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

We study the groups Gal L and Gal KP, and the associated equivalence relations EL and EKP, attached to a first order theory T. An example is given where EL≠ EKP. It is proved that EKP is the composition of EL and the closure of EL. Other examples are given showing this is best possible.

La evaluación constituye un elemento curricular decisivo para mejorar el aprendizaje del alumnado, siempre que se utilice de modo continuo y con carácter formativo. La evaluación formativa evalúa procesos, ofreciendo datos permanentes acerca de cómo se produce paso a paso ese aprendizaje, permitiendo así detectar las dificultades que se presentan y los talentos del alumnado y adoptar las medidas adecuadas de modo inmediato. Este planteamiento favorece la personalización de la evaluación y, con ello, la atención a cada estudiante en función (...) de sus peculiaridades, garantizando la inclusión educativa de calidad para todos. (shrink)

BackgroundIn the Canadian Alliance for Healthy Hearts and Minds (CAHHM) cohort, participants underwent magnetic resonance imaging (MRI) of the brain, heart, and abdomen, that generated incidental findings (IFs). The approach to managing these unexpected results remain a complex issue. Our objectives were to describe the CAHHM policy for the management of IFs, to understand the impact of disclosing IFs to healthy research participants, and to reflect on the ethical obligations of researchers in future MRI studies.MethodsBetween 2013 and 2019, 8252 participants (...) (mean age 58 ± 9 years, 54% women) were recruited with a follow-up questionnaire administered to 909 participants (40% response rate) at 1-year. The CAHHM policy followed a restricted approach, whereby routine feedback on IFs was not provided. Only IFs of severe structural abnormalities were reported.ResultsSevere structural abnormalities occurred in 8.3% (95% confidence interval 7.7–8.9%) of participants, with the highest proportions found in the brain (4.2%) and abdomen (3.1%). The majority of participants (97%) informed of an IF reported no change in quality of life, with 3% of participants reporting that the knowledge of an IF negatively impacted their quality of life. Furthermore, 50% reported increased stress in learning about an IF, and in 95%, the discovery of an IF did not adversely impact his/her life insurance policy. Most participants (90%) would enrol in the study again and perceived the MRI scan to be beneficial, regardless of whether they were informed of IFs. While the implications of a restricted approach to IF management was perceived to be mostly positive, a degree of diagnostic misconception was present amongst participants, indicating the importance of a more thorough consent process to support participant autonomy.ConclusionThe management of IFs from research MRI scans remain a challenging issue, as participants may experience stress and a reduced quality of life when IFs are disclosed. The restricted approach to IF management in CAHHM demonstrated a fair fulfillment of the overarching ethical principles of respect for autonomy, concern for wellbeing, and justice. The approach outlined in the CAHHM policy may serve as a framework for future research studies.Clinical trial registrationhttps://clinicaltrials.gov/ct2/show/nct02220582. (shrink)

In this paper, we describe the use of legal ontologies as a basis to improve IT support for professional judges. As opposed to most legal ontologies designed so far, which are mostly based on dogmatic and normative knowledge, we emphasize the importance of professional knowledge and experience as an important pillar for constructing the ontology. We describe an intelligent FAQ system for junior judges that intensively use the ontology.

A Steiner triple system (STS) is a set S together with a collection B of subsets of S of size 3 such that any two elements of S belong to exactly one element of B. It is well known that the class of finite STS has a Fraïssé limit M_F. Here, we show that the theory T of M_F is the model completion of the theory of STSs. We also prove that T is not small and it has quantifier elimination, (...) TP2, NSOP1, elimination of hyperimaginaries and weak elimination of imaginaries. (shrink)

A model $M$ of countable similarity type and cardinality $\kappa$ is expandable if every consistent extension $T_{1}$ of its complete theory with $|T_{1}|\leq \kappa$ is satisfiable in $M$ and it is compactly expandable if every such extension which additionally is finitely satisfiable in $M$ is satisfiable in $M$ . In the countable case and in the case of a model of cardinality $\geq 2^{\omega}$ of a superstable theory without the finite cover property the notions of saturation, expandability and compactness for (...) expandability agree. The question of the existence of compactly expandable models which are not expandable is open. Here we present a test which serves to prove that a compactly expandable model of cardinality $\geq 2^{\omega}$ of a superstable theory is expandable. It is stated in terms of the existence of a certain elementary submodel whose corresponding theory of pairs of models satisfies a weak elimination of Ramsey quantifiers. (shrink)

This text explores how human beings construe experience: experience as a resource, as a potential for understanding, representing and acting on reality.

