BackgroundDespite its ubiquity in academic research, the phrase ‘ethical challenge(s)’ appears to lack an agreed definition. A lack of a definition risks introducing confusion or avoidable bias. Conceptual clarity is a key component of research, both theoretical and empirical. Using a rapid review methodology, we sought to review definitions of ‘ethical challenge(s)’ and closely related terms as used in current healthcare research literature.MethodsRapid review to identify peer-reviewed reports examining ‘ethical challenge(s)’ in any context, extracting data on definitions of ‘ethical challenge(s)’ (...) in use, and synonymous use of closely related terms in the general manuscript text. Data were analysed using content analysis. Four databases (MEDLINE, Philosopher’s Index, EMBASE, CINAHL) were searched from April 2016 to April 2021.Results393 records were screened, with 72 studies eligible and included: 53 empirical studies, 17 structured reviews and 2 review protocols. 12/72 (17%) contained an explicit definition of ‘ethical challenge(s), two of which were shared, resulting in 11 unique definitions. Within these 11 definitions, four approaches were identified: definition through concepts; reference to moral conflict, moral uncertainty or difficult choices; definition by participants; and challenges linked to emotional or moral distress. Each definition contained one or more of these approaches, but none contained all four. 68/72 (94%) included studies used terms closely related to synonymously refer to ‘ethical challenge(s)’ within their manuscript text, with 32 different terms identified and between one and eight different terms mentioned per study.ConclusionsOnly 12/72 studies contained an explicit definition of ‘ethical challenge(s)’, with significant variety in scope and complexity. This variation risks confusion and biasing data analysis and results, reducing confidence in research findings. Further work on establishing acceptable definitional content is needed to inform future bioethics research. (shrink)

The research aims to understand why individuals break away from the majority religious tradition and adopt a different religion and what their new beliefs mean to them. This study is based on data obtained from semi-structured interviews and eight-month observation notes with 10 members of Başkent (Capital) Church, a Protestant church operating in Ankara. For the research, church services were attended every Sunday, and the individuals' context and interaction styles were also observed. Although the phenomenon of religious conversion is often (...) examined as the complete abandonment of religion under the influence of secularization theses, in fact, the replacement of faith with different religions should also be considered in religious change. Regarding the research field, some individuals move away from Islam but do not turn to a completely non-belief life, but instead adhere to another religion that they think is more suitable for their own world of meaning, expectations, and personality. Against the effect of modern life that pushes people to loneliness and unhappiness, individuals can replace the meaning they have lost with a new religious thought. The research reveals that social bonding, communication, and interaction processes are important social motivations in the process of religious conversion. (shrink)

Americans are increasingly turning to hospice services to provide them with medical care, pain management, and emotional support at the end of life. The increase in the rates of hospice utilization is explained by a number of factors including a “hospice movement” dating to the 1970s which emphasized hospice as a tool to promote dignity for the terminally ill; coverage of hospice services by Medicare beginning in 1983; and, the market for hospice services provision, sustained almost entirely by governmental reimbursement. (...) On the one hand, the growing acceptance of hospice may be seen as a sign of trends giving substance to the death-with-dignity movement and the growing strength of end-of-life decision-makers and planners who integrate medical, community, family and spiritual networks. On the other hand, the precise relationship between the death-with-dignity and commercial processes driving hospice utilization rates are not well understood. On May 2, 2013, the U.S. Government intervened in a lawsuit brought by former hospice employees alleging that behind Vitas Innovative Hospice Care, the largest for-profit hospice service provider in the United States, lie an intricate web of incentives for patient intake nurses, physicians and marketers which not only drove hospice patients to use more expensive crisis care services, but influenced patient and family decisions as to whether or not to discontinue curative treatment. The corporate, investment, and regulatory history behind Vitas provides an important insight into the market realities behind Americans' embrace of hospice care and the risks to patient autonomy and health that accompany the commercialization of this ethically and morally complex health care service. (shrink)

Hospice care in the United States has undergone a remarkable transformation since it assumed its modern form in the late 1960s. It began as a movement driven by small organizations staffed with many volunteer providers focusing on comprehensive spiritual, palliative, and mental health services for a relatively small number of terminally ill patients, typically suffering from cancer. The idea behind hospice during its early days was that a terminally patient and his or her family made a decision to focus on (...) easing a patient’s pain and anxiety, making him or her more comfortable, rather than pursuing additional curative treatment. Because these objectives required a wide range of professional and non-professional skills, hospice care involved not only physicians and nurses, but clergy, social workers, volunteer caretakers, homemakers, and, of course, family members. The process of decision-making by the patient and his or her family was never uniform and never systematically studied. (shrink)

