Background The urgency of ensuring adequate moral courage in clinical nursing practice is evident. However, currently, there are few formal intervention plans targeted at enhancing the moral courage of nurses. Aim To develop a training program for improving the moral courage of nurses using the modified Delphi method. Research design A modified Delphi study. Participants and research context From November to December 2022, a literature review and expert group discussion were conducted to develop a preliminary training plan framework. (...) From January to March 2023, a two-round Delphi survey was performed, and a consensus was reached regarding the plan through online questionnaires. Descriptive statistics were used to analyze the data. Ethical considerations This study was approved by the institutional ethics committee (No. 138, 30 August 2021). All participants provided written informed consent. Results Consensus was reached on eight themes and 33 items to strengthen the moral courage training program for nurses. Conclusions Guided by a unified goal of moral education, a multi-level and acceptable intervention plan was designed to enhance the moral courage of nurses. (shrink)

To foster research integrity (RI), it is necessary to address the institutional and system-of-science factors that influence researchers’ behavior. Consequently, research performing and research funding organizations (RPOs and RFOs) could develop comprehensive RI policies outlining the concrete steps they will take to foster RI. So far, there is no consensus on which topics are important to address in RI policies. Therefore, we conducted a three round Delphi survey study to explore which RI topics to address in institutional RI (...) policies by seeking consensus from research policy experts and institutional leaders. A total of 68 RPO and 52 RFO experts, representing different disciplines, countries and genders, completed one, two or all rounds of the study. There was consensus among the experts on the importance of 12 RI topics for RPOs and 11 for RFOs. The topics that ranked highest for RPOs concerned education and training, supervision and mentoring, dealing with RI breaches, and supporting a responsible research process (e.g. through quality assurance). The highest ranked RFO topics concerned dealing with breaches of RI, conflicts of interest, and setting expectations on RPOs (e.g. about educating researchers about RI). Together with the research policy experts and institutional leaders, we developed a comprehensive overview of topics important for inclusion in the RI policies of RPOs and RFOs. The topics reflect preference for a preventative approach to RI, coupled with procedures for dealing with RI breaches. RPOs and RFOs should address each of these topics in order to support researchers in conducting responsible research. (shrink)

There has been an increase in recent years in the use of empirical methods in healthcare ethics. Appeals to empirical data cannot answer moral questions, but insights into the knowledge, attitudes, experience, preferences and practice of interested parties can play an important part in the development of healthcare ethics. In particular, while we may establish a general ethical principle to provide explanatory and normative guidance for healthcare professionals, the interpretation and application of such general principles to actual practice still requires (...) interpretation and judgement. And many situations in healthcare practice are complex and may involve a variety of principles, each of which may conflict with the others. Simple surveys or interview studies may not be sufficient if we wish to develop a nuanced approach to ethical practice that can be set out in guidelines, codes or directives. We do not resolve moral questions by plebiscite. In this paper, the authors argue for the use of consensus methods to develop shared understanding of ethical practice, and they argue further for the combination of the Delphi method with the use of vignettes to illustrate the kind of situations that may occur in practice. They develop their argument in part by reference to their experience of using this approach in their recent research. (shrink)

Background: Although genetic research into Alzheimer disease (AD) is increasing, the ethical aspects of this kind of research and the differences between ethical issues related to genetic and non-genetic research into AD have not yet received much attention. Objectives: (1) To identify and compare the five ethical issues considered most important by surveyed expert panellists in non-genetic and genetic AD research and (2) to compare our empirical findings with ethical issues in genetic research in general as described in the literature. (...) Method: A modified Delphi study in two rounds Results: Genetic and non-genetic research into AD generated an approximately equal number of topics with a considerable overlap. Different priorities in the ethics of both types of research were found. Genetic research raised new topics such as “confidentiality of genetic information” and “implications of research for relatives” which changes the impact and application of existing ethical topics such as “informed consent” and is judged to have more impact on both individuals and society. A difference with the results of more theoretical approaches on ethical aspects related to AD research was also found. Conclusions: Different priorities are given to ethical issues in genetic and non-genetic research. These arise partly because genetic research causes unique and new questions, mostly related to the position of family members and the status of and access to genetic information. Differences found between the results of our empirical study and the more theoretical literature, suggest an additional value for empirical research in medical ethics. (shrink)

In recent years, the public sector in many countries has had difficulty keeping abreast of social problems due to restricted financial resources and limited organizational capacities. As a consequence, entrepreneurs have started to address social welfare issues that the public sector has been unable to tackle with an innovative approach called social enterprise. The authors present research on the future prospects of social enterprise as a sustainable business model for industrialized countries. As there is a lack of historical and current (...) data, the authors aim to contribute to and structure the debate about the potential of the concept. Therefore, the authors provide initial data from a Delphi survey on the future development of social enterprise in a multistakeholder environment. Experts from academia, business, nongovernmental and governmental organizations, social enterprise investors, and social entrepreneurs evaluated 16 projections for the year 2030. Based on these results, the authors present comprehensive scenarios of four different possible developments of the future of social enterprise in Germany. (shrink)

