Introduction: The high degree of religious/spiritual involvement that brings meaning and purpose to a patients’ life, especially when they are weakened by pain, is among the various reasons to consider the spiritual dimension in clinical practice. This involvement may influence medical decisions and, therefore, should be identified in the medical history of a patient.Objective: To verify the opinion of undergraduate medical students of the Paulista School of Medicine – Federal University of São Paulo regarding the use of a patient’s Spirituality/Religiosity (...) as a therapeutic resource in clinical practice.Method: Quantitative approach of the transversal analytical observational type. The sample was composed of academics’ medical program, from the first to the sixth year, regularly enrolled in 2017. Data collection was performed with a standardized questionnaire divided into three sections: sociodemographic profile; Duke University Religious Index; Spirituality/Religiosity in the clinical and academic context.Results: Participated in the survey 72% of the enrolled students, of which 61.4% had religious affiliation, 26.2% declared themselves agnostic and 12.4% atheists. All of them proposed to answer questions about the insertion of Spirituality/Religiosity in the patient care process. Through the Duke Religiosity Index, we evaluated the importance of religiosity in the student’s personal life and the pertinence of religiosity as a therapeutic insertion for medical treatment. Regarding the clinical and academic context, most participants considered relevant the proposition of didactic-pedagogical actions in medical education related to the spiritual dimension of the patient.Conclusion: We conclude, through our research, that the insertion of the Spirituality/Religiosity of the patient as a therapeutic resource in clinical practice is feasible for most undergraduate students in Medicine of the Escola Paulista de Medicina – Universidade Federal de São Paulo. The result of the research, although it shows only the opinion of medical students at a Brazilian university, indicates that Spirituality/Religiosity is already part of the contemporary medical universe. (shrink)

The time marked by the clock hands, the so-called “objective time,” is deeply different from the one perceived by the individual. Starting from this hypothesis, directly connected to the subjective modality of “living” the time and defined as time perspective, we will try to understand how much it affects the various domains of people's lives, attitudes, and experiences. Therefore, the research investigates whether all our decisions can be influenced by one or more time perspectives beyond our awareness. Last, but not (...) least, we will try to understand if some time perspectives in specific contexts are more functional and adaptive than others. (shrink)

The last two decades have seen considerable efforts directed towards making Electronic Health Records interoperable through improvements in medical ontologies, terminologies and coding systems. Unfortunately, these efforts have been hampered by a number of influential ideas inherited from the work of Eugen Wüster, the father of terminology standardization and the founder of ISO TC 37. We here survey Wüster’s ideas – which see terminology work as being focused on the classification of concepts in people’s minds – and we argue that (...) they serve still as the basis for a series of influential confusions. We argue further that an ontology based unambiguously, not on concepts, but on the classification of entities in reality can, by removing these confusions, make a vital contribution to ensuring the interoperability of coding systems and healthcare records in the future. (shrink)

BackgroundCarefully planned research is critical to developing policies and interventions that counter physical, psychological and social challenges faced by young people living with HIV/aids, without increasing burdens. Such studies, however, must navigate a ‘vulnerability paradox’, since including potentially vulnerable groups also risks unintentionally worsening their situation. Through embedded social science research, linked to a cohort study involving Adolescents Living with HIV/aids (ALH) in Kenya, we develop an account of researchers’ responsibilities towards young people, incorporating concepts of vulnerability, resilience, and agency (...) as ‘interacting layers’.MethodsUsing a qualitative, iterative approach across three linked data collection phases including interviews, group discussions, observations and a participatory workshop, we explored stakeholders’ perspectives on vulnerability and resilience of young people living with HIV/aids, in relation to home and community, school, health care and health research participation. A total of 62 policy, provider, research, and community-based stakeholders were involved, including 27 ALH participating in a longitudinal cohort study. Data analysis drew on a Framework Analysis approach; ethical analysis adapts Luna’s layered account of vulnerability.ResultsALH experienced forms of vulnerability and resilience in their daily lives in which socioeconomic context, institutional policies, organisational systems and interpersonal relations were key, interrelated influences. Anticipated and experienced forms of stigma and discrimination in schools, health clinics and communities were linked to actions undermining ART adherence, worsening physical and mental health, and poor educational outcomes, indicating cascading forms of vulnerability, resulting in worsened vulnerabilities. Positive inputs within and across sectors could build resilience, improve outcomes, and support positive research experiences.ConclusionsThe most serious forms of vulnerability faced by ALH in the cohort study were related to structural, inter-sectoral influences, unrelated to study participation and underscored by constraints to their agency. Vulnerabilities, including cascading forms, were potentially responsive to policy-based and interpersonal actions. Stakeholder engagement supported cohort design and implementation, building privacy, stakeholder understanding, interpersonal relations and ancillary care policies. Structural forms of vulnerability underscore researchers’ responsibilities to work within multi-sectoral partnerships to plan and implement studies involving ALH, share findings in a timely way and contribute to policies addressing known causes of vulnerabilities. (shrink)

