Studies on age-related differences in risk perception in a real-world situation, such as the recent COVID-19 outbreak, showed that the risk perception of getting COVID-19 tends to decrease as age increases. This finding raised the question on what factors could explain risk perception in older adults. The present study examined age-related differences in risk perception in the early stages of COVID-19 lockdown, analyzing variables that can explain the differences in perception of risk at different ages. A total of 1,765 adults (...) aged between 18 and 87 years old completed an online survey assessing perceived risk severity and risk vulnerability of getting COVID-19, sociodemographic status, emotional state, experience relating to COVID-19, and physical health status. Results showed that the older the participants, the lower the perceived vulnerability to getting COVID-19, but the higher the perceived severity. Different predictors explain the perception of risk severity and vulnerability at different ages. Overall, self-reported anxiety over the pandemic is a crucial predictor in explaining risk perceptions in all age groups. Theoretical and practical implications of the empirical findings are discussed. (shrink)

BackgroundEverybody has the right to decide whether to receive specific medical treatment or not and to provide their free, prior and informed consent to do so. As dementia progresses, people with Alzheimer’s dementia (PwAD) can lose their capacity to provide informed consent to complex medical treatment. When the capacity to consent is lost, the autonomy of the affected person can only be guaranteed when an interpretable and valid advance directive exists. Advance directives are not yet common in Germany, and their (...) validity is often questionable. Once the dementia diagnosis has been made, it is assumed to be too late to write an advance directive. One approach used to support the completion of advance directives is ‘Respecting Choices’®—an internationally recognised, evidence-based model of Advance Care Planning (ACP), which, until now, has not been evaluated for the target group of PwAD. This study’s aims include (a) to investigate the proportion of valid advance directives in a memory clinic population of persons with suspected AD, (b) to determine the predictors of valid advance directives, and (c) to examine whether the offer of ACP can increase the proportion of valid advance directives in PwAD.MethodWe intend to recruit at leastN = 250 participants from two memory clinics in 50 consecutive weeks. Of these, the first 25 weeks constitute the baseline phase (no offer of ACP), the following 25 weeks constitute the intervention phase (offer of ACP). The existence and validity of an advance directive will be assessed twice (before and after the memory clinic appointment). Moreover, potential predictors of valid advance directives are assessed.DiscussionThe results of this study will enhance the development of consent procedures for advance directives of PwAD based on the ACP/Respecting Choices (R) approach. Therefore, this project contributes towards increasing the autonomy and inclusion of PwAD and the widespread acceptance of valid advance directives in PwAD.Trial RegistrationDRKS, DRKS00026691, registered 15th of October 2021,https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00026691. (shrink)

The proposed framework by Lynch et al. (2021) for promoting ethical forms of payment in Human Infection Controlled Studies (HICS) in general and SARS-Cov-2 HICS in particular is an important contri...

BackgroundInformed consent forms for clinical research are several and variable at international, national and local levels. According to the literature, they are often unclear and poorly understood by participants. Within the H2020 project CORBEL—Coordinated Research Infrastructures Building Enduring Life-science Services—clinical researchers, researchers in ethical, social, and legal issues, experts in planning and management of clinical studies, clinicians, researchers in citizen involvement and public engagement worked together to provide a minimum set of requirements for informed consent in clinical studies.MethodsThe template was (...) based on a literature review including systematic reviews and guidelines searched on PubMed, Embase, Cochrane Library, NICE, SIGN, GIN, and Clearinghouse databases, and on comparison of templates gathered through an extensive search on the websites of research institutes, national and international agencies, and international initiatives. We discussed the draft versions step-by-step and then we referred to it as the “matrix” to underline its modular character and indicate that it allows adaptation to the context in which it will be used. The matrix was revised by representatives of two international patient groups.ResultsThe matrix covers the process of ensuring that the appropriate information, context and setting are provided so that the participant can give truly informed consent. It addresses the key topics and proposes wording on how to clarify the meaning of placebo and of non-inferiority studies, the importance of individual participants’ data sharing, and the impossibility of knowing in advance how the data might be used in future studies. Finally, it presents general suggestions on wording, format, and length of the information sheet.ConclusionsThe matrix underlines the importance of improving the process of communication, its proper conditions (space, time, setting), and addresses the participants’ lack of knowledge on how clinical research is conducted. It can be easily applied to a specific setting and could be a useful tool to identify the appropriate informed consent format for any study. The matrix is mainly intended to support multicentre interventional randomized clinical studies, but several suggestions also apply to non-interventional research. (shrink)

Written by two of the leading figures in the field, this is a lucid and systematic introduction to semantics as applied to transformational grammars of the ...

