Background When anti-cancer treatments have been given market authorization, but are not (yet) reimbursed within a healthcare system, physicians are confronted with ethical dilemmas. Arranging access through other channels, e.g., hospital budgets or out-of-pocket payments by patients, may benefit patients, but leads to unequal access. Until now, little is known about the perspectives of physicians on access to non-reimbursed treatments. This interview study maps the experiences and moral views of Dutch oncologists and hematologists.Methods A diverse sample of oncologists and hematologists (...) (n = 22) were interviewed. Interviews were analyzed thematically using Nvivo 12 qualitative data software.Results This study reveals stark differences between physicians’ experiences and moral views on access to anti-cancer treatments that are not (yet) reimbursed: some physicians try to arrange other ways of access and some physicians do not. Some physicians inform patients about anti-cancer treatments that are not yet reimbursed, while others wait for reimbursement. Some physicians have principled moral objections to out-of-pocket payment, while others do not.Conclusion Oncologists and hematologists in the Netherlands differ greatly in their perspectives on access to expensive anti-cancer treatments that are not (yet) reimbursed. As a result, they may act differently when confronted with dilemmas in the consultation room. Physicians working in different healthcare systems may face similar dilemmas. (shrink)

BackgroundThe return of genetics and genomics research results has been a subject of ongoing global debate. Such feedback is ethically desirable to update participants on research findings particularly those deemed clinically significant. Although there is limited literature, debate continues in African on what constitutes appropriate practice regarding the return of results for genetics and genomics research. This study explored perspectives and ethical considerations of Ugandan genomics researchers regarding the return of genetics and genomics research results.MethodsThis was a qualitative study that (...) employed in-depth interviews. Thirty participants were purposively selected based on their expertise as genomics researchers in Uganda. Data were analysed through content analysis along the main themes of the study using a comprehensive thematic matrix, to identify common patterns arising from the narratives. NVivo software 12 was used to support data analysis.ResultsThe return of genetics and genomics research results was generally acceptable to researchers, and some indicated that they had previously returned individual or aggregate results to participants and communities. The main reasons cited for sharing research results with participants included their clinical utility, actionability and overall benefit to society. Ethical considerations for appropriate return of results included a need for effective community engagement, genetic counselling prior to disclosure of the results, adequate informed consent, and proper assessment of the implications of, or consequences of returning of results. However, the approaches to return of results were perceived as unstandardized due to the lack of appropriate regulatory frameworks.ConclusionsThe return of genetic and genomic research results is generally acceptable to researchers despite the lack of appropriate regulatory frameworks. Ethical considerations for return of genetics and genomics research results are highly divergent, hence the need for national ethical guidelines to appropriately regulate the practice. (shrink)

ObjectiveIn Belgium, people with an incurable psychiatric disorder can file a request for euthanasia claiming unbearable psychic suffering. For the request to be accepted, it has to meet stringent legal criteria. One of the requirements is that the patient possesses decision-making capacity. The patient’s decision-making capacity is assessed by physicians.The objective of our study is to provide insight in the assessment of decision-making capacity in the context of euthanasia for patients with psychic suffering caused by a psychiatric disorder.MethodTwenty-two semistructured interviews (...) with psychiatrists and neurologists were analysed with NVivo, a qualitative analysis software to code and organise transcribed data.ResultsDifferent views and approaches regarding decision-making capacity in the context of euthanasia emerged from the data.Most of the physicians have some knowledge of the cognitive ability approach on decision-making capacity. According to this approach, four abilities constitute decision-making capacity: communication, understanding, appreciation and reasoning. We observed differences in the way these abilities are valued in relation to competence. Some physicians take additional elements into consideration when assessing decision-making capacity.Physicians acquired their knowledge on the subject in many different ways. Most of the physicians reported that decision-making capacity was not part of their training.ConclusionWe conclude that physicians assess decision-making capacity in different ways and that personal values and beliefs influence their approach. As such, a common approach in assessing the decision-making capacity of a patient among the interviewed physicians is lacking. Less arbitrariness could be obtained by consistently implementing the cognitive ability approach. (shrink)

Controlled human malaria infection (CHMI) studies involve the deliberate infection of healthy volunteers with malaria parasites under controlled conditions to study immune responses and/or test drug or vaccine efficacy. An empirical ethics study was embedded in a CHMI study at a Kenyan research programme to explore stakeholders’ perceptions and experiences of deliberate infection and moral implications of these. Data for this qualitative study were collected through focus group discussions, in‐depth interviews and non‐participant observation. Sixty‐nine participants were involved, including CHMI study (...) volunteers, community representatives and research staff. Data were managed using QSR Nvivo 10 and analysed using an inductive‐deductive approach, guided by ethics literature. CHMI volunteers had reasonable understanding of the study procedures. Decisions to join were influenced by study incentives, trust in the research institution, their assessment of associated burdens and motivation to support malaria vaccine development. However, deliberate malaria infection was a highly unusual research strategy for volunteers, community representatives and some study staff. Volunteers’ experiences of physical, emotional and social burdens or harms were often greater than anticipated initially, and fluctuated over time, related to specific procedures and events. Although unlikely to deter volunteers' participation in similar studies in furture, we argue that the dissonance between level of understanding of the burdens involved and actual experiences are morally relevant in relation to community engagement, informed consent processes, and ongoing support for volunteers and research staff. We further argue that ethics oversight of CHMI studies should take account of these issues in deciding whether consent, engagement and the balance of benefits and harms are reasonable in a given context. (shrink)

Rapid Ethical Assessment is an approach used to design context tailored consent process for voluntary participation of participants in research including human subjects. There is, however, limited evidence on the design of ethical assessment in studies targeting cancer patients in Ethiopia. REA was conducted to explore factors that influence the informed consent process among female cancer patients recruited for longitudinal research from Addis Ababa Population-based Cancer Registry. Qualitative study employing rapid ethnographic approach was conducted from May–July, 2017, at the Tikur (...) Anbessa Specialized Referral Hospital. In-depth and key informants’ interviews were conducted among purposively selected 16 participants. Regular de-briefings among the study team helped to identify emerging themes and ensure saturation. Interviews and debriefings were tape recorded in Amharic, and transcribed and translated to English. Coding of the transcripts was facilitated by use of NVivo software. Thematic analysis was employed to respond to the initial questions and interpret findings. Perceived barriers to voluntary study participation included lack of reporting back study results of previous studies, the decision making status of women, hopelessness or fatigue in the patients, shyness of the women, data collectors approach to the patient, and patient’s time constraints. Most of the patients preferred oral over written consent and face-to-face interview over telephone interview. Provision of detail information about the study, using short and understandable tool, competent, compassionate and respectful enumerators of the same gender were suggested to assure participation. Due to the perceived severity, the use of the term “cancer” was associated with fear and anxiety. Alternatively, uses of phrases like “breast or cervical illness/disease” were suggested during patient interviews. Voluntary participation is not straight forward but affected by different factors. Using competent, compassionate and respectful enumerators, short and precise questioning tools to limit the time of the interview could improve voluntary participation. Moreover, careful consideration of the patients and families concept of the disease such as wording and information has to be taken into account. This assessment helped in improving the consent process of the ongoing project on breast and cervical cancer patients. (shrink)

Background:Complex and expensive treatment options have increased the frequency and emphasis of ethical decision-making in healthcare. In order to meet these challenges effectively, we need to identify how nurses contribute the resolution of these dilemmas.Aims:To identify the values, beliefs and contextual influences that inform decision-making. To identify the contribution made by nurses in achieving the resolution of ethical dilemmas in practice.Design:An interpretive exploratory study was undertaken, 11 registered acute care nurses working in a district general hospital in England were interviewed, (...) using semi-structured interviews. In-depth content analysis of the data was undertaken via NVivo coding and thematic identification.Participants and context:Participants were interviewed about their contribution to the resolution of ethical dilemmas within the context of working in an acute hospital ward. Participants were recruited from all settings working with patients of any age and any diagnosis.Ethical considerations:Ethical approval was obtained from the local National Research Ethics Committee.Findings:Four major themes emerged: ‘best for the patient’, ‘accountability’, ‘collaboration and conflict’ and ‘concern for others’. Moral distress was also evident in the literature and findings, with moral dissonance recognised and articulated by more experienced nurses. The relatively small, single-site sample may not account for the effects of organisational culture on the results; the findings suggested that professional relationships were key to resolving ethical dilemmas.Discussion:Nurses use their moral reasoning based on their beliefs and values when faced with ethical dilemmas. Subsequent actions are mediated though ethical decision-making frames of reference including deontology, consequentialism, the ethics of care and virtue ethics. Nurses use these in contributing to the resolution of these dilemmas. Nurses require the skills to develop and maintain professional relationships for addressing ethical dilemmas and to engage with political and organisational macro- and micro-decision-making.Conclusion:Nurses’ professional relationships are central to nurses’ contributions to the resolution of ethical dilemmas. (shrink)

