Background:Despite their negative consequences, evidence shows that futile medical treatments are still being provided, particularly to terminally ill patients. Uncovering the reasons behind providing such treatments in different religious and sociocultural contexts can create a better understanding of medical futility and help manage it effectively.Research objectives:This study was undertaken to explore Iranian nurses’ and physicians’ perceptions of the reasons behind providing futile medical treatments.Research design:This was a qualitative exploratory study. Study data were gathered through conducting in-depth semi-structured personal interviews and (...) analyzed using the conventional content analysis method.Participants and research context:Twenty-one nurses and nine medical specialists were recruited purposively from four teaching hospitals affiliated to Tehran University of Medical Sciences.Ethical considerations:This study was approved by the Nursing and Midwifery Research Center and the Research Ethics Committee of Tehran University of Medical Sciences. All participants gave informed consent for the research and that their anonymity was preserved.Findings:The main theme of the study was “having an obligation to provide medical treatments despite knowing their futility.” This theme consisted of three main categories including patients’ and family members’ request for continuing life-sustaining treatments, healthcare professionals’ personal motives, and organizational atmosphere and structure.Discussion and conclusion:Different personal and organizational factors contribute to providing futile medical treatments. Promoting the structure and the function of hospital ethics committees, establishing and developing home care facilities, increasing the number of palliative care centers and hospices, and educating healthcare professionals, patients, and family members about the services and the benefits of such centers can facilitate making wise decisions about continuing or discontinuing treatments which have been labeled as futile. (shrink)

BackgroundSexual harassment in the workplace has many negative consequences for nurses and the delivery of patient care. Appropriate policies and strategies can help to create a safe work environment for nurses. Therefore, the present study aimed to investigate Iranian nurses’ strategies for preventing sexual harassment in the workplace.Materials and methodsThis qualitative descriptive-explorative study used conventional content analysis to investigate how Iranian nurses cope with sexual harassment. Participants were selected using a purposeful sampling method. Data was collected through in-depth, semi-structured interviews (...) from September 2020 to April 2021. In order to obtain rich information, maximum variation was considered. The Guba and Lincoln criteria were used to increase the study’s trustworthiness, while the Graneheim and Lundman approach was used to analyze the content.ResultsOne hundred and twelve codes, one main category, four categories, and 12 subcategories were extracted. The main category, strategies to prevent sexual harassment among nurses in the workplace, includes four categories: behavioral response, working conditions adjustment, informing, and performance of hospital security guards. The most common strategy used by nurses was behavioral response.ConclusionBasic measures are required to prevent sexual misconduct against nurses, which is an obvious part of the professional organizational culture. Managers and policymakers should develop workplace ethics, legal accountability, and safety. They should also develop training programs and prevention strategies to help nurses improve their coping skills. Further quantitative and qualitative research in other healthcare groups is required to confirm the findings of this study. (shrink)

Whooping cough is a highly transmitted disease around the world. According to the World Health Organization, 0.15 million cases had reported globally in 2018. Most of the Asian and African states are infected regions. Through the study, we investigated the whole population into the four classes susceptible, exposed, infected, and vaccinated or recovered. The transmission dynamics of whooping cough disease are studied analytically and numerically. Analytical analyses are positivity, boundedness, reproduction number, equilibria, and local and global stabilities. In numerical analysis, (...) we developed an implicit numerical integration scheme consistent with the biological problem’s properties. The analysis of the implicit method for the said model is dynamically consistent, positive, and bounded. Furthermore, an implicit numerical integration scheme is suitable for studying a particular epidemic model such as the whooping cough disease. (shrink)

Neuroarchitecture uses neuroscientific tools to better understand architectural design and its impact on human perception and subjective experience. The form or shape of the built environment is fundamental to architectural design, but not many studies have shown the impact of different forms on the inhabitants’ emotions. This study investigated the neurophysiological correlates of different interior forms on the perceivers’ affective state and the accompanying brain activity. To understand the impact of naturalistic three-dimensional (3D) architectural forms, it is essential to perceive (...) forms from different perspectives. We computed clusters of form features extracted from pictures of residential interiors and constructed exemplary 3D room models based on and representing different formal clusters. To investigate human brain activity during three-dimensional perception of architectural spaces, we used a mobile brain/body imaging (MoBI) approach recording the electroencephalogram (EEG) of participants while they naturally walk through different interior forms in virtual reality (VR). The results revealed a strong impact of curvature geometries on activity in the anterior cingulate cortex (ACC). Theta band activity in ACC correlated with specific feature types (rs (14) = 0.525, p = 0.037) and geometry (rs (14) = - 0.579, p = 0.019), providing evidence for a role of this structure in processing architectural features beyond their emotional impact. The posterior cingulate cortex and the occipital lobe were involved in the perception of different room perspectives during the stroll through the rooms. This study sheds new light on the use of mobile EEG and VR in architectural studies and provides the opportunity to study human brain dynamics in participants that actively explore and realistically experience architectural spaces. (shrink)