ObjectivesTo explore the objectives and outcomes most appropriate for evaluating clinical ethics support services (CESs) in the USA.MethodsA three-round e-Delphi was sent to two professional medical ethics listservs (Medical College of Wisconsin-Bioethics and American Society for Bioethics and Humanities) as well as 19 individual experts. The survey originally contained 15 objectives and 9 outcomes. In round 1, participants were asked to validate the content of these lists. In round 2, we had 17 objectives and 10 outcomes, and participants (...) were asked to rank them for appropriateness in a top 10 list of objectives and a top 5 list of outcomes.ResultsParticipants came to a high(at least 70%) level of agreement on seven objectives: mediate, educate, develop policy, improve the moral quality of a decision or action, counsel, create a moral space and manage moral distress. Participants came to a moderate (at least 51%) level of agreement on three objectives: empower, awareness of ethics and preventative ethics. Participants also came to a moderate (at least 51%) level of agreement on five outcomes: ethical justification, transformation of institution, improvement of quality of life, principled consensus and satisfaction with the expertise of a CES.ConclusionThis e-Delphi identified 10 objectives and 5 outcomes that are a good starting point for developing outcome measures to evaluate CESs in the USA, while reminding us of the diversity of perspectives still evident in the field. (shrink)

BackgroundFear of cancer recurrence is common amongst cancer survivors. There is rapidly growing research interest in FCR but a need to prioritize research to address the most pressing clinical issues and reduce duplication and fragmentation of effort. This study aimed to establish international consensus among clinical and academic FCR experts regarding priorities for FCR research.MethodsMembers of the International Psycho-oncology Society Fear of Cancer Recurrence Special Interest Group were invited to participate in an online Delphi study. Research domains identified in (...) Round 1 were presented and discussed at a focus group to consolidate the domains and items prior to presentation in further survey rounds aimed at gaining consensus on research priorities of international significance.ResultsThirty four research items were identified in Round 1 and 33 of the items were consolidated into six overarching themes through a focus group discussion with FCR experts. The 33 research items were presented in subsequent rounds of the delphi technique. Twenty one participants contributed to delphi round 1, 16 in round 2, and 25 and 29 participants for subsequent delphi rounds. Consensus was reached for 27 items in round 3.1. A further four research items were identified by panelists and included in round 3.2. After round 3.2, 35 individual research items were ratified by the panelists. Given the high levels of consensus and stability between rounds, no further rounds were conducted. Overall intervention research was considered the most important focus for FCR research. Panelists identified models of care that facilitate greater access to FCR treatment and evaluation of the effectiveness of FCR interventions in real world settings as the two research items of highest priority. Defining the mechanisms of action and active components across FCR/P interventions was the third highest priority identified.ConclusionThe findings of this study outline a research agenda for international FCR research. Intervention research to identify models of care that increase access to treatment are based on a flexible approach based on symptom severity and can be delivered within routine clinical care were identified as research areas to prioritize. Greater understanding of the active components and mechanisms of action of existing FCR interventions will facilitate increased tailoring of interventions to meet patient need. (shrink)

Spotting is a typical isolated head coordination used by many dancers during rotation. However, with sporadic and inconclusive explanations as to why dancers spot, the critical characteristics and functionalities of spotting have yet to be identified. Therefore, a Delphi method survey was used as a novel methodology for providing greater insights into this under-examined motor behavior, bringing together experts from various disciplines to generate ideas and identify the crucial elements of spotting. Following the selection of experts, three rounds (...) of data collection and analysis were conducted to narrow down relevant topics and evaluate consensus. To gather opinions in Round 1, experts were asked to respond freely to three prompts regarding the reasoning, characteristics, and uses of successfully spotting; responses were then grouped into predominant items. To rate agreement in Round 2, experts rated their agreement on the relevance of the grouped items from Round 1 on a 5-point Likert scale; items rated 4 or 5 by at least 70% of the experts were taken as those consensually relevant to the group. To rank importance in Round 3, Best-Worst Scaling was used to determine individual rankings of the relevant items from Round 2. In a series of comparisons, experts were prompted to select the most and least important items in multiple sub-groupings. Group mean ranking of items as well as ranking concordance and differentiation were analyzed to determine the most important items and the strength of consensus, respectively. Overall, consensus and differentiation in experts’ item rankings were low; however, novel insights were presented. As characteristics of successfully spotting, experts emphasized head isolation, timing, and gaze specificity alongside functional characteristics, substantiating spotting as purposeful action in rotation. Building on traditional notions of spotting for reduced dizziness and maintaining balance, successfully spotting was further deemed useful for multiple turns, orientation, and rhythm. The findings of this study thus provide informed guidelines for future analysis and training of this complex head coordination in rotations. (shrink)

Background Standard interpretations of the ethical principle of respect for persons have not incorporated the views and values of patients, especially patients from groups underrepresented in research. This limits the ability of research ethics scholarship, guidance, and oversight to support inclusive, patient-centered research. This study aimed to identify the practical approaches that patients in community-based settings value most for conveying respect in genomics research. Methods We conducted a 3-round, web-based survey using the modified Delphi technique to identify areas (...) of agreement among English-speaking patients at primary care clinics in Washington State and Idaho who had a personal or family history of cancer. In Round 1, respondents rated the importance of 17 items, identified in prior qualitative work, for feeling respected. In Round 2, respondents re-rated each item after reviewing overall group ratings. In Round 3, respondents ranked a subset of the 8 most highly rated items. We calculated each item’s mean and median rankings in Round 3 to identify which approaches were most important for feeling respected in research. Results Forty-one patients consented to the survey, 21 (51%) completed Round 1, and 18 (86% of Round 1) completed each of Rounds 2 and 3. Two sets of rankings were excluded from analysis as speed of response suggested they had not completed the Round 3 ranking task. Respondents prioritized provision of study information to support decision-making (mean ranking 2.6 out of 8; median ranking 1.5) and interactions with research staff characterized by kindness, patience, and a lack of judgment (mean ranking 2.8; median ranking 2) as the most important approaches for conveying respect. Conclusions Informed consent and interpersonal interactions are key ways that research participants experience respect. These can be supported by other approaches to respecting participants, especially when consent and/or direct interactions are infeasible. Future work should continue to engage with patients in community-based settings to identify best practices for research without consent and examine unique perspectives across clinical and demographic groups in different types of research. (shrink)