This article aims to focus on how signatories versus nonsignatories in the U.S. pharmaceutical sector compare with respect to the internal and external stakeholders and principles of the United Nations Global Compact (UNGC). We seek to answer the question: Do signatories to the UNGC walk the talk better than nonsignatories as determined by a variety of published rankings and data? This research presents an innovative approach to the evaluation of UNGC signatories. It uses several objective and independent data sources to (...) assess a matched group of signatories versus nonsignatories in the U.S. pharmaceutical sector. Signatory organizations in the same sector as determined by SIC codes were matched with nonsignatories on variables such as size and number of employees in U.S. pharmaceutical companies. Then both types of organizations were compared on the following data sources: Coalition for Environmentally Responsible Economies ratings, ratings by external stakeholders, ratings by employees, unionization data, financial measures, and annual reports to shareholders. Using nonparametric testing the research found there are differences between signatories and nonsignatories in the U.S. pharmaceutical sector for some of the external stakeholder measures and no differences were found for the internal stakeholder measures. (shrink)

Emerging genomic technologies promise more efficient infectious disease control. Whole genome sequencing is increasingly being used in tuberculosis diagnosis, surveillance, and epidemiology. However, while the use of WGS by public health agencies may raise ethical, legal, and socio-political concerns, these challenges are poorly understood. Between November 2017 and April 2018, we conducted semi-structured interviews with 22 key stakeholders across the fields of governance and policy, public health, and laboratory sciences representing the major jurisdictions currently using WGS in national TB programs. (...) Thematic analysis of the interviews was conducted using NVivo 11. Respondents identified several ethical and practical challenges associated with WGS in TB care and surveillance, all related to issues of trust, including: 1) the power of public health; 2) data sharing and profits derived from surveillance efforts; and 3) concerns regarding who has access to, and can benefit from, the technology. Additional challenges included: the potential utility that WGS adds to a public health program, the risks associated with linking necessary epidemiological metadata to the genomic data, and challenges associated with jurisdictional capacity to implement the technology. Successful implementation of WGS is dependent on fostering relationships of trust between those working with genomics technology and those directly impacted by it, including clinicians. Building trust between the public and the public health agencies and within public health agencies themselves is critical due to the inherent complexity of WGS and its implementation for communicable disease control purposes. (shrink)

The COVID-19 pandemic rapidly led to changes in the mode of teaching, learning and assessments in most tertiary institutions worldwide. Notably, non-invigilated summative assessments became predominant. These changes heightened anxiety and depression, especially among individuals with less resilient coping mechanism. We explored the perceptions and experiences of mental health difficulties of students in tertiary education regarding non-invigilated alternative assessments in comparison to invigilated assessments. A pragmatic, mixed method cross sectional design was conducted online via Qualtrics. Thematic analysis of text was (...) carried out using NVivo 12. In the quantitative analysis, univariable and multivariable ordinal logistic models were used to examine the potential factors for preference among students in higher education. A total of 380 Nursing and Social Science students responded to the survey. Approximately 77% of students perceived non-invigilated assessments to be less stressful compared to invigilated exams. Age, course of study, stage of studies, and number of units enrolled per semester were identified as significant drivers for students’ perceived preference for non-invigilated assessments. There was an inverse relationship between the perception of stress associated with invigilated exams and the age of students. For instance, students aged between 18-24 were 5 times more likely to prefer non-invigilated exams compared to those aged 55 or more. Comparatively, students in early stages of studies had higher preference for non-invigilated assessments. However, there was a preference reversal for students enrolled in 2 or less units per semester. Social sciences students were two times more likely to prefer non-invigilated examinations to invigilated examinations compared to nursing students. The findings reinforce the use of alternative assessments in higher education as a mitigating agency to lessen the mental health burden of tertiary students in post COVID-19 era. (shrink)

IntroductionFrontline healthcare workers have faced significant plight during the ongoing Coronavirus disease 2019 pandemic. Studies have shown their vulnerabilities to depression, anxiety disorders, post-traumatic stress, and insomnia. In a developing country like India, with a rising caseload, resource limitations, and stigma, the adversities faced by the physicians are more significant. We attempted to hear their “voices” to understand their adversities and conceptualize their resilience framework.MethodsA qualitative approach was used with a constructivist paradigm. After an initial pilot, a socio-demographically heterogeneous population (...) of 172 physicians working in COVID-designated centers were purposively sampled from all over India. Following in-depth virtual interviews using a pre-formed semi-structured guide, the data was transcribed and translated verbatim. The interview was focused on their challenges, needs, and processes of coping and support. Charmaz’s grounded theory was used for analysis supplemented by NVivo 10 software.ResultsFear of infection, uncertainty, stigma, guilt, and social isolation emerged as the main challenges. Simultaneously, their “unmet needs” were flexible work policies, administrative measures for better medical protection, the sensitivity of media toward the image of HCW, effective risk communication for their health, and finally, social inclusion. Their resilience “framework” emerged as a process while navigating these adversities and consisted of three facets: forming a “resilient identity,” managing the resilience, and working through the socio-occupational distress. The role of mental well-being, social network, peer support, problem negotiation, and self-care emerged as the key coping strategies.ConclusionThe study findings support the global call for better psychosocial health and quality of life of the frontline HCWs. Their “unheard voices” explored in the study can anchor subsequent resilience-enhancing interventions and policies. Guidelines focusing on the psychological wellbeing of frontline HCWs need to be grounded in their unmet needs and lived experiences. (shrink)

BackgroundGenetics and genomics research (GGR) is increasingly being conducted around the world; yet, researchers and research oversight entities in many countries have struggled with ethical challenges. A range of ethics and regulatory issues need to be addressed through comprehensive policy frameworks that integrate with local environments. While important efforts have been made to enhance understanding and awareness of ethical dimensions of GGR in Africa, including through the H3Africa initiative, there remains a need for in-depth policy review, at a country-level, to (...) inform and stimulate local policy development and revision on the continent.MethodsTo identify and characterize existing ethics-related guidelines and laws applicable to GGR across much of Africa, we conducted a scoping review of English language policy documents identified through databases, repositories, and web searches. Thirty-six documents were included and coded using a framework that contained a range of themes across five analytical categories: (1) respect, (2) beneficence, (3) justice, (4) independent oversight, and (5) bans and prohibitions. Data analysis software (NVivo 12) was used to organize, code, and tabulate information according to document characteristics and topics. Illustrative examples of policy requirements were selected for inclusion.ResultsDocuments that met inclusion criteria spanned 20 years; published between 1996 and 2018, with the majority (58%) published after 2009. About two-thirds were denoted as “guidelines,” and slightly more than half were non-exclusive to GGR. Very few (six) country-level documents identified were specific to GGR. Requirements related to the principle of “respect” appeared most often across all documents, relative to other principles and processes. The most commonly stated ban was on reproductive cloning. Other prohibitions applied to germline editing, undue inducements in research, sample use for commercial purposes, employee mandatory DNA testing, fetal sex selection, stem cell use, eugenics, and research without public health benefits.ConclusionsEnforceable policies that are indispensable to the ethical conduct and review of GGR are either deficient or missing in many African countries. Existing international, GGR-specific ethics guidelines can be used to inform GGR policy development at a country-level, in conjunction with insight from country specific ethics committees and other local stakeholders. (shrink)

A literature search indicates an absence of research into boy’s experiences of physical education in classes in which there is a significant majority of girls. The aim of the study was to examine how boys in such classes experience their PE lessons. The methodological approach was qualitative, and data were collected with interviews of 13 boys in classes with more than 90% girls at a Norwegian high school. The data were analyzed with QSR NVivo 10, focused on creating categories (...) of meaning, in which students’ experiences were taken as subjectively true. The data are based on subjective constructions, which students constructed as part of their own interpretations and reflections on what had occurred in PE at the school. Results of the study came out in the form of three main findings. Two of those relate to a negative experience and the third to a positive experience of PE. The boys mostly felt that they are physically superior and have to consider the girls. Furthermore, the boys reported little challenge and feelings of mastery while being together with passive girls who are allowed to choose the activities. However, the boys found it easier to show off in front of the teachers and classmates when there were just a few boys in the class. The results are discussed in relation to gender-related theory on how the respondents are producing a traditional male gender in PE through their mastery, strength, and ambition to compete. We suggest a new approach of teaching that is more student-centered. A strategy could be to include other activities than sport-based activities into PE – activities that do not require strength and other athletic skills leading to feelings of hegemonic masculinity. A larger focus on social interactions during PE classes – activities in which students’ sex is not as important as in traditional teacher- and sport-centered PE classes, may be a good strategy. (shrink)

