Here we identify approximately 40,000 healthy human volunteers who were intentionally exposed to infectious pathogens in clinical research studies dating from late World War II to the early 2000s. Microbial challenge experiments continue today under contemporary human subject research requirements. In fact, we estimated 4,000 additional volunteers who were experimentally infected between 2010 and the present day. We examine the risks and benefits of these experiments and present areas for improvement in protections of participants with respect (...) to safety. These are the absence of maximum limits to risk and the potential for institutional review boards to include questionable benefits to subjects and society when weighing the risks and benefits of research protocols. The lack of a duty of medical care by physician–investigators to research subjects is likewise of concern. The transparency of microbial challenge experiments and the safety concerns raised in this work may stimulate further dialogue on the risks to participants of human experimentation. (shrink)

Experimental philosophers have gathered impressive evidence for the surprising conclusion that philosophers' intuitions are out of step with those of the folk. As a result, many argue that philosophers' intuitions are unreliable. Focusing on the Knobe Effect, a leading finding of experimental philosophy, we defend traditional philosophy against this conclusion. Our key premise relies on experiments we conducted which indicate that judgments of the folk elicited under higher quality cognitive or epistemic conditions are more likely to resemble those of (...) the philosopher. We end by showing how our experimental findings can help us better understand the Knobe Effect. (shrink)

The adaptive landscape is one of the most widely used metaphors in evolutionary biology. It is created by plotting fitness against phenotypes or genotypes in a given environment. The shape of the landscape is crucial in predicting the outcome of evolution: whether evolution will result in populations reaching predictable end points, or whether multiple evolutionary outcomes are more likely. In a more applied sense, the landscape will determine whether organisms will evolve to lose ‘costly’ resistance to antibiotics, herbicides or pesticides (...) when the use of the control agent is stopped. Laboratory populations of microbes allow evolution to be observed in real time and, as such, provide key insights into the topology of adaptive landscapes. BioEssays 27:1167–1173, 2005. © 2005 Wiley Periodicals, Inc. (shrink)

BackgroundWe describe our experience from a multi-national application of a European Union-funded research-driven paediatric trial (DEEP-2, EudraCT 2012-000353-31; NCT01825512). This paper aims to evaluate the impact of the local and national rules on the trial authorisation process in European and non-European countries. National/local provisions and procedures, number of Ethics Committees and Competent Authorities to be addressed, documentation required, special provisions for the paediatric population, timelines for completing the authorisation process and queries received were collected; compliance with the European provisions were (...) evaluated. Descriptive analysis, Wilcoxon Rank-Sum test and General Linear Model analysis were used to determine factors potentially influencing the timelines. The Cluster Analysis procedure was used to identify homogenous groups of cases.ResultThe authorisation process was completed in 7.7 to 53.8 months in European countries and in 17.1 to 27.1 months in non-European countries. The main factors influencing these timelines were the requests for changes/clarifications in European countries and the different national legislations in non-European countries.ConclusionThis work confirms that the procedures and requirements for the clinical trial application of a paediatric trial are different. In the European Union, the timeframes for submission were generally harmonised but longer. In non-European countries, delays were caused by national dispositions but the entire authorisation process resulted faster with less requests from ECs/cas. The upcoming application of Regulation (EU) 536/2014 is expected to harmonise practices in Europe and possibly outside. Networks on paediatric research acting at international level will be crucial in this effort. (shrink)

According to pure imperativism, pain experiences are experiences of a specific phenomenal type that are entirely constituted by imperative content. As their primary argument, proponents of imperativism rely on the biological role that pain experiences fulfill, namely, the motivation of actions whose execution ensures the normal functioning of the body. In the paper, I investigate which specific types of action are of relevance for an imperative interpretation and how close their link to pain experiences actually is. I argue that, although (...) imperative theories constitute an apparently promising version of strong intentionalism, they cannot provide an imperative content that meets their own criteria of both sufficiency and necessity. I further argue that this issue cannot be solved by impure imperative theories either. (shrink)

to appear in Lambert, E. and J. Schwenkler (eds.) Transformative Experience (OUP) -/- L. A. Paul (2014, 2015) argues that the possibility of epistemically transformative experiences poses serious and novel problems for the orthodox theory of rational choice, namely, expected utility theory — I call her argument the Utility Ignorance Objection. In a pair of earlier papers, I responded to Paul’s challenge (Pettigrew 2015, 2016), and a number of other philosophers have responded in similar ways (Dougherty, et al. 2015, (...) Harman 2015) — I call our argument the Fine-Graining Response. Paul has her own reply to this response, which we might call the Authenticity Reply. But Sarah Moss has recently offered an alternative reply to the Fine-Graining Response on Paul’s behalf (Moss 2017) — we’ll call it the No Knowledge Reply. This appeals to the knowledge norm of action, together with Moss’ novel and intriguing account of probabilistic knowledge. In this paper, I consider Moss’ reply and argue that it fails. I argue first that it fails as a reply made on Paul’s behalf, since it forces us to abandon many of the features of Paul’s challenge that make it distinctive and with which Paul herself is particularly concerned. Then I argue that it fails as a reply independent of its fidelity to Paul’s intentions. (shrink)