Despite the growing interest in societal impact in the business and society literature, there remains a notable gap in research on the impact of health interventions on physical and mental health and social welfare. To address this gap, we shift the unit of analysis to the intervention, akin to the level of analysis used in health research. Drawing on a curated subset of health interventions in the workplace from the public health literature, we argue that management scholars can adopt the (...) methods used by public health scholars to design and assess health interventions. By tapping into the rich insights gained from these studies, management scholars can propose evidence-based interventions and policies that can enhance health outcomes, improve productivity, and cultivate a healthier workplace atmosphere. Collaborating with public health researchers, business and society scholars can help create a new field of research on corporate health policy. (shrink)

La infección por el virus del papiloma humano (VPH) constituye la causa necesaria, aunque no suficiente, de la enfermedad de transmisión sexual más frecuente en el mundo, responsable del 4,5 % de todos los cánceres en ambos sexos. La vacunación frente al VPH, con niveles de eficacia y seguridad similares en ambos sexos, está dirigida básicamente a mujeres, para reducir la incidencia de infección y sus consecuencias, como el cáncer de cérvix. La transmisibilidad del virus en ambos sexos y la (...) inmunidad colectiva que proporciona la vacunación universal hace que su extensión al sexo masculino constituya una cuestión no solo de salud pública, sino también un dilema bioético relacionado con la protección de la salud y la equitativa distribución de los recursos. Este trabajo aborda el análisis bioético de la extensión de la vacunación contra VPH a ambos sexos. (shrink)

BackgroundCommunity engagement is a key component in health research. One of the ways health researchers ensure community engagement is through Community Advisory Boards (CABs). The capacity of CABs to properly perform their role in clinical research has not been well described in many resource limited settings. In this study, we assessed the capacity of CABs for effective community engagement in Uganda.MethodsWe conducted a cross sectional study with mixed methods. We used structured questionnaires and key informant interviews (KII) to collect data (...) from CAB members, trial investigators, and community liaison officers. For quantitative data, we used descriptive statistics while for qualitative data we used content analysis.ResultsSeventy three CAB members were interviewed using structured questionnaires; 58.9% males, median age 49 years (IQR 24–70), 71.2% had attained tertiary education, 42.5% never attended any research ethics training, only 26% had a training in human subject protection, 30.1% had training in health research, 50.7% never attended any training about the role of CABs, and 72.6% had no guidelines for their operation. On the qualitative aspect, 24 KIIs cited CAB members to have some skills and ability to understand and review study documents, offer guidance on community norms and expectations and give valuable feedback to the investigators. However, challenges like limited resources, lack of independence and guidelines, and knowledge gaps about research ethics were cited as hindrances of CABs capacity.ConclusionThough CABs have some capacity to perform their role in the Ugandan setting, their functionality is limited by lack of resources to facilitate their work, lack of independence, lack of guidelines for their operations and limited knowledge regarding issues of research ethics and protection of the rights of trial participants. (shrink)

To our knowledge, this is one of the first studies to test different theoretical models of working memory in childhood based on a computerized assessment. We tested this across several countries: Argentina, Brazil, Canada, Italy, and UK. The present study addressed the wider macro-cultural context and how this impacts working memory. We used two economic indices to characterize the participating countries and ranked the countries based on the Global Index of Cognitive Skills and Educational Attainment. Children between 5 and 10 (...) years completed the same set of short-term and working memory tests. There were two main findings. First, there was a similar pattern in verbal working memory across countries, which suggests that this skill may be relatively consistent across different cultural groups. In contrast, the pattern for visuo-spatial working memory was different across countries, which may explained by cultural differences and educational rankings of the countries. The second main finding was that both a domain-general model and a domain-specific model provided a reasonably good fit with the data, there was the high relationship between the verbal and visuo-spatial working memory constructs across the countries in the latter model. Thus, it may be a more parsimonious choice to rely on a three-factor model. The data also suggest culture-similar patterns in a computerized assessment of working memory. (shrink)

