What can we do—and what should we do—to fight against bias? This final chapter introduces empirically-tested interventions for combating implicit (and explicit) bias and promoting a fairer world, from small daily-life debiasing tricks to larger structural interventions. Along the way, this chapter raises a range of moral, political, and strategic questions about these interventions. This chapter further stresses the importance of admitting that we don’t have all the answers. We should be humble about how much we (...) still don’t know and dedicate efforts to gathering as much knowledge as possible. Even so, we know enough now to start making a difference, and this chapter ultimately aims to chip away at the gap between our abstract commitments to treat people fairly and our lived habits and experiences, which continue to be shaped by implicit and explicit prejudices and stereotypes about race, gender, and other social categories. (shrink)

Structural interventions to historic stone masonry buildings require that both structural and heritage values be considered simultaneously. The absence of one of these value systems in implementation can be regarded as an unethical professional action. The research objective of this article is to prepare a guideline for ensuring ethical structural interventions to small-scale stone historic masonry buildings in the conservation areas of Northern Cyprus. The methodology covers an analysis of internationally accepted conservation documents and national (...) laws related to the conservation of historic buildings, an analysis of building codes, especially Turkish building codes, which have been used in Northern Cyprus, and an analysis of the structural interventions introduced to a significant historic building in a semi-intact state in the walled city of Famagusta. This guideline covers issues related to whether buildings are intact or ruined, the presence of earthquake risk, the types of structural decisions in an architectural conservation project, and the values to consider during the decision making phase. (shrink)

Dysfunctionality in socialisation is undoubtedly the most crucial characteristic of autism. For a long time, social functioning and its improvement have been considered among the most important interventions in the literature. Individuals with autism are responsive to therapist-mediated and/or peer-mediated interventions that increase their social engagement. The present study examines the impact of outdoor integrated activities, such as music therapy, equine-assisted therapy, and art therapy, in autistic individuals (n=14). The analysis was carried out on the application of a (...) questionnaire assessing three social skill domains: Joint Attention (JA), Imitation (IMI), and Turn-Taking (T-T) mediated by the therapists and by peers. The development and acquisition of these social behaviours were examined in a structured outdoor context (ASO). Data were collected by two independent observers by White's Scale questionnaire. The results revealed that the proposed interventions facilitated and led to an increase in social-behavioural experience. (shrink)

The purpose of the study is to observe the impact of policy intervention on financial sustainability using the structural vector autoregression analysis. The population of the study is the manufacturing sector of Pakistan, which is an emerging economy. Data for 249 firms operating in the manufacturing sector are taken, collected from Datastream from 2005 to 2019, with total observations of 2,400. To conduct the analysis, R software is used for its better visualization. Results show that firm performance, corporate governance, (...) and sectoral policies have a positive and long-term impact on financial sustainability, whereas earning management and financialization not only have a negative impact, but this impact affects the operations of the corporate for a longer period. This study would be helpful for policymakers as it gives a framework for financial sustainability based on the policies and strategies developed by the sector. (shrink)

This symposium of the Journal of Bioethical Inquiry illustrates structural competency: how clinical practitioners can intervene on social and institutional determinants of health. It will require training clinicians to see and act on structural barriers to health, to adapt imaginative structural approaches from fields outside of medicine, and to collaborate with disciplines and institutions outside of medicine. Case studies of effective work on all of these levels are presented in this volume. The contributors exemplify structural competency (...) from many angles, from the implications of epigenetics for environmental intervention in personalized medicine to the ways clinicians can act on fundamental causes of disease, address abuses of power in clinical training, racially desegregate cities to reduce health disparities, address the systemic causes of torture by police, and implement harm-reduction programs for addiction in the face of punitive drug laws. Together, these contributors demonstrate the unique roles that clinicians can play in breaking systemic barriers to health and the benefit to the U.S. healthcare system of adopting innovations from outside of the United States and outside of clinical medicine. (shrink)