Recent work on a small European cave salamander (Proteus anguinus) has revealed that it has exceptional longevity, yet it appears to have unexceptional defences against oxidative damage. This paper comes at the end of a string of other studies that are calling into question the free‐radical damage theory of ageing. This theory rose to prominence in the 1990s as the dominant theory for why we age and die. Despite substantial correlative evidence to support it, studies in the last five years (...) have raised doubts over its importance. In particular, these include studies of mice with the major antioxidant genes knocked out (both singly and in combination), which show the expected elevation in oxidative damage but no impact on lifespan. Combined, these findings raise fundamental questions over whether the free‐radical damage theory remains useful for understanding the ageing process, and variation in lifespan and life histories.Editor's suggested further reading in BioEssays Blind cave salamanders age very slowly: A new member of Methuselah's Bestiary Abstract. (shrink)

This study focuses on the value of the logical universal in terms of being universal in the philosophy of Avicenna, and al-Ghazālī’s criticisms of Avicenna in the context of the logical universal. A philosophical analysis of al-Ghazālī’s criticisms of Avicenna is made by mentioning how these two thinkers explained the universal and its types, and by revealing the meaning that the universal corresponds to in their thought system. Accordingly, Avicenna talks about three types of universal. The intercourse between these universals (...) is based on an intrinsic relation. The one that determines this kind of relationship and gives a principle has to be an outsider of the universals. According to Avicenna the concept of being determines the meaning of universals and the personal relationship between universal types. In this respect, the rational universal is the reasonable of the universal; the rational universal may be necessary for the logical universal. Therefore, the concept of universal in Avicenna is related to existence. In al-Ghazālī’s thought, we can talk about three types of the universal. He does not name the types of the universal, but distinguishes them by describing them. In his distinction, the concept of partnership is considered in terms of being actual and potential, and being is divided based on these conceptual distinctions. In this respect, we cannot talk about a random distinction between the meaning attributed to universals by Avicenna and by al-Ghazālī but an inherent difference. Based on this separation, al-Ghazālī’s criticisms of Avicenna are also of a essential nature. One of the clearest signs of al-Ghazālī’s criticism of Avicenna lies in the meaning he attributes to the logical universal and the example he gives in the context of the logical universal. al-Ghazālī considers the logical universal as a meaning that does not accept commonality in terms of potential and actual, and attributes the commonality in it to a reason other than what it is. While Avicenna agrees that the meaning that al-Ghazālī’s attributes to the logical universal, saying that it is outside of approval, clearly emphasizes being the subject of conceptualization. al-Ghazālī, on the other hand, ignored this reference of Avicenna and emphasized that Avicenna would accept this, based on the example of “divine/dieu” he gave in the context of the logical universal. However, in Avicenna's philosophical system, it is not possible for the word "divine" to be the subject of imagination, because the “god” is not conceived, but perceived. According to him, the things which are the subjects of imagination potentially contain multiplicity. But the word "god” is not suitable to be the subject of imagination as it is a necessary being. In this respect, it can be analyzed whether al-Ghazālī’s criticisms are austere or nonsense in terms of the five arts (sophistry). The meaning that al-Ghazālī attributed to the logical universal and the examples he gave for this meaning constitute the inherent quality of his criticisms being of the kind of fallacy. (shrink)

