with the melanoma vaccine study being conducted at the medical center. (shrink)

In both academic literature and the media, financial conflicts of interest in human subjects research have come center-stage. The cover of a recent edition of Time magazine features a research subject in a cage with the caption human guinea pigs, signifying perhaps that human research subjects are no more protected from research abuses than are laboratory animals. That magazine issue highlights three well-publicized cases of human subjects research violations that occurred at the University of Oklahoma, the University of Pennsylvania, and (...) Johns Hopkins University.At St. John Medical Center in Tulsa, Oklahoma, a study that was co-sponsored by the University of Oklahoma Health Sciences Center investigated an experimental vaccine for malignant melanoma. In that case, the chair of the university's institutional review board — the committee within each medical institution charged with ethics review of human research projects undertaken at that institution — and the dean of the University's College of Medicine allegedly concealed from both the IRB and the United States Food and Drug Administration a report by an outside consulting firm that had found severe deficiencies with the melanoma vaccine study being conducted at the medical center. (shrink)

BL Features of the new edition: The translation has been completely rewritten, and the commentary thoroughly revised in the light of recent scholarship There is an additional glossary, and extended bibliography The Posterior Analytics contains some of Aristotle's most influential thoughts in logic, epistemology, metaphysics, and the philosophy of science. The first book expounds and develops the notions of a demonstrative argument and of a formal, axiomatized science; the second discusses a cluster of problems raised by the axioms or principles (...) of such a science, and investigates in particular the theory of definition. (shrink)

The sudden emergence of the COVID-19 pandemic brought global disruption to every aspect of society including healthcare, supply chain, the economy, and social interaction. Among the many emergent considerations were the safety and public health of the public, patients, essential workers, and healthcare professionals. In certain locations, clinical research was halted—or terminated—in deference to the immediate needs of patient care, and clinical trials focusing on the treatment and prevention of coronavirus infection were prioritized over studies focusing on other diseases. Difficult (...) decisions were made rapidly; flexibility and reconsideration were necessary not only because the intensity and severity of infection varied over time and by locale but also because knowledge of the disease and understanding of its treatment grew. Here we discuss the ethical challenges in decision-making and competing ethical tensions during the pandemic in an effort to advance future preparedness. (shrink)

Anhedonia is a risk factor for suicide and poor treatment response in depressed individuals. Most evidence-based psychological therapies target symptoms of heightened negative affect instead of deficits in positive affect and typically show little benefit for anhedonia. Viewing positive scenes through virtual reality has been shown to increase positive affect and holds great promise for addressing anhedonic symptoms. In this pilot study, six participants with clinically significant depression completed 13 sessions of exposure to positive scenes in a controlled VR environment. (...) Significant decreases were found in self-reported anhedonia, depression, anxiety, and impairments in functioning from baseline to 1-month follow-up. Negative affect decreased over all 13 sessions, and positive affect increased over sessions 8–13. Results suggest that positive experiences in VR may be a novel avenue for the treatment of anhedonia in depressed individuals. (shrink)

Theorems of hyperarithmetic analysis occupy an unusual neighborhood in the realms of reverse mathematics and recursion-theoretic complexity. They lie above all the fixed iterations of the Turing jump but below ATR $_{0}$. There is a long history of proof-theoretic principles which are THAs. Until the papers reported on in this communication, there was only one mathematical example. Barnes, Goh, and Shore [1] analyze an array of ubiquity theorems in graph theory descended from Halin’s [9] work on rays in graphs. (...) They seem to be typical applications of ACA $_{0}$ but are actually THAs. These results answer Question 30 of Montalbán’s Open Questions in Reverse Mathematics [19] and supply several other natural principles of different and unusual levels of complexity.This work led in [25] to a new neighborhood of the reverse mathematical zoo: almost theorems of hyperarithmetic analysis. When combined with ACA $_{0}$ they are THAs but on their own are very weak. Denizens both mathematical and logical are provided. Generalizations of several conservativity classes are defined and these ATHAs as well as many other principles are shown to be conservative over RCA $_{0}$ in all these senses and weak in other recursion-theoretic ways as well. These results answer a question raised by Hirschfeldt and reported in [19] by providing a long list of pairs of principles one of which is very weak over RCA $_{0}$ but over ACA $_{0}$ is equivalent to the other which may be strong or very strong going up a standard hierarchy and at the end being stronger than full second-order arithmetic. (shrink)

We establish the decidability of the${{\rm{\Sigma }}_2}$theory of both the arithmetic and hyperarithmetic degrees in the language of uppersemilattices, i.e., the language with ≤, 0, and$\sqcup$. This is achieved by using Kumabe-Slaman forcing, along with other known results, to show given finite uppersemilattices${\cal M}$and${\cal N}$, where${\cal M}$is a subuppersemilattice of${\cal N}$, that every embedding of${\cal M}$into either degree structure extends to one of${\cal N}$iff${\cal N}$is an end-extension of${\cal M}$.

