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)

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)

Purpose: To explain physical activity behavior, social-cognitive theories were most commonly used in the past. Besides conscious processes, the approach of dual processes additionally incorporates non-conscious regulatory processes into physical activity behavior theories. Habits are one of various non-conscious variables that can influence behavior and thus play an important role in terms of behavior change. The aim of this review was to examine the relationship between habit strength and physical activity behavior in longitudinal studies.Methods: According to the PRISMA guidelines, a (...) systematic search was conducted in three databases. Only peer-reviewed articles using a longitudinal study design were included. Both, habit and physical activity were measured at least once, and habit was related to physical activity behavior. Study quality was evaluated by assessment tools of the NHLBI.Results: Of 3.382 identified publications between 2016 and 2019, fifteen studies with different study designs were included. Most studies supported that positive correlations between habit and physical activity exist. Some positive direct and indirect effects of habit on physical activity were detected and only a minority of studies showed the influence of physical activity on habit strength. Studies differentiating between instigation and execution habit found positive correlations and revealed instigation habit as a stronger predictor of physical activity. The quality of studies was rated as reasonable using assessment tools of the NHLBI.Conclusion: This review revealed a bidirectional relationship between habit and physical activity. Whether habit predicts physical activity or vice versa is still unclear. The observation of habit influencing physical activity may be most appropriate in studies fostering physical activity maintenance while the influence of physical activity on habit may be reasonable in experimental studies with physical activity as intervention content to form a habit. Future investigations should differentiate between habit formation and physical activity maintenance studies depending on the research objective. Long-term study designs addressing the complexity of habitual behavior would be beneficial for establishing cue-behavior associations for the formation of habits. Furthermore, studies should differentiate between instigation and execution habit in order to investigate the influence of both variables on physical activity behavior independently. (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)

Rooftop gardens, rooftop greenhouses and indoor farms have been established or planned by activists and private companies in Berlin. These projects promise to produce a range of goods that could have positive impacts on the urban setting but also carry a number of risks and uncertainties. In this early innovation phase, the relevant stakeholders’ perceptions and social acceptance of ZFarming represent important preconditions for success or failure of the further diffusion of this practice. We used the framework of acceptance to (...) investigate the stakeholders’ attitudes and to identify the key factors that might hinder or promote the introduction of ZFarming. The results are based on an analysis of 38 qualitative interviews conducted with key stakeholders in Berlin. As the results show, major perceived benefits of ZFarming include improved consumer awareness, education, and the creation of experimental spaces. Stakeholders further perceive opportunities for resource savings, new business models, repurposing of abandoned buildings and improved aesthetics. Major perceived risks are associated with growing techniques that are considered “unnatural”, health risks, conflicts with images of traditional agriculture, the rejection of animal production in urban areas, the risk of projects being too expensive and too complex or being implemented too early, i.e. before the mechanisms are fully understood. The analysis further reveals which contextual factors—political, legal, market-related, spatial or societal—might negatively or positively influence ZFarming acceptance. (shrink)

The aim of the article is to introduce a new concept of “pain-related bodily doubt,” which complements current concepts currently in use, such as pain-related fear, pain catastrophizing, and pain self-efficacy. This new concept, adapted from recent philosophical work on illness experience, has the potential to positively contribute to pain research and clinical practice by providing a vocabulary for clinicians and patients to discuss implicit or tacit dimensions of pain-related experiences.

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)

This edited volume traces cultural appearances of disgust and investigates the varied forms and functions disgust takes and is given in both established and vernacular cultural practises. Contributors focus on the socio-cultural creation, consumption, reception and experiencing of disgust, a visceral emotion whose cultural situatedness and circulation has historically been overlooked in academic scholarship. Chapters challenge and supplement the biological understanding of disgust as a danger reaction and as a base emotion evoked by the lower senses, touch, taste and smell, (...) through a wealth of original case studies in which disgust is analyzed in its aesthetic qualities, and in its cultural and artistic appearances and uses, featuring visual and aural media. Because it is interdisciplinary, the book will be of interest to scholars in a wide range of fields, including visual studies, philosophy, aesthetics, sociology, history, literature, and musicology. (shrink)

The phenomenon of perceptual persistence after the motion stops in shape-from-motion displays was used to study the influence of prior knowledge on the maintenance of a percept in awareness. In SFM displays an object composed of discontinuous line segments are embedded in a background of randomly oriented lines. The object only becomes perceptible when the line segments that compose the object and the lines that compose the background move in counterphase. Critically, once the movement of the line segments stops, the (...) percept of the object persists for a short period of time. In the present study, perceptual persistence for digits exceeded that reported for nonsense shapes composed of the same line segments. This result is taken as evidence that the processes involved in the persistence of SFM, and therefore sustained perception, are sensitive to top-down influences. (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)

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)