The use of virtual fencing in pasture-grazed farm systems is currently close to commercial reality but there are no studies applying the principles of responsible research and innovation, such as foresighting, to this technology. This paper reports results of a study aimed at foresighting potential implications associated with virtual fencing of cattle. A Delphi method was used to survey the opinions of farming practitioners and researchers, using pasture-grazed cattle farming in New Zealand as a case study. The key (...) benefits were identified as environmental protection, improved feed allocation, access to previously unavailable grazing areas, labour savings and individual animal management. The five most important potential barriers identified were device reliability, farmer perception of a value proposition, ethical issues related to community perception of negative animal welfare, lack of feed budgeting skills of farmers, and excessive training time. We suggest that more knowledge is needed on ethical issues associated with VF, including understanding public opinions of such technology developments. We suggest that development and use of VF has been focussed primarily on technical features and user benefits and needs to include consideration of wider socio-ethical principles to ensure responsible innovation processes. The findings from this study will aid focussed research and development to incorporate ethically acceptable development alongside technical factors. (shrink)

Whereas the Mediterranean has not submitted easily to strong theories, still it has inspired a certain kind of theorizing from the ground. The setting of the Mediterranean viewed from the land's edge gave the world theoria, which Greek etymology and usage associates with looking onto a scene with amazement, viewing drama, being sent as an emissary to consult the oracle, or traveling for the purposes of sightseeing. The present essay explores some connections between the Mediterranean and theoria. Following a brief (...) survey of how theoria functioned in antiquity, it studies the case of 20th-century Greek poet Angelos Sikelianos and American director and choreographer Eva Palmer - husband and wife - who sought to revive ancient ideas of theoria. They organized revivals of the Delphic Festivals in 1927 and 1930 as a prelude to re-establishing Delphi as a world center for people with a vision for the world. Their work rivaled that of the Olympic Revivals, except that the Delphic Revival was linked to a particular Mediterranean site and pursued the course of art, music, social thought, and especially tragedy together with athletics. A spectacular, imaginative, ambitious, but stillborn effort, it gives evidence of both the potential and limits of Mediterranean theoria. (shrink)

Rapid advances in the domain of science and technology are having an unprecedented effect upon the provision of higher education in universities throughout the world, the pace of change often being so fast as to make planning for the development of the “classroom of the future” an extremely difficult task. The Mobile Multimedia University (MMU) project, a collaborative action between four leading UK based research facilities, has been established to investigate these issues. Included amongst its aims is the use of (...) novel research methodologies to determine the factors which will influence the shape and form of future education provision, and thus the distribution of knowledge to society, such as mobility, telecommunications and multimedia services. This paper describes the use of a Delphi survey in predicting the technological trends and innovations which will affect university education in the near future. It describes the theory underpinning the Delphi method, illustrating this with examples of how such a technique has been successfully used in the past. It then details the specific application of the Delphi approach within the current MMU research project, detailing the preliminary results and discussing the implications of these findings for the future of universities and other institutes of higher education. (shrink)

A One Health approach holds great promise for attenuating the risk and burdens of emerging infectious diseases (EIDs) in both human and animal populations. Because the course and costs of EID outbreaks are difficult to predict, One Health policies must deal with scientific uncertainty, whilst addressing the political, economic and ethical dimensions of communication and intervention strategies. Drawing on the outcomes of parallel Delphi surveys conducted with policymakers in Singapore and Australia, we explore the normative dimensions of two different (...) precautionary approaches to EID decision-making—which we call regimes of risk management and organizing uncertainty, respectively. The imperative to act cautiously can be seen as either an epistemic rule or as a decision rule, which has implications for how EID uncertainty is managed. The normative features of each regime, and their implications for One Health approaches to infectious disease risks and outbreaks, are described. As One Health attempts to move upstream to prevent rather than react to emergence of EIDs in humans, we show how the approaches to uncertainty, taken by experts and decision-makers, and their choices about the content and quality of evidence, have implications for who pays the price of precaution, and, thereby, social and global justice. (shrink)

