IntroductionThe objectives of this study are to assess and compare differences in the intensity, frequency, and overall severity of moral distress among a diverse group of healthcare professionals.MethodsParticipants from within Baylor Health Care System completed an online seven-point Likert scale (range, 0 to 6) moral distress survey containing nine core clinical scenarios and additional scenarios specific to each participant’s discipline. Higher scores reflected greater intensity and/or frequency of moral distress.ResultsMore than 2,700 healthcare professionals responded to the survey (response rate 18.14 (...) percent); survey respondents represented multiple healthcare disciplines across a variety of settings in a single healthcare system. Intensity of moral distress was high in all disciplines, although the causes of highest intensity varied by discipline. Mean moral distress intensity for the nine core scenarios was higher among physicians than nurses, but the mean moral distress frequency was higher among nurses. Taking into account both intensity and frequency, the difference in mean moral distress score was statistically significant among the various disciplines. Using post hoc analysis, differences were greatest between nurses and therapists.ConclusionsMoral distress has previously been described as a phenomenon predominantly among nursing professionals. This first-of-its-kind multidisciplinary study of moral distress suggests the phenomenon is significant across multiple professional healthcare disciplines. Healthcare professionals should be sensitive to situations that create moral distress for colleagues from other disciplines. Policy makers and administrators should explore options to lessen moral distress and professional burnout that frequently accompanies it. (shrink)

Written memoranda of conversations, or memcons, provide a near‐contemporaneous record of what was said in conversation, and offer important insights into the activities of high‐profile individuals. We assess the impact of writing a memcon on memory for conversation. Pairs of participants engaged in conversation and were asked to recall the contents of that conversation 1 week later. One participant in each pair memorialized the content of the interaction in a memcon shortly after the conversation. Participants who generated memcons recalled more (...) details of the conversations than participants who did not, but the content of recall was equally and largely accurate for both participants. Remarkably, only 4.7% of the details of the conversation were recalled by both of the partners after a week delay. Contemporaneous note‐taking appears to enhance memory for conversation by increasing the amount of information remembered but not the accuracy of that information. These findings have implications for evaluating the testimony of participants on conversations with major political or legal ramifications. (shrink)

Das Buch geht von dem heute angenommenen Stand der Wissenschaft aus: die Peripatetiker brachten eine Terminuslogik zustande, während die stoische Logik eine Aussagenlogik war. Sie standen feindlich einandern gegenüber.Der Verfasser, mit Hilfe eines Textes Avicennas, wo er die Lehre der hypothetischen Syllogismen behandelt, versucht zu beweisen, dass auch die Peripatetiker eine, von der Terminuslogik nicht in jedem Hinblick losgelöste Aussagenlogik hatten, und diese peripatetische Aussenlogik wurde under dem Namen hypothetische Syllogismen" in den griechischen Quellen erwähnt. Die zerstreuten Bermerkungen der Griechen (...) über die hypothetischen Syllogismen lassen sich im Lichte des Textes Avicennas in einem neuen Sinn deuten.Die klassischen/griechischen und lateinischen/ Quellen, wenn wir sie richtig deuten, und wenn wir die versammelten Bruchstücke der Lehre richtig zusammenstellen, zeigten uns das ganze, von dem stoischen abweichende System der peripatetischen Aussagenlogik.Man kann aber nicht nur die ganze Theorie rekonstruieren, sondern auch die Geschichte der peripatetischen Aussagenlogik, von Theophrast bis zu unserem Jahrhundert.". (shrink)

Context: Philosophical debates in recent decades have developed new ways of dealing with old philosophical problems such as reality, truth, knowledge, language, communication, and action. These new approaches deserve serious consideration because they can improve the discourse of radical constructivism. Problem: This paper discusses the following problem: How can we overcome dualistic and ontological approaches to basic philosophical problems – problems that are relevant to all scientific domains? Method: The method applied here can be roughly described as a transition from (...) entities/substantives/identities to actions and processes, the actions and processes from which so-called entities result. Action-orientation – or an actor-based process – is necessarily combined with sense-orientation as provided by culture and society. Results: The paper demonstrates how the problems mentioned above can be reformulated in a non-dualistic and non-ontological way. Implications: Opening up constructivist thinking to insights provided by neighbouring philosophical approaches facilitates interdisciplinary cooperation and helps overcome dualistic remnants – as well as the cognitive one-sidedness of traditional constructivism. (shrink)

Problem: Mitterer's critique of the central argumentations of radical constructivists has been mostly neglected until today. The paper presents and evaluates his criticism and, in the second part, outlines a format of constructivism that tries to draw appropriate consequences. Solution: In his critique Mitterer explains why the radical constructivism represented above all by Maturana, Varela, von Glasersfeld or Roth still remains in a dualistic format. In his view Neurobiology is used in their writings as the indisputable basis for deriving far-reaching (...) epistemological consequences. Therefore constructivism evades self-application. To overcome this serious critique a different approach to constructivist thinking is sketched that operates without using any biological or psychological theories, tries to avoid dualism, and elaborates Mitterer's basic argument that the description of an object and the object under description are the same. Benefits: The paper shows what constructivism can learn from a serious critique and how it can be rewritten in a non-dualistic way. (shrink)