We investigate how people use causal knowledge to design interventions to affect the outcomes of causal systems. We propose that in addition to using content or mechanism knowledge to evaluate the effectiveness of interventions, people are also influenced by the abstract structural properties of a causal system. In particular, we investigated two factors that influence whether people tend to intervene proximally (on the immediate cause of an outcome of interest) or distally (on the root cause of a (...) chain leading to the outcome). We presented people with causal chains describing a variety of real-world and artificial causal systems and asked them where they would intervene to affect the outcome. In Experiment 1, participants who were asked to choose the best long-term intervention intervened more distally than participants asked to choose the best short-term intervention. In Experiment 2, participants presented with a branching structure in which there were two distinct causal pathways from the root cause to the outcome were more likely to intervene on the root cause than participants presented with only one of the pathways. Our findings demonstrate two ways in which people integrate content knowledge and knowledge of a system’s causal structure to design effective interventions. (shrink)

Mobile applications (apps) have gained significant popularity as a new intervention strategy responding to violence against women and girls. Despite their growing relevance, an assessment from the perspective of public health ethics is still lacking. Here, we base our discussion on the understanding of violence against women and girls as a multidimensional, global public health issue on structural, societal and individual levels and situate it within the theoretical framework of structural injustice, including epistemic injustice. Based on a systematic (...) app review we previously conducted, we evaluate the content and functions of apps through the lens of structural injustice. We argue that technological solutions such as apps may be a useful tool in the fight against violence against women and girls but have to be situated within the broader frame of public health that considers the structural dimensions of such violence. Ultimately, the concerns raised by structural injustice are—alongside key concerns of safety, data privacy, importance of human supportive contact, and so forth—crucial dimensions in the ethical assessment of such apps. However, research on the role and relevance of apps as strategies to address the structural and epistemic dimensions of violence remains scarce. This article aims to provide a foundation for further discussion in this area and could be applicable to other areas in public health policy and practice. (shrink)

Taking debates about the roles of structure and agency in health as a lens, this essay asks how Critical Realist and Feminist Intersectional approaches might inform health interventions research. Despite recognition of multiple determinants of health, health problems are often thought of as individual and interventions, in turn, target risky individual behaviours. Such approaches are rooted in a liberal model of personhood. This paper critiques enduring individualist assumptions linked to Western liberal underpinnings embedded in health interventions. It (...) posits the need to include a robust conception of the social world in which change depends on shifting power relations, and individual agency is shaped by power as well as individual will. We propose preliminary steps for undertaking critical realist intersectional interventions research. (shrink)

The application of the formal framework of causal Bayesian Networks to children’s causal learning provides the motivation to examine the link between judgments about the causal structure of a system, and the ability to make inferences about interventions on components of the system. Three experiments examined whether children are able to make correct inferences about interventions on different causal structures. The first two experiments examined whether children’s causal structure and intervention judgments were consistent with one another. In Experiment (...) 1, children aged between 4 and 8 years made causal structure judgments on a three-component causal system followed by counterfactual intervention judgments. In Experiment 2, children’s causal structure judgments were followed by intervention judgments phrased as future hypotheticals. In Experiment 3, we explicitly told children what the correct causal structure was and asked them to make intervention judgments. The results of the three experiments suggest that the representations that support causal structure judgments do not easily support simple judgments about interventions in children. We discuss our findings in light of strong interventionist claims that the two types of judgments should be closely linked. (shrink)

The most important distinction in value theory is the subjective-objective distinction which determines the epistemological status of value judgments about medical intervention. Ethical decisions in medical intervention presuppose one of three structures of justification — namely, an inductive approach, a deductive approach which can be either consequentialist or non-consequentialist, and a uniquely ethical approach. Inductivism and deductivism have been discussed extensively in the literature and are only briefly described here. The uniquely ethical approach which presupposes value objectivism is analyzed in (...) detail. This method involves a purely ethical inference which moves from facts to values directly with an emphasis on reason which involves a non-logical justification (as opposed to illogical). It involves the use of natural practical arguments which have an imperative conclusion but no imperative premise and exhibit a value-requiredness between two states of affairs. (shrink)

In order to enhance the “structural competency” of medicine—the capability of clinicians to address social and institutional determinants of their patients’ health—physicians need a theoretical lens to see how social conditions influence health and how they might address them. We consider one such theoretical lens, fundamental cause theory, and propose how it might contribute to a more structurally competent medical profession. We first describe fundamental cause theory and how it makes the social causes of disease and health visible. We (...) then outline the sorts of “fundamental interventions” that physicians might make in order to address the fundamental causes. (shrink)