Increasing attention and efforts are being put towards engaging patients in health research, and some have even argued that patient engagement in research is an ethical imperative. Yet there is relatively little empirical data on ethical issues associated with PER. A three-round Delphi survey was conducted with a panel of early-career researchers involved in PER. One of the objectives was to examine the ethical dimensions of PER as well as ECRs’ self-perceived level of preparedness to conduct PER ethically. (...) The study was conducted among awardees of the Québec SPOR-SUPPORT Unit in Canada, who represent the next generation of researchers involved in PER. Many themes were addressed throughout the study, such as definition, values, patients’ roles, expected characteristics of patients, and anticipated challenges. Open-ended questions were used, and all quantitative data were collected through statements using 7-point Likert scales. Between April and November 2016, 25 ECRs were invited to participate; 18 completed both the first and second rounds, and 16 completed the third round. Panelists consisted of nine women and seven men with various backgrounds. The majority were between 25 and 44 years old. Panelists’ responses showed PER raises important ethical issues: 1) professionalization of patients involved in research ; 2) adequate remuneration of patients; 3) fair recognition of patients’ experiential knowledge; and 4) tokenism. While the panelists felt moderately prepared to confront these ethical issues, they reported being uncomfortable applying for an ethics certificate for a PER project. If PER is an ethical imperative, it is vital to establish clear ethical standards and to train and support the PER community to identify and resolve ethical issues. Despite their overall readiness to conduct PER, panelists did not feel adequately prepared to address many of these issues. It is not easy for ECRs to reconcile ethical desiderata and logistical imperatives. Additional research should focus on supporting the responsible conduct of PER, which, if not done, can undermine the credibility and feasibility of the entire PER enterprise. (shrink)

This study developed an online career adaptability improvement program as part of the undergraduate curriculum to improve college students’ career adaptability and verify its effectiveness. This 13-week intervention program, developed using the Korea-Career Adaptability Scale, consists of three domains: knowledge and recognition of the self and work environment, self-directed coping related to career behavior, and environmental interaction for career decisions and adaptation. Two sub-studies were conducted to achieve the research objectives: Study 1 included developing and testing a pilot program and (...) Study 2 quantitatively analyzed the final program to test its effectiveness. In Study 1, preliminary program development and validity were verified, and in Study 2, the effectiveness of the final program was verified. As a strategy to achieve the research purpose, in Study 1, literature review and needs analysis, program design reflecting the results of the needs analysis, validity verification through Delphi survey, preliminary program implementation and evaluation, and the operation of the final program were performed. To test the effectiveness of the program in Study 2, a pre-posttest of career adaptability was conducted on experimental, comparison, and control groups using the non-equivalent group pretest–posttest design, followed by a program satisfaction survey. This study is meaningful in that it developed an online program to help college students improve career adaptability and identified its effectiveness. This study yielded two results. First, it successfully developed a career adaptability improvement program for undergraduate students, wherein the career development tasks, and the sub-factors of career adaptability were organically interlinked. Second, it verified the statistically significant differences in the career adaptability scores among the experimental, comparison, and control groups. The highest mean score was obtained by participants in the experimental group, followed by the comparison and the control group. (shrink)

This paper explores the circumstances that influence whether managers in the public services manipulate the measurement information that is used to assess performance; and if they do, what level of deception they might use. The realistic evaluation approach is adopted. A Delphi survey and the collection of critical incidents through interviews are used to identify possible configurations of contexts–mechanisms–outcomes that provide possible explanations of information manipulation. A number of these configurations are discussed. In a later stage of the (...) project these configurations will be further tested through another Delphi survey, with the intention of developing proposals for improved governance of performance measurement systems in the public services. (shrink)

Researchers in several academic fields have indicated an increase in academic authorship disputes and the utilization of unethical authorship practices over the past few decades. This trend has been attributed to a variety of factors such as vague authorship guidelines, power disparities between researchers, dissimilar disciplinary and/or journal practices, and a lack of guidance for emerging scholars. As a rapidly emerging academic field, sport management (and its connected sub-fields) maintains the propensity for unclear procedures due to the various departments, schools, (...) and colleges the field calls home (e.g., kinesiology, sport science, education, business), as well as the wide variety of journals that the field’s scholarship resides in. This situation is similar to many emerging or expanding fields as they navigate the university landscape of more established disciplines and fields. Utilizing a three-round Delphi survey method, the current research examined expert opinion on authorship practices in sport management scholarship. Through a combination of open-ended, response, and Likert-type questions, the expert survey attempted to identify areas of consensus and non-consensus in an effort to determine the current status of publication practices in the field, as well as ascertain areas of need for future study and improvement. (shrink)

Background Patient dignity is sometimes neglected in intensive care unit (ICU) settings, which may potentially cause psychological harm to critically ill patients. However, no instrument has been specifically developed to evaluate the behaviors of dignified care among critical care nurses. Aim This study aimed to develop and evaluate ICU Dignified Care Questionnaire (IDCQ) for measurement of self-assessed dignity-conserving behaviors of critical care nurses during care. Methods The instrument was developed in 3 phases. Phase 1: item generation; phase 2: a two-round (...) Delphi survey and a readability pilot study; phase 3: cross-sectional survey with model estimation. The questionnaire was evaluated by item analysis, exploratory and confirmatory factor analysis, assessment of internal consistency reliability, and test-retest reliability. The investigation was conducted using a convenience sample of 392 critical care nurses from 6 cities in Zhejiang Province, China, of which 30 participated in the test-retest reliability survey 2 weeks later. Ethical considerations The study was approved by ethics committee. All participants provided written informed consent before the survey. The questionnaire survey was anonymous. Results The results showed acceptable reliability and validity of the IDCQ. The 17-item final version questionnaire was divided into 2 dimensions: absolute dignity and relative dignity. These two factors accounted for 62.804% of the total variance, and model fitting results were acceptable. The Cronbach’s alpha coefficient of the questionnaire was 0.94, and the test-retest intraclass correlation coefficient (ICC) was 0.88 after 2 weeks. Conclusions This study developed a brief and reliable instrument (IDCQ) to assess dignified care in ICU nursing. It can help critical care nurses identify their behaviors in maintaining patient dignity and discover their deficiencies. It may also serve as a clinical nursing management tool to help reduce patient disrespect experience in ICU. (shrink)