This chapter defends a legal human right to tobacco control. Building on existing work, the chapter argues that the legal case for such a right is strong. Existing international human rights treaties, chiefly the International Covenant on Economic, Social and Cultural Rights, recognize a human right to health alongside several other rights that speak for covering tobacco control under human rights law. Drawing on Allen Buchanan’s pluralistic justificatory framework for human rights, the chapter argues that the philosophical case is strong (...) too. Tobacco is among the deadliest public health threats worldwide and its health impacts so severe that humans should have a claim against their governments to protect them against the harms of tobacco. Human rights law is a promising avenue to strengthen this claim. The chapter then defends a human right to tobacco control against several philosophical worries. For example, is strong tobacco control compatible with personal freedom? Is it compatible with personal consent? Would human rights legislation facilitate power relations that unduly restrict national and individual self-determination? This chapter argues that concerns with freedom of choice, consent and power relations do not speak against tobacco control. Conversely, a concern with power relations speaks for a human right to tobacco control as it could lessen the power asymmetries between tobacco companies and vulnerable populations, such as children, smokers of lower socio-economic status and citizens in low-income countries with weaker governance structures. (shrink)

Differences in empathic abilities between acting, dance, and psychology students were explored, in addition to the appropriateness of existing empathy measures in the context of these cohorts. Students (N= 176) across Higher Education Institutions in the United Kingdom and Europe were included in the online survey analysis, consisting of the Reading the Mind in the Eyes (RME) test, the Interpersonal Reactivity Index (IRI), the Empathy Quotient (EQ), and the E-drawing test (EDT), each measuring particular facets of empathy. Based on existing (...) evidence and our understanding of the discipline practices, we predicted that acting students would perform the best at identifying people’s emotional expressions but might lack other cognitive or affective empathy skills, particularly those related to emotional reactions. This cohort thus provides an opportunity to evaluate different empathy measures. While actors showed significantly higher RME scores than dancers, the difference between actors and psychologists was marginal. Moreover, actors’ scores did not differ significantly on other empathy measures, such as their concern for others’ emotional wellbeing or fantasy, both measured by IRI subscales. Psychology students scored highest in the IRI perspective taking subscale and the data supported anecdotal evidence that psychologists were more concerned for others’ emotional wellbeing than dancers or actors. Dancers seemed the least concerned with others’ perspectives and emotional states, which we explained through a somatosensory ‘inward’ focus required by their art form. Nevertheless, compared to the general population, our groups reported higher empathic abilities on all IRI subscales except for personal distress. Altogether, our study shows that the RME, the IRI, and the EDT vary in their susceptibility to different facets of empathic abilities in acting, dance, and psychology students whereas the EQ does not. Emotions can be expressed and perceived through language, facial expressions, or behavior. As many empathy tests focus on one type of signal they might miss other strategies. Where empathy tests are applied to individuals that have a predominance to read or respond to others in a particular way, as we showed through these three disciplines, they might not capture these empathic strategies. We thus propose that empathy tests must evolve by means of integrating varied forms of communication. (shrink)

Purpose: The paper provides an overview of Ernst von Glasersfeld's life and theory, concentrating on subjects such as the acquisition of knowledge, language and communication, ethical questions, and aspects of teaching and learning. Conclusion: Ernst von Glasersfeld interests cover a wide range of disciplines. Therefore his work is genuinely rooted in interdisciplinarity.

Open peer commentary on the target article “Who Conceives of Society?” by Ernst von Glasersfeld. Excerpt: Since I agree with von Glasersfeld’s proposal I will not criticise it in my commentary; instead I shall try to augment this proposal starting with an argument von Glasersfeld borrows from Georg Simmel, viz. the importance of reciprocal effect in the course of socialisation.

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)

Problem: An answer to the question of whether or not Radical Constructivism RC can or will become a mainstream endeavour is difficult, because what is called RC is a bundle of quite divergent approaches and not a homogenous (super) theory. Therefore the article concentrates upon “classical” RC as developed first of all by von Glasersfeld, von Foerster and Maturana and Varela. The pros and cons of their approaches are discussed and evaluated. Solution: In order to overcome the most obvious problems (...) of RC, a strict process-oriented kind of argumentation is developed that replaces is/is not assertions with descriptions of processes and their results, thus answering the question of what might reasonably be called “construction.” Benefit: The paper presents a way of rewriting RC, i.e., avoiding its evident problems, without abandoning the insights that RC thinkers have gained in the past. (shrink)

This book traces the development of the notion of self throughout the Western intellectual and religious tradition. While using the historical thread as its guiding norm, it presents a dynamic model of selfhood.