Background Implicit biases are present in the general population and among professionals in various domains, where they can lead to discrimination. Many interventions are used to reduce implicit bias. However, uncertainties remain as to their effectiveness. -/- Methods We conducted a systematic review by searching ERIC, PUBMED and PSYCHINFO for peer-reviewed studies conducted on adults between May 2005 and April 2015, testing interventions designed to reduce implicit bias, with results measured using the Implicit Association Test (IAT) or sufficiently (...) similar methods. -/- Results 30 articles were identified as eligible. Some techniques, such as engaging with others’ perspective, appear unfruitful, at least in short term implicit bias reduction, while other techniques, such as exposure to counterstereotypical exemplars, are more promising. Robust data is lacking for many of these interventions. -/- Conclusions Caution is thus advised when it comes to programs aiming at reducing biases. This does not weaken the case for implementing widespread structural and institutional changes that are multiply justified. (shrink)

According to Woodward’s influential account of explanation, explanations have a counterfactual structure, and explanatory counterfactuals are analysed in terms of causal relations and interventions. In this paper, we provide a formal semantics of explanatory counterfactuals based on a Ramsey Test semantics of conditionals. Like Woodward’s account, our account is guided by causal considerations. Unlike Woodward’s account, it makes no reference to causal graphs and it also covers cases of explanation where interventions are impossible.

We clarify the status of the so-called causal minimality condition in the theory of causal Bayesian networks, which has received much attention in the recent literature on the epistemology of causation. In doing so, we argue that the condition is well motivated in the interventionist (or manipulability) account of causation, assuming the causal Markov condition which is essential to the semantics of causal Bayesian networks. Our argument has two parts. First, we show that the causal minimality condition, rather than an (...) add-on methodological assumption of simplicity, necessarily follows from the substantive interventionist theses, provided that the actual probability distribution is strictly positive. Second, we demonstrate that the causal minimality condition can fail when the actual probability distribution is not positive, as is the case in the presence of deterministic relationships. But we argue that the interventionist account still entails a pragmatic justification of the causal minimality condition. Our argument in the second part exemplifies a general perspective that we think commendable: when evaluating methods for inferring causal structures and their underlying assumptions, it is relevant to consider how the inferred causal structure will be subsequently used for counterfactual reasoning. (shrink)

In Zoopolis, Donaldson and Kymlicka argue that intervention in nature to aid animals is sometimes permissible, and in some cases obligatory, to save them from the harms they commonly face. But they claim these interventions must have some limits, since they could otherwise disrupt the structure of the communities wild animals form, which should be respected as sovereign ones. These claims are based on the widespread assumption that ecosystemic processes ensure that animals have good lives in nature. However, this (...) assumption is, unfortunately, totally unrealistic. Most animals are r-strategists who die in pain shortly after coming into existence, and those who make it to maturity commonly suffer terrible harms too. In addition, most animals do not form the political communities Zoopolis describes. The situation of animals in the wild can therefore be considered analogous to one of humanitarian catastrophe, or to that of irretrievably failed states. It matches closely what a Hobbesian state of nature would be like. This means that intervention in nature to aid nonhuman animals should not be limited as Donaldson and Kymlicka argue. (shrink)

This paper explores structuralism as a way to model theories from scientific practice. As a case study I analyzed a theory about the dynamics of the basal ganglia, a part of the brain that is involved in Parkinson's disease. After introducing the case study I explore how to structurally represent qualitative assumptions about disease, intervention and dynamical systems in general. I further explicate the structure of the basal ganglia theory in detail, how it explains Parkinson's disease and how it implies (...) treatments. I close with a consideration of how a structuralist representation could be useful in practice to explore and develop theories with the aid of a computer. (shrink)

Real causal systems are complicated. Despite this, causal learning research has traditionally emphasized how causal relations can be induced on the basis of idealized events, i.e. those that have been mapped to binary variables and abstracted from time. For example, participants may be asked to assess the efficacy of a headache-relief pill on the basis of multiple patients who take the pill (or not) and find their headache relieved (or not). In contrast, the current study examines learning via interactions with (...) continuous dynamic systems, systems that include continuous variables that interact over time (and that can be continuously observed in real time by the learner). To explore such systems, we develop a new framework that represents a causal system as a network of stationary Gauss--Markov (``\OU'') processes and show how such \textit{OU networks} can express complex dynamic phenomena such as feedback loops and oscillations. To assess adult's abilities to learn such systems, we conducted an experiment in which participants were asked to identify the causal relationships of a number of OU networks, potentially carrying out multiple, temporally-extended interventions. We compared their judgments to a normative model for learning OU networks as well as a range of alternative and heuristic learning models from the literature. We found that, although participants exhibited substantial learning of such systems, they committed certain systematic errors. These successes and failures were best accounted for by a model that describes people as focusing on pairs of variables, rather than evaluating the evidence with respect to the full space of possible structural models. We argue that our approach provides both a principled framework for exploring the space of dynamic learning environments as well as new algorithmic insights into how people interact successfully with a continuous causal world. (shrink)