The Abrahamic tradition that the Arabs value most was ḥajj. The ḥajj, which means to visit Kaʿba was the greatest means of getting closer to Allāh. The Kaʿba was the house of Allāh. And the visitors of the Kaʿba were Allāh’s guests. For this reason, the Arabs used to great respect to the visitors and they never used to attack a man in the ḥarem (the area around the Kaʿba). The same respect included visitors’ travels to the Kaʿba. There were (...) two Abrahamic traditions that ensured the safety of visitors and sacrifices: Ḥaram months and qalāid. Ḥaram months were Dhū l-Qaʿdah, Dhū l-Ḥijjah, Muḥarram and Rajab. And the Arabs did not used to attack anyone in those months. For visits outside the ḥaram months, the visitors used to use the qalāid as a primitive visa. Qalāid is the plural of the word qilāda, meaning necklace. The Arab, who saw the qilādas, used to understand that the person who wore the qilāda wanted to go to the Kaʿba or had returned home from the Kaʿba. Qilādas used to be knitted from wool ropes and they used to be hung on animals’ neck or humps. Sometimes horseshoes used to hang on these qilādas. On the way back from Kaʿba, the barks of the ḥarem trees used to hang on the qilādas instead of the horseshoes. The Qurʾān orders Muslims not to disrespect the qilādas. This order also reveals that the Qurʾān recognizes the qilāda tradition. Allāh’s Apostle (sallallaahu ‘alayhi wa sallam) and Ṣaḥāba are also known to continue this tradition.Summary: Ḥajj was the most important worship of the Arabs in the pre-Islamic period. Human and commodity mobility in the ḥajj had an important place in the life of the Meccans who lived in land unfit for agriculture. This fact is expressed as follows in Abraham’s (Ibrāhīm al-Khalīl) prayer: “Our Lord! Lo! I have settled some of my posterity in an uncultivable valley near unto Thy holy House, our Lord! That they may establish proper worship; so incline some hearts of men that they may yearn toward them, and provide Thou them with fruits in order that they may be thankful.” (Ibrahim 14:37) The Arabs who lived in various parts of the Arabian Peninsula used to come to Mecca during the ḥajj season and present their sacrifices. They also used to buy their needs from nearby markets. These markets were also places where traders had the opportunity to sell their products.Because the Arabian Peninsula is unfavorable in terms of climate and soil, many Arab tribes used to raid and attack other tribes to sustain their existence. It is even known that some Arabs proud of their raids. The attacks only used to stop in the ḥaram months (Dhū l-Qaʿdah, Dhū l-Ḥijjah, Muḥarram and Rajab). Because of the prohibition of fighting in the ḥaram months, the visitors used to visit the Kaʿba with confidence. Thanks to this truce, the trade goods carried by visitors used to reach to Mecca with confidence.It was possible that the visits outside of the ḥaram months were safe. However, it was necessary to follow some traditions in order to achieve this confidence. Visitors to the Kaʿba used to use some signs that they were visitors to the Kaʿba. One of these signs was qilāda (necklace) hanging on the neck or hump of the animal. The person wearing qilāda was Allāh’s guest, and his sacrifice was the property of Allāh. For this reason, no Arab would to dare to attack these visitors and property. Because of the Arab reverence for the Kaʿba, visitors wearing qilādas used to come to the Kaʿba and present their sacrifices throughout the year. The sacrifices had an important place in the livelihood of the poor.Qilādas were mostly used for visits outside the ḥaram months. The qilādas used to hang on the necks of the animals shipped to the Kaʿba as sacrifice. However, it is also known that qilādas are sometimes hung on hump. People who did not deliver sacrifices (animals) to the Kaʿba used to hang the qilāda his neck to show that he was a visitor to the Kaʿba. Similarly, it is known that people who sacrificed their animals on the Kaʿba hang the qilāda their neck on the way back. The qilādas fitted on the way to the Kaʿba were made of ropes spun from wool or hair. Sometimes horseshoes used to hang on these qilādas. Ḥarem plants (grass, tree bark) used to use in the qilādas on the way back.The Qurʾān orders Muslims not to disrespect the qilādas. This order also reveals that the Qurʾān recognizes the qilāda tradition. The word qalāid is mentioned twice in the Qurʾān: “O ye who believe violate not the sanctity of the symbols of Allāh, nor of the sacred month, nor of the animals brought for sacrifice, nor the qalāid, nor the people resorting to the sacred house, seeking of the Bounty and good pleasure of their Lord.” (Al Māʼidah 5:2), “Allāh made the Kaʿba, the sacred house, an asylum of security of men as also the sacred months, the animals for offerings, and the qalāid.” (Al Māʼidah 5:97) Considering the practices of the qilāda, it is understood that qilādas are a kind of visa. It is understood that all practices related to the visit to the Kaʿba, especially the ḥajj, have an aim to satisfy the material-spiritual needs of those who come there for the purpose of visiting and trading, as well as those who reside in the Kaʿba. Therefore, it will not be far away to say that qilādas can be used today for the same purpose. For example, labels, banderols, visas and passports can be used instead of ropes, horseshoes and plants. On the other hand, the meaning of the āyāt (verse) in which the word qalāid is mentioned is not limited to the Arabs. The same āyāt declare that qilādas are a development (qiyām) instrument for people. Therefore, the qilāda has a meaning potential beyond the 7th century and the inhabitants of this century. (shrink)

The mortality salience hypothesis postulates that anxiety elicited by mortality awareness leads people to develop negative emotions toward those who hold values inconsistent with their worldview faith. We explored this hypothesis in a sample of 76 Israeli combat soldiers, who were asked to reflect on either their mortality or dental pain. Subsequently, participants reported their motivation to help a father in need who was either an Arab or a Jewish Israeli, as well as their perceptions of threat by Arab Israelis. (...) Regression analysis indicated that mortality reminders intensified soldiers’ perception of threat by the outgroup, leading to an increased desire to assist a Jewish-Israeli father, and a decreased motivation to help an Arab-Israeli one. The findings demonstrate the pronounced effects of MS on soldiers involved in frequent combat actions in terms of evoking negative emotions leading to reluctance to help unarmed civilian outgroup members. Recommendations for soldiers’ pre-deployment psychoeducation sessions are provided. (shrink)