The current research is based on Senninger’s Learning Zone Model applied to the tourists’ comfort zone. This model was created in 2000 and it proved to be useful in many applied areas: Psychology, Sociology, Marketing and Management. This modes is a behavioral one and shows how a person can justify his action based on previous tested experiences or dares to step beyond in fear, learn or growth zone. Our research is extending the existent area of expertise to tourism. We aimed (...) at exploring whether the tourists’ apprehension toward choosing their next destination from a comfort zone perspective or rather from the other zones’ perspectives such as fear, learning or growth. To meet this purpose we conducted a mixed method: firstly a qualitative one, an in-depth interview based on Delphi method with 10 tourism specialists and secondly an online survey on 208 Generation Z tourists. The interviews were meant to help developing a 20 items scale to measure from which of the 4 zones are the respondents making the choice of the future travel destination. Our conclusions show that Gen Z tourists display behaviors that can be associated with learning or growth zones rather than the comfort zone. This is relevant when choosing the next travel destination, because our findings could bring about a new approach to promoting tourist destinations as part of various products. As a result, a large range of managerial tools can better adapt the promotion messages to the target market from a new psychological perspective. (shrink)

Historically, land grant universities and their colleges of agriculture have been discipline driven in both their curricula and research agendas. Critics call for interdisciplinary approaches to undergraduate curriculum. Concomitantly, sustainable agriculture (SA) education is beginning to emerge as a way to address many complex social and environmental problems. University of California at Davis faculty, staff, and students are developing an undergraduate SA major. To inform this process, a web-based Delphi survey of academics working in fields related to SA (...) was conducted. Faculty from colleges and universities across the US were surveyed. Participants suggested that students needed knowledge of natural and social science disciplines relating to the agri-food system. In addition, stakeholders suggested students learn through experiences that link the classroom to field work, engaging a broad range of actors within applied settings. Stakeholders also emphasized the need for interdisciplinary and applied scholarship. Additionally, they proposed a range of teaching and learning approaches, including many practical experiences. Given the diverse suggestions of content knowledge and means of producing knowledge, the survey presented unique challenges and called into question the epistemological and pedagogical norms currently found in land grant colleges of agriculture. This study has implications for land grant universities seeking to develop undergraduate curriculum appropriate to the field of SA. (shrink)

This paper explores the circumstances that influence whether managers in the public services manipulate the measurement information that is used to assess performance; and if they do, what level of deception they might use. The realistic evaluation approach is adopted. A Delphi survey and the collection of critical incidents through interviews are used to identify possible configurations of contexts–mechanisms–outcomes that provide possible explanations of information manipulation. A number of these configurations are discussed. In a later stage of the (...) project these configurations will be further tested through another Delphi survey, with the intention of developing proposals for improved governance of performance measurement systems in the public services. (shrink)

Consent remains a crucial, yet challenging, cornerstone of clinical practice. The ethical, legal and professional understandings of this construct have evolved away from a doctor-centred act to a patient-centred process that encompasses the patient’s values, beliefs and goals. This alignment of consent with the philosophy of shared decision-making was affirmed in a recent high-profile Supreme Court ruling in England. The communication of information is central to this model of health care delivery but it can be difficult for doctors to gauge (...) the information needs of the individual patient. The aim of this paper is to describe ‘core information sets’ which are defined as a minimum set of consensus-derived information about a given procedure to be discussed with all patients. Importantly, they are intended to catalyse discussion of subjective importance to individuals. The model described in this paper applies health services research and Delphi consensus-building methods to an idea orginally proposed 30 years ago. The hypothesis is that, first, large amounts of potentially-important information are distilled down to discrete information domains. These are then, secondly, rated by key stakeholders in multiple iterations, so that core information of agreed importance can be defined. We argue that this scientific approach is key to identifying information important to all stakeholders, which may otherwise be communicated poorly or omitted from discussions entirely. Our methods apply systematic review, qualitative, survey and consensus-building techniques to define this ‘core information’. We propose that such information addresses the ‘reasonable patient’ standard for information disclosure but, more importantly, can serve as a spring board for high-value discussion of importance to the individual patient. The application of established research methods can define information of core importance to informed consent. Further work will establish how best to incorporate this model in routine practice. (shrink)

There is an urgent need to learn how to appropriately integrate technologies into dementia care. The aims of this Delphi study were to project which technologies will be most prevalent in dementia care in five years, articulate potential benefits and risks, and identify specific options to mitigate risks. Participants were also asked to identify technologies that are most likely to cause value tensions and thus most warrant a conversation with an older person with mild dementia when families are deciding (...) about their use. Twenty-one interdisciplinary domain experts from academia and industry in aging and technology in the U.S. and Canada participated in a two-round online survey using the Delphi approach with an 84% response rate and no attrition between rounds. Rankings were analyzed using frequency counts and written-in responses were thematically analyzed. Twelve technology categories were identified along with a detailed list of risks and benefits for each. Suggestions to mitigate the most commonly raised risks are categorized as follows: intervene during design, make specific technical choices, build in choice and control, require data transparency, place restrictions on data use and ensure security, enable informed consent, and proactively educate users. This study provides information that is needed to navigate person-centered technology use in dementia care. The specific recommendations participants offered are relevant to designers, clinicians, researchers, ethicists, and policy makers and require proactive engagement from design through implementation. (shrink)