BackgroundWork stress is a serious problem in primary education. Decades of research underline the importance of participatory, organizational-level work stress prevention approaches. In this approach, measures are planned to tackle causes of work stress in a participatory manner and implemented by a working group consisting of members of the organization. This approach can only be effective if the measures contain effective ingredients to decrease work stress risks and are successfully implemented. The aim of this paper is to present an outline (...) of a work stress prevention approach that is evaluated in primary education. To ensure the appropriateness of measures, a logic model of change is built as part of the risk assessment to facilitate the selection of appropriate measures. Progression on target behaviors as well as implementation factors are real-time monitored during implementation and fed back to the working groups, to provide the opportunity to adjust action plans when needed to optimize implementation.MethodsThe approach consists of five steps: preparation: installing an advisory board and working groups, risk assessment: inventory of work stress risks. In addition, a behavioral analysis is performed to build a logic model of change to facilitate selection of measures, action planning: conducting an action plan with appropriate measures, implementation: implementing the action plan. During implementation progression on target behaviors and implementation factors are monthly monitored and fed back to the working groups, and evaluation: effects of the approach are studied in a controlled trial with measurements at baseline, 1 year, and 2 years follow-up. A process evaluation is carried out using quantitative and qualitative data to study the implementation process of all steps of the work stress approach.DiscussionWe believe that building a logic model of change and real-time monitoring of implementation could be of added value to improve the success of the work stress prevention approach. With this study, we aim to provide more insights into work stress intervention research, especially in primary education.Clinical Trial RegistrationThe study is registered in Netherlands Trial Register. (shrink)

ABSTRACTThe ‘Scientific Culture at Enterprises’ project aims to identify the different factors that characterize the image of science held by entrepreneurs and business managers, explore the relationships among these factors, and shed light on the role they play in defining this image and ultimately in developing a culture of science in the business sector. This article is based on the results of the SCe 2016 survey with a specially designed telephone survey questionnaire of a representative sample of Spanish companies. The (...) novelty of our approach lies in the application of a model developed in the fields of Social Studies of Science and Public Understanding of Science to the business sector, in order to obtain information on the dispositions of perception, interest, knowledge and action and their relationships with science and innovation in the business sector in Spain. Using the PIKA model of the image of science, we found this image in the business sector to be shaped by entrepreneurs... (shrink)

Los avances científico-tecnológicos han abierto una brecha en cuanto a los tratamientos médicos y los valores morales que deben sustentar la atención de salud. El profesional de enfermería no está exento de estos peligros, por lo que se ha generado un nuevo modelo ético que se integre al proceso de atención de enfermería. Con el objetivo de determinar los conocimientos y opiniones de estos profesionales, del área de cirugía de mínimo acceso, acerca de la aplicación del modelo en el contexto (...) de estos servicios, se diseñó una investigación de tipo observacional descriptiva con empleo de metodología cualitativa. Como técnica de exploración se usó la entrevista en profundidad, así como un panel de expertos para la construcción de la guía de entrevista. Se entrevistó a 34 enfermeras que laboraban en el Centro Nacional de Cirugía de Mínimo Acceso durante el período del estudio. Se concluye que la práctica de la cirugía de mínimo acceso es propicia para que médicos y enfermeras hagan una mayor observancia del derecho de autonomía de los pacientes. Se reconoce la capacidad de este personal para tomar decisiones independientes de los médicos en cuanto a las acciones de cuidado, lo que implica una mayor responsabilidad. Scientific and technological advances have opened a gap between medical treatments and the moral values that should support health care. The nurse is not exempt from these dangers. As such, a new ethical model that integrates to the process of nursing care has emerged. In order to determine the knowledge and opinions of the professionals who work in minimal access surgery services on the implementation of this model, a descriptive, observational study was designed utilizing qualitative methodology. In-depth interviewing was used as the primary testing technique. A panel of experts from the National Center of Minimal Access Surgery was consulted to develop the interview guide. Thirty-four nurses from the National Center for Minimal Access Surgery were interviewed over the course of the study period. Results suggest that the setting of minimal access surgery is conducive to medical professionals making greater observance of the right to patient autonomy. The ability of this staff to make independent decisions regarding medical care action is recognized, which implies greater responsibility. (shrink)

