Health care professionals often face moral dilemmas. Not dealing constructively with moral dilemmas can cause moral distress and can negatively affect the quality of care. Little research has been documented with methodologies meant to support professionals in care for the homeless in dealing with their dilemmas. Moral case deliberation is a method for systematic reflection on moral dilemmas and is increasingly being used as ethics support for professionals in various health-care domains. This study deals with the question: What is the (...) contribution of MCD in helping professionals in an institution for care for the homeless to deal with their moral dilemmas? A mixed-methods responsive evaluation design was used to answer the research question. Five teams of professionals from a Dutch care institution for the homeless participated in MCD three times. Professionals in care for the homeless value MCD positively. They report that MCD helped them to identify the moral dilemma/question, and that they learned from other people’s perspectives while reflecting and deliberating on the values at stake in the dilemma or moral question. They became aware of the moral dimension of moral dilemmas, of related norms and values, of other perspectives, and learned to formulate a moral standpoint. Some experienced the influence of MCD in the way they dealt with moral dilemmas in daily practice. Half of the professionals expect MCD will influence the way they deal with moral dilemmas in the future. Most of them were in favour of further implementation of MCD in their organization. (shrink)

Research on value congruence rests on the assumption that values denote desirable behaviors and ideals that employees and organizations strive to approach. In the present study, we develop and test the argument that a more complete understanding of value congruence can be achieved by considering a second type of congruence based on employees’ and organizations’ counter-ideal values. We examined this proposition in a time-lagged study of 672 employees from various occupational and organizational backgrounds. We used difference scores as well as (...) polynomial regression and response surface analyses to test our hypotheses. Consistent with our hypotheses, results reveal that counter-ideal value congruence has unique relations to employees’ trust in the organization that go beyond the effects of ideal value congruence. We discuss theoretical and practical implications of this expanded perspective on value congruence. (shrink)

This paper discusses the debate over whether emotional expressions are spontaneous or intentional actions. We describe a variety of empirical evidence supporting these two possibilities. But we argue that the spontaneous-intentional distinction fails to explain the psychological dynamics of emotional expressions. We claim that a complex systems perspective on intentions, as self-organized critical states, may yield a unified view of emotional expressions as a consequence of situated action. This account simultaneously acknowledges the embodied status of environment, evolution, culture and mind (...) in theories of emotion. (shrink)

SummaryIntense, sustained nursing lengthens inter-birth intervals and is causally linked with low natural fertility. However, in traditional settings, the effects of such nursing on fertility are difficult to disentangle from those of nutrition. Results from an prospective, direct observational study of reproductive function in well-nourished Amele women who nurse intensively and persistently but who also have high fertility are here presented. Endocrine measures show that ovarian activity resumes by median 11·0 months postpartum. Median duration of postpartum amenorrhoea is 11·3 months, (...) time to next conception is 19·0 months, and the inter-birth interval is 28·0 months. Average life time fertility is 6·8. High fertility in Amele women is due both to refractoriness of reproductive function to suckling stimuli, and to maintenance of equivalent age-specific fertility rates across the reproductive life span. (shrink)

The authors of the paper ‘Advance euthanasia directives: a controversial case and its ethical implications’ articulate concerns and reasons with regard to the conduct of euthanasia in persons with dementia based on advance directives. While we agree on the conclusion that there needs to be more attention for such directives in the preparation phase, we disagree with the reasons provided by the authors to support their conclusions. We will outline two concerns with their reasoning by drawing on empirical research and (...) by providing reasons that contradict their assumptions about competence of people with dementia and the importance of happiness in reasoning about advance directives of people with dementia. We will draw attention to the important normative questions that have been overstepped in their paper, and we will outline why further research is required. (shrink)

It is argued that the equilibrium point model can lead to new insights regarding transition and stability processes in movement coordination. The role of movement control parameters on equifinality and phase-resetting is discussed; not only control but also external control parameters can affect the global dynamical regime.

