The purpose of this paper is to examine the various discourses, particularly the dominant instrumental and economic discourses that have brought the phenomena of the nurse practitioner into being. It is proposed that NPs have been constituted as an object of nature and therefore understood metaphorically as a tool or instrument within the health care system to be used efficiently and effectively. Heidegger's philosophical analysis of the question concerning technology is used to argue that our current ways of knowing the (...) NP through these discourses, with their emphasis on calculative logic, have resulted from our modern view of the essence of technology. It is also argued that there is now a need to shape our horizons concerning the NP in new and different ways. There is a need to engage in dialogical forms of research in order to evoke the richness and depth of what it means to be an NP, that is, to reveal the other modes of expression by which we define ourselves, understand others and nursing. (shrink)

The aim of this article is to explore the complex forms of knowledge involved in diagnostic and interventional decision making by comparing the processes in medicine and nursing, including nurse practitioners. Many authors assert that the practice of clinical decision making involves the application of theoretical knowledge (acquired in the classroom and textbooks) as well as research evidence, upon concrete particular cases. This approach draws on various universal principles and algorithms to facilitate the task. On the other hand, others argue (...) that this involves an intuitive form of judgement that is difficult to teach, one that is acquired principally through experience. In an exploration of these issues, this article consists of three sections. A clarification of terms commonly used when discussing decision making is provided in the first section. In the second section, an epistemological analysis of decision making is presented by examining several perspectives and comparing them for their use in the nursing and medical literature. Bunge's epistemological framework for decision making (based on scientific realism) is explored for its fit with the aims of medicine and nursing. The final section presents a discussion of knowledge utilization and decision making as it relates to the implications for the education and ongoing development of nurse practitioners. It is concluded that Donald Schön's conception of reflective practice best characterizes the skilful conduct of clinical decision making. (shrink)

Background The ethical governance of Artificial Intelligence (AI) in health care and public health continues to be an urgent issue for attention in policy, research, and practice. In this paper we report on central themes related to challenges and strategies for promoting ethics in research involving AI in global health, arising from the Global Forum on Bioethics in Research (GFBR), held in Cape Town, South Africa in November 2022. Methods The GFBR is an annual meeting organized by the World Health (...) Organization and supported by the Wellcome Trust, the US National Institutes of Health, the UK Medical Research Council (MRC) and the South African MRC. The forum aims to bring together ethicists, researchers, policymakers, research ethics committee members and other actors to engage with challenges and opportunities specifically related to research ethics. In 2022 the focus of the GFBR was “Ethics of AI in Global Health Research”. The forum consisted of 6 case study presentations, 16 governance presentations, and a series of small group and large group discussions. A total of 87 participants attended the forum from 31 countries around the world, representing disciplines of bioethics, AI, health policy, health professional practice, research funding, and bioinformatics. In this paper, we highlight central insights arising from GFBR 2022. Results We describe the significance of four thematic insights arising from the forum: (1) Appropriateness of building AI, (2) Transferability of AI systems, (3) Accountability for AI decision-making and outcomes, and (4) Individual consent. We then describe eight recommendations for governance leaders to enhance the ethical governance of AI in global health research, addressing issues such as AI impact assessments, environmental values, and fair partnerships. Conclusions The 2022 Global Forum on Bioethics in Research illustrated several innovations in ethical governance of AI for global health research, as well as several areas in need of urgent attention internationally. This summary is intended to inform international and domestic efforts to strengthen research ethics and support the evolution of governance leadership to meet the demands of AI in global health research. (shrink)

The application of neurostimulation techniques such as deep brain stimulation —often called a brain pacemaker for neurological conditions like Parkinson's disease —has generated “currents of hope.” Building on this hope, there is significant interest in applying neurostimulation to psychiatric disorders such as major depression and obsessive-compulsive disorder. These emerging neurosurgical practices raise a number of important ethical and social questions in matters of resource allocation, informed consent for vulnerable populations, and commercialization of research.