Visual artists and scientists frequently employ the labour of assistants and technicians, however these workers generally receive little recognition for their contribution to the production of artistic and scientific work. They are effectively “invisible”. This invisible status however, comes at the cost of a better understanding of artistic and scientific work, and improvements in artistic and scientific practice. To enhance understanding of artistic and scientific work, and these practices more broadly, it is vital to discern the nature of an assistant (...) or technician’s contribution to the production of a work, which is difficult as it is uncommon to discuss these workers. To address this, I investigate how different kinds of parallel working arrangements in collective artistic and scientific practices affect the creative potential of individuals involved. Different working arrangements permit different degrees of autonomy for individuals involved in these practices. Significantly, a lack of autonomy precludes the opportunity to act spontaneously and so exercise, what I term, “creative agency”. Evaluating the contribution of an assistant or technician based on the degree of autonomy that they are granted in the production of a work is an approach that I show can be used to precisely determine the nature of their contribution to the production of a work and accordingly, what kind of recognition an agent should receive for this. Importantly, this approach has the advantage of explaining the artistic and epistemic significance of different kinds of contribution to the production of artistic and scientific work. (shrink)

Automated Influence is the use of Artificial Intelligence to collect, integrate, and analyse people’s data in order to deliver targeted interventions that shape their behaviour. We consider three central objections against Automated Influence, focusing on privacy, exploitation, and manipulation, showing in each case how a structural version of that objection has more purchase than its interactional counterpart. By rejecting the interactional focus of “AI Ethics” in favour of a more structural, political philosophy of AI, we show that the real problem (...) with Automated Influence is the crisis of legitimacy that it precipitates. (shrink)

Nietzsche’s interest in tragedy continues throughout his work. And yet scholarship on Nietzsche’s account of tragedy has focused almost exclusively on his first book, The Birth of Tragedy – a work which is in many ways discontinuous with his more mature philosophical views. In this paper, I aim to illuminate Nietzsche’s post-Birth of Tragedy views on tragedy by setting them in the context of a particular historical conversation. Ever since Plato banished the tragic poets from the kallipolis, various philosophers have (...) attempted to respond to his challenge to offer a ‘defense of poetry’. What Nietzsche offers, I argue, is a distinctive form of response to Plato’s challenge. I show how Nietzsche takes seriously Plato’s worries, and even ends up in partial agreement with him: tragedy is not (unqualifiedly) valuable; it can be spiritually dangerous. Key to Nietzsche’s account is a distinction he draws between two types of tragic audience. For the ‘lower types’, tragedy is – as Plato feared – dangerous. For the ‘higher types’, however, tragedy can act as a regenerative force. Finally, I discuss a distinctive form of value that tragedy makes available to a modern audience: tragedy can act as a stimulus towards the process of the revaluation of values. (shrink)