While structural equations modeling is increasingly used in philosophical theorizing about causation, it remains unclear what it takes for a particular structural equations model to be correct. To the extent that this issue has been addressed, the consensus appears to be that it takes a certain family of causal counterfactuals being true. I argue that this account faces difficulties in securing the independent manipulability of the structural determination relations represented in a correct structural equations model. I (...) then offer an alternate understanding of structural determination, and I demonstrate that this theory guarantees that structural determination relations are independently manipulable. The account provides a straightforward way of understanding hypothetical interventions, as well as a criterion for distinguishing hypothetical changes in the values of variables which constitute interventions from those which do not. It additionally affords a semantics for causal counterfactual conditionals which is able to yield a clean solution to a problem case for the standard ‘closest possible world’ semantics. (shrink)

Causal models show promise as a foundation for the semantics of counterfactual sentences. However, current approaches face limitations compared to the alternative similarity theory: they only apply to a limited subset of counterfactuals and the connection to counterfactual logic is not straightforward. This article addresses these difficulties using exogenous interventions, where causal interventions change the values of exogenous variables rather than structural equations. This model accommodates judgments about backtracking counterfactuals, extends to logically complex counterfactuals, and validates familiar (...) principles of counterfactual logic. This combines the interventionist intuitions of the causal approach with the logical advantages of the similarity approach. (shrink)

Evaluating clinical ethics support services has been hailed as important research task. At the same time, there is considerable debate about how to evaluate CESS appropriately. The criticism, which has been aired, refers to normative as well as empirical aspects of evaluating CESS. In this paper, we argue that a first necessary step for progress is to better understand the intervention in CESS. Tools of complex intervention research methodology may provide relevant means in this respect. In a first step, we (...) introduce principles of “complex intervention research” and show how CESS fulfil the criteria of “complex interventions”. In a second step, we develop a generic “conceptual framework” for “ethics consultation on request” as standard for many forms of ethics consultation in clinical ethics practice. We apply this conceptual framework to the model of “bioethics mediation” to make explicit the specific structural and procedural elements of this form of ethics consultation on request. In a final step we conduct a comparative analysis of two different types of CESS, which have been subject to evaluation research: “proactive ethics consultation” and “moral case deliberation” and discuss implications for evaluating both types of CESS. To make explicit different premises of implemented CESS interventions by means of conceptual frameworks can inform the search for sound empirical evaluation of CESS. In addition, such work provides a starting point for further reflection about what it means to offer “good” CESS. (shrink)

AbstractWe propose an emerging conceptualization of “intervention hesitancy” to address a broad spectrum of hesitancy to disease prevention interventions among healthcare personnel (HCP) beyond vaccine hesitancy. To demonstrate this concept and its analytical benefits, we used a qualitative case-study methodology, identifying a “spectrum” of disease prevention interventions based on (1) the intervention’s effectiveness, (2) how the intervention is regulated among HCP in the Israeli healthcare system, and (3) uptake among HCP in the Israeli healthcare system. Our cases ultimately (...) contribute to a more nuanced conceptualization of hesitancy that HCP express towards disease prevention interventions. Our case interventions included the seasonal influenza vaccine, the Mantoux test, and the hepatitis B (HBV) vaccine. Influenza and HBV are vaccine-preventable diseases, though their respective vaccines vary significantly in effectiveness and uptake among HCP. The Mantoux test is a tuberculin skin test which provides a prevention benchmark for tuberculosis (TB), a non-vaccine preventable disease. We conducted semi-structured interviews with relevant stakeholders and analyzed them within Israeli and international policy context between 2016 and 2019, a period just prior to the COVID-19 pandemic. We propose the conceptualization of “intervention hesitancy”—beyond “vaccine hesitancy”—as “hesitancy towards a wide range of public health interventions, including but not limited to vaccines”. Results suggested that intervention hesitancy among HCP is rooted in weak trust in their employer, poor employment conditions, as well as mixed institutional guidelines and culture. Conceptualizing intervention hesitancy expands the ability of healthcare systems to understand the root of hesitancy and foster a supportive institutional culture and trust, cognizant of diverse disease prevention interventions beyond vaccination. (shrink)