This article examines soldier performance optimisation, enhancement, and augmentation across the three dimensions of physical performance, cognitive performance, and socio-cultural understanding. Optimisation refers to combatants attaining their maximum biological potential. Enhancement refers to combatants achieving a level of performance beyond their biological potential through drugs, surgical procedures, or even gene editing. Augmentation refers to a blending of organic and biomechatronic body parts such as electronic or mechanical implants, prosthetics, and brain–machine interfaces. This article identifies that soldier optimisation is a necessity (...) to protect individual combatants and to give them the ability to make legal and morally justifiable decisions in battle. While enhancement and augmentation of military personnel can lead to accelerated and more destructive warfare, it can also be argued that there is an ethical and moral responsibility to provide combatants the best opportunity for survivability, and that better functioning, less fatigued, and better informed military personnel can make better decisions in battle. There is also a moral responsibility of the state for the combatants themselves, and short-term military success must be balanced against the short- and long-term health and wellbeing of the personnel. This article concludes that it is both the intent and the degree that decide the acceptability. (shrink)

This article highlights and evaluates the role of CEPI and its contribution to global equitable access to COVID-19 vaccines through its established partnerships for vaccine development. The article adds to the understanding of how and when such partnerships can work for public health, especially under emergency citations.

A correspondence allows application of Landau and Lifshitz’ formulation of Le Chatelier’s principle from statistical physics to a simple 2-D model of biological symbiosis. The insight: symbionts stabilize the occupation of narrow peaks on fitness landscape.

Stochastic dynamical reduction for the case of spin-z measurement of a spin-1/2 particle describes a random walk on the spin-z axis. The measurement’s result depends on which of the two points: spin-z=±ħ/2 is reached first. Born’s rule is recovered as long as the expected step size in spin-z is independent of proximity to endpoints. Here, we address the questions raised by this description: (1) When is collapse triggered, and what triggers it? (2) Why is the expected step size in spin-z (...) (as opposed to polar angle) independent of proximity to endpoints? (3) Why does spin “lock” in the vertical directions? The difficulties associated with (1) are rooted, as is Bell’s theorem, in the time-asymmetric assumption that the present distribution over hidden variables is independent of future settings. We believe, a priori of any of the experiments of modern physics, that such a time-asymmetric assumption is dubious when probing the microscopic scale. As for (2) and (3), they are simultaneously resolved by abandoning the fundamental distinction drawn between spin and spatial angular momentum, and by appealing to very tiny (in both magnitude and spatial extent) but numerous patches of magnetic noise in the Stern-Gerlach’s field. (shrink)

Anthropogenic climate change is causing temperature rise in temperate zones resulting in climate conditions more similar to subtropical zones. As a result, rising temperatures increase the range of disease-carrying insects to new areas outside of subtropical zones, and increased precipitation causes flooding that is more hospitable for vector breeding. State governments, the federal government, and governmental agencies, like the Animal and Plant Health Inspection Service of USDA and the National Notifiable Disease Surveillance System of the U.S. Centers for Disease Control (...) and Prevention, lack a coordinated plan for vector-borne disease accompanying climate change. APHIS focuses its surveillance primarily on the effect of illness on agricultural production, while NNDSS focuses on the emergence of pathogens affecting human health. This article provides an analysis of the current framework of surveillance of, and response to, vector-borne infectious diseases, the impacts of climate change on the spread of vector-borne infectious diseases, and recommends changes to federal law to address these threats. (shrink)

We group encephalitic behaviors as shown in Table 1. It is striking that the majority of these behaviors, namely groups 1 and 2, help spread viral and bacterial infections underlying encephalitis, a situation similar to Ophiocordyceps unilateralis .Could some of the behaviors in Table 1 be of utility to the host as well? Note that the behavioral symptoms may not coincide with impaired intellect . Furthermore, these symptoms may be vestigial in the sense of having been of utility to the (...) host species at a time when the latter possessed lower intelligence to begin with. It is also important to note that encephalitis is often triggered by physical and emotional stress, so that utility of behaviors is better assessed for such conditions.Continuous and compulsive exploration of one’s environment is of course a recipe for learning and discovery. Drinking, eating, biting, chewi .. (shrink)