Indigenous people (IP) have faced multiple difficulties in education. Indigenous students often do worse academically than non-indigenous student peers. These stated the low enrollment rates showed a dropout rate, absenteeism, repetition rates, literacy rate, and thus the educational outcomes, with retention and completion being two significant issues. Further, this study explores the lived experiences and challenges faced by indigenous high school students amidst the new normal education. Employing the Interpretative Phenomenological Analysis, the findings of this study were: (1) The reason (...) why IP learners were not satisfied with their performance is that they cannot understand some of the lessons due to the language barrier. (2) IP learners are committed to finishing their studies, however, some of the students lack resources for studying, like gadgets for researching, and they do not have cell phones. And the other students may have gadgets or cellphones, but their internet connection is low or not accessible in some places at their location. (shrink)

A single mother is a person who is accountable for raising their children alone because they do not have a husband or live-in partner. Single mothers claim to have no co-parenting relationships at all, comparing single parents to those who are married, cohabiting, or without children, single parents experience the worst work-life balance. A single parent may feel overwhelmed by the demands of juggling child care, a career, paying bills, and maintaining household responsibilities. Single-parent households frequently deal with several extra (...) obligations and possible complications that other families would not. The study also emphasizes the difficulties and coping mechanisms faced by contractual single parents as well as their lived experiences. The study's findings, which were based on an Interpretative Phenomenological Analysis, were as follows: (1) Work-life balance can be difficult for single parents. They struggle to keep their jobs while taking care of their family because they are the only ones in charge of the children. (2) Single contractual mothers face particular difficulties due to a lack of resources for basic expenses. (3) Contractual single women lean on their kids, the good people in their lives, and their faith in God to get through problems. (shrink)

Background Few empirical studies have been found that explore ethical challenges among persons in high public positions that are responsible for elder care. The aim of this paper was to illuminate the meaning of being in ethically difficult situations related to elder care as experienced by high level decision-makers. Methods A phenomenological-hermeneutic method was used to analyse the eighteen interviews conducted with political and civil servant high level decision-makers at the municipality and county council level from two counties in Sweden. (...) The participants worked at a planning and control as well as executive level and had both budget and quality of elder care responsibilities. Results Both ethical dilemmas and the meaning of being in ethically difficult situations related to elder care were revealed. No differences were seen between the politicians and the civil servants. The ethical dilemmas mostly concerned dealings with extensive care needs and working with a limited budget. The dilemmas were associated with a lack of good care and a lack of agreement concerning care such as vulnerable patients in inappropriate care settings, weaknesses in medical support, dissimilar focuses between the caring systems, justness in the distribution of care and deficient information. Being in ethically difficult situations was challenging. Associated with them were experiences of being exposed, having to be strategic and living with feelings such as aloneness and loneliness, uncertainty, lack of confirmation, the risk of being threatened or becoming a scapegoat and difficult decision avoidance. Conclusion Our paper provides further insight into the ethical dilemmas and ethical challenges met by high level decision-makers', which is important since the overall responsibility for elder care that is also ethically defensible rests with them. They have power and their decisions affect many stakeholders in elder care. Our results can be used to stimulate discussions between high level decision-makers and health care professionals concerning ways of dealing with ethical issues and the necessity of structures that facilitate dealing with them. Even if the high level decision-makers have learned to live with the ethical challenges that confronted them, it was obvious that they were not free from feelings of uncertainty, frustration and loneliness. Vulnerability was revealed regarding themselves and others. Their feelings of failure indicated that they felt something was at stake for the older adults in elder care and for themselves as well, in that there was the risk that important needs would go unmet. (shrink)

This is a descriptive qualitative study using phenomenological approach involving 46 nurses working in hospitals that cater to COVID-19 patients. This was conducted in April 2020. Results show that the challenges of nurses during the tour of duty in COVID-19 wards includes physical, procedural, psychological and protection. Likewise, nurses uncovered some difficulty with regard to the following experiences: struggle to be in complete PPE and with lack of PPE, not always being able to provide timely care, increased workload, nursing care (...) limitations, their risk to safety and having anxiety. This most often leads to some opportunities that bridges the gap towards achievement of their personal development and professional growth, as such, nurses became more compassionate, confident, resilient and resourceful, altruistic, and develop a stronger faith in God. Their leadership skills were also enhanced as they learned new knowledge and developed skills through education, trainings and experience. All the challenges and difficulties became avenue for the nurses to be able to unleash their potentials and further develop them into a God fearing and humane health care providers. Furthermore, the nurses being in the forefront of health care should be given assurance of safety and protection. Likewise, the nurse should closely adhere to standard protocol designed for COVID-19 infection control. It is thus recommended that there should be effective communication system to address issues and resolve conflicts. Lastly, emotional support and positive feedback should be given to nurses during the critical situations in the ward and collaborative working environment should be established all the time. (shrink)