SCHOFIELD I, TOLSON D and FLEMING V. Nursing Inquiry 2012; 19: 165–176 [Epub ahead of print]How nurses understand and care for older people with delirium in the acute hospital: a Critical Discourse AnalysisDelirium is a common presentation of deteriorating health in older people. It is potentially deleterious in terms of patient experience and clinical outcomes. Much of what is known about delirium is through positivist research, which forms the evidence base for disease‐based classification systems and clinical guidelines. There is little (...) systematic study of nurses’ day‐to‐day practice of nursing patients with delirium. The aim was to uncover the kinds of knowledge that informs nurses’ care and to explicate the basis of that knowledge. Critical Discourse Analysis is underpinned by the premise that powerful interests within society mediate how social practices are constructed. Links were made between the grammatical and lexical features of nurses’ language about care in interviews and naturalistic settings, and the healthcare context. Care focused on the continuous surveillance of patients with delirium by nurses themselves or vicariously through other patients, and containment. Nurses influenced by major discourses of risk reduction and safety, constructed patients with delirium as risk objects. The philosophy of person‐centred and dignified care advocated in nursing literature and government policy is an emerging discourse, though little evident in the data. The current dominant discourses on safety must give space to discourses of dignity and compassion. (shrink)

This essay is a critical review of two recent collections, Feminism and Foucault: Reflections on Resistance, edited by Irene Diamond and Lee Quinby and Feminism as Critique: On the Politics of Gender, edited by Seyla Benhabib and Drucilla Cornell. While the collections differ in their manner of addressing the critical sources that have inspired them-the former relying upon a single theorist, the latter attempting to move through some of the philosophical history that constitutes our present theoretical terrain-both attempt to (...) think through and thus revisualize some of the categories of difference which we have inherited. Though the best essays from these collections are celebrated for demonstrating how "feminism as critique" can work to move us toward a clearer and more inclusive feminist theory, questions are raised about what the inattention to race in these volumes suggests about our own role in the construction of power and knowledge, and the erasures that help to secure them both. (shrink)

Background The aim was to explore how the clinical ethics committees in Norway have worked and functioned within mental health care and addiction treatment services. Methods Analysis of 256 annual reports from clinical ethics committees from 2003 to 2012 and a survey to clinicians who had used a clinical ethics committee. Results Dilemmas related to coercion, confidentiality, information, and patient autonomy dominated. The committees established only for psychiatric hospitals, had received more cases from mental health and addiction services than the (...) committees also serving somatic services. Many of the case discussions involved both somatic and mental health care, complicated legal issues as well as ethical dilemmas. Mental health care professionals that have used the clinical ethics committees evaluated the clinical ethics committees deliberation as useful. Conclusion Given the many difficult ethical dilemmas in mental health care ethics work need to be strengthened. The complexity of the cases requires varied and interdisciplinary competence and training among the clinical ethics committee members. (shrink)

ArgumentThe Ashkenazi grammars of Hebrew written between roughly 1600 and 1800 fill a modest and largely forgotten shelf in the Jewish scholarly library. At first sight, especially when compared with the medieval Jewish and contemporary Christian Hebrew traditions, they seem to lack technical sophistication. As this paper hopes to demonstrate, however, this apparent lack of sophistication was not so much an intrinsic flaw as a deliberate choice. For the earliest Ashkenazi textbooks were not about studying grammar, but about teaching Hebrew. (...) By adapting the existing descriptive models to the needs of the classroom and the gemeyne leytn, Jewish scholars and teachers in such cities as Prague, Wilhelmsdorff, and Amsterdam hoped to find and instruct new audiences. Depending on context and target audience, they either relied on Hebrew, Yiddish, or on an intricate interplay of the two for maximum success and efficiency. It was this innovative combination of didactic simplification and functional bilingualism that allowed them not only to reach a new readership, but also to equip that readership to henceforth read their Bible and prayers with unprecedented autonomy. (shrink)

Research from behavioural sciences shows that people reach decisions in a much less rational and well-considered way than was often assumed. The doctrine of informed consent, which is an important ethical principle and legal requirement in medical practice, is being challenged by these insights into decision-making and real-world choice behaviour. This article discusses the implications of recent insights of research on decision-making behaviour for the informed consent doctrine. It concludes that there is a significant tension between the often non-rational choice (...) behaviour and the traditional theory of informed consent. Responsible ways of dealing with or solving these problems are considered. To this end, patient decisions aids are discussed as suitable interventions to support autonomous decision-making. However, current PDAs demand certain improvements in order to protect and promote autonomous decision-making. Based on a conception of autonomy, we will argue which type of improvements are needed. (shrink)