Definition of the problem Refugees show a high prevalence of mental health burden. Catering to the need for mental health services is made difficult by access barriers. These barriers consist of structural factors as well as culturally different attitudes towards mental health, mental illness, and therapeutic interventions. One option to overcome these access barriers and to provide mental healthcare services in an appropriate manner is seen in digital interventions. In the form of interactive websites or smartphone apps, (...) these interventions have proven to be effective in mental healthcare. There are also promising examples of successful use of these technologies with refugees. However, the ethical aspects of digital interventions for refugees have scarcely been studied yet. Arguments Aim of this paper is to tackle this research desiderate. The instrument of the ethical analysis to be conducted is the concept of agency. According to the concept of agency, persons have to be seen as actors capable of acting based on their own resources and competencies. Agency is the guiding principle here for analyzing the opportunities and risks of digital interventions for refugees. In addition, I will attempt to point out prospects for an agency-based application of digital interventions. Conclusion The ethical analysis could be used as the blueprint for developing therapeutic concepts that contribute to the improvement of mental healthcare services for refugees from an ethical perspective. (shrink)

This paper draws on the example of the Northern Territory Intervention to examine the role of Australia's broader socio‐cultural context in maintaining racist policies concerning Indigenous self‐governance. Central to this paper is the claim that legislative, constitutional, and other structural reforms are limited on their own to prevent institutional practices of violence and exclusion that are bound up with popular ways of imagining Indigenous and non‐Indigenous identities. In light of the potential limitations of top‐down reforms to prevent the perpetuation (...) of discriminatory policymaking in relation to Australia's First Peoples, this paper explores the value of bottom‐up initiatives that constructively engage the imaginative, affective, and reflective capacities of individuals to facilitate a ‘critical re‐imagining’ (The Epistemology of Resistance: Gender and Racial Oppression, Epistemic Injustice, and Resistant Imaginations, Oxford University Press, 2013) of Indigenous Australians as social and political actors. Developing and supporting such initiatives, on this view, is integral to the wider task of promoting and protecting Indigenous rights, interests, and entitlements. (shrink)

The widely cited Nuffield Council on Bioethics ‘Intervention Ladder’ structurally embodies the assumption that personal autonomy is maximized by non-intervention. Consequently, the Intervention Ladder encourages an extreme ‘negative liberty’ view of autonomy. Yet there are several alternative accounts of autonomy that are both arguably superior as accounts of autonomy and better suited to the issues facing public health ethics. We propose to replace the one-sided ladder, which has any intervention coming at a cost to autonomy, with a two-sided ‘Balanced Intervention (...) Ladder,’ where intervention can either enhance or diminish autonomy. We show that not only the alternative, richer accounts of autonomy but even Mill’s classic version of negative liberty puts some interventions on the positive side of the ladder. (shrink)

This volume discusses and expands the current state of research on military interventions. In this regard, it discusses questions concerning the legitimacy of interventions, their implementation and the actors involved. The volume is structured into three interdisciplinary parts, each with a focus on a specific topic. Part I deals with the question of under which circumstances intervention is legitimate and, if so, how it should be conducted. Part II focuses on the question of whether and, if so, why (...) the high thresholds currently applied to interventions should be considered legitimate. Finally, Part III elaborates on the question of who should intervene and which parts of society should be involved in post-conflict reconstruction. (shrink)

In this paper, I explore the possibility of understanding locality restrictions on the distribution of Negative Polarity Items (NPIs) as a consequence of covert movement. The present proposal restates Linebarger’s Immediate Scope Constraint in terms of morphology-driven checking requirements. These requirements cannot be met if a blocking element intervenes between the NPI feature and its morphosemantic licenser at Logical Form (LF). The empirical generalization is that the class of NPI ‘blocking expressions’ (a.k.a. ‘interveners’) overlaps to a large extent with interveners (...) identified in wh-questions. Therefore, the same grammatical checking mechanisms operating in that domain, rather than the presence of an implicature, are here shown to be responsible both for apparent violations to Linebarger’s constraint (contra Linebarger) and for intervention effects (contra Krifka, 1995, and Chierchia, 2004). This approach is argued to be superior on empirical grounds as it predicts facts that are left unaccounted for in a theory like Linebarger’s, where pragmatics rescues otherwise ill-formed structures. In addition, the proposal allows us to view the locality constraints operating in the domain of NPI-licensing as an instance of more general (though yet to be fully understood) principles of the grammar whose effects are attested in other domains, such as wh-questions in German, Discourselinked (D-linked) wh-questions in English, and Negative Concord (NC) configurations (e.g. in Italian and French). (shrink)