Background Moral distress has negative effects on physical and mental health. However, there is little information about nurses’ coping strategies reducing moral distress. Aim The purpose of this study was to investigate the coping strategies of intensive care unit nurses reducing moral distress in Iran. Study design This is a qualitative study with a content analysis approach. Participants and research context The research sample consisted of nurses working in intensive care units of teaching hospitals affiliated to Tehran University of Medical (...) Sciences. Samples were selected among eligible nurses by purposive sampling. Data were obtained through 17 in-depth, individual, and semi-structured interviews with 17 nurses. Graneheim and Lundman’s (2004) 6-step content analysis method was used to analyze the data. Data management was also performed by MAXQDA software version 20. The COREQ checklist was used to report the study. Ethical considerations This project was approved by the Ethics Committee of Tehran University of Medical Sciences. All ethical guidelines in research were followed. Finding The data analysis resulted in the formation of two main categories of desirable coping strategies (with two subcategories of compensation and rejuvenation) and less desirable coping strategies (with three subclasses of indifference over time, escape and concealment). Discussion The intensive care unit nurses in dealing with ethical problems first try to solve the problem through discussion, but when they fail to resolve it peacefully, they resort to several coping strategies. Factors, such as increasing experience, lack of support from hospital managers and officials, poor communication between colleagues, the need to maintain hierarchy, fear of reprimand, and a sense of powerlessness, changed the nurses’ preferred strategies. It is important for managers to provide a blame/punishment-free atmosphere for expression of ethical experiences; a supportive atmosphere in which staff can engage in ethical discussions without fear of punishment. They should also provide opportunities for rest, rejuvenation, and adequate training for their employees. (shrink)

The dissertation abstract and reflection commentary present the work of Dr. Maryam Kouchaki. The abstract provides an overview of research examining the role of professional identities on ethical behavior. Across a number of studies, this work demonstrates that professionalism, either measured or manipulated, can increase individuals’ unethical behaviors. This dissertation extends prior work on professionalism by examining its psychology and shedding new light on importance of its meanings in driving individuals’ behaviors. Below, the author discusses the reasons for why (...) professionals may engage in unethical behaviors. Finally, the reflection commentary provides insights about the author’s journey as a PhD student. (shrink)

BackgroundHaving moral courage is a crucial characteristic for nurses to handle ethical quandaries, stay true to their professional obligations towards patients, and uphold ethical principles. This concept can be influenced by various factors including personal, professional, organizational, and leadership considerations. The purpose of this study was to explore the predictors of moral courage among nurses working in hospitals.MethodsIn 2018, an observational cross-sectional study was carried out on 267 nurses employed in six hospitals located in the northern region of Iran. The (...) participants were selected through a simple random sampling technique. To collect data, a demographic information form was used along with two questionnaires. The first questionnaire was a standard survey on moral courage, while the second questionnaire was designed to assess the ethical climate. Linear regression was used to assess the predictors of moral courage.ResultsNurses had an average moral courage score of 87.07 ± 15.52 and an average moral climate score of 96.12 ± 17.17. The study showed that 16% of the variation in moral courage scores among nurses was explained by ethical climate and monthly overtime hours.ConclusionThis study underscores the significance of establishing an ethical work environment and minimizing overtime hours in order to enhance moral courage among nurses. These findings carry weight for both nursing practice and organizational policies focused on fostering ethical conduct within healthcare settings. (shrink)

Respect for human dignity is a basic and crucial component of nursing care. Illness with restricted physical ability and being confined to bed can compromise the dignity of patients. The views of adolescents regarding dignity in care have not previously been researched. This article details a descriptive-analytic study in which survey data was collected from all nurses and compared with a convenience sample of 180 hospitalized adolescents in two hospitals in Iran. The data was analyzed with SPSS software. A significant (...) difference between nurses and hospitalized ill adolescents’ perceptions was identified in relation to: understanding the importance of privacy (p < 0.001); observance of privacy (p < 0.001); importance of interaction between nurses and patients (p = 0.019); and the observance of interaction between nurses and patients (p < 0.001). Attention to adolescents’ views about dignity can help nurses to improve quality of care for this group. (shrink)