This paper aims to investigate the effect of gamification in engaging and motivating consumers for online shopping and also the use of gamification to enhance sales. Moreover, this study has also explored the ethical concerns in gamified marketing. This is a qualitative study to investigate the effect of gamification during online shopping and the ethical issues involved in gamified marketing. Semi-structured interviews with ten gamification experts are conducted and analyzed through NVivo. The themes that emerged from qualitative analysis are (...) the applicability of gamification in online retail, consumer experiences in gamified retail, and ethics and challenges in gamification. Semantic analysis is performed, and as per the viewpoint of the gamification experts, it was found that the perception of ethics in gamification is negative, which shows that there are many unethical practices in gamified marketing. This paper shows that by focusing on every relational aspect of consumer engagement, retailers can build trust and retain their most valuable stakeholders — the customers, thereby addressing the crucial negative concerns of gamified marketing. This research is one of its types to explore the significant ethical issues that affect consumers in the retail context. The undertaking of this study in an emerging economy adds further insight into gamified retail literature by generalizing the applicability of gamified studies across geographic contexts. (shrink)

The last decade has seen a surge of interest and investment in green social prescribing, however, both healthcare and social enterprise has been impacted by the COVID-19 crisis, along with restricted access to public green spaces. This study examines the challenges and opportunities of delivering green social prescribing during and in the aftermath of COVID-19, in the light of goals of green social prescribing to improve mental health outcomes and reduce health inequalities. Thirty-five one-to-one interviews were conducted between March 2020 (...) and January 2022. Interviewees included Link Workers and other social prescribers, general practitioners, managers, researchers, and volunteers working in urban and rural Scotland and North East England. Interview transcripts were analyzed in stages, with an inductive approach to coding supported by NVivo. Findings revealed a complex social prescribing landscape, with schemes funded, structured, and delivered diversely. Stakeholders were in general agreement about the benefits of nature-based interventions, and GPs and volunteers pointed out numerous benefits to participating in schemes such as parkrun. Link Workers were more circumspect about suggesting outdoor activities, pointing out both psychological and practical obstacles, including health anxieties, mobility issues, and transport deficits. Exacerbated by the pandemic, there was a way to go before older and/multi-morbidity clients would feel comfortable and safe to socialize in open air spaces. Our findings support the premise that time spent in open green spaces can alleviate some of the negative mental health effects compounded by the pandemic. However, the creation of healthy environments is complex with population health intrinsically related to socioeconomic conditions. Social disadvantage, chronic ill health and health crises all limit easy access to green and blue spaces, while those in the most socially economically deprived areas receive the lowest quality of healthcare. Such health inequities need to be borne in mind in the planning of schemes and claims around the potential of future nature-based interventions to reduce health inequalities. (shrink)

Increasing adoption of electronic health records in hospitals provides new opportunities for patient data to support public health advances. Such learning healthcare models have generated ethical debate in high-income countries, including on the role of patient and public consent and engagement. Increasing use of electronic health records in low-middle income countries offers important potential to fast-track healthcare improvements in these settings, where a disproportionate burden of global morbidity occurs. Core ethical issues have been raised around the role and form of (...) information sharing processes for learning healthcare systems, including individual consent and individual and public general notification processes, but little research has focused on this perspective in low-middle income countries. We conducted a qualitative study on the role of information sharing and governance processes for inpatient data re-use, using in-depth interviews with 34 health stakeholders at two public hospitals on the Kenyan coast, including health managers, providers and researchers. Data were collected between March and July 2016 and analysed using a framework approach, with Nvivo 10 software to support data management. Most forms of clinical data re-use were seen as an important public health good. Individual consent and general notification processes were often argued as important, but contingent on interrelated influences of the type of data, use and secondary user. Underlying concerns were linked to issues of patient privacy and autonomy; perceived risks to trust in health systems; and fairness in how data would be used, particularly for non-public sector re-users. Support for engagement often turned on the anticipated outcomes of information-sharing processes, as building or undermining trust in healthcare systems. As reported in high income countries, learning healthcare systems in low-middle counties may generate a core ethical tension between supporting a public good and respecting patient autonomy and privacy, with the maintenance of public trust acting as a core requirement. While more evidence is needed on patient and public perspectives on learning healthcare activities, greater collaboration between public health and research governance systems is likely to support the development of efficient and locally responsive learning healthcare activities in LMICs. (shrink)

This study aims to determine the opinions of teachers of Religious Culture and Ethics Course (DKAB) about subject-based classroom application in-depth. The research has been carried from qualitative research methods with a case study design. In order to determine the working group of the study, criteria sampling was used in the first stage, and the maximum diversity sampling method was used in the next step. The sample of this research consists of 8 DKAB teachers working in Ankara province. A semi-structured (...) interview form has been used as a data collection tool in the study. The data of the qualitative of this research has been analyzed with both descriptive and content analysis by NVivo 10 program. In order to ensure validity and reliability in the study, credibility, transferability, consistency, and verifiability strategies have been used. When the research data were analyzed, four themes were formed: positive opinions about the application, negative opinions and problems related to the application, contribution of the practice to religious education and training, and recommendations about the application. DKAB teachers find the application more positive than the classroom system. It has been found that the practice of subject-based classrooms is a motivational tool for Primary School students, while it causes some problems for lower secondary school and upper secondary school students.Summary: Learning environments are among the key elements in the acquisition of 21st-century skills. Classrooms are also a part of the learning environment. Classes are the learning environment in which teachers and students spend most of their education and training process. In this context, subject-based classroom application is one of the preferred methods in the arrangement of classrooms.Subject-based classroom application means that the teachers have a special classroom related to their branches in the school building, and students attend the teacher's classroom according to the syllabus. In this practice, the teacher can decorate walls, floor, ceiling, column, and beam of the classroom with students’ study materials such as banner, poster, painting, cartoon to make the course more effective and efficient and to create a psychological atmosphere called classroom atmosphere-air.This application aims to activate the student by enriching the classroom and make learning effective and efficient. The classroom equipped with appropriate equipment and materials provides a favorable environment for the implementation of effective teaching strategies. The application can create “class/classroom culture” by using ordinary meanings and symbols related to the course. It provides students the opportunity to exhibit their products and contributes to students' self-regulation skills development. Besides, real-life practices or practices close to reality can be brought into the classroom. As a result, permanent learning can be realized with the possibility of creating a shared living space and the number of sensory organs participating in learning.This current study aims to address in-depth information about the opinions of Religious Culture and Moral Ethics (DKAB) teachers in primary, secondary, and high schools regarding the subject-based classroom application. When the studies in the literature are examined, it is seen that the studies related to the subject-based classroom application have increased since 2010. However, it is clear that this research is directed towards social studies, geography, science, and mathematics courses and is based on the opinions of students, teachers, and administrators at the secondary school level. In the context of DKAB course, there has been no research including the views of teachers, students, or school administrators regarding the application of subject-based classrooms. This study is carried out revealing perspectives of DKAB teachers by examining their opinions on the subject-based classroom application and contribute to the field. The research was conducted with a case study design from the qualitative research methods. The participants consist of 8 DKAB teachers working in Ankara province. A mixed purposive sampling method was used to determine the study group. In the first stage, the teachers implementing the DKAB classrooms application were taken as criteria. In the next step, the study group was determined within the framework of the maximum diversity sampling method by considering the variables such as school level, gender, age, education level, duration of teachers' work. The data were collected through a semi-structured interview form with expert opinion. In the form, there are nine main questions and probe questions, which include questions related to subject-based classrooms application, the contribution of the application to religious education and training, the contribution of teachers to professional and personal development, the effect of teachers' belonging to the school, the effectiveness, and improvement of the application. Permission has been obtained from the Ankara Provincial Directorate of National Education and participants via consent form for the interview. The interviews were recorded in audio, 169.58-minute audio recording transcripts, and 52-page interview data obtained. The qualitative data of this research has been analyzed with both descriptive and content analysis by NVivo 10 program. In order to ensure validity and reliability in the study, credibility, transferability, consistency, and verifiability strategies have been used.When the data of the research were analyzed, the opinions of DKAB teachers about the subject-based classrooms application categorized under four themes; positive and negative opinions/problems about the practice, the contribution of the practice to religious education and teaching and practical suggestions. Under the theme of positive opinions on the application, positive aspects for the teacher, student, parents, and comparison with the classroom system were formed. According to the participants, the practice of DKAB classroom is a “facilitation” element for the teacher because of the factors such as the teacher not moving around the classroom, not carrying material, having freedom to organize the classroom, and material regularity. In this application, since the teacher has a class of his own, the teacher adopts and owns the classroom and the sense of belonging to school increases. This sense of belonging is felt so strongly that there is even a participant who plans to retire if the application is abandoned. The positive aspects of the application for the students are that; a classroom is a motivating tool, the boards and walls can be used, and the student has the opportunity to exhibit their activities. When compared with the classroom system, it was stated that as a result of the branch classroom practice, the school equipment could be better protected, class order and cleaning easier, and the success of the students would be increased.The negative views of the participants on the application were grouped under the categories of students, teachers, and parents. Not having a fixed class of their own, continually relocating and losing time in recess, staying in the classroom door when the classroom is locked, not adopting the classroom and lack of lockers constitute the negative aspects of the application for the students. The overuse of classrooms, less use of teachers' rooms, lack of communication between colleagues are the negative aspects of the application for the teachers. It was stated by (75%) most of the participants that branch classroom application contributed to the continual learning of students in religious education and teaching. To make the application more functional, DKAB teachers have proposed arrangements such as improving physical infrastructure, enriching teaching materials, and arranging school syllabus and keeping classrooms open. As a result, teachers find the application more positive than the classroom system. While it is a motivation tool for primary school students, it causes some problems for secondary and high school students, such as carrying bags, staying at the door, and wasting time. In this sense, the application is recommended to be applied in primary schools that have a sufficient number of classrooms. Also, the system should be applied in secondary and high schools where the number of students is low, or the number of classrooms is sufficiently provided that the problems experienced by the students are eliminated. School administrations and teachers need to take necessary measures to make the application effective and efficient. (shrink)

