Contemporary organizations often reciprocate to society for using resources and for affecting stakeholders by engaging in corporate social responsibility. It has been shown that CSR has a positive impact on employee attitudes. However, not all employees may react equally strongly to CSR practices. Based on socio-emotional selectivity theory, we contend that the effect of CSR on employee satisfaction will be more pronounced for older than for younger employees, because CSR practices address those emotional needs and goals that are prioritized when (...) people’s future time perspective decreases. In one multi-source field study and one experimental study, we demonstrate that CSR indeed has a stronger positive effect on employee satisfaction for older relative to younger employees. Accordingly, engaging in CSR can be an attractive tool for organizations that aim to keep their aging workforce satisfied with their job. (shrink)

ABSTRACTInspired by the discovery of positive age trends in emotional well-being across adulthood, lifespan researchers have uncovered fascinating age differences in cognition–emotion interactions in healthy adult samples, for example in emotion processing, memory, reactivity, perception, and regulation. Taking stock of this body of research, I identify four trends and five remaining gaps in our understanding of emotional functioning in adulthood. In particular, I suggest that the field should pay stronger attention to the prediction of real-world behaviour. Using the sample case (...) of work functioning, I outline gaps in current knowledge, including the lack of data on middle-aged adults, the neglect of relevant cognitive-emotional mechanisms, and the unclear role of life experience. Filling these gaps will enable progress in research on emotional aging in and beyond the work setting and enhance its practical utility for individuals, organisations, and society. (shrink)

Multiple studies revealed detrimental effects of face masks on communication, including reduced empathic accuracy and enhanced listening effort. Yet, extant research relied on artificial, decontextualised stimuli, which prevented assessing empathy under more ecologically valid conditions. In this preregistered online experiment (N = 272), we used film clips featuring targets reporting autobiographical events to address motivational mechanisms underlying face mask effects on cognitive (empathic accuracy) and emotional facets (emotional congruence, sympathy) of empathy. Surprisingly, targets whose faces were covered by a mask (...) (or a black bar) elicited the same level of empathy motives (affiliation, cognitive effort), and accordingly, the same level of cognitive and emotional empathy compared to targets with uncovered faces. We only found a negative direct effect of face coverings on sympathy. Additional analyses revealed that older (compared to young) adults showed higher empathy, but age did not moderate face mask effects. Our findings speak against strong negative face mask effects on empathy when using dynamic, context-rich stimuli, yet support motivational mechanisms of empathy. (shrink)

Contemporary organizations often reciprocate to society for using resources and for affecting stakeholders by engaging in corporate social responsibility. It has been shown that CSR has a positive impact on employee attitudes. However, not all employees may react equally strongly to CSR practices. Based on socio-emotional selectivity theory, we contend that the effect of CSR on employee satisfaction will be more pronounced for older than for younger employees, because CSR practices address those emotional needs and goals that are prioritized when (...) people’s future time perspective decreases. In one multi-source field study and one experimental study, we demonstrate that CSR indeed has a stronger positive effect on employee satisfaction for older relative to younger employees. Accordingly, engaging in CSR can be an attractive tool for organizations that aim to keep their aging workforce satisfied with their job. (shrink)

This article is concerned with developing a philosophical approach to a number of significant changes to academic publishing, and specifically the global journal knowledge system wrought by a range of new digital technologies that herald the third age of the journal as an electronic, interactive and mixed-media form of scientific communication. The paper emerges from an Editors' Collective, a small New Zealand-based organisation comprised of editors and reviewers of academic journals mostly in the fields of education and philosophy. The paper (...) is the result of a collective writing process. (shrink)

Climate change and decarbonization raise complex justice questions that researchers and policymakers must address. The distributions of greenhouse gas emissions rights and mitigation efforts have dominated justice discourses within scenario research, an integrative element of the IPCC. However, the space of justice considerations is much larger. At present, there is no consistent approach to comprehensively incorporate and examine justice considerations. Here we propose a conceptual framework grounded in philosophical theory for this purpose. We apply this framework to climate mitigation scenarios (...) literature as proof of concept, enabling a more holistic and multidimensional investigation of justice. We identify areas of future research, including new metrics of service provisioning essential for human well-being. [Can be freely read by clicking the ReadCube link below.]. (shrink)