Non-reductive interventionist theories of causation and methodologies of causal reasoning embedded in that theoretical framework have become increasingly popular in recent years. This paper argues that one variant of an interventionist account of causation, viz. the one presented, for example, in Woodward (2003 ), is unsuited as a theoretical fundament of interventionist methodologies of causal reasoning, because it renders corresponding methodologies incapable of uncovering a causal structure in a finite number of steps. This finding runs counter to Woodward's own assessment (...) and to other recent studies which presume that Woodward's version of interventionism is effectively applicable to uncover causal structures, e.g. Campbell (2007 ) or Shapiro and Sober (2007 ). (shrink)

With the human genome mapped, and with the mapping of more than one hundred animal genomes in progress, the amount of genetic data available is increasing exponentially. This exponential increase in data is having an immediate impact on the process of drug development. By using techniques of information technology to manipulate data regarding the genes, proteins, and biochemical pathways associated with various diseases, scientists are beginning to be able to design drugs in a systematic fashion. In the context of any (...) given disease, scientists look to see whether a gene, a protein for which the gene codes, or another protein in the relevant biochemical pathway could be the “target” biological molecule, the “knocking out” of which would halt or slow the disease's progression. Once a target molecule has been identified and characterized structurally, drug therapies that would be likely to knock out this target can be identified and tested systematically. The merger of information technology and genetic technology has changed the process of pharmaceutical development so much that a new term—bioinformatics—has been coined to describe this new approach to such development. (shrink)

Non-reductive interventionist theories of causation and methodologies of causal reasoning embedded in that theoretical framework have become increasingly popular in recent years. This paper argues that one variant of an interventionist account of causation, viz. the one presented, for example, in Woodward (2003), is unsuited as a theoretical fundament of interventionist methodologies of causal reasoning, because it renders corresponding methodologies incapable of uncovering a causal structure in a finite number of steps. This finding runs counter to Woodward's own assessment and (...) to other recent studies which presume that Woodward's version of interventionism is effectively applicable to uncover causal structures, e.g. Campbell (2007) or Shapiro and Sober (2007). (shrink)

Scientific inquiry has led to immense explanatory and technological successes, partly as a result of the pervasiveness of scientific theories. Relativity theory, evolutionary theory, and plate tectonics were, and continue to be, wildly successful families of theories within physics, biology, and geology. Other powerful theory clusters inhabit comparatively recent disciplines such as cognitive science, climate science, molecular biology, microeconomics, and Geographic Information Science (GIS). Effective scientific theories magnify understanding, help supply legitimate explanations, and assist in formulating predictions. Moving from their (...) knowledge-producing representational functions to their interventional roles (Hacking 1983), theories are integral to building technologies used within consumer, industrial, and scientific milieus. -/- This entry explores the structure of scientific theories from the perspective of the Syntactic, Semantic, and Pragmatic Views. Each of these views answers questions such as the following in unique ways. What is the best characterization of the composition and function of scientific theory? How is theory linked with world? Which philosophical tools can and should be employed in describing and reconstructing scientific theory? Is an understanding of practice and application necessary for a comprehension of the core structure of a scientific theory? How are these three views ultimately related? (shrink)

In order to contribute to the consolidation in the field ofPositive Psychology, we reinvestigated the factor structure of top 10 positive emotions of Barbara Fredrickson. Former research in experimental settings resulted in a three-cluster solution, which we tested withexploratoryandconfirmatorymethodology against different factor models. Within our non-experimental data (N= 312), statistical evidence is presented, advocating for a single factor model of the 10 positive emotions. Different possible reasons for the deviating results are discussed, as well as the theoretical significance to various (...) subfields inPositive Psychology(e.g., therapeutical interventions). Furthermore, the special role ofawewithin the study and its implications for further research in the field are discussed. (shrink)