In Allamah Tabatabaee’s works there are found at least three apparently different views about the relation of Divine essence and His attributes of act: 1. the unity of God’s essence and His attributes of act; 2. the ontological distinction between His essence and His attributes of act and 3. the impossibility of attribution of such properties to God’s essence. In this paper we try to establish that these three views are essentially consistent. Our analysis shows that each one of the (...) above-mentioned positions can be considered from a special aspect. The first view is based on considering the mere reality of such attributes while in the second view we are just concerned to the appearance of them. The third view, however, is a result of a pluralistic analysis of the attributes of act. (shrink)

The purpose of this study was to investigate the difference between the performance of Iranian male and female EFL learners on the five dimensions of the California Critical Thinking Skills Test.88 learners, out of 120, who were selected through convenience sampling method, participated in this study. The researcher used a quantitative research method with one-group pretest posttest design. This group received some treatment in the form of “the Meeting-House Debate” strategy. Data analysis was done using descriptive and inferential statistics. Result (...) showed that there was no significant difference in the performance of males and females on the sub-scales measured; i.e. evaluation, analysis, inference, deductive reasoning, and inductive reasoning. It was concluded that gender did not have a significant effect on the students’ critical thinking skills. (shrink)

This paper examines the ethical issues that arise when healthcare providers act as gatekeepers to research involving vulnerable populations. Traumatised refugees serve as an example of this subset of research participants. Highlighting the particular vulnerabilities of this group, we argue that specific ethical considerations are required that go beyond the conventional research approaches. While gatekeeping responds to some of those vulnerabilities, it risks wronging through unwarranted paternalism. Instead, we will propose that a relational ethics of justice and care serves as (...) a more appropriate framework for responding to the challenges of research involving traumatised refugees. Specifically, such a framework allows us to reflect more deeply on the role of the gatekeeper. In conclusion, we recommend that clinicians and researchers collaborate with survivors’ advisory groups in the development of specific research ethical guidelines. (shrink)

Background: Nursing students experience ethical conflicts and challenges during their clinical education. These may lead to moral distress and disturb the learning process. Objectives: This study aimed to explore and to evaluate the nursing students’ ethical challenges in the clinical settings in Iran. Research design: This was a mixed-methods study with an exploratory sequential design. Participants and research context: A total of 37 and 120 Iranian nursing students participated in the qualitative and quantitative phases, respectively. Ethical considerations: The ethical committee (...) of Kerman University of Medical Sciences, Iran, approved the protocol of the study. Findings: Three main categories were extracted from qualitative data including Low attention of nurses to the patients’ preferences; Lack of authority; and Inadequate support. A total of 97% of the students had more than one ethical challenge in clinical settings and 48% of them stated that their challenges did not resolve. The total score of perceived ethical challenges was 62.03 ± 9.17, which was moderate. The highest mean score related to the “Low attention of nurses to the patients’ preferences” subscale. Discussion: The finding confirmed most of the existing results of other international researches about the frequency and kinds of baccalaureate nursing students’ ethical challenges. Conclusion: Identifying student ethical challenges helps teachers to manage their clinical learning process better. This study may provide a view for the nurses, clinical educators, and managers toward nursing students’ ethical challenges and their impact on nursing students’ clinical experiences. (shrink)

This paper explores ethical issues raised by whole slide image-based computational pathology. After briefly giving examples drawn from some recent literature of advances in this field, we consider some ethical problems it might be thought to pose. These arise from the tension between artificial intelligence research—with its hunger for more and more data—and the default preference in data ethics and data protection law for the minimisation of personal data collection and processing; the fact that computational pathology lends itself to kinds (...) of data fusion that go against data ethics norms and some norms of biobanking; the fact that AI methods are esoteric and produce results that are sometimes unexplainable and the fact that computational pathology is particularly dependent on scanning technology manufacturers with interests of their own in profit-making from data collection. We shall suggest that most of these issues are resolvable. (shrink)

Artificial Immune Systems (AIS) are intelligent algorithms derived on the principles inspired by human immune system. In this research work, electroencephalography (EEG) signals for four distinct motor movement of human limbs are detected and classified using Negative Selection Classification Algorithm (NSCA). For this study, a widely studied open source EEG signal database (BCI IV - Graz dataset 2a, comprising 9 subjects) has been used. Mel Frequency Cepstral Coefficients (MFCCs) are extracted as selected feature from recorded EEG signals. Dimensionality reduction of (...) data is carried out by applying two hidden layered stacked auto-encoder. Genetic Algorithm (GA) optimized detectors (Artificial Lymphocytes) are trained using Negative Selection Algorithm (NSA) for detection and classification of four motor movements. The trained detectors consist of four sets of detectors, each set is trained for detection and classification of one of the four movements from the other three movements. The optimized radius of detector is small enough not to mis-detect the sample. Euclidean distance of each detector with every training dataset sample is taken and compared with optimized radius of detector as a non-self detector. Our proposed approach achieved a mean classification accuracy of 86.39% for limb movements over 9 subjects with a maximum individual subject classification accuracy of 97.5 % for subject number eight. (shrink)

Despite the ever-changing field of artificial intelligence (AI) and its preponderance of pre-print articles, Cohen offers a timely, nuanced, and self-aware overview of ChatGPT and the world of Larg...