This article examines the role of emotions during insurgent conditions by focusing on the Nicaraguan revolution, in particular the two-year period (1977–1979) leading to the overthrow of the Somoza regime. Based on an analysis of testimonial accounts from an oral history volume, ¡Y Se Armó La Runga!, and a NVivo-10 content analysis of testimonies therein, it sets out to make a case for the significance of hope as a dominant emotion during guerrilla offensives. The manuscript answers the following questions: (...) 1) What is the role of hope during guerrilla offensives?; 2) what other emotions are in play during these events?; and 3) in what ways does hope combine with other emotions to maintain insurgent activism? In addition to defining and coding eleven negative and positive emotions (analyzed as secondary emotions), it evaluates the varied relationships these have to hope. To accomplish the latter varied emotion chains are identified for each respective secondary emotion. (shrink)

BackgroundObtaining consent has become a standard way of respecting the patient’s rights and autonomy in clinical research. Ethical guidelines recommend that the child’s parent/s or authorised legal guardian provides informed consent for their child’s participation. However, obtaining informed consent in paediatric research is challenging. Parents become vulnerable because of stress related to their child’s illness. Understanding the views held by guardians and researchers about the consent process in Malawi, where there are limitations in health care access and research literacy will (...) assist in developing appropriate consent guidelines.MethodsWe conducted 20 in-depth interviews with guardians of children and research staff who had participated in paediatric clinical trial and observational studies in acute and non-acute settings in the Southern Region of Malawi. Interviews were audio-recorded, transcribed verbatim, and thematically analysed. Interviews were compared across studies and settings to identify differences and similarities in participants’ views about informed consent processes. Data analysis was facilitated by NVIVO 11 software.ResultsAll participants across study types and settings reported that they associated participating in research with therapeutic benefits. Substantial differences were noted in the decision-making process across study settings. Guardians from acute studies felt that the role of their spouses was neglected during consenting, while staff reported that they had problems obtaining consent from guardians when their partners were not present. Across all study types and settings, research staff reported that they emphasised the benefits more than the risks of the study to participants, due to pressure to recruit. Participants from non-acute settings were more likely to recall information shared during the consent process than participants in the acute setting.ConclusionThe health care context, culture and research process influenced participants’ understanding of study information across study types and settings. We advise research managers or principal investigators to define minimum requirements that would not compromise the consent process and conduct study specific training for staff. The use of one size fits all consent process may not be ideal. More guidance is needed on how these differences can be incorporated during the consent process to improve understanding and delivery of consent.Trial registration Not applicable. (shrink)

BackgroundDespite the recognition that developing artificial intelligence (AI) that is trustworthy is necessary for public acceptability and the successful implementation of AI in healthcare contexts, perspectives from key stakeholders are often absent from discourse on the ethical design, development, and deployment of AI. This study explores the perspectives of birth parents and mothers on the introduction of AI-based cardiotocography (CTG) in the context of intrapartum care, focusing on issues pertaining to trust and trustworthiness.MethodsSeventeen semi-structured interviews were conducted with birth parents (...) and mothers based on a speculative case study. Interviewees were based in England and were pregnant and/or had given birth in the last two years. Thematic analysis was used to analyze transcribed interviews with the use of NVivo. Major recurring themes acted as the basis for identifying the values most important to this population group for evaluating the trustworthiness of AI.ResultsThree themes pertaining to the perceived trustworthiness of AI emerged from interviews: (1) trustworthy AI-developing institutions, (2) trustworthy data from which AI is built, and (3) trustworthy decisions made with the assistance of AI. We found that birth parents and mothers trusted public institutions over private companies to develop AI, that they evaluated the trustworthiness of data by how representative it is of all population groups, and that they perceived trustworthy decisions as being mediated by humans even when supported by AI.ConclusionsThe ethical values that underscore birth parents and mothers’ perceptions of trustworthy AI include fairness and reliability, as well as practices like patient-centered care, the promotion of publicly funded healthcare, holistic care, and personalized medicine. Ultimately, these are also the ethical values that people want to protect in the healthcare system. Therefore, trustworthy AI is best understood not as a list of design features but in relation to how it undermines or promotes the ethical values that matter most to its end users. An ethical commitment to these values when creating AI in healthcare contexts opens up new challenges and possibilities for the design and deployment of AI. (shrink)

ABSTRACT Academic dishonesty has remained high in Chinese college students. We examined Chinese college senior students’ everyday academic practices, especially academic dishonesty, considering the contextual changes inside and outside higher learning settings in China. Data were collected from 120 college seniors from four universities and were analyzed using a qualitative content-based exploratory approach in NVivo 10. Three themes were identified, including college seniors’ perceptions of academic dishonesty, contextual influences on academic dishonesty, and seniors’ personal attitudes about academic misconduct. Interview (...) results indicated that the contextual changes have reduced cheating both at the national level and at the college level; however, some contextual factors stubbornly remain unchanged, suggesting that the current, contextual climate on and beyond the Chinese college campuses should be restructured, not necessarily exclusively using top-down approaches. A theoretical model was provided to illustrate mechanisms associated with these students’ academic misconduct. Suggestions are discussed regarding future research and implications made for university personnel practice. (shrink)

Background Noninvasive prenatal testing (NIPT) designed to screen for fetal genetic conditions, is increasingly being implemented as a part of routine prenatal care screening in the United States (US). However, these advances in reproductive genetic technology necessitate empirical research on the ethical and social implications of NIPT among populations underrepresented in genetic research, particularly Black women with sickle cell disease (SCD).Methods Forty (N = 40) semi-structured interviews were conducted virtually with Black women in the US (19 participants with SCD; 21 (...) participants without SCD) from June 2021 to January 2022. We employed a qualitative approach to examine the study participants’ perceptions of the potential advancement of NIPT for screening SCD in the fetus. Data were analyzed using NVivo 12 qualitative software.Results The themes revealed the complexities involving the intersectional lived experiences of SCD, prenatal care, lack of synergy among health providers, and NIPT decision-making. The results further revealed that even when Black women have shared commonalities in their lived experiences while navigating SCD and motherhood, their perceptions of NIPT screening technologies are divergent.Conclusion Expanding the ethical discourse on the social implications of NIPT is critical to fully elucidate how Black women perceive NIPT’s utility, particularly as NIPT advances to screen for SCD in the fetus. Neglecting to include Black women with genetic conditions in empirical studies on NIPT may contribute to ongoing health inequities and limit and constrain reproductive choices among Black women with and without SCD. (shrink)