Recognized in his day as a man of letters equaling Rousseau and Voltaire in France and rivaling Samuel Johnson, David Hume passed from favor in the Victorian age--his work, it seemed, did not pursue Truth but rather indulged in popularization. Although Hume is once more considered as one of the greatest British philosophers, scholars now tend to focus on his thought rather than his writing. To round out our understanding of Hume, M. A. Box in this book charts the interrelated (...) development of Hume's literary ambitions, theories of style, and compositional practice from his Treatise in 1739 through the Enquiries. In so doing, Box makes the case for Hume's career-long concern with the presentational modes of reaching an audience for his philosophical writings. Hume reacted to the popular failure of his masterpiece, A Treatise of Human Nature, Box suggests, by self-consciously exploring strategies in his subsequent works for agreeably bringing his readership to participate in the act of philosophizing. Combining a sensitive grasp of the ways Restoration period and eighteenth-century writers conceived the relations between rhetoric and philosophy with sound readings of particular texts, Box shows how Hume's literary concerns went beyond matters of style to involve persona, structure, and doctrine. While this book helps explain long-standing ambiguities surrounding Hume, especially by pointing out the tension between his created persona and his own voice, it also serves as an excellent introduction to his philosophy. (shrink)

Metabolism is a criterion of life. Three senses are distinguished. The weakest allows strong A-Life: virtual creatures having physical existence in computer electronics, but not bodies, are classes as 'alive'. The second excludes strong A-Life but allows that some non-biochemical A-Life robots could be classed as alive. The third, which stresses the body's self-production by energy budgeting and self-equilibrating energy exchanges of some (necessary) complexity, excludes both strong A-Life and living non-biochemical robots.

The study presents the broad outlines for a relationalist interpretation of the Indian epistemological doctrine svataḥ prāmāṇya. Due to the inadequacy of the main western interpretations thereof, the paper’s approach can be considered an inference to the best explanation. Its main part is devoted to the typologization of various epistemological doctrines based on the svataḥ prāmāṇya principle in terms of strong and weak disjunctivism. Three paradigm cases of strong disjunctivism and a special variety of weak disjunctivism have thus been identified (...) in Indian epistemology, which allowed to draw a conclusion that strong disjunctivism constituted one of its general paradigms. (shrink)

M A B Degenhardt; Sartre, Imagination and Education1, Journal of Philosophy of Education, Volume 9, Issue 1, 30 May 2006, Pages 72–92, https://doi.org/10.1111/j.

Is there an effect of depressed mood on the interpretation of ambiguity? Are depressed individuals biased to interpret ambiguous information in a negative manner? We used a cross-modal semantic priming task to look for evidence of a negative interpretative bias. Participants listened to ambiguous prime sentences (e.g., Joan was stunned by her final exam mark) and made lexical decisions to target words presented immediately after the sentence offset or after a delay of 1000 ms or 2000 ms. For the semantically (...) related targets, the target was negatively related (distress), positively related (success), or neutrally related (grades) to the ambiguous prime. The experiment was conducted with and without a negative mood induction. The expectation was that depressed participants would be more likely to consider the negative interpretations of the ambiguous primes and would therefore experience larger priming effects for negatively related targets. Although there were large priming effects for all semantically related targets, there was no evidence of a negative interpretative bias. (shrink)

This chapter contains sections titled: Philosophies and Philosophers Peters' Authenticity Why Value Authenicity? An Apparent Paradox: Peters' Expressed Disdain for Authenticity Conclusion References.

Many educators persist in opposing art to intellect. This is incompatible with modern understandings of the interdependence of cognition and feeling. It also causes neglect of the value of art as one medium for presenting and exploring ideas. Historical examples add weight to the point by showing the richness of thought that has often informed visual art. The educational waste and cultural damage consequent on neglecting this aspect of art is indicated and remedial approaches are suggested.

R. K. Elliott once commended R. S. Peters' work in philosophy of education for being an authentic expression of the self. Many philosophers, probably including Peters, might see this more as a weakness. In an attempt to resolve this difference various kinds of continuity between philosopher and philosophy are explored. These point to an ideal of a two-way, and ultimately ‘organic’, relationship whereby the philosophy expresses the self and the self is formed by the philosophy. Ways of teaching to favour (...) the development of such authenticity in novice philosophers are discussed. (shrink)