Im Rahmen des Modellvorhabens „Patienten als Partner—Tumorpatienten und ihr Mitwirken bei medizinischen Entscheidungen“ wurden zwischen März 2002 und August 2003 272 palliativ behandelte Tumorpatienten nach ihrer Einstellung zur Patientenverfügung und zur gewünschten Beteiligung an medizinischen Entscheidungen befragt. Von den Befragten kannten 30% Patientenverfügungen nicht, darunter signifikant mehr Befragte mit formal niedrigerem Bildungsabschluss. Es hatten bereits 11% eine Patientenverfügung abgeschlossen, 22% wollten wahrscheinlich eine abschließen, und 30% wollten keine abschließen. Es fand sich ein statistisch signifikanter Zusammenhang zwischen dem Abschluss einer Patientenverfügung (...) und dem Wunsch nach mehr eigener Entscheidungsverantwortung. Die Einstellung zur Patientenverfügung und der Wunsch nach partizipativer Entscheidungsfindung stehen in keinem statistisch signifikanten Zusammenhang. Patienten mit schriftlichen Vorausverfügungen haben einen erhöhten Kommunikations- und Rückkopplungsbedarf, auf den Ärzte sensibel eingehen sollten. Bei der Information über Patientenverfügungen sollten Menschen mit niedrigerem Bildungsstand mehr als bisher berücksichtigt werden. (shrink)

Background: Due to recent legislations on euthanasia and its current practice in the Netherlands and Belgium, issues of end-of-life medicine have become very vital in many European countries. In 2002, the Ethics Working Group of the German Association for Palliative Medicine (DGP) has conducted a survey among its physician members in order to evaluate their attitudes towards different end-of-life medical practices, such as euthanasia (EUT), physician-assisted suicide (PAS), and terminal sedation (TS). Methods: An anonymous questionnaire was sent to the 411 (...) DGP physicians, consisting of 14 multiple choice questions on positions that might be adopted in different hypothetical scenarios on situations of “intolerable suffering” in end-of-life care. For the sake of clarification, several definitions and legal judgements of different terms used in the German debate on premature termination of life were included. For statistical analysis t-tests and Pearson-correlations were used. Results: The response rate was 61% (n=251). The proportions of the respondents who were opposed to legalizing different forms of premature termination of life were: 90% opposed to EUT, 75% to PAS, 94% to PAS for psychiatric patients. Terminal sedation was accepted by 94% of the members. The main decisional bases drawn on for the answers were personal ethical values, professional experience with palliative care, knowledge of alternative approaches, knowledge of ethical guidelines and of the national legal frame. Conclusions: In sharp contrast to similar surveys conducted in other countries, only a minority of 9.6% of the DGP physicians supported the legalization of EUT. The misuse of medical knowledge for inhumane killing in the Nazi period did not play a relevant role for the respondents’ negative attitude towards EUT. Palliative care needs to be stronger established and promoted within the German health care system in order to improve the quality of end-of-life situations which subsequently is expected to lead to decreasing requests for EUT by terminally ill patients. (shrink)

The present two-study paper examined the role of communication strategies that athletes use to develop their coach-athlete relationship. Study 1 examined the mediating role of motivation, support and conflict management strategies between the quality of the coach-athlete relationship and athletes’ perceptions of sport satisfaction. Study 2 examined the longitudinal and mediational associations of communication strategies and relationship quality across two time points, over a six-week period. Within both studies, data were collected through multi section questionnaires assessing the studies’ variables. For (...) study 1, structural equation modelling highlighted significant indirect effects for motivation and support strategies between the quality of the coach-athlete relationship and athletes’ experiences of sport satisfaction. For study 2, significant indirect effects were found for the athletes’ perceptions of the quality of the coach-athlete relationship at time 2 between athletes’ use of communication strategies at time point 1 and time point 2. Together these findings provide support for the practical utility of communications strategies in enhancing the quality of the coach-athlete relationship and athlete’s experiences of sport satisfaction. In addition, the findings provide evidence to highlight the potential cyclical relationship between communication and relationship quality across time. (shrink)