Community Engagement (CE) has been presented by bio-ethicists and scientists as a straightforward and unequivocal good which can minimize the risks of exploitation and ensure a fair distribution of research benefits in developing countries. By means of ethnographic fieldwork undertaken in Kenya between 2007 and 2009 we explored how CE is understood and enacted in paediatric vaccine trials conducted by the Kenyan Medical Research Institute and the US Centers for Disease Control (KEMRI/CDC). In this paper we focus on the role (...) of paid volunteers who act as an interface between villagers KEMRI/CDC. Village Reporters’ (VRs) position of being both with the community and with KEMRI/CDC is advantageous for the conduct of trials. However it is also problematic in terms of exercising trust, balancing allegiances and representing community views. VRs role is shaped by ambiguities related to their employment status and their dual accountability to researchers and their villages. VRs are understandably careful to stress their commitment to self-less community service since it augments their respectability at community level and opens up opportunities for financial gain and self-development. Simultaneously VRs association with KEMRI/CDC and proximity to trial participants requires them to negotiate implicit and explicit expectations for material and medical assistance in a cultural setting in which much importance is placed on sharing and mutuality. To ensure continuity of productive interactions between VRs, and similar community intermediaries, and researchers, open discussion is needed about the problematic aspects of relational ethics, issues concerning undue influence, power relations and negotiating expectations. (shrink)

With the surge of the COVID-19 pandemic, online sellers faced challenges in managing their online business daily. Aside from it, their work-life balance has been negatively affected as well, considering that they work from home and are responsible for household responsibilities. Thus, this study is conducted during the pandemic and gathered data using a semi-structured interview through Messenger call. It is conducted to explore the lived experiences of online sellers and how they managed their online business and personal life. It (...) also determines the specific challenges they’ve encountered and how they coped with them. Lastly, this study aims to map out how these experiences will benefit online sellers and consumers and explain that online selling can be both sustainable and convenient in terms of earning a good living and meeting their daily needs. Moreover, three major conclusions emerged from this study’s findings: (1) online sellers faced psychological and physical difficulties in managing their online business during the pandemic, (2) online sellers discovered ways on how to cope with the struggles they are facing, and (3) online sellers reflected on their experience to be more effective in the online selling industry. (shrink)

Taking the problem of perception and illusion as a leading clue, this article presents a new phenomenological approach to perception and the world: holism of experience. It challenges not only Husserl’s transcendentalism, but also what remains of it in Heidegger’s early thought, on the grounds that it is committed to the skeptical inference: Since we can always doubt any perception, we can always doubt perception as a whole. The rejection of such an implicit inference leads to a relational paradigm of (...) Being-in-the-World that differs from Heidegger’s on many points. (shrink)

While provisions of youth sports concussion laws are very similar, little is known as to how they are being implemented, factors that promote or impede implementation, or the level of compliance in each jurisdiction. We aimed to describe state experiences with implementation in order to inform ongoing efforts to reduce the harm of sports-related traumatic brain injury and to guide future evaluations of the laws’ impacts and the development of future public health laws. We conducted key-informant interviews in 35 states (...) with recently enacted concussion legislation. States varied considerably in their readiness and capacity for implementation. Factors facilitating implementation included existing partnerships, procedures, and resources; centralized implementation authority; prior related efforts; and involvement in the policymaking process by those now charged with implementation. Inhibitors included ambiguous statutory language, unclear delegation of authority, and compliance difficulties. Ongoing challenges persist, including primary prevention; determining which providers are qualified to make return-to-play assessments and contents of those assessments; compliance difficulties in rural and under-served areas; and unclear responsibility for enforcement. Despite the similarity of youth sports concussion laws, early evidence suggests there is considerable variation in their implementation. These findings are critical for ongoing empirical investigations to accurately evaluate the laws’ provisions and to identify successful legal approaches to protecting young athletes. (shrink)