Cofactor squelching is the term used to describe competition between transcription factors (TFs) for a limited amount of cofactors in a cell with the functional consequence that TFs in a given cell interfere with the activity of each other. Since cofactor squelching was proposed based primarily on reporter assays some 30 years ago, it has remained controversial, and the idea that it could be a physiologically relevant mechanism for transcriptional repression has not received much support. However, recent genome‐wide studies have (...) demonstrated that signal‐dependent TFs are very often absent from the enhancers that are acutely repressed by those signals, which is consistent with an indirect mechanism of repression such as squelching. Here we review these recent studies in the light of the classical studies of cofactor squelching, and we discuss how TF cooperativity in so‐called hotspots and super‐enhancers may sensitize these to cofactor squelching. (shrink)

This study investigates the increased commercialization of African indigenous vegetables (AIV)—former subsistence crops such as African nightshade, cowpea leaves and amaranth species grown mainly by women—from a feminist economics perspective. The study aims to answer the following research question: How does AIV commercialization affect the gendered division of labor, women’s participation in agricultural labor, their decision-making power, and their access to resources? We analyze commercialization’s effects on gender relations in labor and decision-making power and also highlight women’s agency. Based on (...) a mixed method design and analyzing household-level panel data and qualitative focus groups from Kenya, we observe an economic empowerment of women that we relate to women’s individual and collective strategies as well as their retention of control over AIV selling and profits. Yet, while we see economic empowerment of women through commercialization—how they broaden their scope of action and are empowered by generating revenue—that does not contribute to a redistribution of labor or land rights, which are key for gender equality, instead it increases women’s labor burden. (shrink)

Number processing abilities are important for academic and personal development. The course of initial specialization of ventral occipito-temporal cortex sensitivity to visual number processing is crucial for the acquisition of numeric and arithmetic skills. We examined the visual N1, the electrophysiological correlate of vOTC activation across five time points in kindergarten, middle and end of first grade, second grade, and fifth grade. A combination of cross-sectional and longitudinal EEG data of a total of 62 children at varying familial risk for (...) dyslexia were available to form groups of 23, 22, 27, 27, and 42 participants for each of the five time points. The children performed a target detection task which included visual presentation of single digits, false fonts, and letters to derive measures for coarse and fine digit sensitive processing across development. The N1 amplitude analyses indicated coarse and fine sensitivity characterized by a stronger N1 to digits than false fonts across all five time points, and stronger N1 to digits than letters at all but the second time point. In addition, lower arithmetic skills were associated with stronger coarse N1 digit sensitivity over the left hemisphere in second grade, possibly reflecting allocation of more attentional resources or stronger reliance on the verbal system in children with poorer arithmetic skills. To summarize, our results show persistent visual N1 sensitivity to digits that is already present early on in pre-school and remains stable until fifth grade. This pattern of digit sensitivity development clearly differs from the relatively sharp rise and fall of the visual N1 sensitivity to words or letters between kindergarten and middle of elementary school and suggests unique developmental trajectories for visual processing of written characters that are relevant to numeracy and literacy. (shrink)

This comprehensive collection offers a unique look at nursing practice, theory, research and nursing history from various critical theoretical perspectives. It aims to initiate an international discussion among scholars from diverse countries, particularly Germany and Anglo-American countries, coming from distinctive schools of thought, e.g. German Critical theory and Post-structural approaches, and influenced by their respective histories of sciences. This book analyzes and criticizes nursing theory, nursing research and practice along several dimensions: Nursing Ethics, Subjectivity, Body and Flesh (Leib), Technology, Power, (...) History, and Education. (shrink)

If few authors have paid much attention to the feminine concerns in new reproductive technologies, actually it is mainly some feminist authors, who, to a great extent, have allowed these concerns to enter into public debate. On the other hand, the preoccupation about women's interests and points of view is a feature in common of all feminist approaches, independently of their other philosophical concepts. Nevertheless, another feature of feminist discourses is their plurality and heterogeneity. So, we have not find back (...) answers to the questions we have analysed in this paper, because there is not only one answer. This is not an inconvenience but an incentive to continue the democratic debate within the framework of plurality and tolerance. We must incorporate to this debate the, often forgotten, women's own interests, and a critical view of the underlying assumptions and biases. These two points of view are common to the majority of feminist approaches, and should be seriously considered as worthy to be incorporated to our discourses when debating the issues linked to the new reproductive technologies. (shrink)

Die Sprachlichkeit des Glaubens ist von Anfang an zentrales Thema protestantischer Theologie. Der Glaube, als Vertrauen auf das biblisch bezeugte und lebendig gepredigte Evangelium, lebt in der Sprache, weil er aus dem Horen kommt: Er vollzieht sich im Modus des Verstehens. Seit jeher sind daher theologische Hermeneutik und Homiletik Orte, an denen die Sprachlichkeit des Glaubens reflektiert wird. Diese Reflexion setzen die Beitrage des vorliegenden Bandes in je unterschiedlicher Facherperspektive fort.