Emotions are a core factor of learning. Studies have shown that multiple emotions are co-experienced during learning and have a significant impact on learning outcomes. The present study investigated the importance of multiple, co-occurring emotions during learning about human biology with MetaTutor, a hypermedia-based intelligent tutoring system. Person-centered as well as variable-centered approaches of cluster analyses were used to identify emotion clusters. The person-centered clustering analyses indicated three emotion profiles: a positive, negative and neutral profile. Students with a negative profile (...) learned less than those with other profiles and also reported less usage of emotion regulation strategies. Emotion clusters identified through spectral co-clustering confirmed these results. Throughout the learning activity, emotions built a stable correlational structure of a positive, a negative, a neutral and a boredom emotion cluster. Positive emotion cluster scores before the learning activity and negative emotion cluster scores during the learning activity predicted learning, but not consistently. These results reveal the importance of negative emotions during learning with MetaTutor. Potential moderating factors and implications for the design and development of educational interventions that target emotions and emotion regulation with digital learning environments are discussed. (shrink)

Critical reasoning (CR) when confronted with contradictory information from multiple sources is a crucial ability in a knowledge-based society and digital world. Using information without critically reflecting on the content and its quality may lead to the acceptance of information based on unwarranted claims. Previous personal beliefs are assumed to play a decisive role when it comes to critically differentiating between assertions and claims and warranted knowledge and facts. The role of generic epistemic beliefs on critical stance and attitude in (...) reflectively dealing with information is well researched. Relatively few studies have been conducted on the influence of domain-specific beliefs, i.e. beliefs in relation to specific content encountered in a piece of information or task, on the reasoning process, and on how these beliefs may affect the information-processing and decision-making processes. This study focuses on students’ task- and topic-related beliefs that may influence their reasoning when dealing with multiple and partly contradictory sources of information. To validly assess CR among university students, we used a newly developed computer-based performance assessment in which the students were confronted with an authentic task which contains theoretically defined psychological stimuli for measuring CR. To investigate the particular role of task- and topic-related beliefs on CR, a purposeful sample of 30 university students took part in a performance assessment and then were interviewed immediately afterwards. In the semi-structured cognitive interviews, the participants’ task-related beliefs were assessed. Based on qualitative analyses of the interview transcripts, three distinct profiles of decision-making among students have been identified. More specifically, the different types of students’ beliefs and attitudes derived from the cognitive interview data suggest their influence on information processing, reasoning approaches and decision-making. The results indicated that the students’ beliefs had an influence on their selection, critical evaluation and use of information as well as on their reasoning processes and final decisions. (shrink)

BackgroundThe SARS-COVID-19 pandemic and its associated disease control restrictions have in multiple ways affected families with young children, who may be especially vulnerable to mental health problems. Studies report an increase in perinatal parental distress as well as symptoms of anxiety or depression in children during the pandemic. Currently, little is known about the impact of the pandemic on infants and their development. Infant regulatory problems have been identified as early indicators of child socio-emotional development, strongly associated with maternal mental (...) health and the early parent–infant interaction. Our study investigates whether early parenthood under COVID-19 is associated with more maternal depressive symptoms and with a perception of their infants as having more RPs regarding crying/fussing, sleeping, or eating, compared to mothers assessed before the pandemic.MethodsAs part of a longitudinal study, 65 women who had given birth during the first nationwide disease control restrictions in Northern Germany, were surveyed at 7 months postpartum and compared to 97 women assessed before the pandemic. RPs and on maternal depressive symptoms were assessed by maternal report. Number of previous children, infant negative emotionality, and perceived social support were assessed as control variables.ResultsCompared to the control cohort, infants born during the COVID-19 pandemic and those of mothers with higher depressive symptoms were perceived as having more sleeping and crying, but not more eating problems. Regression-based analyses showed no additional moderating effect of parenthood under COVID-19 on the association of depressive symptoms with RPs. Infant negative emotionality was positively, and number of previous children was negatively associated with RPs.LimitationsDue to the small sample size and cross-sectional assessment, the possibility for more complex multivariate analysis was limited. The use of parent-report questionnaires to assess infant RPs can support but not replace clinical diagnosis.ConclusionsThe pandemic conditions affecting everyday life may have a long-term influence on impaired infant self- and maternal co-regulation and on maternal mental health. This should be addressed in peripartum and pediatric care. Qualitative and longitudinal studies focusing on long-term parental and infant outcomes under ongoing pandemic conditions are encouraged. (shrink)