Individuals with Autism spectrum disorders (ASD) have difficulties in the recollection of past experiences (Episodic Memory). Accumulating evidence suggests that they might have also difficulties in the ability to imagine potential future scenarios (Episodic Future Thinking, EFT) and in narrative generation skills. This investigation aimed to determine 1) whether impairments of EFT can be identified in a large cohort of children with high functioning ASD using a task with minimal narrative demands; and 2) if such impairments are related to the (...) ability to generate a narrative's scenario. 77 children with high-functioning ASD and 77 children with typical development were recruited for the study. The two groups were balanced for age, level of formal education, and IQ. EFT was assessed by administering a task with minimal narrative demands, whereas narrative generation skills were assessed with three tasks requiring children to generate past, middle or future episodes in a narrative discourse. With respect to control participants, a subgroup of children with ASD had impaired EFT skills and also showed significant impairments in the ability to generate adequate narratives. On the contrary, participants with spared EFT had normal performance on the narrative generation task. Interestingly, EFT skills predicted narrative generation abilities in both groups. The results of this study support the hypothesis that EFT may be impaired in some but not all children with ASD and of a relation between difficulties with EFT and impairments in the process of narrative generation. The assessment of EFT should employ tasks that do not require narrative production, as children with impaired EFT may also have reduced narrative skills. (shrink)

Introduction: Motor evoked potentials (MEPs) to transcranial magnetic stimulation are known to be susceptible to several sources of variability. However, conflicting evidences on individual characteristics in relatively small sample sizes have been reported. We investigated the effect of age, height, and sex on MEPs of the motor cortex and spinal roots in a large cohort. Methods: A total of 587 subjects clinically and neuroradiologically intact were included. MEPs were recorded during mild tonic contraction through a circular coil applied over the (...) “hot spot” of the first dorsal interosseous and tibialis anterior muscles, bilaterally. Central motor conduction time (CMCT) was estimated as the difference between MEP cortical latency and the peripheral motor conduction time by cervical or lumbar magnetic stimulation. Peak-to-peak MEP amplitude to cortical stimulation and right-to-left difference of each parameter were also measured. Results: After Bonferroni correction, general linear (multiple) regression analysis showed that both MEP cortical latency and peripheral motor conduction time at four limbs positively correlated with age and height. At lower limbs, an independent effect of sex on the same measures was also observed (with females showing smaller values than males). CMCT correlated with both age (negatively) and height (positively) when analyzed by a single regression; however, with a multiple regression analysis this significance disappeared, due to the correction for the multicollinearity within the dataset. Conclusions: Physical individual features need to be considered for a more accurate and meaningful MEPs interpretation. Both in clinical practice and in research setting, patients and controls should be matched for age, height, and sex. (shrink)

Background:Many nursing homes appear as multicultural workplaces where the majority of healthcare providers have an ethnic minority background. This environment creates challenges linked to communication, interaction and cultural differences. Furthermore, the healthcare providers have varied experiences and understanding of what quality care of patients with dementia involves.Purpose:The aim of this study is to illuminate multi-ethnic healthcare providers’ lived experiences of their own working relationship, and its importance to quality care for people with dementia.Research design:The study is part of a greater (...) participatory action research project: ‘Hospice values in the care for persons with dementia’. The data material consists of extensive notes from seminars, project meetings and dialogue-based teaching. The text material was subjected to phenomenological-hermeneutical interpretation.Participants and research context:Participants in the project were healthcare providers working in a nursing home unit. The participants came from 15 different countries, had different formal qualifications, varied backgrounds and ethnic origins.Ethical considerations:The study is approved by the Norwegian Regional Ethics Committee and the Norwegian Social Science Data Services.Findings:The results show that good working relationships, characterized by understanding each other’s vulnerability and willingness to learn from each other through shared experiences, are prerequisites for quality care. The healthcare providers further described ethical challenges as uncertainty and different understandings.Discussion:The results are discussed in the light of Lögstrup’s relational philosophy of ethics and the concepts of vulnerability, ethic responsibility, trust and openness of speech.Conclusion:The prerequisite for quality care for persons with dementia in a multicultural working environment is to create arenas for open discussions between the healthcare providers. Leadership is of great importance. (shrink)