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)

BackgroundRich in different kind of potent cells, embryos are used in modern regenerative medicine and research. Neurobiologists today are pushing the boundaries for what can be done with embryos existing in the transitory margins of medicine. Therefore, there is a growing need to develop conceptual frameworks for interpreting the transformative cultural, biological and technical processes involving these aborted, donated and marginal embryos. This article is a contribution to this development of frameworks.MethodsThis article examines different emotional, cognitive and discursive strategies used (...) by neurobiologists in a foetal cell transplantation trial in Parkinson’s disease research, using cells harvested from aborted embryos. Two interviews were analysed in the light of former observations in the processing laboratories, using the anthropologist Mary Douglas’s concept of pollution behaviour and the linguist, philosopher, psychoanalyst and feminist Julia Kristeva’s concept of the abjective to explain and make sense of the findings.ResultsThe findings indicate that the labour performed by the researchers in the trial work involves transforming the foetal material practically, as well as culturally, from trash to treasure. The transformation process contains different phases, and in the interview material we observed that the foetal material or cells were considered objects, subjects or rejected as abject by the researchers handling them, depending on what phase of process or practice they referred to or had experience of. As demonstrated in the analysis, it is the human origin of the cell that makes it abjective and activates pollution discourse, when the researchers talk of their practice.ConclusionsThe marginal and ambiguous status of the embryo that emerges in the accounts turns the scientists handling foetal cells into liminal characters in modern medicine. Focusing on how practical as well as emotional and cultural strategies and rationalizations of the researchers emerge in interview accounts, this study adds insights on the rationale of practically procuring, transforming and utilizing the foetal material to the already existing studies focused on the donations. We also discuss why the use and refinement of a tissue, around which there is practical consensus but cultural ambiguity, deserves further investigation. (shrink)

Many apps request access to users’ contacts or photos and many consumers agree to these requests. However, agreeing is ethically questionable as it also gives apps access to others’ data. People thus regularly infringe each other’s information privacy. This behavior is at odds with offline practices and still poorly understood. Introducing a novel application of the theory of neutralization, we explore how people justify the giving away of others’ data and the emerging norms surrounding this behavior. To obtain a deeper (...) understanding of the potentially ambiguous norms surrounding the behavior, we investigate how people justify, i.e., neutralize, the behavior from both offender and victim perspectives. Across four studies, offenders appear more likely to admit to moral wrongdoing than victims assume. This suggests moral disagreement between offenders and victims. The discrepancy appears to be reasonably robust across different samples, apps and whether the other is identified, but diminishes when people learn how easily others’ data could be protected. These insights offer suggestions for businesses, consumers and public policy. (shrink)

This book offers a new account of what it is to act for a normative reason. The first part of the book examines the problems of causal accounts of acting for reasons and suggests to solve them by a dispositional approach. The author argues for a dispositional account which unites epistemic, volitional, and executional dispositions in a complex normative competence. This ‘Normative Competence Account’ allows for more and less reflective ways of acting for normative reasons. The second part of the (...) book clarifies the relation between the normative reason that an agent acts for and his or her motivating reasons. It refutes the widely held ‘identity view’ that acting for a normative reason requires the normative reason to be identical with a motivating reason. The author describes how normative reasons are related to motivating reasons by a relation of correspondence, and proposes a new understanding of how normative reasons explain those actions that are performed for them. Determined by Reasons engages with current debates from a wide range of different philosophical areas, including action theory, metaethics, moral psychology, epistemology, and ontology, to develop a new account of acting for normative reasons. (shrink)

There is resistance to policies that would reduce overall consumption levels to promote sustainability. In part, this resistance is aided by the economic concept of consumer sovereignty (CS) and its presumption that choice promotes wellbeing. We investigate the concept of consumer sovereignty in the context of deepening concerns about sustainability and scrutinise whether the two concepts are compatible. We draw on new findings in psychology on human decision-making traits; we take into account increasing awareness about human dependencies on 'functioning' ecosystems (...) and uncertainties on how ecosystems, human activities and human wellbeing are interlinked. We conclude that commitment to the concept of consumer sovereignty is incompatible with sustainability due to human characteristics, the difficult-to-predict behaviour of ecological systems and ignorance about the impact of human action on natural systems. We propose that the choice-set of available goods and services on markets should be constrained when consumption patterns can be linked to degradation of services provided by nature when those services are seen as crucial for human wellbeing. We advocate constraining the available choice-set through established governmental institutions aided by deliberative processes that engage members of the general public. Finally, we acknowledge that such processes are imperfect; nevertheless, we foresee that they will be essential for fostering wise decision-making and moving towards sustainability. (shrink)