Algorithmic systems are increasingly used by state agencies to inform decisions about humans. They produce scores on risks of recidivism in criminal justice, indicate the probability for a job seeker to find a job in the labor market, or calculate whether an applicant should get access to a certain university program. In this contribution, we take an interdisciplinary perspective, provide a bird’s eye view of the different key decisions that are to be taken when state actors decide to use an (...) algorithmic system, and illustrate these decisions with empirical examples from case studies. Building on these insights, we discuss the main pitfalls and promises of the use of algorithmic system by the state and focus on four levels: The most basic question whether an algorithmic system should be used at all, the regulation and governance of the system, issues of algorithm design, and, finally, questions related to the implementation of the system on the ground and the human–machine-interaction that comes with it. Based on our assessment of the advantages and challenges that arise at each of these levels, we propose a set of crucial questions to be asked when such intricate matters are addressed. (shrink)

An increase in narcissism has been reported by experts over the years. Narcissists bring a lot of negative consequences to themselves and to the people around them. This study investigates that perceived parenting leads to the development of inflated, unstable self-concept. The inflated self-concept lays the framework for the development of narcissistic traits among individuals; perceived parenting affects this relationship. A sample of 628 adults was taken from North Cyprus through purposive sampling. Scales for perceived parenting, self-concept, and narcissism were (...) administered. Results showed that the statistically significant variance in the self-concept is explained by perceived parenting. Both mothers and fathers contributed significantly to the development of inflated self-concept. Moreover, multiple linear regression results showed a higher significant variance in narcissistic traits due to self-concept compared with perceived parenting. Mediational tests also showed that high levels of narcissistic traits were indirectly related to self-concept through perceived parenting. The study findings have challenged the notion of only mothers being responsible for narcissistic traits among their children. The study results also suggest that targeting self-concept in individuals with narcissistic traits may be a good directive for therapeutic interventions. (shrink)

Conflict of interests is a situation when someone is in need of other people’s trust on one the hand and has personal or general interests on the other hand, resulting in conflict with the given responsibility. In this research work, an attempt was made to find the relation between declarations of conflict of interests and reporting positive outcomes in the dental journals in Iran. In this analytical/cross-sectional study, first Health and Biomedical Information was searched and all the Persian and English (...) dental journals published in Iran were collected. Then, all the papers published in the journals from December 2000 to December 2016 were collected and categorized in terms of the year of publication, author or authors’ affiliations, Persian and English journal, type of the substance or the drug used, declarations of conflict of interests and the positive or negative conclusion of the report. Data were analyzed with the Fisher’s exact test and Chi squared test, using the program SPSS 18. In numerical analysis, the significance was set at P < 0.05. Seventeen dental journals in Persian and English were analyzed: 10 in English and 7 in Persian. Reviewing these studies showed that of 1021 articles in Persian, in 128 cases there was no mention of a declaration of conflict of interests and in 11 cases, the COI had been stated. In addition, from 1220 articles in English, in 825 cases there was no mention of declarations of conflict of interests and in 45 cases, the declarations of COI had been mentioned. There was no significant relation between the COI and ‘no’ COI and the reporting of positive outcomes in papers in Iranian dental journals in terms of the journal type, year of publication and the journals’ guarantee form. A total of 83% of studies with declarations of COI had one positive outcome, with a significant relationship in this field; however, in 73% of studies with no COI, there was one positive outcome, too. In general, the society expects that doctors would not consider any incentives except the health of the patients in the efforts made by them. The severity of the consequences of COI is of higher value when the patients’ health is endangered due to it. In addition, COI might change the attitude and approach of other doctors and peers. (shrink)

