According to the care crisis in modern medicine, the existential needs of patients are not sufficiently satisfied. One idea is that to address the crisis physicians should be educated to be virtuous. This suggestion is helpful but incomplete. It does not take into account the part of (non-)human factors, including (medical) technologies. In particular, the paper focuses on online caring forums and argues that they are technological factors that can play the role of focal things, in which the members gather (...) together to do a care-related focal practice. Furthermore, we empirically study the online forums of Ninisite, a popular Persian website on pregnancy, childbirth, and parenting, and suggest that these forums shape focal practices that are helpful in alleviating the care crisis. (shrink)

BackgroundConsidering ethical issues in midwifery care is essential for improving the quality of health services and the client's satisfaction. This study aimed to develop and validate the code of ethics for Midwives in Iran (ICEM).Materials and methodsThis was a mixed sequential study that was performed in three phases including a qualitative study, a review, and the content validity assessment. The first phase was a qualitative study with a content analysis approach. The data were collected by conducting in-depth semi-structured individual interviews (...) with 14 midwifery and ethics experts. The purposive sampling method was used to recruit the participants and sampling continued until data saturation. The data were analyzed using the conventional content analysis described by Graneheim and Lundman. Lincoln and Guba’s criteria were used to confirm the trustworthiness of the data. Then, a narrative review of the selected national and international codes of ethics for Midwives was performed to complete the items of the ICEM. For validity assessment, the face and content validity of the items of ICEM was assessed by 15 experts to calculate the content validity ratio (CVR) and index (CVI).ResultsFourteen experts were interviewed in the qualitative phase, and 207 codes were extracted from a content analysis which were categorized into 23 sub-categories and 6 main categories. The extracted codes were considered as the items for ICEM that were completed by a review of the selected national and international code of ethics for Midwives. The content validity and ratio assessment of the items demonstrated an average CVI = 0.92 and CVR = 0.85. Then, the final version of ICEM was developed with 92 items in 6 domains about; 1) "professional Commitments" with 30 items; 2) "providing midwifery services to the client and her companions” with 26 items; 3) “relationship with colleagues" with 11 items; 4) “herself” with 6 items; 5) “education and research” with 8 items; and, 6) “management” with 11 items.ConclusionICEM was prepared with 92 items in six sections that facilitate its use for midwives who are working in the different fields of care, counseling, education, research, and management. In this new version of the ICEM, the items related to recent social-, scientific, and technical improvements were considered for providing ethical midwifery care. (shrink)

GraphicalExercise, neurotransmitters, growth factors, myokines, and potential effects on the brain.As human life expectancy increases, cognitive decline and memory impairment threaten independence and quality of life. Therefore, finding prevention and treatment strategies for memory impairment is an important health concern. Moreover, a better understanding of the mechanisms involved underlying memory preservation will enable the development of appropriate pharmaceuticals drugs for those who are activity limited. Exercise training as a non-pharmacological tool, has been known to increase the mean lifespan by maintaining (...) general body health and improving the cardiovascular and nervous systems function. Among different exercise training protocols, aerobic exercise has been reported to prevent the progression of memory decline, provided adequate exertion level, duration, and frequency. Mechanisms underlying exercise training effects on memory performance have not been understood yet. Convergent evidence suggest several direct and indirect mechanisms at molecular and supramolecular levels. The supramolecular level includes improvement in blood circulation, synaptic plasticity and neurogenesis which are under controls of complex molecular signaling of neurotransmitters, neurotrophic factors, exerkines, and epigenetics factors. Among these various factors, irisin/BDNF signaling seems to be one of the important mediators of crosstalk between contracted skeletal muscles and the brain during exercise training. This review provides an affordable and effective method to improve cognitive function in old ages, particularly those who are most vulnerable to neurodegenerative disorders. (shrink)

When it comes to making decisions in vague problems, rough is one of the best tools to help analyzers. So based on rough and hoop concepts, two kinds of approximations (Lower and Upper) for filters in hoops are defined, and then some properties of them are investigated by us. We prove that these approximations- lower and upper- are interior and closure operators, respectively. Also after defining a hyper operation in hoops, we show that by using this hyper operation, set of (...) all rough filters is monoid. For more study, we define the implicative operation on the set of all rough filters and prove that this set with implication and intersection is made a hoop. (shrink)

Virtue epistemology is a new recent approach to epistemology that gives to epistemic or intellectual virtues an important role. Having many similaritywith Externalist Reformed Epistemology, Virtue based view can be used as a new model in religious epistemology. We can define religious virtue and religious perspective that produce true apt beliefs. These presuppositions lead to a new concept of rationality that can defend the rationality of religious beliefs.Therefore we can hold the possibility of religious knowledge against skepticism and its rationality (...) against atheism. (shrink)

In this paper, we will discuss what is called the “Manifestation Challenge” to semantic realism, which was originally developed by Michael Dummett and has been further refined by Crispin Wright. According to this challenge, semantic realism has to meet the requirement that knowledge of meaning must be publically manifested in linguistic behaviour. In this regard, we will introduce and evaluate John McDowell’s response to this anti-realistic challenge, which was put forward to show that the challenge cannot undermine realism. According to (...) McDowell, knowledge of undecidable sentences’ truth-conditions can be properly manifested in our ordinary practice of asserting such sentences under certain circumstances, and any further requirement will be redundant. Wright’s further objection to McDowell’s response will be also discussed and it will be argued that this objection fails to raise any serious problem for McDowell’s response and that it is an implausible objection in general. (shrink)