The humanist treatises presented here are only peripheral to the history of logic, but I think historians of logic may read them with interest, if perhaps with irritation. In the early sixteenth century the humanists set about to demolish medieval logic based on syllogistic and disputation, and to replace it in the university curriculum with a 'rhetorical' logic based on the use of topics and persuasion. To a very large extent they succeeded. Although Aris totelian logic retained a vigorous life (...) in the schools, it never again attained to the overwhelming primacy it had so long enjoyed in the northern universities. It has been the custom to take the arguments of the humanists at face value, and the word 'scholastic' has continued to have pejorative overtones. This is easy to understand, because until recently our knowledge of the high period of medieval logic has been slight, and the humanists' testimony as to its decadent state in the sixteenth century has, for the most part, been accepted uncritically. Within the past two decades important work on medieval logic has recovered the brilliant achievement of thirteenth and fourteenth century logicians, philosophers, and natural scientists. New studies are constantly appearing, and the logico-semantic system of the terminists has become fruitful territory not only for historians of logic but also for students of modern linguistics and semiotics. (shrink)

Concern is growing as research continues to find evidence of academic misconduct among medical students. There is, however, paucity of information on this issue among medical students and medical graduates in Africa. We determined the perceptions and attitude of house officers on academic misconduct within Nigerian medical schools. We conducted 7 focus group discussions among pre-registration house-officers working in a Nigerian Teaching hospital between October and November 2013. A FGD guide containing 7 broad questions related to their perception and attitude (...) on academic misconduct was employed. Ethnographic content analysis and manual coding were adopted in identifying themes, issues and representative quotations. A total of 58 participants out of an eligible pool of 76 PRHOs were recruited. All the groups associated academic misconduct chiefly with cheating in examinations, and perceived it as a commonplace problem. “It is a part of school life”, admitted one PRHO. Copying during exam appeared to be the commonest form of cheating. Another respondent opined that “The lecturers should be more concerned with helping students understand better. They should not make passing an exam a do-or-die affair.” The perception and attitudes towards academic misconduct may be a reflection of the prevailing moral decline in the contemporary Nigerian society. Underlying the reasons adduced by the participants for getting involved in academic misconduct is the fear of failure in examinations. Apart from consolidating formal and informal medical ethics education, the medical schools should ensure that the opportunities and pressures to indulge in academic misconduct are minimized. (shrink)

Although anomic feelings have been found to lead employees to unethical performance, little is known about why this relationship is possible. The aim of this study is to test a compassion-based explanation of why anomic employees harm co-workers by displaying interpersonal deviance. The prediction is made that once sociological anomie enters organizations in the form of employees’ private feelings of anomie—i.e., “anomia”—, this anomia will individually move staff to be uncompassionate in the workplace. Three uncompassionate feelings toward co-workers are then (...) hypothesized to mediate the relationship between anomia and interpersonal deviance: negative judgments about others, over-identification, and isolation. Data were collected from 280 employees at ten hotels in the Canary Islands. The results indicated that anomia was significantly and positively linked to uncompassionate feelings and interpersonal deviance, but only negative judgments about others mediated the anomia effects on interpersonal deviance. Findings suggest to managers that by spreading ethical standards that discourage negative judgments about others in the workplace, they can neutralize the mechanisms leading anomia to interpersonal deviance. (shrink)

The present study examined whether cinematographic editing density affects viewers’ perception of time. As a second aim, based on embodied models that conceive time perception as strictly connected to the movement, we tested the hypothesis that the editing density of moving images also affects viewers’ eye movements and that these later mediate the effect of editing density on viewers’ temporal judgments. Seventy participants watched nine video clips edited by manipulating the number of cuts (slow‐ and fast‐paced editing against a master (...) shot, unedited condition). For each editing density, multiple video clips were created, representing three different kinds of routine actions. The participants’ eye movements were recorded while watching the video, and the participants were asked to report duration judgments and subjective passage of time judgments after watching each clip. The results showed that participants subjectively perceived that time flew more while watching fast‐paced edited videos than slow‐paced or unedited videos; by contrast, concerning duration judgments, participants overestimated the duration of fast‐paced videos compared to the master‐shot videos. Both the slow‐ and the fast‐paced editing generated shorter fixations than the master shot, and the fast‐paced editing led to shorter fixations than the slow‐paced editing. Finally, compared to the unedited condition, editing led to an overestimation of durations through increased eye mobility. These findings suggest that the editing density of moving images by increasing the number of cuts effectively altered viewers’ experience of time and add further evidence to prior research showing that performed eye movement is associated with temporal judgments. (shrink)