Can we make mistakes about what rationality requires? A natural answer is that we can, since it is a platitude that rational belief does not require truth; it is possible for a belief to be rational and mistaken, and this holds for any subject matter at all. However, the platitude causes trouble when applied to rationality itself. The possibility of rational mistakes about what rationality requires generates a puzzle. When combined with two further plausible claims – the enkratic principle, and (...) the claim that rational requirements apply universally – we get the result that rationality generates inconsistent requirements. One popular and attractive solution to the puzzle denies that it is possible to make rational mistakes about what rationality requires. I show why (contra Titelbaum (2015b), and Littlejohn (2015)) this solution is doomed to fail. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Nietzsche’s Philosophical Psychology by Mattia RiccardiClaire KirwinMattia Riccardi, Nietzsche’s Philosophical Psychology. Oxford: Oxford University Press, 2021. xi + 249 pp. isbn: 9780198803287. Hardcover, $70.00.Nietzsche was not a systematic philosopher. Indeed, it is probably fair to say, as many commentators have, that he was an anti-systematic philosopher. It is harder to say what this means, and harder still to know how to deal with it when we aim to (...) interpret his philosophy. For we wish to attribute to Nietzsche certain claims and positions, perhaps even arguments, and in doing so we generally prefer that these not contradict each other. And so as we attempt to understand “Nietzsche’s philosophy” as a coherent entity, we tend to find ourselves—for better or worse—heading down the path of systematizing that philosophy.Mattia Riccardi’s Nietzsche’s Philosophical Psychology is an impressive example of such a systematizing reading of Nietzsche. In developing his account of Nietzsche’s (mature) philosophy of mind, Riccardi acknowledges that Nietzsche’s own approach to this topic is “scattered” and “piecemeal” (5). What Riccardi aims to offer is a comprehensive reconstruction of the systematic account that Nietzsche, for whatever reason, did not explicitly give us. And what we are presented with here is a very systematic Nietzsche, one who offers a comprehensive and detailed account of the inner workings of the mind in terms of drives and affects and their relation (this is the topic of the book’s Part I, “Beneath the Surface”); consciousness—three different types of consciousness, to be precise—and the sense in which it is epiphenomenal (in Part II, “Mapping the Surface”); and the nature of the self, the possibility of self-knowledge, the nature of the will, and the relevance of all of this for the Nietzschean “ideal type” of human being (in Part III, “The Upshot”). [End Page 203]We might worry that such a systematic philosopher is no longer quite recognizable as Nietzsche—that in doing such comprehensive and systematic reconstructive work one is somehow leaving behind the Nietzsche who wrote not treatises but rather aphorisms, polemics, pseudo-biblical texts, and poetry. But Riccardi is upfront that what he is doing is reconstructive work of this kind and meticulous in showing how the positions he develops can plausibly be attributed to Nietzsche—or at the very least, that such positions can be constructed out of genuinely Nietzschean building blocks. These positions are fleshed out and given contemporary relevance through discussion of their relation to modern accounts of mindedness (the higher-order thought theory of consciousness, for example, a version of which—carefully modified—Riccardi attributes to Nietzsche), but at the same time Nietzsche’s thought is throughout set carefully within the relevant historical and biographical contexts. The seeds and impetus for Nietzsche’s ideas are located in authors he was known to have read (Schopenhauer, Leibniz, and Stendhal, of course, but also Schneider, Mayer, Fouillée, Espinas, and more). The development of these ideas over time is then traced through Nietzsche’s notes and published work. At each point, alternative readings of these texts that have been proposed in the secondary literature are considered and carefully, persuasively, refuted. For philosophers seeking to offer a systematic reconstruction of Nietzsche’s thought on some topic, this sort of approach should be seen as the gold standard. And for anyone interested in understanding what Nietzsche has to say about human psychology, this book will be essential reading.Riccardi’s Nietzsche offers us a serious and detailed philosophy of mind. It seems appropriate, then, to respond to it as such. Rather than giving a précis of each chapter, or debating the exegetical accuracy of the account, I shall instead offer some critical engagement with the detail of the account itself. I will focus on two key components of the system Riccardi elaborates: first, the account of reflective consciousness and, second, the sense in which he takes that form of consciousness to be epiphenomenal. These parts of the system, the topics of chapters 5 and 7, respectively, play crucial roles within the architecture of the book as a whole. For taken together, they show just how radically... (shrink)

Cinema, thought and time -- Deleuze's cinema books -- Technology -- Essences -- Space and time -- Bergson, time, and life -- The movement-image -- The history of time and space and the history of cinema -- The movement-image and semiotics -- Styles of sign -- The whole of movement -- Image and life -- Becoming-inhuman, becoming imperceptible -- The deduction of the movement-image -- Art and time -- Destruction of the sensory motor apparatus and the spiritual automaton -- Time (...) and money -- Art and history -- Monument -- Framing, territorialization, and the plane of composition -- Politics and the origin of meaning -- Transcending life and the genesis of sense -- Beyond symbolic and imaginary -- Shit and money -- Exchange, gift, and theft -- The fiction of mind -- Collective investment and group fantasy -- The time of man -- The intense germinal influx. (shrink)