Background In neonatal intensive care, a child's death is often preceded by a medical decision. Nurses, social workers and pastors, however, are often excluded from ethical case deliberation. If multiprofessional ethical case deliberations do take place, participants may not always know how to perform to the fullest. Setting A level-IIID neonatal intensive care unit of a paediatric teaching hospital in the Netherlands. Methods Structured multiprofessional medical ethical decision-making (MEDM) was implemented to help overcome problems experienced. Important features were: all professionals (...) who are directly involved with the patient contribute to MEDM; a five-step procedure is used: exploration, agreement on the ethical dilemma/investigation of solutions, analysis of solutions, decision-making, planning actions; meetings are chaired by an impartial ethicist. A 15-item questionnaire to survey staff perceptions on this intervention just before and 8 months after implementation was developed. Results Before and after response rates were 91/105 (87%) and 85/113 (75%). Factor analysis on the questionnaire suggested a four-factor structure: participants' role; structure of MEDM; content of ethical deliberation; and documentation of decisions/conclusions. Effect sizes were 1.67 (p<0.001), 0.69 (p<0.001) and 0.40 (p<0.01) for the first three factors respectively, but only 0.07 (p=0.65) for the fourth factor. Nurses' perceptions of improvement did not significantly exceed those of physicians. Conclusion Professionals involved in ethical case deliberation perceived that the process of decision-making had improved; they were more positive about the structure of meetings, their own role and, to some extent, the content of ethical deliberation. Documentation of decisions/conclusions requires further improvement. (shrink)

Prompted by the debate over Michael Lebowitz's contributions on the relative absence of class struggle in Marx's Capital, this paper seeks to push analysis forward by closer examination of the notion of the value of labour-power. It does so by arguing that labour markets are structured, reproduced and transformed in complex and differentiated ways, whilst the moral and historical elements that make up the use-value interpretation of the value of labour-power also need to be addressed in a differentiated manner rather (...) than as a fixed bundle. (shrink)

Moral distress is a well-documented phenomenon for health care providers (HCPs). Exploring HCPs’ perceptions of participation in moral distress interventions using qualitative and quantitative methods enhances understanding of intervention effectiveness. The purpose of this study was to measure and describe the impact of a two-phased intervention on participants’ moral distress. Using a cross-over design, the project aimed to determine if the intervention would decrease moral distress, enhance moral agency, and improve perceptions about the work environment. We used quantitative instruments (...) and explored participants’ perceptions of the intervention using semi-structured interviews. Participants were from inpatient settings, within three major hospitals of a large, urban healthcare system in the Midwest, United States. Participants included nurses (80.6%) and other clinical care providers. Using generalized linear mixed modeling we assessed the change in each of the outcome variables over time controlling for groups. Interviews were audiotaped and professionally transcribed. The written narratives were coded into themes. The change in scores on study instruments trended in the desired direction however did not meet statistical significance. Qualitative interviews revealed that intervention effectiveness was derived from a combination of learning benefits, psychological benefits, and building community that promoted moral agency. Findings demonstrate a clear link between moral distress and moral agency and suggest that Facilitated Ethics Conversations can enhance the work environment. Findings provide insight for developing evidenced-based approaches to address moral distress of hospital nurses. (shrink)

Modern psychology does not address the great variety of elements constituting subjective experience or the relations among them. This essay examines ideas on the fine structure of awareness and suggests a more precisely characterized set of variables, useful to all psychologists interested in awareness, whether their focus is on computer simulation, neuroscience, or clinical intervention. This view builds on William James' insight into the qualitative differences among the parts of subjective experience, a concept nearly forgotten until recently reinterpreted in contemporary (...) cognitive terms by Mangan. I review, revise, and expand these ideas, and suggest their application to self-monitoring in several domains, including metacognition, action, and emotion. Sharpening and extending the distinctions James drew among key descriptive aspects of awareness gives us a more differentiated vocabulary for research and theory. (shrink)