Religious moderation is a crucial issue, along with religious and cultural values that develop in society. Religious moderation’s success will significantly determine millennial Muslim youth’s tolerant attitudes, mediated by intellectual humility. This study aimed to identify and design a model of religious moderation on tolerance by mediating intellectual humility. The research used mixed methods; data analysis used NVivo 12 Plus (software by QSR International), to compile variable nominations; and Partial Least Squares - Structural Equation (PLS-SEM) creates research models. There (...) were 350 Indonesian youth informants in the study, which used interviews and focus group discussions. The results showed that religious moderation in youth, including national commitment, antiviolence and acceptance of local culture, can strengthen tolerance, mediated by intellectual humility. The tolerant attitude shows high and stable data and confirms the strengthening of religious moderation in young people. From the identification, a model of religious moderation in youth was designed and revised, and the results have met all the requirements for modelling so that it can be continued for testing.Contribution: This research provides essential assistance in implementing religious moderation for young people, which is currently the most prevalent issue in Indonesia. The world needs a moderate religious attitude to become a middle ground for various religious and cultural differences among people globally. (shrink)

Background Given that AI-driven decision support systems (AI-DSS) are intended to assist in medical decision making, it is essential that clinicians are willing to incorporate AI-DSS into their practice. This study takes as a case study the use of AI-driven cardiotography (CTG), a type of AI-DSS, in the context of intrapartum care. Focusing on the perspectives of obstetricians and midwives regarding the ethical and trust-related issues of incorporating AI-driven tools in their practice, this paper explores the conditions that AI-driven CTG (...) must fulfill for clinicians to feel justified in incorporating this assistive technology into their decision-making processes regarding interventions in labor. Methods This study is based on semi-structured interviews conducted online with eight obstetricians and five midwives based in England. Participants were asked about their current decision-making processes about when to intervene in labor, how AI-driven CTG might enhance or disrupt this process, and what it would take for them to trust this kind of technology. Interviews were transcribed verbatim and analyzed with thematic analysis. NVivo software was used to organize thematic codes that recurred in interviews to identify the issues that mattered most to participants. Topics and themes that were repeated across interviews were identified to form the basis of the analysis and conclusions of this paper. Results There were four major themes that emerged from our interviews with obstetricians and midwives regarding the conditions that AI-driven CTG must fulfill: (1) the importance of accurate and efficient risk assessments; (2) the capacity for personalization and individualized medicine; (3) the lack of significance regarding the type of institution that develops technology; and (4) the need for transparency in the development process. Conclusions Accuracy, efficiency, personalization abilities, transparency, and clear evidence that it can improve outcomes are conditions that clinicians deem necessary for AI-DSS to meet in order to be considered reliable and therefore worthy of being incorporated into the decision-making process. Importantly, healthcare professionals considered themselves as the epistemic authorities in the clinical context and the bearers of responsibility for delivering appropriate care. Therefore, what mattered to them was being able to evaluate the reliability of AI-DSS on their own terms, and have confidence in implementing them in their practice. (shrink)

Despite the prevalence of beliefs across religions regarding repentance and divine forgiveness and their recognition in theoretical and religious studies, these constructs are relatively understudied phenomena in the social sciences. Furthermore, in recent years, multiple scholars have argued for the need for research to systematically study and highlight the experience and processes of repentance and divine forgiveness. Subsequently, this study explored processes of repentance, antecedents and motivations of repentance, resources to aid in repentance, and outcomes of repentance that should be (...) further examined. This analysis was done using in-depth qualitative interviews with 15 emerging adult religious exemplars identifying with the Church of Jesus Christ of Latter-day Saints. The authors used NVivo 12 and team-based qualitative coding processes to identify themes. Repentance processes included personal change, took various lengths of time, were a part of participants’ religious identity, were recurrent processes, and were influenced by participants’ view of God. Antecedents and motivations included religious practices and rituals, emotions, interpersonal interactions, and their relationship with God. Resources that aided in repentance included religious practices and rituals, interpersonal relationships, and a relationship with God. Finally, participants reported experiencing personal changes in their behavior and character, positive emotions (including feelings of divine forgiveness), improved interpersonal relationships, and a better relationship with God. These processes align with some previously discovered and theorized findings on repentance, contribute a number of novel findings, and offer future direction regarding the motivations, resources, and transformative experiences that participants reported in their personal repentance and experience of forgiveness. (shrink)

COVID-19 has made it difficult to adopt traditional face-to-face psychological intervention under this situation because of the blocked down and social distancing, which brings big psychological crisis to the public among the global. To explore the emotional change of the public in China at the outburst of the pandemic at different phases, to establish an online working platform and create a new model of an online intervention to hold public emotions under pandemic, and test its effectiveness, so to give advisement (...) for government emergency management system. We established an online organization to work for this program ad innovated a model of online group counseling with online emotional support accompany group right after the outburst of a pandemic. We analyzed 53 OESAGs from February 10 to April 9, including 555 application forms, 253 feedback from members, and 139 feedback from group leaders by using NVivo and SPSS to explore the evolution and characteristics of public emotion during COVID-19 and the effectiveness of OESAG. Our results showed that the emotional changes of members ranged from shock to depression to positive. The public's emotions swiftly changed from stress, anxiety, and isolation, to the hope of returning to work or finding a job during the pandemic with the help of OESAG. OESAG has effectively regulated the negative emotions of members by conducting psychological crisis intervention to provide members a space to communicate with each other, especially the female and frontline staff. Policy makers can set up an online systematic psychological crisis intervention system as soon as possible to make up for the lack of psychological assistance in the emergency management system. (shrink)

In the care of patients with disorders of consciousness (DOC), some ethical difficulties stem from the challenges of accurate diagnosis and the uncertainty of prognosis. Current neuroimaging research on these disorders could eventually improve the accuracy of diagnoses and prognoses and therefore change the context of end-of-life decision making. However, the perspective of healthcare professionals on these disorders remains poorly understood and may constitute an obstacle to the integration of research. We conducted a qualitative study involving healthcare professionals from an (...) acute care university medical center. A short questionnaire captured demographic data as well as the experience of participants with DOC patients. A semi-structured interview was used to explore attitudes toward ethical issues identified in a previous literature review. Qualitative content analysis of interviews was conducted with the NVivo software. Accurate diagnosis among DOC is often regarded as a challenge, but this was generally not the case for our participants because most reported high confidence in DOC diagnoses. However, participants reported struggling with prognosis, especially because of its essential role for end-of-life decision making and communication with families. Variability of opinion between healthcare professionals was reported and identified by some as a minor issue while others stressed how families struggle with different medical opinions. End-of-life decision making encompassed a large proportion of ethical challenges in these patients, and the removal of artificial nutrition and hydration created significant discomfort in a minority of participants. The concept of futility was subject to wide-ranging understandings with both favorable and unfavorable opinions. Our data suggest that to ensure the incorporation of new evidence-based advances, attention should be directed to the real-world practices and challenges of accurate diagnosis and prognosis. Given pervasive challenges in end-of-life care, we recommend improved training of healthcare professionals in the care of patients with DOC, particularly in end-of life care, understanding the context of decision making, and determining how to optimally integrate new neuroscience research on the care of patients with DOC. (shrink)

Strengthening Muslim-Christian relations is very important for a nation such as Indonesia that has plurality in terms of tribes, ethnicity and religion. This study aims to analyse the role of Muslim women who live in a pluralistic socio-religious situation. This is a qualitative research that uses purposive sampling to determine the informants. The approach used by the Discovering Cultural Themes model is to understand the symptoms of the many themes, cultures, values and cultural symbols. Data analysis was conducted by using (...) software for qualitative research, which is needed in managing data found from the field, in this case, nVivo Basic 12.00 for Windows. The results show that Muslim women translate justice, empathy and rationality in religion by building relationships with other religions. This attitude is part of Islamic teachings that contain moderate, accommodating and tolerant aspects. In addition, culture has encouraged women to blend in and form egalitarian equality in the social and cultural realm. The culture of generosity and mutual help has become a tradition both in religious and customary activities. CONTRIBUTION: This article provides an insight into the contribution of Muslim women in strengthening Muslim-Christian relations. This agenda is very important because Islam and Christianity have the largest adherents in Indonesia. This contribution is very important and crucial in the midst of radicalism issues in Indonesia lately. (shrink)

PurposeThe purpose of this paper is to analyze written reflections of final year computing students taking a professionalism module that covered the social, legal, professional and ethical aspects of computing. Society's dependence on computers makes it essential that computing students, whose future work may involve the analysis, storage and security of private data, are capable of identifying ethical issues and of making reflective moral judgements. The capacity to make moral judgements has been linked to an ability to reflect, so the (...) aim of this research was twofold, to investigate students' familiarity with the concepts the module covered and their reflective ability.Design/methodology/approachThe research takes the form of an exploratory case study with qualitative data from written reflections examined using NVivo and word cloud analysis.FindingsThe students found it difficult to write reflectively and the majority of their reflections were either descriptive writing or descriptive reflection which considered events from one perspective. Awareness of the topics covered by the module appeared to be low prior to taking the module.Research limitations/implicationsThis research identifies the need to develop students' reflective skills and professional awareness in order to enhance their professional performance.Practical implicationsReflective writing and concepts such as profession and ethics need to be included throughout computing degrees, not just in a final year module. As students are strategic learners these topics also need to be covered in enough depth at each level so they are assessed and treated seriously by students.Social implicationsGiven the ubiquitous nature of computers and society's high level of dependence on them it is essential that students' moral reasoning skills are developed throughout their course, so on graduation they are capable of ethical thinking and can make reflective moral judgements.Originality/valueNo other qualitative research was found which covered this area and no research was found which raised these issues. (shrink)