Objectives The objective of this research was to develop ethics accreditation standards for hospitals. Research design Our research methods included a literature review, an expert focus group, the Delphi technique and a hospital survey. The entire process was separated into two stages: (1) the development of a draft of hospital ethics accreditation standards; and (2) conducting a nationwide hospital survey of the proposed standards. Results This study produced a tentative draft of hospital ethics accreditation standards comprised of (...) six chapters and 62 standards based on the expert focus group and Delphi technique. The six chapters are: Medical ethics policies, regulations and leadership; The establishment and operation of a medical ethics committee; The establishment and operation of research-related ethics committees; Medical ethics education; Organisational ethical climate; and Respect for patients' rights and establishment of good hospital-patient relationships. The hospital survey indicated that the concept of an organisational ethical climate was new to most hospital managers, most hospitals disliked the idea of having a separate hospital ethics accreditation system, and small hospitals were concerned about their ability to comply with all of the standards. Conclusions Regardless of whether hospital ethics accreditation can be a stand-alone accreditation or just part of existing hospital accreditation programmes, we hope this draft can serve as a good reference for future endeavours by hospital accreditation authorities. (shrink)

Consumer indirect misbehavior in access-based consumption is a significant challenge for enterprises. The literature is in short of a deep understanding of the antecedent conditions of consumer indirect misbehavior in this context and limited by inconsistent findings, calling for developing a holistic and integrative theoretical framework. This study integrates three commonly used theoretical perspectives in the consumer misbehavior literature to present holistic archetypes of consumer indirect misbehavior formation. In accordance with this theoretical objective, we adopted an emerging approach for configurational (...) analysis, i.e., fuzzy-set qualitative comparative analysis, to analyze the complex combinations of six influencing factors. We collected data using a scenario-based field survey of 264 experienced consumers of a popular bike-sharing service in China. The scenarios were developed based on relevant literature and a Delphi study. The fsQCA results reveal multiple configurations for high and low levels of consumer misbehavior intention. Specifically, perceived benefits and moral definition play important roles, while the effect of sanctions is highly dependent on other factors. These results lead us to derive three theoretical propositions for antecedent conditions leading to consumers’ indirect misbehavior intentions in access-based consumption. This study enriches our understanding of the causes of misbehavior and provides novel insights for management practitioners to take appropriate countermeasures. (shrink)

Se realizó un estudio de intervencisn educativa, con el objetivo de determinar el nivel de conocimientos acerca del VIH/sida en estudiantes de la ESBU "Marcos Rammrez Rodrmguez" en el permodo comprendido desde el 1ro de marzo al 30 de mayo del 2010. Se estudiaron 150 adolescentes, escogidos de un universo de 347, a travis de un muestreo por conglomerado bietapico. Inicialmente se aplics una encuesta previamente sometida al mitodo de expertos (Delphi) y evaluada de muy adecuada, donde se determins (...) que el 82 % tenman conocimientos generales inadecuados Despuis de la intervencisn educativa -evaluada de muy adecuada por el mitodo de expertos- el 98,7 % de los adolescentes alcanzaron un nivel de conocimientos adecuados. El analisis estadmstico utilizando la prueba de McNemar, evidencis la asociacisn estadmsticamente significativa (p=0.0000) entre el nivel de conocimiento que tenman los estudiantes antes y despuis de la intervencisn, lo que demostrs que el modelo educativo-participativo empleado aumenta el nivel de conocimientos en los adolescentes. A study of educational intervention was carried out in order to determine the level of knowledge about HIV/AIDS in students of Marcos Rammrez Rodrmguez ESBU in the period from March 1th to May 30th 2010. 150 Teenagers, selected from a universe of 347, were studied through a conglomerate two sampling. Initially, a survey previously submitted to method of expert (Delphi) was applied and properly assessed. It was determined that 82 % had inadequate general knowledge. After the educational intervention - assessed fairly by the method of expert - 98, 7% of teenagers achieved an adequate level of knowledge. Statistical analysis using the McNemar test, showed a statistically significant association (p = 0.0000) between the level of knowledge that students had before and after the intervention, which demonstrated that the educational participative model used increases the level of knowledge among adolescents. (shrink)

Background and rationale Clinicians often encounter a variety of ethical challenges in their routine clinical practice, and it varies across healthcare and cultural settings of their practice. Despite of this, there are no clear-cut available guidelines concerning the right course of action in a given ethically challenging situation. A validated instrument that could capture the health care providers’ viewpoints in this regard is lacking from Indian settings. Thus, the current study aimed at developing an instrument to assess the HCP’s perspective (...) regarding different ethically challenging situations encountered in the Indian settings. Methods The questionnaire was developed by involving 15 medical experts. A mixed-method approach, Delphi-technique, and online survey were used for item generation and validation. Results The questionnaire comprised of 11 items representing four factors: health-resource constraints, medical responsibility of the HCP, obtaining patients/family members’ consent for the treatment, and treatment beyond the standard protocol. The gender and clinical disciplines of the participants were related to their level of endorsement for various domains of the ECCS-Q. Conclusions Ethical challenges in the clinical practice fall in different clusters. The clinicians’ course of action in such situations have many socio-demographic and professional determinants. Future studies are warranted to investigate these phenomena. (shrink)