While research in HCI on dealing with cultural issues when designing ICTs tended to adopt fixed and taxonomic views, recent theoretical perspectives closer to the social sciences have called for attending to the contingent, fluid, and dynamic aspects of the notion of culture. In this article, we contribute to translating these perspectives into an approach for informing design. We focus on abandoning prior conceptions of culture to allow the discovery of cultural differences through inductive field research while engaging with the (...) target community. This allows a view on cultural difference that is generative for design: it is unique to each case, and it also remains close to the concerns of community members. We base our approach on Basile Zimmermann’s waves and forms framework, and we illustrate it through our engagement and design with VOCI, a local voluntary community of tech-savvy university students in Syria between 2011 and 2015. (shrink)

This article analyzes the relationship between the structure of federal Title IX investigations and the existing evidence addressing the emotional and mental health needs of sexual harassment and sexual assault victims. The article argues that federal requirements for investigating sexual harassment should be restructured so as to address the challenges stigma poses for the realization of Title IX's objectives.

Among the Turkish verse texts, the mawlid named Wasīlat al-najāt by Süleyman Çelebi has been one of the most widely read works in various geographies for centuries. The text of Mawlid, which has been produced in many manuscripts over time, has diversified, and various versions have emerged. Although there is no detailed information about its beginning and development, it is understood that Süleyman Çelebi’s mawlid had a musical performance form from an early period. In integrating Mawlid with music, various forms (...) of performance developed over time and stated that were composed in some narratives. In some Mawlid manuscripts, it is found that various maqām names are written next to the couplet or on the mar-gin of the pages. Nineteen manuscripts of the Mawlid registered with maqām information, which have essential clues in terms of the performance of the work, have been identified and analyzed in this study. After a brief introduction of the copies, the formal features of the Mawlid manuscripts with the maqām registered, their characteristics for use in performance, and the frequency of recording the maqām names were evaluated. In the nineteen Mawlid copies investigated, the preferred maqāms for each divi-sion/chapter were listed numerically. Thus, the preferred maqāms in the performance and the maqām diversity in the manuscripts were analyzed comparatively. The performance features reflected in the Mawlid manuscripts and the transfers regarding the composition of the Mawlid were discussed through the results. (shrink)

Teravih namazının dört rekâtlık bölümlerinin farklı makamlardan tilavetle kılınması ile aralarında uygun ilahi ve salavatların okunması şeklindeki cami musikisi uygulaması teravih tertibi adıyla anılmaktadır. Tarihi süreciyle ilgili detaylı bilgi bulunmasa da özellikle son yüzyılda Ramazan ayının her gecesi için seçilmiş ilahilerin yer aldığı birkaç derleme kaleme alınmıştır. Bu çalışmada Kasımpaşa Mevlevîhânesi dervişlerinden Edirneli Ömer Efendi tarafından 1889’da hazırlanan, bugün Milli Kütüphane Yazmalar Koleksiyonu’nda A-1258 numarada kayıtlı, Ramazân-ı Şerîfe Mahsûs Âyîn-i Şerîf Mecmûası değerlendirilecektir. Mecmuanın diğer tertiplerden farkı, repertuvarın ağırlıklı olarak Mevlevî (...) âyinlerinden seçilen pasajlardan oluşmasıdır. Yirmi altı gece için hazırlanan mecmuanın girişinde bir fihrist yer almaktadır. İlerleyen sayfalarda her gece için seçilen âyin pasajları ve az sayıdaki ilahinin güfteleri yazılmıştır. Çalışmada öncelikle mecmuanın yapısı, düzeni ve kullanımı analiz edilmiştir. Ardından pasajlarının hangi Mevlevî âyinlerine ait olduğu tespit edilerek mecmuanın repertuvarı ortaya konmuştur. Buradan hareketle ilgili mecmua ile sonraki teravihe mahsus ilahi derlemelerinin mukayesesi yapılarak teravih tertibinde ortaya çıkan çeşitlilik tartışılmıştır. (shrink)

Bu yazı organ nakli ile ilgili şu soruyu ele almaktadır: Doktorlar sağlıklı bir kişinin organlarını alarak organ nakline gereksinim duyan birden fazla kişinin yaşamını kurtarırlarsa ahlaksal açıdan yanlış bir şey yapmış olurlar mı? Her ne kadar sağlıklı bir insanın organlarını alarak onun ölümüne neden olmak kabul edilemez görünse de bunu yapmamanın daha çok sayıda kişinin ölümüne neden olacağı düşünülürse ortada araştırılmaya değer bir soru olduğu görülür.