Precision medicine is an emerging approach to individualized care. It aims to help physicians better comprehend and predict the needs of their patients while effectively adopting in a timely manner the most suitable treatment by promoting the sharing of health data and the implementation of learning healthcare systems. Alongside its promises, PM also entails the risk of exacerbating healthcare inequalities, in particular between ethnoracial groups. One often-neglected underlying reason why this might happen is the impact of structural racism on (...) PM initiatives. Raising awareness as to how structural racism can influence PM initiatives is paramount to avoid that PM ends up reproducing the pre-existing health inequalities between different ethnoracial groups and contributing to the loss of trust in healthcare by minority groups. We analyse three nodes of a process flow where structural racism can affect PM’s implementation. These are: the collection of biased health data during the initial encounter of minority groups with the healthcare system and researchers, the integration of biased health data for minority groups in PM initiatives and the influence of structural racism on the deliverables of PM initiatives for minority groups. We underscore that underappreciation of structural racism by stakeholders involved in the PM ecosystem can be at odds with the ambition of ensuring social and racial justice. Potential specific actions related to the analysed nodes are then formulated to help ensure that PM truly adheres to the goal of leaving no one behind, as endorsed by member states of the United Nations for the 2030 Agenda for Sustainable Development. Structural racism has been entrenched in our societies for centuries and it would be naïve to believe that its impacts will not spill over in the era of PM. PM initiatives need to pay special attention to the discriminatory and harmful impacts that structural racism could have on minority groups involved in their respective projects. It is only by acknowledging and discussing the existence of implicit racial biases and trust issues in healthcare and research domains that proper interventions to remedy them can be implemented. (shrink)

Listening appears as elusive as it is crucial to democratic life, particularly in conditions of structural injustice. Dominant groups benefit from histories and habits of inattention and, when enlisted, common responses of denial, defensiveness, and resentment. What lies behind this pervasive and persistent failure to listen to claims of structural injustice by more advantaged groups, and what does this mean for democratic engagement? This paper addresses this question via three interventions: first, it develops a novel account of (...) listening that reveals why listening to claims of structural injustice often proves difficult. Second, it examines how inhabiting positions of relative advantage shapes whether and how people listen to such claims. Finally, it explores the implications these challenges have for the design of democratic processes that seek to engage advantaged groups regarding structural injustice. To develop this account, I draw together current scholarship regarding listening and structural injustice with original fieldwork of recent and current efforts to engage more advantaged communities regarding a specific form of structural injustice: specifically, interviews and observation of the ten organizations across Aotearoa New Zealand most active in efforts to engage communities regarding socio-economic inequality in the country. (shrink)

The conditional intervention principle is a formal principle that relates patterns of interventions and outcomes to causal structure. It is a central assumption of the causal Bayes net formalism. Four experiments suggest that preschoolers can use the conditional intervention principle both to learn complex causal structure from patterns of evidence and to predict patterns of evidence from knowledge of causal structure. Other theories of causal learning do not account for these results.

Judging an act’s causal efficacy plays a crucial role in causal decision theory. A recent development appeals to the causal modeling framework with an emphasis on the analysis of intervention based on the causal Bayes net for clarifying what causally depends on our acts. However, few writers have focused on exploring the usefulness of extending structural causal models to decision problems that are not ideal for intervention analysis. The thesis concludes that structural models provide a more general framework (...) for rational decision makers. (shrink)

This article argues that political injustices can arise from the distribution and character of our sexual desires and that we can be held responsible for correcting these injustices. It draws on a conception of structural injustice to diagnose unjust patterns of sexual attraction, which are taken to arise when socio-structural processes shaping the formation of sexual desire compound systemic domination and capacity-deprivation for the occupants of a social position. Individualistic and structural solutions to the problem of unjust (...) patterns of sexual attraction are assessed in the context of racialised sexual aversion, racial fetishism, and the desexualisation of people with disabilities. While both forms of intervention can help in principle, some of the advantages of structural approaches are laid out. A schema for assigning political responsibilities for addressing this injustice is proposed, with some limits identified to the kinds of state and social responses that are justified. Finally, the status of the merely aesthetically unappealing is considered, with a relational egalitarian approach concluding that they are subject to structurally unjust patterns of sexual desire only when exposed to oppression or second-class citizenship as a result. (shrink)

Qualitative data of a 'failing' junior school are used to highlight the ways in which a particular Local Education Authority (LEA) responded to 'serious weaknesses' outlined by a team of Office for Standards in Education inspectors and how staff mediated such LEA intervention. Such mediation will be theorised via the employment of analytical dualism, whereby structure and agency are held to be irreducible emergent strata of social reality. The purpose of this paper is not to complement and buttress the ideological (...) nature of school effectiveness research, but to provide a micro insight into current mediation of macro-level policy. (shrink)