Whereas the Mediterranean has not submitted easily to strong theories, still it has inspired a certain kind of theorizing from the ground. The setting of the Mediterranean viewed from the land's edge gave the world theoria, which Greek etymology and usage associates with looking onto a scene with amazement, viewing drama, being sent as an emissary to consult the oracle, or traveling for the purposes of sightseeing. The present essay explores some connections between the Mediterranean and theoria. Following a brief (...) survey of how theoria functioned in antiquity, it studies the case of 20th-century Greek poet Angelos Sikelianos and American director and choreographer Eva Palmer - husband and wife - who sought to revive ancient ideas of theoria. They organized revivals of the Delphic Festivals in 1927 and 1930 as a prelude to re-establishing Delphi as a world center for people with a vision for the world. Their work rivaled that of the Olympic Revivals, except that the Delphic Revival was linked to a particular Mediterranean site and pursued the course of art, music, social thought, and especially tragedy together with athletics. A spectacular, imaginative, ambitious, but stillborn effort, it gives evidence of both the potential and limits of Mediterranean theoria. (shrink)

Purpose This study aims to explore the association between internet addiction and problem behaviours on social networking sites using the general strain theory. Design/methodology/approach Using the purposive sampling method, a survey was conducted, which collected data from 414 college students studying in two public universities in South Australia. The Delphi method was used to develop the questionnaire used for the survey. Findings 'Results of this research indicated a significant association between internet addiction and problem behaviours on SNS. (...) Respondents who had engaged in problem behaviours on SNS had high internet addiction test scores. On the basis of this finding, the present research argues that the general strains associated with the suffering of newly emerging challenges such as internet addiction might contribute to victimisation and deviant and problem behaviours on SNS in specific and possibly in cyberspace in general. Research limitations/implications Results of the present study need to be interpreted cautiously due to many limitations it has. This research is a cross-sectional study, which might not adequately explain the associations between internet addiction and problem behaviours on SNS. Longitudinal studies involving larger samples might have added significant value to this study. The present study uses purposive sampling technique, which has limited its generalizability, and its findings may not be generalised to large populations. Originality/value Limited information is available pertaining to the association between problem behaviours on SNS and internet addiction. The present study is a pioneering effort, which argues that rapid popularity of SNS is likely to increase internet addiction and the frustration of not getting proper treatment for their internet addiction might lead to deviant behaviours on SNS. (shrink)

Separate and Dominate is Delphy's manifesto, lambasting liberal hypocrisy and calling for a fluid understanding of political identity that does not place different political struggles in a false opposition. She dismantles the absurd claim that Afghanistan was invaded to save women, and that homosexuals and immigrants alike should reserve their self-expression for private settings. She calls for a true universalism that sacrifices no one at the expense of others. In the aftermath of the Charlie Hebdo massacre, her arguments appear more (...) prescient and pressing than ever.--Provided by publisher. (shrink)

Fascism, according to the Deleuzo-Guattarian perspective and new materialist viewpoints, can be conceived of in terms of desire. In mediating desire’s pure flows, the schizoanalytical programme attempts to bypass what Deleuze calls ‘the strange detour of the other’ (B, 356). In this respect, concepts developed in Gilles Deleuze and Félix Guattari’s Capitalism and Schizophrenia cycle are critical to the project of the problematic of desire, the other and (neo-)fascism. In this chapter, we explore how Deleuzo-Guattarian anti-fascist concepts, such as the (...) Body without Organs (BwO), together with new materialist approaches towards vital materialism, may help us to ‘keep an eye on all that is fascist, even [the fascist] inside us’ (TP, 165). Such a critical-creative analysis, we argue, is needed to distinguish contemporary vitalist new materialisms from so-called Lebensphilosophien (philosophies of life) and frame the rise of neoliberal capitalism-supported regimes of neo-fascism. (shrink)

This essay argues for a transversal posthumanities-based pedagogy, rooted in an attentive ethico-onto-epistemology, by reading the schizoanalytical praxes of Deleuzoguattarian theory alongside the work of various feminist new materialist scholars.