This article uses a conversation analytic framework to describe a type of wh-question used to challenge a prior utterance, specifically to challenge the basis for or right to do an action done by the prior utterance. These wh-questions are able to do challenging because, rather than asking for new information, they are used to convey a strong epistemic stance of the questioner, a negative assertion. The utterances are designed as requests for an account for a prior claim or action, but (...) by conveying a negative assertion, they suggest that there is no adequate account available and, thus, that there are no grounds for the prior claim or action. The use of these questions in institutional settings can display participants' orientation to institutional goals, norms and roles, showing that institutional roles can thus be enacted, and goals accomplished, by means of practices of talk which are not, themselves, institutionally specific. (shrink)

With the increased use of Artificial Intelligence (AI) in wildlife conservation, issues around whether AI-based monitoring tools in wildlife conservation comply with standards regarding AI Ethics are on the rise. This review aims to summarise current debates and identify gaps as well as suggest future research by investigating (1) current AI Ethics and AI Ethics issues in wildlife conservation, (2) Initiatives Stakeholders in AI for wildlife conservation should consider integrating AI Ethics in wildlife conservation. We find that the existing literature (...) weakly focuses on AI Ethics and AI Ethics in wildlife conservation while at the same time ignores AI Ethics integration in AI systems for wildlife conservation. This paper formulates an ethically aligned AI system framework and discusses pre-eminent on-demand AI systems in wildlife conservation. The proposed framework uses agile software life cycle methodology to implement guidelines towards the ethical upgrade of any existing AI system or the development of any new ethically aligned AI system. The guidelines enforce, among others, the minimisation of intentional harm and bias, diversity in data collection, design compliance, auditing of all activities in the framework and ease of code inspection. This framework will inform AI developers, users, conservationists, and policymakers on what to consider when integrating AI Ethics into AI-based systems for wildlife conservation. (shrink)

The concept of sustainability was developed in response to stakeholder demands. One of the key mechanisms for engaging stakeholders is sustainability disclosure, often in the form of a report. Yet, how reporting is used to engage stakeholders is understudied. Using resource dependence and stakeholder theories, we investigate how companies within the same industry address different dependencies on stakeholders for economic, natural environment, and social resources and thus engage stakeholders accordingly. To achieve this objective, we conducted our research using qualitative research (...) methods. Our findings suggest that the resource dependencies on different stakeholders lead to development of different stakeholder relationships and thus appropriate resources within the company to execute engagement strategies that are informing, responding, or involving. Our research explains why diversity exists in sustainability disclosure by studying how it is used to engage stakeholders. We find that five sustainability reporting characteristics are associated with the company’s stakeholder engagement strategy: directness of communication, clarity of stakeholder identity, deliberateness of collecting feedback, broadness of stakeholder inclusiveness, and utilization of stakeholder engagement for learning. Our study develops the literature by providing insight into companies’ choices of stakeholder engagement strategy thus explaining diversity in sustainability reporting based on the characteristics and relationships with specific stakeholders. (shrink)

Kevin Smith's utilitarian argument against homeopathy1 is flawed because he did not review and refute the relevant basic science literature on ultra-high dilutions. He also failed to appreciate that allopathic medicine is based on a deductive-nomothetic method and that homeopathic medicine is based on an inductive-idiographic method, and thus that the implications for clinical research are very different. His misunderstanding of provings and of the holism of homeopathic medicine also demonstrated his failure to understand the history, philosophy and method of (...) homeopathy. Finally, I questioned the value of introducing ethical judgment into an ongoing scientific debate. (shrink)

There are several conceptions of truth, such as the classical correspondence conception, the coherence conception and the pragmatic conception. The classical correspondence conception, or Aristotelian conception, received a mathematical treatment in the hands of Tarski (cf. Tarski [1935] and [1944]), which was the starting point of a great progress in logic and in mathematics. In effect, Tarski's semantic ideas, especially his semantic characterization of truth, have exerted a major influence on various disciplines, besides logic and mathematics; for instance, linguistics, the (...) philosophy of science, and the theory of knowledge. The importance of the Tarskian investigations derives, among other things, from the fact that they constitute a mathematical, formal mark to serve as a reference for the philosophical (informal) conceptions of truth. Today the philosopher knows that the classical conception can be developed and that it is free from paradoxes and other difficulties, if certain precautions are taken. We believe that is not an exaggeration if we assert that Tarski's theory should be considered as one of the greatest accomplishments of logic and mathematics of our time, an accomplishment which is also of extraordinary relevance to philosophy, as we have already remarked. In this paper we show that the pragmatic conception of truth, at least in one of its possible interpretations, has also a mathematical formulation, similar in spirit to that given by Tarski to the classical correspondence conception. (shrink)