_Misapprehensions of culture and religion are used for the early marriages of women in Pakistan, which generates few significant challenges for women to pursue their higher education. The present study identifies such challenges for married women in higher education. These challenges are relevant to women’s post-marriage lifespan in rural Pakistan. Building upon Fredrickson’s (2001) and Hobfoll’s (2001) theories focused on post marriages issues, the study has developed open-ended questions for collecting in-depth information. Therefore, 43 in-depth interviews with married women were (...) conducted and through qualitative data analysis using NVIVO software, the study has highlighted that early marriages of girls have become a cultural norm, and education priorities of the girls are insignificant for parents to decide the marriage date. Married women pursuing education at marriage do not get any support from husbands and in-laws as the patriarchal norms prohibit women from stepping out from home. In these circumstances, women may get subject to the victim of many unlawful practices, including intimate partner violence (IPV). Thus, the present study findings imply that married women's participation in higher education is negligible due to weak legislation on women’s rights and strong illegitimate tribal practices._. (shrink)

Protecting human subjects from being exploited is one of the main ethical challenges for clinical research. However, there is also a responsibility to protect and respect the communities who are hosting the research. Recently, attention has focused on the most efficient way of carrying out clinical research, so that it benefits society by providing valuable research while simultaneously protecting and respecting the human subjects and the communities where the research is conducted. Collaboration between partners plays an important role and that (...) is why we carried out a study to describe how collaborative partnership and social value are emerging in clinical research. A supra-analysis design for qualitative descriptive secondary analysis was employed to consider a novel research question that pertained to nurse leaders’ perceptions of ethical recruitment in clinical research and the ethics-related aspects of clinical research from the perspective of administrative staff. The data consisted of two separate pre-existing datasets, comprising 451 pages from 41 interviews, and we considered the research question by using deductive-inductive content analysis with NVivo software. A deductive analysis matrix was generated on the basis of two requirements, namely collaborative partnership and social value, as presented in An Ethical Framework for Biomedical Research by Emanuel et al. The findings showed that collaborative partnership was a cornerstone for ethical clinical research and ways to foster inter-partner collaboration were indicated, such as supporting mutual respect and equality, shared goals and clearly defined roles and responsibilities. In addition, the social value of clinical research was an important precondition for ethical clinical research and its realisation required the research partners to demonstrate collaboration and shared responsibility during the research process. However, concerns emerged that the multidimensional meaning of clinical research for society was not fully recognised. Achieving greater social value for clinical research required greater transparency, setting research priorities, shared responsibility for the dissemination and use of the findings and stronger community awareness of the ethics-related aspects of clinical research. Collaborative partnership and social values are essential for protecting the human subjects and communities involved in clinical research. (shrink)

The article examines the effect of cooking food in kitchens on the health of women, as women and children are at a greater risk to indoor air pollution (IAP). It is important to study the cooking practices and prevalent behaviours among African women to understand the magnitude of the danger they face. The study suggests that a decline in the combustion of solid fuels and the use of clean energy can improve health among women and children, as well as sustainability (...) goals. Proverbs 17:22 says, ‘A joyful heart is the health of the body, but a depressed spirit dries up the bones’. Bible verse Numbers 35:33–34 indicates, ‘You shall not pollute the land in which you live’. The cooking fuel analysis framework among rural women in Africa will guide forward the governments’ sustainability policies for communities to ensure healthy lives and promote well-being of women and children. Contribution: The article conducts a comprehensive analysis of the literature on African cooking practices. A combined search string is made with keywords. Thematic content analysis is conducted with NVivo (produced by QSR International). The article covers two themes, namely improved well-being and suggesting policies to combat climate change and its impacts. Policies and schemes at grassroots levels and better economic conditions in African countries can help to overcome challenges and change health-damaging cooking behaviours. The new advanced sustainability analysis framework has the potential to influence modern kitchen fuels and increase the adoption of new technologies in African villages. (shrink)

ObjectivesWomen who underwent chemotherapy for metastatic breast cancer used both adaptive and maladaptive coping strategies but had low implementation levels. The present study explores the qualitative experience of coping strategies for women with MBC undergoing CT in Beijing.MethodsA hermeneutic phenomenological approach was employed on twenty Chinese MBC women undergoing CT. These interviews were transcribed verbatim, coded using thematic analysis, and analyzed using NVivo 11.ResultsThree themes are highlighted: Maintaining hope; Spiritual growth, and Self-perceived support resources.ConclusionThe present study results have led (...) to a greater understanding of the tremendous impact of CT on MBC women’s lives. This research provides insight into the scope of maintaining hope. Spiritual growth and self-perceived support resources were crucial factors to coping strategies among MBC women to improve their quality of life.Clinical RelevanceBy attaining the adaptive coping strategies and further understanding about Chinese MBC women, health care professionals are encouraged to appraise MBC women’s specific problems and adopt effective interventions to improve MBC women’s psychosocial wellbeing. (shrink)

Background Altruism is the core of nursing professionalism. Graduate nursing education in China started late and is still developing, exploring the current state of altruistic behavior and the perceived experience of altruism among graduate nursing students may have important implications for nursing education. Objective Explore the current state of altruistic behavior and the perceived experience of altruism among graduate nursing students in China. Research design This is a descriptive phenomenological qualitative research study, semi-structured in-depth interviews were conducted. Seventeen graduate nursing (...) students from three schools were selected to participate in the study. Colaizzi’s analysis method was performed with NVivo software to develop common themes from the data. Ethical considerations The research proposal was approved by the Research Ethic Committee of Yangzhou University, China. Results Four themes emerged from the analysis of the interviews of the 17 participants: “Definition of altruism,” “Altruism in the nursing profession,” “Altruism applied in practice,” and “Factors influencing altruistic behavior.” Conclusions Although participants indicated that the concept of “altruism” was relatively new to them, altruistic behavior is common in both their work and life. Many factors influence the altruistic behavior of graduate nursing students, including the environment, personal factors, education, recipient factors, occupational factors, and gains and losses. Families, schools, and hospitals should create favorable environments to foster altruistic tendencies in students. (shrink)

The situation and human rights of people living with HIV and AIDS were explored through focus groups in five African countries (Lesotho, Malawi, South Africa, Swaziland and Tanzania). A descriptive qualitative research design was used. The 251 informants were people living with HIV and AIDS, and nurse managers and nurse clinicians from urban and rural settings. NVivo™ software was used to identify specific incidents related to human rights, which were compared with the Universal Declaration of Human Rights. The findings (...) revealed that the human rights of people living with HIV and AIDS were violated in a variety of ways, including denial of access to adequate or no health care/services, and denial of home care, termination or refusal of employment, and denial of the right to earn an income, produce food or obtain loans. The informants living with HIV and AIDS were also abused verbally and physically. Country governments and health professionals need to address these issues to ensure the human rights of all people. (shrink)

Settler-colonialism is founded in environmental racism, and environmental justice is foundational to all forms of decolonialization. Native American groups located in the Gulf Coast Region of the United States are particularly vulnerable to environmental justice issues such as climate change and oil spills due to their geographic location and reliance on the coastal region for economic and social resources. This study used the framework of historical oppression, resilience, and transcendence to explore the historic and contemporary forms of environmental injustice experienced (...) by a Native American tribe in the Gulf Coast region of the United States. This critical ethnography analyzeda series of individual, family, and focus group semi-structured qualitative interviews with a total of 208 participants. Following the critical ethnographic method, data were interpreted through reconstructive analysis using NVivo. Findings of this study reveal the continuing impact of the BP oil spill and difficulty accessing resources following the spill, complicated by the tribe’s lack of federal recognition. Additional themes include the continuing impact of coastal erosion, historical and contemporary land loss, geographic marginalization, and concerns about a loss of tribal identity when tribal members are forced to relocate. Lack of federal tribal recognition has exacerbated all of these issues for this tribe. This study supports national findings that Native American groups experience extensive historic and contemporary environmental injustices and contextualizes these findings for a Native American tribe in the Gulf Coast region of the United States. Recognizing Native American sovereignty is key to addressing the environmental justice issues described. (shrink)