Patients’ experience of symptoms does not follow the body–mind divide that characterizes the classification of disease in the health care system. Therefore, understanding patients in their entirety rather than in parts demands a different theoretical approach. Attempts have been made to formulate such approaches but many of these, such as the biopsychosocial model, are still basically dualistic or methodologically reductionist. In primary care, patients often present with diffuse symptoms, making primary care the ideal environment for understanding patients’ undifferentiated symptoms and (...) disease patterns which could readily fit both bodily and mental categories. In this article we discuss theoretical models that have attempted to overcome this challenge: The psychosomatic approach could be called holistic in the sense of taking an anti-dualistic stance. Primary care theorists have formulated integrative views but these have not gained a foothold in primary care medicine. McWhinney introduced a new metaphor, ‘the body–mind’, and Rudebeck advocated cultivating ‘bodily empathy’. These views have much in common with both phenomenological thinking and mentalization, a psychological concept for understanding others. In the process of understanding patients there is a need for the physician to enter an intersubjectivity that aims at understanding the patient’s experiences and sensations without initially jumping to diagnostic conclusions or into a division into mental and physical phenomena. Mentalization theory could form the basis of an approach to a more comprehensive understanding of patients. The success of such an approach is, however, dependent upon structural and organizational conditions that do not counteract it. (shrink)

The series Topics in Current Chemistry presents critical reviews of the present and future trends in modern chemical research. The scope of coverage is all areas of chemical science including the interfaces with related disciplines such as biology, medicine and materials science. The goal of each thematic volume is to give the non-specialist reader, whether in academia or industry, a comprehensive insight into an area where new research is emerging which is of interest to a larger scientific audience. Each review (...) within the volume critically surveys one aspect of that topic and places it within the context of the volume as a whole. The most significant developments of the last 5 to 10 years are presented using selected examples to illustrate the principles discussed. The coverage is not intended to be an exhaustive summary of the field or include large quantities of data, but should rather be conceptual, concentrating on the methodological thinking that will allow the non-specialist reader to understand the information presented. Contributions also offer an outlook on potential future developments in the field. Review articles for the individual volumes are invited by the volume editors. Readership: research chemists at universities or in industry, graduate students. (shrink)

This article comprises a short case exemplifying ethical challenges arising for a participatory researcher working with Afghan women refugees during the Covid-19 pandemic in Germany. The researcher is an Iranian-German woman, qualified as a midwife, undertaking doctoral research on refugees’ access to reproductive health care. Disclosures about some women’s experience of domestic violence are made, which raise ethical issues for the researcher relating to personal-professional boundaries, roles and responsibilities. Two commentaries are given on this case from participatory researchers based in (...) Germany, UK and Austria. Both commentaries highlight the relevance of the ethics of care for participatory research and for this research in particular, which entails very close relationships between the doctoral researcher and the refugee women with whom she is researching. The first commentary analyses the research process in terms of Tronto’s five phases of care, while the second illustrates the importance of caring institutions in supporting researchers working on sensitive topics. (shrink)