A recently proposed model of sensory processing suggests that perceptual experience is updated in discrete steps. We show that the data advanced to support discrete perception are in fact compatible with a continuous account of perception. Physiological and psychophysical constraints, moreover, as well as our awake-primate imaging data, imply that human neuronal networks cannot support discrete updates of perceptual content at the maximal update rates consistent with phenomenology. A more comprehensive approach to understanding the physiology of perception (and experience at (...) large) is therefore called for, and we briefly outline our take on the problem. (shrink)

This participatory study recounts conversational practices occurring between three teachers, a head of school, and a researcher during a month-long curriculum design workshop mediated by the MagicSchool AI technology to create social studies, language arts, science, and mathematics lessons for a virtual special education program. A social paradigm of AI-mediated educational practices is presented, wherein teachers interact with AI tools by embodying co-agency and a spirit of inquiry. Collective practices are interpreted using Gordon Pask’s conversation theory framework, showcasing how to (...) design systems of human-AI feedback loops devoted towards curriculum design. Meeting transcriptions, AI-prompt data, AI-mediated lesson plans, teacher feedback, and final products are shared using narrative inquiry to illustrate how collaborative co-agency culminated in lesson plans that co-observers felt confident in deploying. (shrink)

We explore the Covid-19 pandemic’s impact on companies’ sustainability strategies and practices. Prior research has identified a number of factors that shape such effects, including crisis severity, resource slack, and prior investments, but their interactions have not been given much attention. We thus collected qualitative data on 25 companies in four African countries, which we analyzed inductively and iteratively through cross-case comparison and with fuzzy set Qualitative Comparative Analysis. We identify two pathways associated with strengthening responses (“building on strengths” and (...) “governance gap-filling”) and three associated with restricting responses (“hard hit,” “low-road business-as-usual,” and “bunkering down”). Our findings enhance our understanding of organizational responses to crises by attending to configurational effects, by elaborating the role of prior sustainability investments, and by foregrounding the relevance of governance contexts. We describe implications for future research and managers, investors, and sustainability initiatives such as the United Nations Global Compact. (shrink)

Major depression is among the most common, challenging and disabling conditions. It is highly heterogeneous, affects patients throughout the lifespan and, in up to one-third of people affected, res...

Although research has examined factors influencing understanding of informed consent in biomedical and forensic research, less is known about participants' attention to details in consent documents in psychological survey research. The present study used a randomized experimental design and found the majority of participants were unable to recall information from the consent form in both in-person and online formats. Participants were also relatively poor at recognizing important aspects of the consent form including risks to participants and confidentiality procedures. Memory effects (...) and individual difference characteristics also appeared to influence recall and recognition of consent form information. (shrink)

Abstract:Open neural tube defects or myelomeningoceles are a common congenital condition caused by failure of closure of the neural tube early in gestation, leading to a number of neurologic sequelae including paralysis, hindbrain herniation, hydrocephalus and neurogenic bowel and bladder dysfunction. Traditionally, the condition was treated by closure of the defect postnatally but a recently completed randomized controlled trial of prenatal versus postnatal closure demonstrated improved neurologic outcomes in the prenatal closure group. Fetal surgery, or more precisely maternal-fetal surgery, raises (...) a number of ethical issues that we address including who the patient is, informed consent, surgical innovation and equipoise as well maternal assumption of risk. As the procedure becomes more widely adopted into practice, we suggest close monitoring of new fetal surgery centers, in order to ensure that the positive results of the trial are maintained without increased risk to both the mother and fetus. (shrink)

Psychological distress, including depression and anxiety, and Type-D personality are prevalent in patients with coronary heart disease and associated with poor cardiovascular outcomes. Worry and rumination may be among the core features responsible for driving psychological distress in these patients. However, the nature of associations between these constructs remains to be delineated, yet they may have implications for the assessment and treatment of CHD patients. This study aimed to explore the factorial structure and potential overlap between measures of depression, anxiety (...) and the Type-D personality factors known as negative affectivity and social inhibition, and examine how these constructs relate to worry and rumination in a sample of 1,042 CHD outpatients who participated in the in the cross-sectional NORwegian CORonary Prevention study. We conducted confirmatory factor analyses and regression analyses within a structural equation modeling framework. Results showed all constructs to have acceptable factor structure and indicated an overlap between the constructs of depression and negative affectivity. Worry was most strongly associated with anxiety, whereas rumination was most strongly associated with depression and negative affectivity. The results suggest conceptual similarities across the measures of depression and negative affectivity. They further suggest that intervention efforts could benefit from targeting worry and/or rumination in the treatment of CHD outpatients presenting with symptoms of psychological distress. (shrink)