The situation and human rights of people living with HIV and AIDS were explored through focus groups in five African countries . A descriptive qualitative research design was used. The 251 informants were people living with HIV and AIDS, and nurse managers and nurse clinicians from urban and rural settings. NVivo™ software was used to identify specific incidents related to human rights, which were compared with the Universal Declaration of Human Rights. The findings revealed that the human rights of (...) people living with HIV and AIDS were violated in a variety of ways, including denial of access to adequate or no health care/services, and denial of home care, termination or refusal of employment, and denial of the right to earn an income, produce food or obtain loans. The informants living with HIV and AIDS were also abused verbally and physically. Country governments and health professionals need to address these issues to ensure the human rights of all people. (shrink)

Detection of Alzheimer’s disease in an early stage is receiving increasing attention for a number of reasons, such as the failure of drug trials in more advanced disease stages, the demographic evolution, the financial impact of AD, and the approval of amyloid tracers for clinical use. Five focus group interviews with stakeholders were conducted.. The verbatim transcripts were analysed via the Nvivo 11 software. Most stakeholder groups wanted to know their own amyloid PET scan result. However, differences occurred between (...) FGs: two groups wanted to know, whilst in the three other groups FG members opted not to know or were still in doubt about their decision. Stakeholders provided insight into their reasons for wanting to know their amyloid PET scan result, for not wanting to know their result, or why they were in doubt about their decision. Several advantages and disadvantages were mentioned as part of knowing their amyloid PET scan result. Certain considerations were clustered in a grey zone, in between advantage and disadvantage, such as the emotional consequences. Clinicians, researchers, and policymakers ought to be aware of the diversity of reasons for wanting to know their result and how possible benefits and risks can be viewed differently. The current findings are of importance for future early diagnosis and disclosure of results in the research setting. (shrink)

Today, there are different understandings of the first article on the content of the Christian faith, for which an analysis from a theological perspective is necessary. This research sought to reveal the meaning of the first article on the content of the Christian faith in recent theological works that have been produced, through the use of a hermeneutic exercise, conducting a bibliometric and categorical analysis and using NVivo software to analyse the qualitative data. We concluded that the recent theological (...) literature addresses the meaning of the first article of the Christian faith based on the existence, concept and definition of God and his attributes, as well as his power, behaviour, creation, revelation and reign. Although there is little extant material compared to other topics or areas of knowledge that can be explored using these tools, this fact is explained because, normally, theologians are not interested in publishing in high-impact journals. The way of approaching God in contemporary literature can be enriched by taking into account specific contexts, such as poverty, discrimination, suffering, violence, human trafficking, immigration and political realities, in such a way that it is not only a metaphysical reflection of God but also a historical and immanent and even an interreligious research that broadens the concept of the Christian God and answers questions that contemporary society asks in daily life. (shrink)

In an increasingly globalized world, the accessibility of healthcare and medication has expanded beyond local healthcare systems and national borders. This study aims to investigate the transnational health and self-care experiences of 11 Japanese women who have resided in South Korea for a minimum of six months and have utilized oral contraceptives, including those that were acquired over-the-counter (OTC). Data were gathered through semi-structured interviews and analyzed by utilizing the NVivo software. The analysis yielded three significant thematic categories, namely (...) (1) experiences and perceptions of obtaining and utilizing contraceptive pills, including OTC access; (2) individual and social perceptions of pills and their accessibility in Japan, insights from actual users; and (3) enhancing pill accessibility, transnational health and self-care experiences and perspectives. Participants acknowledged that oral contraceptives are a global product and experienced communication challenges with healthcare providers as a result of differing understandings of these medications. Additionally, this study identified transnational strategies, such as purchasing an adequate supply of pills just before departure and seeking pills from local families or acquaintances. This study not only highlights the implications of clinical care for transnational patients but also underscores their critical global perspectives on access to oral contraceptives. Furthermore, it proposes two models for improving accessibility within the Japanese healthcare system, even in prescription-only contexts, by introducing OTC options. (shrink)

BackgroundA fundamental ethical challenge in conducting genomics research is the question of what and how individual level genetic findings and aggregate genomic results should be conveyed to research participants and communities. This is within the context of minimal guidance, policies, and experiences, particularly in Africa. The aim of this study was to explore the perspectives of key stakeholders' on returning genomics research results to participants in Kenya.MethodsThis qualitative study involved focus group discussions (FGDs) and in-depth interviews (IDIs) with 69 stakeholders. (...) The purposively selected participants, included research ethics committee (REC) members (8), community members (44), community resource persons (8), and researchers (9). A semi-structured interview guide was used to facilitate discussions. Six FGDs and twenty-five (IDIs) were conducted among the different stakeholders. The issues explored in the interviews included: (1) views on returning results, (2) kind of results to be returned, (3) value of returning results to participants, and (4) challenges anticipated in returning results to participants and communities. The interviews were audio-recorded, transcribed verbatim, and coded in Nvivo 12 pro. Thematic and content analysis was conducted.ResultsParticipants agreed on the importance of returning genomic results either as individual or aggregate results. The most cited reasons for returning of genomic results included recognizing participants' contribution to research, encouraging participation in future research, and increasing the awareness of scientific progress. Other aspects on how genomic research results should be shared included sharing easy to understand results in the shortest time possible and maintaining confidentiality when sharing sensitive results.ConclusionsThis study identified key stakeholders’ perspectives on returning genomic results at the individual and community levels in two urban informal settlements of Nairobi. The majority of the participants expect to receive feedback about their genomic results, and it is an obligation for researchers to see how to best fulfil it. (shrink)

Background Generally, there is unanimity about the value of community engagement in health-related research. There is also a growing tendency to view genetics and genomics research (GGR) as a special category of research, the conduct of which including community engagement (CE) as needing additional caution. One of the motivations of this study was to establish how differently if at all, we should think about CE in GGR. Aim To assess the perspectives of genetics and genomics researchers in Uganda on CE (...) in GGR. Method A cross-sectional qualitative study was conducted at Makerere University and Uganda Virus Research Institute. Twenty-five individuals participated, the majority being male (sixteen). Participants included nineteen genetics and genomics researchers (researchers and research coordinators), two CE officers, three nurses and one nursing counsellor. Data were collected using in-depth interviews and analyzed in a thematic manner using NVivo version 12 Plus. Study findings Thirteen of the respondents had conducted CE in their GGR in either a geographical and disease-specific community. Some respondents said CE principles are the same and there is no need for special consideration for CE in GGR. Others gave ethical issues in GGR that require special consideration for CE in such research and these were categorized into six themes: GGR is new to communities, Difficulty in communicating GGR by the researchers, Genes are shared in communities, Cultural sensitivities against GGR, Community attitude toward GGR, Some GGR studies take long to end, and Negotiation of research benefits. Special considerations for CE when conducting GGR were suggested and categorized into seven themes: creating awareness of GGR in communities, obtaining both community acceptance and individual consent, CE team composition, involve communities in solving GGR challenges, prolong CE in some GGR, develop guidelines for CE in GGR, and legal considerations on GGR. Conclusion GGR was characterized by special issues that require special CE considerations for such research. (shrink)

Background Physicians face competing values of truth-telling and beneficence when deception may be employed in patient care. The purposes of this study were to assess resident physicians' attitudes towards lying, explore lie types and reported reasons for lying. Method After obtaining institutional review board review and receiving exempt status, posts written by Loma Linda University resident physicians in response to forum questions in required online courses were collected from 2002 to 2007. Responses were blinded and manually coded by two investigators (...) using NVivo software. Qualitative and quantitative analyses of the data were performed with links to various attributes. A 95% binomial proportion CI was used to analyse the attribute data. Results The study found that the majority of residents would disclose the truth about medical errors. Similarly, many residents would disclose the truth regarding unanticipated events, especially if the error was serious enough to result in a malpractice suit. However, many residents would not reveal a near miss event because they believe it has no impact on patient health. Some residents would deceive the insurance company for additional patient benefits. Of those willing to lie, only a small group gave self-serving reasons. Conclusions This study demonstrates that the ethical issues related to deception that trouble attending physicians also exist at the resident physician level. Residents primarily lie for altruistic reasons and rarely for egoistic or self-serving purposes that may or may not result in harm to patients, insurance companies and/or physicians themselves. (shrink)