This article looks at how and why addiction should be understood as a ‘sociorelational’ disorder, and what this implies on a policy level in terms of the treatment and prevention of addiction. In light of scientific research, we argue that the neurobiological changes that underlie addiction are heavily influenced by sociorelational processes. We thereby advocate for a conceptual approach in which autonomy in addiction is a sociorelational concept, and social environments are considered autonomy undermining or autonomy promoting. We then discuss (...) the various implications this should have on policies. (shrink)

L(ow) tone in Mandarin Chinese causes both downstep and post-low-bouncing. Downstep refers to the lowering of a H(igh) tone after a L tone, which is usually measured by comparing the H tones in a “H…HLH…H” sentence with a “H…HHH…H” sentence (cross-comparison), investigating whether downstep sets a new pitch register for the scaling of subsequent tones. Post-low-bouncing refers to the raising of a H tone after a focused L tone. The current study investigates how downstep and post-low-bouncing interact with focus and (...) phrasing in Mandarin Chinese. In the experiment, we systematically manipulated (a) the tonal environment by embedding two syllables with either LH or HH tone (syllable X and Y) sentence-medially in the same carrier sentences containing only H tones; (b) boundary strength between X and Y by introducing either a syllable boundary or a phonological phrase boundary; and (c) information structure by either placing a contrastive focus in the HL/HH word (XF), syllable Y (YF), or the sentence-final word (ZF). A wide-focus condition served as the baseline. With systematic control of focus and boundary strength around the L tone, the current study shows that the downstep effect in Mandarin is quite robust, lasting for 3–5 H tones after the L tone, but eventually levelling back again to the register reference line of a H tone. The way how focus and phrasing interact with the downstep effect is unexpected. Firstly, sentence-final focus has no anticipatory effect on shortening the downstep effect; instead, it makes the downstep effect lasts longer as compared to the wide focus condition. Secondly, the downstep effect still shows when the H tone after the L tone is on-focus (YF), in a weaker manner than the wide focus condition, and is overridden by the post-focus-compression. Thirdly, the downstep effect gets greater when the boundary after the L tone is stronger, because the L tone is longer and more likely to be creaky. We further analyzed downstep by measuring the F0 drop between the two H tones surrounding the L tone (sequential-comparison). Comparing it with F0 drop in all-H sentences (i.e., declination), it showed that the downstep effect was much greater and more robust than declination. However, creaky voice in the L tone was not the direct cause of downstep. At last, when the L tone was under focus (XF), it caused a post-low-bouncing effect, which is weakened by a phonological phrase boundary. Altogether, the results showed that although intonation is largely controlled by informative functions, the physical-articulatory controls are relatively persistent, varying within the pitch range of 2.5 semitones. Downstep and post-low-bouncing in Mandarin Chinese thus seem to be mainly due to physical-articulatory movement on varying pitch, with the gradual tonal F0 change meeting the requirement of smooth transition across syllables, and avoiding confusion in informative F0 control. (shrink)

Studies involving direct language imitation tasks have shown that pronunciation ability is related to musical competence and working memory capacities. However, this type of task may measure individual differences in many different linguistic dimensions, other than just phonetic ones. The present study uses an indirect imitation task by asking participants to a fake a foreign accent in order to specifically target individual differences in phonetic abilities. Its aim is to investigate whether musical expertise and working memory capacities relate to phonological (...) awareness (i.e., participants’ implicit knowledge about the phonological system of the target language and its structural properties at the segmental, suprasegmental and phonotactic levels) as measured on this task. To this end, French native listeners (N = 36) graded how well German native imitators (N = 25) faked a French accent while speaking in German. The imitators also performed a musicality test, a self-assessment of their singing abilities and working memory tasks. The results indicate that the ability to fake a French accent correlates with singing ability and musical perceptual abilities, but not with working memory capacities. This suggests that heightened musical abilities may lead to an increased phonological awareness probably by providing participants with highly efficient memorization strategies and highly accurate long-term phonetic representations of foreign sounds. Comparison with data of previous studies shows that working memory could be implicated in the pronunciation learning process which direct imitation tasks target, whereas musical expertise influences both storing of knowledge and later retrieval here assessed via an indirect imitation task. (shrink)