Education is essential to life, and the epidemic affected everything. Parents want to get their kids the most important teaching. However, since COVID-19 has affected schools and other institutions, providing education has become the most significant issue. Online learning pedagogy uses technology to provide high-quality learning environments for student-centered learning. Further, this study explores the experiences and challenges faced by Filipino tertiary students regarding the lack of gadgets amidst online learning. Employing the Interpretative Phenomenological Analysis, the findings of this study (...) were: Some college students still have difficulty with online learning. Attending online classes is difficult, especially for students with limited resources. Smartphones, other gadgets, and internet connections play a significant role in online classrooms because they are the ones that students utilize while learning online, which is essential for successful participation in online higher education as well as for solving a variety of other difficulties in the new normal. Further, College students face similar health challenges. Having an online learning setup is not just about students' struggles with learning resources but also about their health issues. When our respondents used their smartphones for an extended period, they reported eye aches and blurred vision. They also said that some of their body parts, such as their legs and back, are aching, and feel pressured because they tend to overthink things in their surroundings, which causes them incredible difficulty in performing their best in attending online classes. Even though college students continue to suffer from a lack of learning resources during online sessions, they do their best to manage their needs and the scarcity of learning resources. Students have unique coping methods for dealing with difficulties in online classes. (shrink)

Williamson and others have recently argued against the significance of the a priori/a posteriori distinction. My aim in this paper is to explain, defend, and expand upon one of these arguments. In the first section, I develop in some detail a line of argument sketched in Williamson. In the second section, I consider two replies to Williamson and show that they miss the structure of the challenge, as I understand it. The problem for defenders of the distinction is to (...) find a way to draw it without leaving out some paradigmatic a priori knowledge or including some paradigmatic a posteriori knowledge. Interestingly, the two replies fail in opposite directions. I then consider the view that, in cases of a priori knowledge, one needs only understanding and some reasoning to gain justified belief. Such reasoning, I argue, should itself not be dependent on experience. Next, I consider, and reject, the attempt to spell out independence of experience for reasoning based on a link between the modal and epistemic status of the proposition involved. Finally, I provide some general grounds to think that the role of experience in forming a reasoning competence, while not evidential, is not devoid of normative value. The main reason is that the normative status of intellectual competences depends on the experiences that constitute their acquisition and development. (shrink)

Background Thirst and dry mouth are common symptoms in terminally ill patients. In their day-to-day practice, palliative care physicians regularly encounter ethical dilemmas, especially regarding artificial hydration. Few studies have focused on thirst and the ethical dilemmas palliative care physicians encounter in relation to this, leading to a knowledge gap in this area. Aim The aim of this study was to explore palliative care physicians’ experiences of ethical challenges in relation to thirst in terminally ill patients. Methods A qualitative interview (...) study with an inductive approach was conducted. Sixteen physicians working in four different specialised palliative care units and one geriatric care unit in different hospitals in Sweden were interviewed. The interviews were transcribed verbatim and analysed with a reflexive thematic analysis. Results When presented with an ethical challenge relating to thirst, physicians attempted to balance benefits and harms while emphasizing respect for the patient’s autonomy. The ethical challenges in this study were: Starting, continuing or discontinuing drips; lack of evidence and traditions create doubt; and lack of interest and time may result in patient suffering. Conclusions All physicians in this study reported that “Starting, continuing or discontinuing drips” was the main ethical challenge they encountered, where some were so accustomed to the decision that they had a standard answer ready to offer patients and families. Physicians reported that drips were a symbol of thirst quenching, life and survival but were not necessary in end-of-life care. Others questioned the traditions regarding thirst and emphasised drips in particular. (shrink)

As English Studies researchers and teachers, our experience has shown that there continues to exist an urgent need to incorporate gender as a reading tool of literary texts to foster a non-discriminatory and equality perspective. Given the many advances in gender equality that have been achieved as well as the rising backlash against such progressive moves that spread through Europe, our proposal is based on the “queerification of the classroom”, a notion defined as a transgressive initiative that effectively and systematically (...) incorporates the deconstruction of normativity and fosters resistance to socially constructed assumptions about normativity and deviance. (shrink)

Due to the outbreak of COVID-19 many families experience the threat of the COVID-19. This study aims to explore the lived experiences, challenges, and coping mechanisms of COVID-19 Family Survivors. The study employed the Interpretative Phenomenological Analysis with ten (10) participants. Based on the findings, the following conclusions were drawn: (1) Most of the participants consulted health professionals for their medications and advised herbal medicines in boosting their immune system. (2) Family survivors had to make adaptations to their daily routines (...) and established stringent health standards in their homes, such as separating the parents' and children's rooms, using disposable utensils, and ensuring that every surface of their homes was clean. (3) They were able to meet their necessities due to the generosity of their neighbors. These people were helped financially by their employers, neighbors, churchmates, and loved ones. Similarly, the government offered a different forum for the COVID-19 Family survivors to receive help and assistance. (4) Despite the hardships they faced, COVID-19 family survivors did not lose hope that they would be cured of COVID-19. These people tried their hardest to maintain their health by eating good meals, sleeping early, obtaining enough sunlight in the morning, and carefully selecting the vitamins they took. (5) Finally, despite the difficult battle against COVID19, these individuals grew resilient by building their spiritual lives, exercising their faith, and being brave for the sake of their loved ones. (shrink)