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)

This intra-view explores a number of productive junctions between contemporary Deleuzoguattarian and new materialist praxes via a series of questions and provocations. Productive tensions are explored via questions of epistemological, ontological, ethical, and political intra-sections as well as notions of difference, transversal contamination, ecosophical practices, diffraction, and, lastly, schizoanalysis. Various irruptions around biophilosophy, transduction, becomology, cartography, power relations, hyperobjects as events, individuation, as well as dyschronia and disorientation, take the discussion further into the wild pedagogical spaces that both praxes have (...) in common. -/- . (shrink)

Whether we are said to be living in the Anthropocene, the Capitalocene, or are witnessing the start of the Chthulucene, as feminist science studies scholar Donna J. Haraway (2016) would describe the current post-anthropocentric era, there is a demonstratable need for affective, entangled, transversal forms of thinking-doing today. Writing this editorial almost a year after the COVID-19 pandemic erupted, and that as inhabitants of Belgium and South Africa—countries with complex ongoing capitalist-colonial legacies, socio-political presents, and heavily but also differently hit (...) by said pandemic—we more than ever feel that these are times of entwined crisis, chaos, and hardship, overflowing with cravings for pedagogical-philosophical responses that are affirmative, productive, and future-oriented. Reactions that are moreover part theory, part praxis, counter the nihilistic, and are future-focused while still grounded in the present, as to not defer responsibilities to future times (see Geerts & Carstens, 2019). (shrink)

French Feminism Reader is a collection of essays representing the authors and issues from French theory most influential in the American context. The book is designed for use in courses, and it includes illuminating introductions to the work of each author. These introductions include biographical information, influences and intellectual context, major themes in the author's work as a whole, and specific introductions to the selections in this volume. This collection includes selections by Simone de Beauvoir, Christine Delphy, Colette Guilluamin, Monique (...) Wittig, Michele Le Doeuff, Julia Kristeva, Luce Irigaray, and Helene Cixious. (shrink)

Context: Although ethics consultation is commonplace in United States (U.S.) hospitals, descriptive data about this health service are lacking. Objective: To describe the prevalence, practitioners, and processes of ethics consultation in U.S. hospitals. Design: A 56-item phone or questionnaire survey of the "best informant" within each hospital. Participants: Random sample of 600 U.S. general hospitals, stratified by bed size. Results: The response rate was 87.4%. Ethics consultation services (ECSs) were found in 81% of all general hospitals in the U.S., (...) and in 100% of hospitals with more than 400 beds. The median number of consults performed by ECSs in the year prior to survey was 3. Most individuals performing ethics consultation were physicians (34%), nurses (31%), social workers (11%), or chaplains (10%). Only 41% had formal supervised training in ethics consultation. Consultation practices varied widely both within and between ECSs. For example, 65% of ECSs always made recommendations, whereas 6% never did. These findings highlight a need to clarify standards for ethics consultation practices. (shrink)

Brain dead organ donors are the principal source of transplantable organs. However, it is controversial whether brain death is the same as biological death. Therefore, it is unclear whether organ removal in brain death is consistent with the ‘dead donor rule’, which states that organ removal must not cause death. Our aim was to evaluate the public9s opinion about organ removal if explicitly described as causing the death of a donor in irreversible apneic coma. We conducted a cross-sectional internet (...) class='Hi'>survey of the American public (n=1096). Questionnaire domains included opinions about a hypothetical scenario of organ removal described as causing the death of a patient in irreversible coma, and items measuring willingness to donate organs after death. Some 71% of the sample agreed that it should be legal for patients to donate organs in the scenario described and 67% agreed that they would want to donate organs in a similar situation. Of the 85% of the sample who agreed that they were willing to donate organs after death, 76% agreed that they would donate in the scenario of irreversible coma with organ removal causing death. There appears to be public support for organ donation in a scenario explicitly described as violating the dead donor rule. Further, most but not all people who would agree to donate when organ removal is described as occurring after death would also agree to donate when organ removal is described as causing death in irreversible coma. (shrink)

This article is a critical survey of the debate over the value of the social discount rate, with a particular focus on climate change. The ma- jority of the material surveyed is from the economics rather than from the philosophy literature, but the emphasis of the survey itself is on founda- tions in ethical and other normative theory rather than highly technical details. I begin by locating the standard approach to discounting within the overall landscape of ethical theory, (...) and explaining the assumptions and simplifications that are needed in order to arrive at the model that is standard in the discounting literature. The article then covers the general theory of the Ramsey equation and its relationship to observed interest rates, arguments for and against a positive rate of pure time preference, the consumption elasticity of utility, and the effect of various sorts of uncertainty on the discount rate. Finally, it turns specifically to the ap- plication of this debate to the case of climate change, focussing on the recent controversy over the low discount rate used in the Stern Review of the Economics of Climate Change. (shrink)

This acclaimed book is back in print with a new introduction by its award-winning author.

This unique collection of reports encompasses a wide range of challenges and activities of business ethics in most parts of the world. In the introduction, after a brief explanation of the sixfold questionnaire and its assumptions, I try to highlight a number of striking features contained in these reports, which may help to delineate the state-of-the-art of business ethics at national and regional levels. As a result of this international comparison, the following features deserve particular attention: the relevance of semantics, (...) corruption, leadership, corporate responsibilities, the need for case studies, business ethics as a social institution, and the question as to how important international issues really are. (shrink)

In this paper, the Author reviewed the typical objections against the claim that brains are computers, or, to be more precise, information-processing mechanisms. By showing that practically all the popular objections are based on uncharitable interpretations of the claim, he argues that the claim is likely to be true, relevant to contemporary cognitive science, and non-trivial.

Standard approaches to defining and evaluating environmental risk tend to reflect technocratic rather than democratic values. One consequence is that institutional mechanisms for achieving citizen participation in risk decisions rarely are studied or evaluated. This article presents a survey of five institutional mechanisms for allowing the lay public to influence environmental risk decisions: public hearings, initiatives, public surveys, negotiated rule making, and citizens review panels. It also defines democratic process criteria for assessing these and other participatory mechanisms.