As we experience and manipulate time—be it as boredom or impatience—it becomes an object: something materialized and social, something that affects perception, or something that may motivate reconsideration and change. The editors and contributors to this important new book, _Ethnographies of Youth and Temporality, _have provided a diverse collection of ethnographic studies and theoretical explorations of youth experiencing time in a variety of contemporary socio-cultural settings. The essays in this volume focus on time as an external and often troubling factor (...) in young people’s lives, and shows how emotional unrest and violence but also creativity and hope are responses to troubling times. The chapters discuss notions of time and its and its “objectification” in diverse locales including the Georgian Republic, Brazil, Denmark and Uganda. Based on long-term ethnographic fieldwork, the essays in _Ethnographies of Youth and Temporality_ use youth as a prism to understand time and its subjective experience. In the series _Global Youth_, edited by Craig Jeffrey and Jane Dyson. (shrink)

Experiences of discrimination such as everyday racism can negatively affect the mental and physical health of children and adolescents with an immigrant background and impair their integration process in the host societies. Although experiences of racism are part of the everyday life of many minors affected by the process of “Othering”, an overview of empirical findings is missing for this age group worldwide. A systematic review was conducted to identify and analyze international research on the impact of discrimination on the (...) developmental outcomes and integration of immigrant children and adolescents. Three scientific databases were systematically searched up to June 11, 2021. A total of k = 4,769 identified publications were reviewed based on inclusion and exclusion criteria in terms of the PICOS format by independent reviewers. Thirty-four primary studies published between 1998 and 2021 met all inclusion criteria. The samples examined were mainly migrant youth, with only k = 2 studies assessing refugee youth and k = 1 study assessing both migrant and refugee youth. The majority of included studies assessed perceived discrimination, with only k = 1 study directly assessing experiences of racism. The association between discrimination or racism and developmental outcomes was assessed by the included studies within the three main topics of mental and physical health-related outcomes, school-related outcomes, and other developmental outcomes. Data collection procedures were implemented, and findings on minors’ developmental outcomes and integration process who experience discrimination and racism were summarized and discussed. The current review suggests experienced discrimination as a negative predictor of children and adolescents’ health-related outcomes, while no clear results could be found for the association between discrimination and school-related outcomes. A need for more empirical research focusing on the path and indirect link between discrimination and children and adolescents’ school-related outcomes as well as resulting school recommendations and the chosen career path was derived.Systematic Review Registration[https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=260291], identifier [CRD42021260291]. (shrink)

Die Verbindlichkeit von Patientenverfügungen (PV) wird kontrovers diskutiert. Dabei ist nicht bekannt, wie verbindlich PV von denen gewollt sind, die sie verfassen. Mit Hilfe eines anonymen Fragebogens wurden Verfasser von PV in bayerischen Palliativeinrichtungen und Beratungsstellen hierzu befragt. Von den 402 Befragten gaben 69,1% an, dass ihre PV auch für Bevollmächtigte und Betreuer strikt verbindlich sein soll. Demgegenüber räumten 23,9% ihrem Stellvertreter ein, von der PV abzuweichen. Die lebensbedrohlich Erkrankten unter den Befragten legten nicht weniger, sondern signifikant mehr Wert auf (...) hohe Verbindlichkeit. Für den Fall, dass die PV nicht anwendbar sein sollte, wünschen deren Verfasser eine Entscheidung durch ihren Vertreter. Abgelehnt wird die richterliche Entscheidung bei Dissens. (shrink)