Although the use of the cluster randomized trial (CRT) design to evaluate vaccines, public health interventions or health systems is increasing, the ethical issues posed by the design are not adequately addressed, especially in low- and middle-income country settings (LMICs). To help reveal ethical challenges, qualitative interviews were conducted with key stakeholders experienced in designing and conducting two selected CRTs in Malawi. The 18 interviewed stakeholders included investigators, clinicians, nurses, data management personnel and community workers who were invited to share (...) their experiences related to implementation of CRTs. Data analysis revealed five major themes with ethical implications: (1) The moral obligation for health care providers to participate in health research and its compensation; (2) Suboptimal care services compromising the integrity of CRT; (3) Ensuring scientific validity and withholding care service; (4) Obtaining valid consent and permission for waiver of consent; and (5) Inadequate risk assessment for trial participation. Understanding key ethical issues posed by CRTs in Malawi could improve ethical review and research oversight of this particular study design. (shrink)

One of the main highlights from last year’s event was the 2022 Philippine National and Local Elections. The Philippine elections involve a lot of people interaction from poll workers and other deputized agencies. Further, this study explores the lived experiences, challenges, and coping mechanisms of poll watchers during the 2022 Philippine election. Employing the Interpretative Phenomenological Analysis, the findings of this study were: (1) Filipino workers value a good-paying job and preferred meaningful work. (2) Amidst the experiences and challenges, the (...) poll watchers remain determined and motivated to take part in the seasonal election. (3) Poll watchers must be physically, emotionally, and mentally prepared to participate in this crucial work. Mainly, pollwatching is a self-reliant job. (shrink)

ABSTRACT The current study is a qualitative investigation aimed at exploring the lived experiences of Tibetan youth who had escaped to India as unaccompanied minors and since then have been living as refugees in India without their parents. The study attempts to explore the challenges, struggles and coping of this unique population of youth refugees growing up in exile in India without the support of parents. Ten Tibetan refugee youth now studying at university level were interviewed in depth. Interpretative phenomenological (...) analysis was used to analyse their narratives. Major findings included the unique sociocultural, political and emotional challenges they faced related to acclimatisation, status of their own political identity, difficulties pertaining to retaining their Tibetan culture in a host country, and loneliness. Their adaptation in the host country was perceived to be facilitated by their unique Buddhist spiritual and cultural beliefs, strong faith in the Dalai Lama, community bonding and peer support and the use of social media to communicate with family in Tibet. The Tibetan refugee youth derived a sense of growth from their adversities related to appreciating the value of family, personal growth in the form of self-reliance, and finding meaning in life by feeling part of a larger purpose related to the Tibetan cause. Implications for practice: The study highlights the unique psychosocial issues of Tibetan refugee youth in exile in India. Culturally sensitive psychosocial support and an understanding of traditional spiritual and religious coping mechanisms may be integrated into health services for the Tibetan refugees who lack family support and may not be familiar with the Western constructs of mental health. (shrink)

This qualitative study explores the experiences and challenges SPED teachers face amidst the new normal of education. Employing Heidegerian Phenomenology and Interpretative Phenomenology analysis, findings suggest that the SPED teachers can’t enjoy their life outside work because of a lack of support from the government, physically and financially; thus, they experience burnout. Also, the salary they earn is not even enough to raise a family, and the fact that they almost shoulder the learning resources in the class makes it worse. (...) Moreover, the participants need practical training to adapt to the needs of their students amidst the challenges of the new learning modality. (shrink)

Applied to video games, Csikszentmihalyi’s work on flow evidences that a positive gaming experience is intrinsically self-rewarding and primarily determined by the skill/challenge balance. A multi-layered measure of enjoyment is built to take these components into account. Gamers were asked to report the concentration-enjoyment they experienced during a first-person shooter game, and to better assess the gap between skill and challenge, the challenge enjoyment was also rated. Along with concentration level, concentration enjoyment is used to build a (...) gaming experience typology that accounts for the self-rewarding component. An enjoyment-based challenge mapping is also drawn up, crossing challenge enjoyment and challenge level. The results show that this integrative enjoyment measure strengthens the causal link between challenge and gaming experience. Most importantly, the findings suggest that challenge or concentration-based enjoyment measures outweigh the standard concentration and difficulty measures as they are more likely to ensure a pleasant and positive experience (flow or relaxation) for the gamers. Indeed, regardless of the reported level of challenge, a gamer is more likely to have a positive experience when challenged at a level she perceives as pleasant. This article emphasizes the importance for game publishers of gathering enjoyment-based concentration and challenge assessments to ensure a positive gaming experience and gamers’ commitment. (shrink)