The global COVID-19 pandemic has created a crisis of suffering. We conceptualize suffering as a deeply existential issue that fundamentally changes people indelible ways and for which there are no easy solutions. To better understand its effects and how people can flourish in the midst of this crisis, we formally introduce and elaborate on an Existential Positive Psychology Model of Suffering (EPPMS) and apply that to the COVID-19 global pandemic. Our model has three core propositions: (a) suffering reveals existential concerns, (...) (b) existential anxiety impairs one's ability to find meaning, and (c) cultivating meaning is the primary way to address suffering and allay existential anxiety, eventually leading to flourishing (and potentially growth). We apply this model to the COVID-19 pandemic, including how to build meaning, and discuss clinical implications. (shrink)

Background: Issues concerning legislation and regulation with respect to the role of nurses in euthanasia and physician-assisted suicide gave the Minister for Health reason to commission a study of the role of nurses in medical end-of-life decisions in hospitals, home care and nursing homes.Aim: This paper reports the findings of a study of the role of nurses in euthanasia and physician-assisted suicide, conducted as part of a study of the role of nurses in medical end-of-life decisions. The findings for hospitals, (...) home care and nursing homes are described and compared.Method: A questionnaire was sent to 1509 nurses, employed in 73 hospitals, 55 home care organisations and 63 nursing homes. 1179 responses were suitable for analysis. The questionnaire was pilot-tested among 106 nurses, with a response rate of 85%.Results: In 37.0% of cases, the nurse was the first person with whom patients discussed their request for euthanasia or physician-assisted suicide. Consultation between physicians and nurses during the decision-making process took place quite often in hospitals and nursing homes and less frequently in home care situations . In some cases , nurses administered the euthanatics.Conclusions: The results show substantial differences between the intramural sector and the extramural sector , which are probably linked to the organisational structure of the institutions. Consultation between physicians and nurses during the decision-making process needs improvement, particularly in home care. Some nurses had administered euthanatics, although this task is by law exclusively reserved to physicians. (shrink)

Cho and Martinez-Martin provide a wide-ranging analysis of what they label “digital simulacra”—which are in essence data-driven AI-based simulation models such as digital twins or models used for i...

Sankary et al. (2022) report the results of an empirical study on research participant experiences of exiting research at the end of clinical trials of deep-brain-stimulation (DBS) and responsive n...

In the novels of Tahsin Germiyani, who stands out as a narrator and novelist, dialogue was a basic technique for artistic work. Because he used the art of dialogue in a unique way to carry out communication and understanding and to fictionalize events. Such that Tahsin Germiyani's novels are considered to fill a gap in this aspect, especially in Iraq and in the Arab world in general. What makes him important is the writers he read and was influenced by. Such (...) that when we look at his works, this effect is noticeable. Rather than a reflection, this influence manifests itself in a new and different form with internalization. The new work now contains in itself his character, is far from alienation, and becomes compatible with the culture and values of the society in which he lives. It is possible to see this situation not only in dialogues, but also in the whole structure of the work. Tahsin Germiyani has written 7 novels. However, in this study, we will focus on his three novels (al-Huznu'l-vesim, Evladu'l-Yahudiyye and Zaknemut) to reveal how the dialogue is used as a technique. After giving basic information about the concept of dialogue and Tahsin Germiyani's life and works, we will try to reveal how he used dialogue in these three novels that we will take as a field of application and his artistic connections in the storylines. Germiyani used both forms of dialogues in different stages. In his novel Zaknemut, he performed the internal dialogue mostly in the forms of monologue, pleading and reaction. While the external dialogue is mostly includedin the novel al-Huznu'l-Vesim, he used both dialogues to convey his thoughts, to effectively present his reaction and his opinionson the social phenomena in Iraqi society. Because he wanted to bring to light the mistakes and deficiencies that he saw and experienced in the society. He did this with an artistic task, by describing situations that trigger interpersonal conflict, sometimes using the inner and external dialogues of the protagonists and sometimes of the deuteragonists. One of his prominent features during this fiction is hisability to make the dialogues more vivid and permanent in the mind of the reader by using the cinema technique and to make the reader a partner in this fiction. We also witness that he makes this ability more effective by using the folkspeech. We will try to put forward the relevant issues practically within the framework of his 3 novels. (shrink)

The method of positron emission tomography illustrates the circular logic popular in subtractive neuroimaging and linear reductive cognitive psychology. Both require that strictly feed-forward, modular, cognitive components exist, before the fact, to justify the inference of particular components from images after the fact. Also, both require a "true" componential theory of cognition and laboratory tasks, before the fact, to guarantee reliable choices for subtractive contrasts. None of these possibilities are likely. Consequently, linear reductive analysis has failed to yield general, reliable, (...) componential accounts. (shrink)