ObjectiveBreast cancer may profoundly affect a couple’s sex life. The present study examines whether patient-, partner- and relationship-related characteristics are associated with sexual activity of couples following breast cancer diagnosis in the treatment phase and over time.MethodsWomen with breast cancer and their male cohabiting partners participated in a longitudinal study in Denmark. Logistic regression was used to examine associations of patient-, partner- and relationship-related characteristics at baseline with couples’ sexual activity at baseline, 5 and 12 months later. The longitudinal analyses (...) were stratified for couples’ sexual activity status at baseline.ResultsA total of 722, 533 and 471 couples were included in the analyses at baseline, 5- and 12-months follow-up, respectively. Older age, depressive symptoms and lower vitality of patients were associated with lower odds of couples’ sexual activity at baseline; chemotherapy treatment and older age of patients were associated with lower odds at 5-months follow-up in couples who were not sexually active at baseline. Higher ratings of emotional closeness, affectionate behavior and satisfaction with dyadic coping were associated with higher odds for sexual activity at baseline and over time in couples who were sexually active at baseline.ConclusionSexual counseling during cancer treatment and rehabilitation should include a couple perspective. Relationship-related variables may be a protective factor for remaining sexually active after breast cancer diagnosis. Interventions could focus on strengthening these factors. Health professionals also need to consider the patients’ breast cancer treatment, vitality, and emotional distress in counselling on sexuality. (shrink)

Business leaders are increasingly responsible for the societal and environmental impacts of their actions. Yet conceptual views on responsible leadership differ in their definitions and theoretical foundations. This study attempts to reconcile these diverse views and uncover the phenomenon from a business leader’s point of view. Based on rational egoism theory, this article proposes a formal mathematical model of responsible leadership that considers different types of incentives for stakeholder engagement. The analyses reveal that monetary and instrumental incentives are neither sufficient (...) nor necessary for business leaders to consider societal and environmental stakeholder needs. Non-monetary and non-instrumental incentives, such as leaders’ values and authenticity, as well as their planning horizons, counterbalance pure monetary and instrumental orientations. The model in this article complements the growing body of research on responsible leadership by reconciling its various conceptual views and providing a foundation for future theory development and testing. (shrink)

BackgroundDecision-making in out-of-hospital cardiac arrest should ideally include clinical and ethical factors. Little is known about the extent of ethical considerations and their influence on prehospital resuscitation. We aimed to determine the transparency in medical records regarding decision-making in prehospital resuscitation with a specific focus on ethically relevant information and consideration in resuscitation providers’ documentation.MethodsThis was a Danish nationwide retrospective observational study of out-of-hospital cardiac arrests from 2016 through 2018. After an initial screening using broadly defined inclusion criteria, two experienced (...) philosophers performed a qualitative content analysis of the included medical records according to a preliminary codebook. We identified ethically relevant content in free-text fields and categorised the information according to Beauchamp and Childress’ four basic bioethical principles: autonomy, non-maleficence, beneficence, and justice. ResultsOf 16,495 medical records, we identified 759 (4.6%) with potentially relevant information; 710 records (4.3%) contained ethically relevant information, whereas 49 did not. In general, the documentation was vague and unclear. We identified four kinds of ethically relevant information: patients’ wishes and perspectives on life; relatives’ wishes and perspectives on patients’ life; healthcare professionals’ opinions and perspectives on resuscitation; and do-not-resuscitate orders. We identified some “best practice” examples that included all perspectives of decision-making. ConclusionsThere is sparse and unclear evidence on ethically relevant information in the medical records documenting resuscitation after out-of-hospital cardiac arrests. However, the “best practice” examples show that providing sufficient documentation of decision-making is, in fact, feasible. To ensure transparency surrounding prehospital decisions in cardiac arrests, we believe that it is necessary to ensure more systematic documentation of decision-making in prehospital resuscitation. (shrink)

The French jurist and courtier Géraud de Cordemoy (1622-1684) was one of the leading exponents of early Cartesianism. Although he felt closely connected to René Descartes' philosophy, he corrected it in some central points. Thus he advocates an atomistic phsics and a theory of causation known as Occasionalism, which Leibniz calls the System of Occasional Causes in the "New System". The volume contains selected central passages from Cordemoy's main philosophical writings, which are made accessible here for the first time in (...) a bilingual study edition. These are excerpts from the "Six Discussions on the Difference and Union of Body and Soul" from 1666, and a "Metaphysical Treatise" that appeared posthumously in 1691. (shrink)