Breaking bad news (BBN) to parents whose newborn has a major disease is an ethical dilemma. In Saudi Arabia, BBN about newborns is performed according to the parental preferences that have been reported from non-Arabic/non-Islamic countries. Saudi mothers' preferences about BBN have not yet been studied. Therefore, we aimed to elicit the preferences of Saudi mothers about BBN concerning newborns. We selected a convenience sample of 402 Saudi mothers, aged 18-50 years, who had no previous experience with BBN. We selected (...) them via a simple number-randomization scheme from the premises of a level III Saudi hospital between October of 2009 and January of 2011. We used a hypothetical situation (BBN about trisomy 21) to elicit their preferences about BBN concerning newborns via a structured verbal questionnaire composed of 12 multiple-choice questions. We expressed their preferences as percentages (95% confidence interval), and we used the Kendall's W test (W) to assess the degree of agreement in preferences. The Saudi mothers preferred that BBN be conducted with both parents together (64% [60-69]), albeit with weak levels of agreement (W = 0.29). They showed moderate agreement in their preferences that BBN should be conducted early (79% [75-83], W = 0.48), in detail (81% [77-85], W = 0.52), in person (88% [85-91], W = 0.58), and in a quiet setting (86% [83-90], W = 0.53). With extremely weak agreement, they preferred to have a known person present for support during BBN (56% [51-61], W = 0.01), to have close bodily contact with their babies (66% [61-70], W = 0.10), and to have no another patients present (64% [59-68], W = 0.08). They showed moderate levels of agreement in their desires to detail, in advance, their preferences about process of BBN by giving a reversible, written informed consent that could be utilized for guidance, if needed (80% [76-84], W = 0.36). In our experience, Saudi mothers' preferences about BBN concerning newborns are varied, suggesting that a "one-size-fits-all" approach is inappropriate. A reversible, written informed consent detailing their preferences about BBN that would be kept in their medical records and utilized for guidance, if needed, may be the best solution, given this level of diversity. These findings merit further study. (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)

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)

This chapter contains sections titled: Note.

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)

The fault ride-through capability and fault current issues are the main challenges in doubly fed induction generator- based wind turbines. Application of the bridge-type fault current limiter was recognized as a promising solution to cope with these challenges. This paper proposes a nonlinear sliding mode controller for the BFCL to enhance the FRT performance of the DFIG-based WT. This controller has robust performance in unpredicted voltage sag level and nonlinear features. Theoretical discussions, power circuit, and nonlinear control consideration of the (...) SMC-based BFCL are conducted, and then, its performance is verified through time-domain simulations in the PSCAD/EMTDC environment. To reduce the chattering phenomenon and decrease the reaching time, it used the exponential reaching law for designed SMC. Also, the SMC-based BFCL performance is compared with the conventional and PI controller-based BFCL for both symmetrical and asymmetrical short-circuit faults. Simulation results reveal that the SMC-based BFCL provides better performance compared with the conventional and PI controller-based BFCL to enhance the FRT. (shrink)

Argumentation has remained under-researched in studies analyzing academic journal publications despite its importance in academic writing. This paper reports a study in which we investigated stereotypical argumentative trends, lexico-grammatical features, and interactional metadiscourse markers in 354 research article free-standing discussion sections from the journal of ESP over forty years. The field of ESP was chosen because of its maturity, which has given substance to a dynamic ground for arguments. We drew on the pragma-dialectical approach to analyzing argumentations in the corpus. (...) Findings indicated that due to the argumentative nature of the discussion section, certain argumentative trends recurred more often. The analysis of the lexico-grammatical features and metadiscourse markers of the standpoints also showed patterns of variability over time. The study concludes that it is imperative to incorporate relevant facets from various argumentation models to construct a comprehensive argumentation theory and gain deeper insights into argumentation in academic writing. (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)

This study presents the fundamental concepts and technical details of a U-model-based control system design framework, including U-model realisation from classic model sets, control system design procedures, and simulated showcase examples. Consequently, the framework provides readers with clear understandings and practical skills for further research expansion and applications. In contrast to the classic model-based design and model-free design methodologies, this model-independent design takes two parallel formations: it designs an invariant virtual controller with a specified closed-loop transfer function in a feedback (...) control loop and it determines the real controller output by resolving the inverse of the plant U-model. It should be noted that this U-control provides a universal control system design platform for many existing linear/nonlinear and polynomial/state-space models and it complements many existing design approaches. Simulation studies are used as examples to demonstrate the analytically developed formulations and guideline for potential applications. (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)

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)

According to the World Health Organization, female genital cutting affects millions of girls and women worldwide, particularly on the African continent and in the Middle East. This paper presents a plausible, albeit hypothetical, clinical vignette and then explores the legal landscape as well as the ethical landscape physicians should use to evaluate the adult patient who requests re-infibulation. The principles of non-maleficence, beneficence, justice, and autonomy are considered for guidance, and physician conscientious objection to this procedure is discussed as well. (...) Analyses of law and predominant principles of bioethics fail to yield a clear answer regarding performing female genital cutting or re-infibulation on an adult in the United States. Physicians should consider the patient’s physical, mental, and social health when thinking about female genital cutting and should understand the deep-rooted cultural significance of the practice. (shrink)

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)

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)

The primary objective of this research is to examine the potential influence of environmental, social, and governance (ESG) disclosure on cash holdings. Additionally, the study explores the role of earnings management (EM) practices as a mediating factor in this relationship. The sample comprises 797 companies listed on financial markets across 19 European countries, and the data spans from 2013 to 2019. The outcomes indicate a significant negative correlation between ESG disclosure and cash holdings, implying that ESG performance can be used (...) by management to resolve disputes with stakeholders. The outcomes further indicate that the existence of EM practices partially mediates the link between ESG disclosure and cash holdings. Moreover, they are robust by substitute cash holdings specification, three distinct initiatives of ESG disclosure (i.e., environment, social, and governance), and a two-stage least squares assessment. Therefore, the findings document that nonfinancial reporting in the form of ESG disclosure can assist in controlling agency conflict, leading to better valuations of company performance by stakeholders. (shrink)

One of the highly contraversial discussions in philosophy of mind is equivalence of human being mind and machines. Here we show that no one could prove that, in certain he is a machine.

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)

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.

It is hypothesized that iron from biological tissues, liberated during decay, may have played a role in inhibiting loss of anatomical information during fossilization of extinct organisms. Most tissues in the animal kingdom contain iron in different forms. A widely distributed iron‐bearing molecule is ferritin, a globular protein that contains iron crystallites in the form of ferrihydrite minerals. Iron concentrations in ferritin are high and ferrihydrites are extremely reactive. When ancient animals are decaying on the sea floor under anoxic environmental (...) conditions, ferrihydrites may initialize the selective replication of some tissues in pyrite FeS2. This model explains why some labile tissues are preserved, while other more resistant structures decay and are absent in many fossils. A major implication of this hypothesis is that structures described as brains in Cambrian arthropods are not fossilization artifacts, but are instead a source of information on anatomical evolution at the dawn of complex animal life. (shrink)

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)