Post-abortion care research is increasingly being conducted in low- and middle-income countries to help reduce the high burden of unsafe abortion. This study aims to help address the evidence gap about ethical challenges that researchers in LMICs face when carrying out PAC research with adolescents. Employing an explorative qualitative approach, the study identified several ethics challenges encountered by PAC researchers in Zambia, including those associated with seeking ethics and regulatory approvals at institutional and national levels. Persistent stigma around abortion and (...) community perceptions that PAC studies encourage adolescents to seek abortion affected adolescents’ right to exercise their autonomy and to make decisions as well as exposed adolescents to social stigmatization risks. Challenges with recruitment was reported to result in abandoning of studies, thereby undermining development of PAC services that are more responsive to adolescent needs. Training needs identified included knowledge of best practices for conducting and disseminating PAC research. Strategies for addressing the ethical challenges included trust building and using less value-laden terminology when seeking permission and consent. It is essential to the future of PAC research in Zambia and globally that these important challenges be addressed through the development of comprehensive ethics guidance. (shrink)

Over the past decade, a flurry of media stories devoted to sports-related concussions have drawn attention to the previously “silent epidemic” of traumatic brain injury in athletes. From 2001 to 2009, the annual number of sports-related TBI emergency department visits in individuals age 19 and under climbed from 153,375 to 248,414, an increase of increase of 62 percent. Multiple head injuries place youth athletes at risk for serious health conditions, including cerebral swelling, brain herniation, and even death — postconcussive conditions (...) that have collectively been referred to as “second impact syndrome.” Studies have shown that children and teens — and girls, in particular — are more likely to sustain a concussion and have a longer recovery time than adults. Recent research also suggests that even subconcussive hits in children and adolescents may result in longer-term health effects such as decreased cognitive functioning, increased rates of depression, memory problems, and mild cognitive impairment. (shrink)

Educational institutions all over the world continue to attract the services of foreign-born scholars. In addition to the culture shock that immigrants experience in unfamiliar countries, these scholars often undergo "pedagogical shock." Through autobiographical accounts of foreign-born professors from Africa, Asia, Europe, and the US, this volume examines the experiences of foreign-born professors around the world to provide insight on the curricular, school-systemic, and sociological differences and challenges that are encountered, and how to help resolve them. It will help administrators, (...) institutions, and immigration and comparative education scholars understand the cross-cultural challenges and coping strategies that define the private and professional lives of foreign-born professors across the globe. (shrink)

Biodiversity has become one of the most important conservation values that drive our ecological management and directly inform our environmental policy. This paper highlights the dangers of strategically appropriating concepts from ecological sciences and also of uncritically inserting them into conservation debates as unqualified normative landmarks. Here, I marshal evidence from a cutting-edge research program in microbial ecology, which shows that if species richness is our major normative target, then we are faced with extraordinary ethical implications. This example challenges (...) our well-received beliefs about biodiversity and it invites us to critically rethink the nature of this concept so that a more robust understanding of biodiversity and of its role in conservation policy could emerge. (shrink)

Chronically disabling health impairments affect an increasing number of people worldwide. In close relationships, disability is an interpersonal experience. Psychological distress is thus common in patients as well as their spouses. Dyadic coping can alleviate stress and promote adjustment in couples who face disabling health impairments. Much research has focused on dyadic coping with cancer. However, other health problems such as physical and sensory impairments are also common and may strongly impact couple relationships. In order to promote couples' optimal adjustment (...) to impaired health, the identification of disability-related relationship challenges is required. Furthermore, ways in which dyadic coping with these challenges may benefit couples could inform researchers and practitioners how to support couples in coping with health impairments. Accordingly, the aims of this study were to systematically review dyadic challenges and dyadic coping when one partner has a chronically disabling physical or sensory impairment. Out of 873 articles identified through database searches, 36 studies met inclusion criteria. The disability-related dyadic challenges identified in the review were changed roles and responsibilities within the couple, altered communication, compromised sexual intimacy, and reduced social participation. These challenges were reported to burden both partners and the couple relationship. Dyadic adjustment benefitted from a we-perspective, i.e., when couples viewed the disability as a shared challenge and engaged in conjoint dyadic coping. The results suggest that patient/care recipient and partner/caregiver roles should be de-emphasized and that disability should be recognized as an interpersonal experience. (shrink)

According to pure imperativism, pain experiences are experiences of a specific phenomenal type that are entirely constituted by imperative content. As their primary argument, proponents of imperativism rely on the biological role that pain experiences fulfill, namely, the motivation of actions whose execution ensures the normal functioning of the body. In the paper, I investigate which specific types of action are of relevance for an imperative interpretation and how close their link to pain experiences actually is. I argue that, although (...) imperative theories constitute an apparently promising version of strong intentionalism, they cannot provide an imperative content that meets their own criteria of both sufficiency and necessity. I further argue that this issue cannot be solved by impure imperative theories either. (shrink)

