Background Moral distress is a common challenge among professional nurses when caring for their patients, especially when they need to make rapid decisions. Therefore, leaving moral distress unconsidered may jeopardize patient quality of care, safety, and satisfaction. Aim To estimate moral distress among nurses. Methods This systematic review and meta-analysis conducted systematic search in Scopus, PubMed, ProQuest, ISI Web of Knowledge, and PsycInfo up to end of February 2022. Methodological quality of included studies was assessed using the Newcastle Ottawa checklist. (...) Data from included studies were pooled by meta-analysis with random effect model in STATA software version 14. The selected key measure was mean score of moral distress total score with its’ 95% Confidence Interval was reported. Subgroup analyses and meta-regressions were conducted to identify possible sources of heterogeneity and potentially influencing variables on moral distress. Funnel plots and Begg’s Tests were used to assess publication bias. The Jackknife method was used for sensitivity analysis. Ethical consideration The protocol of this project was registered in the PROSPERO database under decree code of CRD42021267773. Results Eighty-six manuscripts with 19,537 participants from 21 countries were included. The pooled estimated mean score of moral distress was 2.55 on a 0–10 scale [95% Confidence Interval: 2.27–2.84, I2: 98.4%, Tau2:0.94]. Publication bias and small study effect was ruled out. Moral distress significantly decreased in the COVID-19 pandemic versus before. Nurses working in developing countries experienced higher level of moral distress compared to their counterparts in developed countries. Nurses' workplace (e.g., hospital ward) was not linked to severity of moral disturbance. Conclusion The results of the study showed a low level of pooled estimated score for moral distress. Although the score of moral distress was not high, nurses working in developing countries reported higher levels of moral distress than those working in developed countries. Therefore, it is necessary that future studies focus on creating a supportive environment in hospitals and medical centers for nurses to reduce moral distress and improve healthcare. (shrink)

BackgroundAcrophobia is a specific phobia characterized by a severe fear of heights. The purpose of the present study was to investigate the efficacy of two therapies that may ameliorate symptoms of acrophobia and anxiety sensitivity, i.e., virtual reality exposure therapy (VRET) and eye movement desensitization and reprocessing (EMDR) therapy with a Waiting List Control Condition (WLCC).MethodsWe applied a three-armed randomized controlled pre-post-test design with 45 female adolescent students. Students who met DSM-5 criteria for acrophobia were randomly assigned to either VRET (...) (N = 15;Mage = 17.26; SD = 1.32), EMDR (N = 15;Mage = 17.15; SD = 1.57), or a WLCC (N = 15;Mage = 17.50; SD = 1.26). The study groups were evaluated one week before the intervention and one week after the last intervention session regarding symptoms of acrophobia (Severity Measure for Acrophobia) and anxiety sensitivity (Anxiety Sensitivity Index).ResultsThe data showed that both the application of VRET and EMDR therapy were associated with significantly reduced symptoms of acrophobia (d = 1.03 for VRET and d = 1.08 for EMDR) and anxiety sensitivity (d = 1.15 for VRET and d = 1.13 for EMDR) in comparison to the Waiting List.LimitationsThe sample consisted only of adolescent women. Due to the recognizable differences between the two interventions, the therapists and the participants were not blind to the conditions.ConclusionThe results suggest that both VRET and EMDR are interventions that can significantly improve symptoms of acrophobia and anxiety sensitivity in female adolescents.Clinical Trial Registrationhttps://www.irct.ir/trial/57391, identifier: IRCT20210213050343N1. (shrink)

For decision making in government, it is necessary to have well-structured sources of information. In several countries, it is difficult to access government data as the information are dispersed, disconnected, and poorly structured. For this reason, this work presents a framework to gather, unify, and enrich missing person data from distributed web sources. The framework allows inserting new tasks specific to the user’s domain to improve data quality. In this study, Brazilian missing person data from non-governmental organizations (NGOs) and governmental (...) websites were collected and semantically enriched. To enhance the understanding of the gathered missing people cases, we create interpretive models using machine learning techniques to extract knowledge and to encourage the use of standards for publishing the data that are frequently ignored by organizations, hindering analysis and decision-making on data. After the collection and semantic enrichment process, there was an increase of approximately 11% in the data present in the base. Also, the mining process evidenced the disappearance and reappearance of a person in Brazil according to several factors such as age, state initiatives, skin tone, hair colors, etc. (shrink)

ZusammenfassungDie moderne Religionsgeschichte hat Mazdak, Anführer einer sozioreligiösen Reformbewegung im Sasanidenreich, auf divergierende Weise konzeptualisiert. Insbesondere die diskrepanten Quellenhinweise auf angeblich von Mazdak geforderte Frauen- und Gütergemeinschaften eröffneten Spielraum, eigene, zumeist anachronistische und somit problematische Vorannahmen in Bezug auf das Verhältnis von sogenannten ‚sozialen‘ und ‚religiösen‘ Faktoren der Reformbewegung zu projizieren. Die in Bezug auf Mazdak besonders deutlich hervortretende Problematik nachträglicher Zuschreibungen und narrativer Überlagerungen unterstreicht die grundsätzliche Notwendigkeit, Forschungsgeschichte und Begrifflichkeiten konsequent zu historisieren, und schliesst damit (...) an die übergeordnete Fragestellung an, wie historische Gegenstände (re-)konstruiert werden können. (shrink)

INTRODUCTION The most remarkable feature of the character of the Persian people is their love of Metaphysical speculation. Yet the inquirer who approaches the extant literature of Persia expecting to find any comprehensive systems of thought, like those of Kapila or Kant, will have to turn back disappointed, though deeply impressed by the wonderful intellectual subtlety displayed therein. It seems to me that the Persian mind is rather impatient of detail, and consequently destitute of that organising faculty which gradually works (...) out a system of ideas, by interpreting the fundamental principles with reference to the ordinary facts of observation. The subtle Brahman sees the inner unity of things; so does the Persian. But while the former endeavours to discover it in all the aspects of human experience, and illustrates its hidden presence in the concrete in various ways, the latter appears to be satisfied with a bare universality, and does not attempt to verify the richness of its inner content. The butterfly imagination of the Persian, flies half-inebriated as it were, from flower to flower, and seems to be incapable of reviewing the garden as a whole. For this reason, his deepest thoughts and emotions find expression mostly in disconnected verses (Ghazal), which reveal all the subtlety of his artistic soul. The Hindu, while admitting, like the Persian, the necessity of a higher source of knowledge, yet calmly moves from experience to experience, mercilessly dissecting them, and forcing them to yield their underlying universality. In fact the Persian is only half-conscious of Metaphysics as a system of thought; his Brahman brother, on the other hand, is fully alive to the need of presenting his theory in the form of a thoroughly reasoned out system. And the result of this mental difference between the two nations is clear. In the one case we have only partially worked out systems of thought; in the other case, the awful sublimity of the searching Vedanta ... (shrink)