The Stroop effect is a well-documented phenomenon, demonstrating both interference and facilitation effects. Many versions of the Stroop task were created, according to the purposes of its applications, varying in numerous aspects. While many versions are developed to investigate the mechanisms of the effect itself, the Stroop effect is also considered a general measure of attention, inhibitory control, and executive functions. In this paper, we implement “eStroop”: a new digital version based on verbal responses, measuring the main processes involved in (...) the traditional effect. eStroop features four categories of stimuli in four different colors: geometrical shapes, neutral words, congruent words, and incongruent words. The results of the administration to 307 University students confirm the Stroop effect and offer baseline data for future research and clinical testing. Direct comparisons with other recent versions of the task are discussed, offering insights into differences and similarities between different task variables. (shrink)

Background:The nursing community in the Nordic countries has become multicultural because of migration from European, Asian and African countries. In Norway, minority health care providers are recruited in to nursing homes which have become multicultural workplaces. They overcome challenges such as language and strangeness but as a group they are vulnerable and exposed to many challenges.Purpose:The aim is to explore minority healthcare providers, trained nurses and nurses’ assistants, and their experiences of challenges when working in a multicultural team in a (...) Norwegian context.Research method:The study has a qualitative design, using narrative interviews, and a phenomenological–hermeneutic analysis method to explore the experiences of challenges in dementia care.Ethical considerations:The study was approved by The Norwegian Regional Ethics Committee, and the Norwegian Social Science Data Services.Participation and research context:Five informants from different African, Asian and European countries participated in the study. The study was conducted in a Norwegian nursing home, in a dementia care unit.Findings:The results show that minority health care providers experience and find meaning in being a member of a team, they overcome challenges, characterized by the interdependency in the team, appreciating new cultural experiences and striving to belong. They must overcome challenges such as language problems and the feeling of strangeness.Discussion:The findings are discussed considering Løgstrup’s ethic of proximity, the ethical demand of trust, and interdependency. The ethical demand is an answer to a common, transparent, unspoken agreement to be met, seen, and understood.Conclusion:The study shows that cooperation in a multi-professional and multi-ethnic team is important, and secures the quality of care to persons with dementia. Further research is necessary to examine the relation between a multi-ethnic staff and the patients experiencing dementia. Further research is necessary to examine ethnicity, the relation between a multi-ethnic staff, the patients experiencing dementia and next of kin. (shrink)

In the post-1945 world, constitutionalism has transcended the nation state, with an array of transnational arrangements now manifesting constitutional characteristics—so says a growing number of scholars. This article reveals an earlier but largely forgotten discourse of transnational constitutionalism: the constitutional theory of the British Empire in the late 19th and early 20th centuries. Focusing on the work of Albert Venn Dicey, the article shows that, when the Empire was at the height of its power and prestige, British constitutional scholars came (...) to see the Empire as a constitutional order and project. For Dicey, a committed constitutionalist and imperialist, the central dynamic of the imperial constitutional order was balancing British constitutional principles with imperial unity. This article focuses in particular on parliamentary sovereignty, a constitutional principle that, for Dicey, was both necessary for and dangerous to the Empire’s integrity. An exercise in intellectual history, the article rethinks Dicey’s work and the constitutional tradition in which Dicey has played such an integral part, seeking to reveal empire's forgotten significance. (shrink)

Constitutional law in the United States is, for most practical purposes, the product of ‘judicial review’, the power of judges to disallow policy choices made by other officials or institutions of government, ostensibly because those choices are prohibited by the Constitution. This extraordinary and unprecedented power, America's dubious contribution to the science of government, has made American judges the most powerful in the world, not only legislators but super-legislators, legislators with virtually the last word. Because lawmaking power divorced from popular (...) will is tyranny, most states have attempted to reconcile the lawmaking power of judges with representative self-government by subjecting all or some judges to some form of popular election. In all but four such states, judges, encouraged and supported by their fellow lawyers in the organized bar—would-be judges and beneficiaries of judicial power—have responded by adopting codes of judicial ethics that limit what candidates for election to judicial office are permitted to say. The effect is to undermine elections as a control on judicial power by limiting criticism of judicial activism, the misuse of judicial power. (shrink)

In this timely and highly original merging of theory and practice, conflict photographer and critical theorist Rita Leistner applies Marshall McLuhan's semiotic theories of language, media, and technology to iPhone photographs taken during a military embed in Afghanistan. In a series of what Leistner calls iProbes—a portmanteau of iPhone and probe—Leistner reveals the face of war through the extensions of man. As digital photography becomes more ubiquitous, and as the phones we carry with us become more advanced, the process (...) of capturing images becomes more democratic and more spontaneous. Leistner's photos result from both access and impulse. Looking for Marshall McLuhan in Afghanistan will appeal anyone with an interest in the conflicts in the Middle East, the seminal communications theorist, or iPhone apps and photography. (shrink)