Background The enhancement of nursing care quality is closely related to the clinical competence of nurses, making it a crucial component within health systems. Objective The present study investigated the relationship between nurses’ clinical competence, moral identity, and moral injury during the COVID-19 outbreak. Research design This cross-sectional study was carried out among frontline nurses, using the Moral Identity Questionnaire (MIQ), the Moral Injury Symptom Scale-Healthcare Professionals version (MISS-HP), and the Competency Inventory for Registered Nurse (CIRN) as data collection tools. (...) Participants and research context: The research population for this study consisted of all frontline nurses ( n = 251) employed in a hospital in southern Iran. Sampling was conducted between May 1, 2021 and September 30, 2021, during the COVID-19 outbreak. Ethical considerations The present study received approval from the research ethics committee of Rafsanjan University of Medical Sciences, with project No. 99267 and code of ethics ID No. IR. RUMS.REC.1399.262, dated 15.02.2021. Results According to the study findings, 42.2% of the nurses demonstrated high clinical competence, while 51.4% exhibited moderate clinical competence. The results indicated a positive correlation between moral identity and clinical competence but a negative correlation between moral injury and clinical competence. Furthermore, the variables of moral identity and moral injury were found to predict 10% of the variance in clinical competence. Conclusion According to the results, moral identity and moral injury had an impact on the clinical competence of nurses. Therefore, implementing a program aimed at enhancing moral identity and providing training strategies to address moral injury during crises like the COVID-19 pandemic can lead to improvements in nurses’ clinical competence and the overall quality of care they provide. (shrink)

This chapter contains sections titled: Note.

The goal of most scientific research published in peer-review journals is to discover and report the truth. However, the research record includes tongue-in-cheek papers written in the conventional form and style of a research paper. Although these papers were intended to be taken ironically, bibliographic database searches show that many have been subsequently cited as valid research, some in prestigious journals. We attempt to understand why so many readers cited such ironic science seriously. We draw from the literature on error (...) propagation in research publication for ways categorize citations. We adopt the concept of irony from the fields of literary and rhetorical criticism to detect, characterize, and analyze the interpretations in the more than 60 published research papers that cite an instance of ironic science. We find a variety of interpretations: some citing authors interpret the research as valid and accept it, some contradict or reject it, and some acknowledge its ironic nature. We conclude that publishing ironic science in a research journal can lead to the same troubles posed by retracted research, and we recommend relevant changes to publication guidelines. (shrink)

Recent protests in Iran have clearly shown the extent of humanism there. Whilst resistance to dictatorship and Islamism has always been in existence, the 2009 Twitter revolution in Iran gave people everywhere an insight into a social movement that is deeply humanist, modern, and secular. What it has also shown is the irrelevance and antithetical character of Islamism with people’s demands and desires. This is what many of us have been saying for a very long time. Recent events, broadcast via (...) citizen journalism, however, have given the world an opportunity to see it for itself. There are several factors contributing to this rise. (shrink)

There are many lessons that bioethics can learn from the Holocaust. Forefront are the lessons from the Nuremberg trials and the formation of research ethics. An often-overlooked lesson is how the Nazi regime was able to construct a hierarchy in such a way that influenced people to act in horrendous ways. Fernandes & Ecret, writing in Conatus – Journal of Philosophy 4, no. 2, highlight the influence of hierarchy on the moral silence of nurses and physicians within the Nazi regime. (...) While we greatly enjoyed the paper, and think it is an important contribution, we find several misrepresentations of current bioethical discourse. There is not a global acceptance of euthanasia or medical aid in dying, the contemporary position in bioethics does not favor removal of conscience-based protections, and the lack of personal conscience-based protections was not the main factor in the analysis of Nazi medical hierarchy. The authors’ overall conclusion that their analysis suggests the importance of strengthening personal conscience-based objections to prevent medical hierarchy from influencing immoral behavior misses the more significant issue of institutional behavior. Instead, we argue, that the lessons from the analysis of Nazi nurses and physicians speak to the importance of protecting patients from institutional conscience-based objections that violate patient rights of access to legal medical services. This paper will respond to the misrepresentations. We highlight the growing threats to health care access from religious affiliated institutions, the threats to professional ethics and physician and nurse scope of practice. We conclude that the analysis by Fernandes & Ecret does point out an important lesson, but rather than showing the importance of individual conscience protections, it speaks to the importance of protecting patient rights. (shrink)

This inquiry examines the question how the category of ‘religion’ generates a complex form of power oriented to the government of subjects. It does this through a critical reading of the right to freedom of religion, offered from the perspective of governmentality. It is argued that the right to freedom of religion enables the rational goals of government to relate to religiosity in such a manner that those subject to them are made at once freer and more governable ‘in this (...) world’. (shrink)

Bell introduces local beables in contrast to quantum mechanical observables. The present article emphasizes the importance and necessity of introducing local beables in quantum mechanics from the ontological and epistemological points of view. We argue that suggesting beables in the ontology of quantum mechanics is necessary to give an adequate account of its testability.