We divide the class of infinite computable trees into three types. For the first and second types, 0' computes a nontrivial self-embedding while for the third type 0'' computes a nontrivial self-embedding. These results are optimal and we obtain partial results concerning the complexity of nontrivial self-embeddings of infinite computable trees considered up to isomorphism. We show that every infinite computable tree must have either an infinite computable chain or an infinite Π01 antichain. This result is optimal and has connections (...) to the program of reverse mathematics. (shrink)

Written in an engaging narrative style these philosophical investigations undermine racist hierarchies along with false natualistic conceptions of the meanings of race and universalistic understandings of gender, by considering whiteness as it shapes and is infused by gender, class, sexuality, and culture. Central to this project are questions about how it is that culture and the state create such a wide range of different people who understand themselves as white. The essays collected here discuss how one learns to be a (...) good white Southern woman, what it means to pass as white, and whether there really is a dilemma that accompanies white privilege. (shrink)

Canada has historically relied on a system of ad hoc committees for ethical guidance on public health and science policy, unlike the more centralized approach of more than 140 countries worldwide. Here, drawing on interviews with leaders across the country, we offer a perspective on the imperative and a strategy for a coordinated, Bioethics Council for Canada structured to ensure proactive thinking, provide rapid responses, and engage the public on urgent bioethics matters concerning the health and well-being of Canadians.

The worldwide decline in bees and other pollinating insects is a threat to biodiversity and food security, and urgent action must be taken to stop and then reverse this decline. An established cause of the insect decline is the use of harmful pesticides in agriculture. This case study focuses on the use of pesticides in Norwegian apple production and considers who among farmers, consumers and public authorities is most responsible for protecting bees against harmful pesticides. The extent to which these (...) three different groups consider themselves responsible and the degree to which they are trusted by each of the other groups are also studied. This empirical study involves both qualitative interviews with Norwegian apple farmers, consumers and public authorities and survey data from consumers and farmers. The results show that consumers consider public authorities and farmers equally responsible for protecting bees, while farmers are inclined to consider themselves more responsible. Farmers, consumers and public authorities do not consider consumers significantly responsible for protecting bees, and consumers have a high level of trust in both farmers and public authorities regarding this matter. This study also finds that a low level of consumer trust in farmers or public authorities increases consumers’ propensity to purchase organic food, suggesting that those who do not trust that enough action is adopted to protect the environment take on more individual responsibility. This paper adds to the existing literature concerning the allocation of responsibility for environmental outcomes, with empirical evidence focusing specifically on pesticides and bees. (shrink)

Courtin, Judy As a young girl in the 1960s, I attended a Catholic boarding school. The nuns could be scary. When they walked the wintry and un-illuminated corridors of the convent, their knee-length rosary beads jangled against their ankle-length black habits.

Quarterly publication discussing various topics in environmental ethics, including features, discussion papers, book reviews, editorial commentaries, and other text related to environmental philosophies. Some issues also include announcements and other news related to the environmental studies community.

Quarterly publication discussing various topics in environmental ethics, including features, discussion papers, book reviews, editorial commentaries, and other text related to environmental philosophies. Some issues also include announcements and other news related to the environmental studies community.

Quarterly publication discussing various topics in environmental ethics, including features, discussion papers, book reviews, editorial commentaries, and other text related to environmental philosophies. Some issues also include announcements and other news related to the environmental studies community.