Background While integrating genomic sequencing into clinical care carries clear medical benefits, it also raises difficult ethical questions. Compared to traditional sequencing technologies, genomic sequencing and analysis is more likely to identify unsolicited findings (UF) and variants that cannot be classified as benign or disease-causing (variants of uncertain significance; VUS). UF and VUS pose new challenges for genetic health professionals (GHPs) who are obtaining informed consent for genomic sequencing from patients.Methods We conducted semi-structured interviews with 31 GHPs across Europe, Australia (...) and Canada to identify some of these challenges.Results Our results show that GHPs find it difficult to prepare patients to receive results because a vast amount of information is required to fully inform patients about VUS and UF. GHPs also struggle to engage patients – many of whom may be focused on ending their ‘diagnostic odyssey’ – in the informed consent process in a meaningful way. Thus, some questioned how ‘informed’ patients actually are when they agree to undergo clinical genomic sequencing.Conclusions These findings suggest a tension remains between sufficient information provision at the risk of overwhelming the patient and imparting less information at the risk of uninformed decision-making. We suggest that a shift away from ‘fully informed consent’ toward an approach aimed at realizing, as far as possible, the underlying goals that informed consent is meant to promote. (shrink)

Background While integrating genomic sequencing into clinical care carries clear medical benefits, it also raises difficult ethical questions. Compared to traditional sequencing technologies, genomic sequencing and analysis is more likely to identify unsolicited findings (UF) and variants that cannot be classified as benign or disease-causing (variants of uncertain significance; VUS). UF and VUS pose new challenges for genetic health professionals (GHPs) who are obtaining informed consent for genomic sequencing from patients.Methods We conducted semi-structured interviews with 31 GHPs across Europe, Australia (...) and Canada to identify some of these challenges.Results Our results show that GHPs find it difficult to prepare patients to receive results because a vast amount of information is required to fully inform patients about VUS and UF. GHPs also struggle to engage patients – many of whom may be focused on ending their ‘diagnostic odyssey’ – in the informed consent process in a meaningful way. Thus, some questioned how ‘informed’ patients actually are when they agree to undergo clinical genomic sequencing.Conclusions These findings suggest a tension remains between sufficient information provision at the risk of overwhelming the patient and imparting less information at the risk of uninformed decision-making. We suggest that a shift away from ‘fully informed consent’ toward an approach aimed at realizing, as far as possible, the underlying goals that informed consent is meant to promote. (shrink)

During the set-up phase of an international study of genetic influences on outcomes from sepsis, we aimed to characterise potential differences in ethics approval processes and outcomes in participating European countries. Between 2005 and 2007 of the FP6-funded international Genetics Of Sepsis and Septic Shock project, we asked national coordinators to complete a structured survey of research ethic committee approval structures and processes in their countries, and linked these data to outcomes. Survey findings were reconfirmed or modified in 2017. Eighteen (...) countries participated in the study, recruiting 2257 patients from 160 ICUs. National practices differed widely in terms of composition of RECs, procedures and duration of the ethics approval process. Eight countries used a single centralised process for approval, seven required approval by an ethics committee in each participating hospital, and three required both. Outcomes of the application process differed widely between countries because of differences in national legislation, and differed within countries because of interpretation of the ethics of conducting research in patients lacking capacity. The RECs in four countries had no lay representation. The median time from submission to final decision was 1.5 months; in nine approval was received within 1 month; six took over 6 months, and in one 24 months; had all countries been able to match the most efficient approvals processes, an additional 74 months of country or institution-level recruitment would have been available. In three countries, rejection of the application by some local RECs resulted in loss of centres; and one country rejected the application outright. The potential benefits of the single application portal offered by the European Clinical Trials Regulation will not be realised without harmonisation of research ethics committee practices as well as national legislation. (shrink)

Background Ethical reasoning and sensitivity are always important in public health, but it is especially important in the sensitive and complex area of public health emergency preparedness. Here, we explored the ethical challenges, and dilemmas encountered by frontline health workers amid the coronavirus disease-19 (COVID-19) pandemic in Ethiopia. Methods A nationwide survey was conducted amongst the frontline health workers from nineteen public hospitals. Health workers were invited to respond to a self-administered questionnaire. Data were weighted and analyzed using descriptive statistics. (...) Results Of the 285 frontline health workers to whom questionnaires were distributed, 217 of them gave their responses (response rate 76.1%). Respondents frequently reported encountering rationing dilemmas on health commodities directly used for the prevention and treatment of COVID-19. Most (83.9%) of the health workers agreed that they encountered ethical challenges very frequently or frequently. Almost all [215(99.1%)] claimed that the limitation of resources was directly used for the treatment and prevention of COVID-19. The frequency of difficulty in the provision of essential clinical services varied between 77% and 98.7% for different services. More than half of the study participants reported that they had encountered difficulty in the provision of clinical care on a daily or weekly basis. Regarding rationing strategies, isolating COVID-19 treatment units and limiting admission were the most frequent rationing strategies used by two-thirds of health workers on a daily or weekly basis. Conclusion Front-line health workers encountered numerous ethically challenging situations during COVID-19. More than half of health workers reported that they encountered ethical challenges in rationing the resources and delivery of different clinical services such as family planning services, maternal and childcare, immunization, and chronic care. With limited resources such as ventilators and hospital beds, healthcare providers have been faced with the difficult task of deciding who gets access to these resources and who doesn't. Overall, the COVID-19 pandemic has presented numerous ethical challenges for healthcare providers, highlighting the importance of ethical considerations in healthcare delivery. By being aware of these dilemmas and having policies in place to address them, healthcare providers can ensure that they are providing the best possible care to their patients while upholding ethical standards. (shrink)