Across two studies, a wide age range of participants was interviewed about the nature of death. All participants were living in rural Madagascar in a community where ancestral beliefs and practices are widespread. In Study 1, children (8–17 years) and adults (19–71 years) were asked whether bodily and mental processes continue after death. The death in question was presented in the context of a narrative that focused either on the corpse or on the ancestral practices associated with the afterlife. Participants (...) aged 8 years and older claimed that death brings an end to most bodily and mental processes. Nevertheless, particularly in the context of the religious narrative, they claimed that certain mental processes continue even after death. This assertion of an afterlife was more evident among adults than children, especially with respect to cognitive processes, such as knowing and remembering. In Study 2, 5‐ and 7‐year‐olds were asked similar questions in connection with the death of a bird and a person. Seven‐year‐olds consistently claimed that bodily and mental processes cease at death, whereas 5‐year‐olds were unsystematic in their replies. Together, the two studies replicate and extend findings obtained with Western children showing that, in the course of development, different conceptions of death are elaborated—a biological conception in which death terminates living processes and a religious conception in which death marks the beginning of a new form of spiritual existence. (shrink)

The doctor patient relationship starts with a story. Doctors' notes, a patient's chart, the recommendations of ethics committees and insurance justifications all hinge on written and verbal narrative interaction. The "practice" of narrative profoundly affects decision making, patient health and treatment and the everyday practice of medicine. In this edited collection, the contributors provide conceptual foundations, practical guidelines and theoretical considerations central to the practice of narrative ethics.

This paper argues that research in the primary sources must precede the investigation of Byzantine philosophy. Two points are to be considered, on the one hand, the gathering of texts, and, on the other hand, the study of texts in relation to their sources. Thus the external evidence as well as the internal evidence of texts should be examined. In this double regard, the manuscripts containing Aristotle’s Nicomachean Ethics are considered. Their authors are Michael of Ephesos, Eustratios of Nicaea, “Anonymus”, (...) Heliodoros of Prussa, Georgios Pachymeres, Michael Psellos, John Italos, Nikephoros Blemmydes, George Gemistos Plethon. (shrink)

If our sense of the past is inevitably shaped by the explanatory logic of narrative, then the stories that we create in turn reveal the inescapable presence and ...

Proposing that the interaction between reader and literature involves four “modes of textual engagement” — recognition, enchantment, knowledge, and shock — The Uses of Literature bridges the gap between literary theory and common-sense beliefs about why we read literature.

The notion of freedom was in ancient philosophy formed in the sense of the privileges belonging to adult free citizens, and thus foreigners, minors, women, and slaves were deprived of the possibility of freedom. This definition of freedom was also adopted by Roman law, unlike Stoic philosophy and the New Testament Christianity, where freedom was extended to belong to all human beings. In comparison, the Stoics condemn slavery, while Christianity eschatologises freedom. The Middle Ages built on such a concept of (...) freedom. Still, in that period the secular concept of freedom was formulated, which especially comes to the fore in the Magna charta libertatum. The modern concept of freedom was shaped in the Modern Age, from Locke’s definition of life, freedom, and property as inalienable civil rights, through Voltaire’s request for the freedom of thought and Rousseau’s identification of freedom with the essence of human being, to Kant’s understanding of freedom that is possible only through the mind. The ideals of French Revolution, Liberty, Equality, Fraternity, are concretised in the Declaration of the Rights of Man and of the Citizen. John Stuart Mill formulated the classical liberal concept of freedom. Today freedom is discussed, on the one hand, at the level of questions about individual freedom, and on the other hand, at the level of the problematisation of social presumptions regarding the freedom of human being. (shrink)

In this paper, I consider the claim that a corporation cannot be held to be morally responsible unless it is a person. First, I argue that this claim is ambigious. Person flags three different but related notions: metaphysical person, moral agent, moral person. I argue that, though one can make the claim that corporates are metaphysical persons, this claim is only marginally relevant to the question of corporate moral responsibility. The central question which must be answered in discussions of corporate (...) moral responsibility is whether corporations are moral agents or moral persons. I argue that, though we can make a case for saying corporations are moral agents, they are not moral persons, and hence, we can hold them responsible. In addition, we need not treat them the way we would be obligated to treat a moral person; we needn't have the same scruples about holding a corporation morally responsible as we would a moral person. (shrink)