Long-term potentiation is one of the most extensively studied forms of neuroplasticity and is considered the strongest candidate mechanism for memory and learning. The use of event-related potentials and sensory stimulation paradigms has allowed for the translation from animal studies to non-invasive studies of LTP-like synaptic plasticity in humans. Accumulating evidence suggests that synaptic plasticity as measured by stimulus-specific response modulation is reduced in neuropsychiatric disorders such as major depressive disorder, bipolar disorders and schizophrenia, suggesting that impaired synaptic plasticity plays (...) a part in the underlying pathophysiology of these disorders. This is in line with the neuroplasticity hypothesis of depression, which postulate that deficits in neuroplasticity might be a common pathway underlying depressive disorders. The current study aims to replicate and confirm earlier reports that visual stimulus-specific response modulation is a viable probe into LTP-like synaptic plasticity in a large sample of healthy adults. Further, this study explores whether impairments in LTP-like synaptic plasticity is associated with self-reported subclinical depressive symptoms and stress in a healthy population. Consistent with prior research, the current study replicated and confirmed reports demonstrating significant modulation of visual evoked potentials following visual high-frequency stimulation. Current results further indicate that reduced LTP-like synaptic plasticity is associated with higher levels of self-reported symptoms of depression and perceived stress. This indicate that LTP-like plasticity is sensitive to sub-clinical levels of psychological distress, and might represent a vulnerability marker for the development of depressive symptoms. (shrink)

Dieser Beitrag bietet eine umfassende Diskussion des Textes “Humanismus und Christentum” (1950) des dänischen Philosophen und Theologen Knud E. Løgstrup. Er verortet den Text in seinem geistesgeschichtlichen Kontext und analysiert seine wichtigsten Argumente wie auch seine zentrale These, der zufolge Humanismus und Christentum einen entscheidenden Grundsatz teilen, insofern beide die Ethik als “stumm“ oder “unausgesprochen“ verstehen. Darüber hinaus wird dargelegt, wie Løgstrups Text zentrale Überlegungen in dessen späteren Publikationen, besonders in dem Hauptwerk Die ethische Forderung (1956), vorwegnimmt.

This book discusses the new field of eco-ethica, explores issues arising from a technology-mediated environment and our changing moral consciousness, and presents an ethics that transcends interpersonal ethics so as to also encompass companies and governments.

Recent advances in the brain sciences have dramatically improved our understanding of brain function. As we find out more and more about what makes us tick, we must stop and consider the ethical implications of this new found knowledge. This ground-breaking book on the emerging field of neuroethics answers many pertinent questions, such as: What makes monitoring and manipulating the human brain so ethically challenging? Will having a new biology of the brain through imaging make us less responsible for our (...) behavior and lose our free will? Should certain brain scan studies be disallowed on the basis of moral grounds? A distinguished group of contributors from a wide range of fields make this an invaluable introduction to neuroethics. (shrink)

Business and society researchers, as well as practitioners, have been critiqued for ignoring those with less voice and power often referred to as “fringe stakeholders.” Existing methods used in B&S research often fail to address issues of meaningful participation, voice and power, especially in developing countries. In this article, we stress the utility of visual participatory research methods in B&S research to fill this gap. Through a case study on engaging Ghanaian cocoa farmers on gender inequality issues, we explore how (...) VPR methods may be used by researchers to achieve more inclusive, and thus more credible, stakeholder research that can improve decision making within businesses. Furthermore, we argue that ingrained social and environmental problems tackled by B&S research and the unique context in which they occur may open up new opportunities to develop participatory visual methods for social change. (shrink)

There is little doubt that Corporate Social Responsibility (CSR) is now a global concept and a prominent feature of international business, with its practice localised and differing across countries. Despite the growing body of research focussing on CSR in developing countries, there is dearth research on CSR institutionalisation in African countries. Drawing on institutional theory (IT), this article examines the focus and form of CSR practice of companies in Kenya. It is evident from our findings that the nature and orientation (...) of CSR differ across companies with operations only in Kenya and those headquartered abroad or with international operations. Significantly, firm-related drivers such as public relations and performance, as well as global institutional pressures explain the focus and form of CSR in Kenya. This article concludes that for the institutionalisation of CSR in Kenya, attention must be paid to conditions that stifle CSR uptake such as lack of government regulations, and the government's capacity and commitment to enforce regulation. The establishment of functional CSR institutions and a vibrant civil society that advance civil regulation ought to be encouraged. (shrink)

This paper reviews major structural drivers of place-based health disparities in the context of Canada, an industrialized nation with a strong public health system. Likelihood that the COVID-19 pandemic will facilitate rejuvenation of Canada’s northern and remote areas through remote working, advances in online teaching and learning, and the increased use of telemedicine are also examined. The paper concludes by identifying some common themes to address healthcare disparities for northern and remote Canadian residents.