McTaggart, in his famous paper, “The Unreality of Time” (1908), argues in favor of the sceptical claim that time is unreal. His main argument is based on detecting a paradox in our ordinary descriptions of time or events occurring in time. Based on our common sense conception of time, time and the events happening in it can be described in two ways: either as having the properties of “being past”, “being present” and “being future”, or as having the properties of (...) “being earlier than”, “being later than”, or “being simultaneous with”. McTaggart argues that employing the second sort of properties fails to properly explain “change” in time. However, having assumed the essentiality of the first type of properties to time, McTaggart argues that these properties will themselves lead to a paradox, according to which all events are at the same time in the past, present, and future. In this essay, we are going to provide a clear exposition of McTaggart’s argument and briefly review some of the main responses to it. We will then show that McTaggart’s argument will amount to error-theory about the content of our utterances about time. We will then employ Boghossian’s argument against error-theory (1990) to show why McTaggart’s argument leads to paradoxical conclusions. (shrink)

Even though the COVID-19 pandemic has represented an intense period of stress and anxiety for individuals, it has also been an opportunity for firms to engage in cause-related marketing initiatives as a means of providing support and helping them cope with this global pandemic. This study analyzes the influence of cause–brand fit and cause–brand alliance on customer-based legitimacy and reputation. This study also examines the mediating and moderating roles of trust and betrayal, respectively. Data were collected from 455 participants during (...) the first wave of the pandemic, especially during the first lockdown. The results contribute to unveiling the economic and societal outcomes of cause-related marketing. The findings also enrich the antecedents of the legitimacy and reputation conferred by customers. (shrink)

IntroductionOne of the most important duties of hospital ethics committees is to provide medical ethics consultation to the staff and patients. This study was conducted with the aim of the needs assessment of the staff for optimal provision of medical ethics consultation services.Materials and methodsThe data collection tool was a self-administered questionnaire. Hospital managers, chief nursing officers, ward managers, and head nurses of all hospitals affiliated with Tehran and Iran University of Medical Sciences entered the study. The questionnaire together with (...) an invitation letter was sent to the samples. In the next stage, telephone follow-up of the incomplete forms was performed by the research team.ResultsA total of 448 persons participated in this study (response rate: 54.2%). The mean frequency of the need for ethics consultation in each ward was 5.2 times in the last 3 months with a median of 3. The highest needs for consultation, which were common in all wards, were observed in treatment rejection by the patient, providing necessary information to obtain informed consent and obtaining consent to high risk procedures, conflict between the decisions made by the patient and the family members, decision making for the high risk patient, request for futile or inappropriate treatments, giving bad news, and decision making for the incompetent patient.ConclusionThe prevalence of ethical issues in clinical wards is variably high. The ethical issues in the clinical setting are mainly related to respect for the patient’s autonomy and competency for decision making. (shrink)

Neurofibromatosis type 1 is associated with peripheral and central nervous system tumors. It is noteworthy that the regions in which these tumors frequently arise are the optic pathways and the brainstem. Thus, we decided to trace the procedure of diffusion Magnetic Resonance Imaging alterations along with Short-Wavelength Automated Perimetry examinations of the OPs after surgery and chemotherapy over 1 year, which enabled us to evaluate chemotherapy's efficacy in an NF1 patient with an OP tumor. In this study, a 25-year-old woman (...) with NF1 and left optic radiation glioma underwent surgery to remove the glioma. Immunohistochemistry revealed a Pilocytic Astrocytoma WHO grade I. Post-operation chemotherapy done using nine treatment cycles of administering Temozolomide for 5 days every 4 weeks. Applying the region of interest differential tractography method and SWAP four times every 3 months allowed us to follow the patient's visual acuity alterations longitudinally. The differential deterministic tractography method and statistical analyses enabled us to discover the white matter tracts anisotropy alterations over time. Furthermore, statistical analyses on the SWAP results along time illustrated possible alterations in visual acuity. Then, we could compare and associate the findings with the SWAP examinations and patient symptoms longitudinally. Statistical analyses of SWAP tests revealed a significant improvement in visual fields, and longitudinal differential tractography showed myelination and dense axonal packing in the left OR after 1 year of treatment. In this study, we examined an old hypothesis suggesting that chemotherapy is more effective than radiotherapy for NF1 patients with OP gliomas because of the radiation side effects on the visual field, cognition, and cerebrovascular complications. Our longitudinal clinical case study involving dMRI and SWAP on a single NF1-OPG patient showed that chemotherapy did not suppress the OP myelination over time. However, it should be noted that this is a clinical case study, and, therefore, the generalization of results is limited. Future investigations might focus on genetic-based imaging, particularly in more cases. Further, meta-analyses are recommended for giving a proper Field Of View to researchers as a subtle clue regarding precision medicine. (shrink)