ABSTRACT Post-abortion care (PAC) research is increasingly being conducted in low- and middle-income countries (LMICs) to help reduce the high burden of unsafe abortion. This study aims to help address the evidence gap about ethical challenges that researchers in LMICs face when carrying out PAC research with adolescents. Employing an explorative qualitative approach, the study identified several ethics challenges encountered by PAC researchers in Zambia, including those associated with seeking ethics and regulatory approvals at institutional and national levels. Persistent stigma (...) around abortion and community perceptions that PAC studies encourage adolescents to seek abortion affected adolescents’ right to exercise their autonomy and to make decisions as well as exposed adolescents to social stigmatization risks. Challenges with recruitment was reported to result in abandoning of studies, thereby undermining development of PAC services that are more responsive to adolescent needs. Training needs identified included knowledge of best practices for conducting and disseminating PAC research. Strategies for addressing the ethical challenges included trust building and using less value-laden terminology when seeking permission and consent. It is essential to the future of PAC research in Zambia and globally that these important challenges be addressed through the development of comprehensive ethics guidance. (shrink)

This article provides a critical examination of a controversial issue that has theoretical and practical importance to a broad range of academic disciplines: Are religious experiences localized within the brain? Research into the neuroscience of religious experiences is reviewed and conceptual and methodological challenges accompanying the neurotheology project of localizing religious experiences within the brain are discussed. An alternative theory to current reductive and mechanistic explanations of observed mind–brain correlations is proposed — a mediation theory of cerebral action — that (...) has the potential for addressing what Chalmers called the “hard problem” of consciousness. (shrink)

Public engagement in science and technology has grown in importance as developments in science and technology make increasingly significant impacts on people's lives. Now, efforts to engage publics in social decision-making or consensus-building regarding science and technology involve participation, learning or deliberation opportunities, as well as interactive or coproductive efforts among various sectors in society based on the recognition of scientific activities as a part of social operations - even those performed by scientific communities. We have conducted a community engagement (...) program in the HapMap project, the international human genome program, in Japan since 2002. Consequent upon our various approaches to engage Japanese publics, a range of observations were made, such as that: public engagement is not yet recognized or institutionalized in Japan; there is a wide gap between science and society; and the implications of public engagement in a Japanese context have not been examined enthusiastically, especially from the perspectives of political decision making, social consensus-building or self-determination. In this paper, we provide an overview of public engagement in Japan, and discuss issues and challenges raised by the HapMap community engagement project. We also discuss the implications of public engagement for social decision-making and self-determination, and explore the prospects for public engagement in science and technology in Japan. (shrink)

Carpendale & Lewis's (C&L's) proposal of a social interaction account makes clear the need for researchers of all theoretical orientations to get specific about how social experience influences children's developing understanding of mind, but it is premature to reject other theories, such as theory-theory, which also attribute a major role to experience.

Taking the case of H. pylori and ulcer, Lynch et al., demonstrate how framing Koch’s postulate by an interventionist account clarifies the latter’s explanatory strength in proportionality with the weaknesses in specificity and stability due to the influence of background conditions. They suggest this approach as an efficient way to bypass the enigma of background conditions and microbial activity in the microbiome’s causal relations. However, it is the background conditions and the microbial interactions in the stomach that determine (...) whether the presence of H. pylori results in an ulcer. I agree with their analysis of the problems and challenges with the microbiome causal explanation but argue that their suggested framework is insufficient without a proper understanding and inclusion of the background conditions and microbial interactions. The reductionist approach fits well within the model of causal explanation that centers on one causal entity. However, such a model is weak in specificity and is too broad because it does not address the factors of microbial activity and background conditions. I argue that for a better causal explanation with explanatory strength in specificity, it is essential to include the background conditions and microbial interactions. Furthermore, I argue that this inclusion changes the framework of the causal relations from looking for the causal entity to looking at the causal process. (shrink)