Background Debates and controversies have shaped the understanding and the practices related to death determined by neurological criterion . Confusion about DNC in the public domain could undermine this notion. This confusion could further jeopardise confidence in rigorous death determination procedures, and raise questions about the integrity, sustainability, and legitimacy of modern organ donation practices.Objective We examined the depictions of ‘brain death’ in major American and Canadian print media to gain insights into possible common sources of confusion about DNC and (...) the relationship between expert and lay views on this crucial concept.Methods We gathered 940 articles, available in electronic databases, published between 2005 and 2009 from high-circulation Canadian and American newspapers containing keywords ‘brain dead’ or ‘brain death’. Articles were systematically examined for content using the NVivo 8 software.Results Our results showed problematic aspects in American and Canadian media, with some salient differences. DNC was used colloquially in 39% of the articles and its medical meaning infrequently defined . The neurological criterion for determination of death was mentioned in less than 10% of the articles, and life support in about 20% of the articles. Organ donation issues related to DNC were raised more often in Canadian articles than in American articles .Interpretation Further discussion is needed to develop innovative strategies to bridge media representations of DNC with experts’ views in connection with organ donation practices. (shrink)

Purpose – The purpose of this study is to investigate the reasons behind unethical behaviour in the Australian Information and Communications Technology workplace. Design/methodology/approach – The study employed a qualitative research methodology. A total of 43 ICT professionals were interviewed during the month of February 2014 in six Australian capital cities. All interviews were conducted face-to-face and followed a semi-structured interviewing format utilising open-end questions and further probing questions. The purposive sample represented ICT professionals from large and small organisations, government (...) and private sector, different geographic locations, ages, genders, types of jobs and employment experience. Data analysis was completed with the help of QSR NVivo 10, a software package for managing qualitative data. Findings – Of the 25 reasons identified for unethical behaviour in ICT workplaces, 30 per cent of participants agreed on five major ones: pressure, bad management, greed, lack of respect towards ICT and communication issues. Practical implications – By focussing on the reasons behind unethical behaviour in the Australian ICT workplace, this article helps those identifying strategies for dealing with unprofessional behaviour to take into account the root causes of unprofessional behaviour. Originality/value – There is hardly any literature on reasons for unethical behaviour in the ICT workplaces. This article seeks to address this imbalance in the literature. Also, integrity systems in ICT are a new focus in collective, organisational ethics. Identification of and resolving unethical ICT workplace practice is an innovative contribution to the literature. (shrink)

Background Current requirements for ethical research in Canada, specifically the standard of active or signed parental consent, can leave Indigenous children and youth with inequitable access to research opportunities or health screening. Our objective was to examine the literature to identify culturally safe research consent processes that respect the rights of Indigenous children, the rights and responsibilities of parents or caregivers, and community protocols. Methods We followed PRISMA guidelines and Arksey and O’Malley’s approach for charting and synthesizing evidence. We searched (...) MEDLINE, PsycINFO, ERIC, CINAHL, Google Scholar, Web of Science, Informit Indigenous Collection, Bibliography of Native North Americans, and Sociological Abstracts. We included peer-reviewed primary and theoretical research articles written in English from January 1, 2000, to March 31, 2022, examining Indigenous approaches for obtaining informed consent from parents, families, children, or youth. Eligible records were uploaded to Covidence for title and abstract screening. We appraised the findings using a Two-Eyed Seeing approach. These findings were inductively coded using NVivo 12 and analyzed thematically. Results We identified 2,984 records and 11 eligible studies were included after screening. Three key recommendations emerged: addressing tensions in the ethics of consent, embracing wise practices, and using relational approaches to consent. Tensions in consent concerned Research Ethics Board consent requirements that fall short of protecting Indigenous children and communities when culturally incongruent. Wise practices included allowing parents and children to consent together, land-based consenting, and involving communities in decision-making. Using relational approaches to consent embodied community engagement and relationship building while acknowledging consent for Indigenous children cannot be obtained in isolation from family and community. Conclusions Very few studies discussed obtaining child consent in Indigenous communities. While Indigenous communities are not a monolith, the literature identified a need for community-driven, decolonized consent processes prioritizing Indigenous values and protocols. Further research is needed to examine nuances of Indigenized consent processes and determine how to operationalize them, enabling culturally appropriate, equitable access to research and services for all Indigenous children. (shrink)

In Australia, the ethics of the use of animals for scientific purposes are assessed by Animal Ethics Committees that are comprised of the four major parties involved in the animal experimentation debate: veterinarians, scientists using animals, animal welfare representatives and members of the public. AECs are required to assess animal experiments as ethical based on a cost/benefit analysis, suggesting the use of consequentialist ethics. However, people are more likely to use a mixture of frameworks when making ethical decisions. Therefore, we (...) hypothesised that AEC members will make their decisions using argumentation relying on multiple frameworks, including ethical relativism, deontology and emotional ethics; frameworks commonly used in the public debate about animal experimentation. The language used by AEC members, examined using discourse analysis techniques, can indicate which ethical frameworks they rely upon. Using a role playing method, representatives from each of the four AEC categories discussed the ethical value of eight fictional protocols involving animal experimentation. The discussions were recorded and analysed using Nvivo for instances of emotional and ethical language. Data were analysed using ANOVAs and Tukey tests. Emotional language was more common than ethical language (p. (shrink)

The World Health Organization (WHO) recommends couple human immunodeficiency virus (HIV) counselling and testing (CHCT) as one of the beneficial and cost-effective means for the prevention of mother-to-child transmission (PMTCT) of HIV within couple’s relationships. However, CHCT within the PMTCT of HIV settings in Zimbabwe remains low. This study explored adult men and women’s views from a rural district of Zimbabwe regarding the possible factors that facilitate or inhibit the uptake of CHCT for the PMTCT of HIV. The study utilised (...) qualitative methods. Data were collected by conducting eight focus group discussions among adult men and women, as well as eight in-depth interviews with pregnant women admitted in antenatal wards in local hospitals. Thematic analysis was used for analysing the data with the aid of NVivo software. The study revealed that CHCT initiatives were hampered by certain patriarchal behaviours and beliefs that make it acceptable for men to have multiple sexual partners, thereby exposing their marriages and relationships to HIV. Social constructions around gender roles tend to prescribe women as the sole custodians of children’s health, and this led to stigmatisation against men who participated in PMTCT programmes. In addition, certain religious practices do not allow the use of medicine, which makes CHCT a nonevent. However, engaging men on platforms that advocate for progressive masculinities and raising awareness of this practice through information dissemination were identified as enablers in increasing CHCT. Contribution: The significant contribution of this study is that it demonstrated the importance of acknowledging the societal, cultural and religious practices inherent in a community, as they are central to their responses to HIV prevention interventions. (shrink)

The World Health Organization (WHO) recommends couple human immunodeficiency virus (HIV) counselling and testing (CHCT) as one of the beneficial and cost-effective means for the prevention of mother-to-child transmission (PMTCT) of HIV within couple’s relationships. However, CHCT within the PMTCT of HIV settings in Zimbabwe remains low. This study explored adult men and women’s views from a rural district of Zimbabwe regarding the possible factors that facilitate or inhibit the uptake of CHCT for the PMTCT of HIV. The study utilised (...) qualitative methods. Data were collected by conducting eight focus group discussions among adult men and women, as well as eight in-depth interviews with pregnant women admitted in antenatal wards in local hospitals. Thematic analysis was used for analysing the data with the aid of NVivo software. The study revealed that CHCT initiatives were hampered by certain patriarchal behaviours and beliefs that make it acceptable for men to have multiple sexual partners, thereby exposing their marriages and relationships to HIV. Social constructions around gender roles tend to prescribe women as the sole custodians of children’s health, and this led to stigmatisation against men who participated in PMTCT programmes. In addition, certain religious practices do not allow the use of medicine, which makes CHCT a nonevent. However, engaging men on platforms that advocate for progressive masculinities and raising awareness of this practice through information dissemination were identified as enablers in increasing CHCT.Contribution: The significant contribution of this study is that it demonstrated the importance of acknowledging the societal, cultural and religious practices inherent in a community, as they are central to their responses to HIV prevention interventions. (shrink)

The paper brings into discussion the social construction of organization and proposes a new model in organizational development. The paper begins with a synthesis on the paradigm of social constructionism, emphasizing its utility in organizational studies. In times of uncertainty and rapid changes, a lot of organizations lose their missions and meanings, or have the capacity to reinvent and to thrive. The question is what makes the difference? In this line, the paper proposes a theoretical model, gathering the social constructionism, (...) relational constructionism, and appreciative inquiry. Using the grounded theory strategy, in-depth interviews and focus groups were developed with employees and leaders from nongovernmental organizations, Iasi, and Bacau Counties. Data are analyzed through NVivo program and present multiple perspectives regarding their activity in social field. The theoretical model may be an inspiration for organizations that are interested in achieving new ideas, solutions, and results. (shrink)