Several scholars have recently entertained proposals for "epistocracy," a political regime in which decision-making power is concentrated in the hands of a society's most informed and competent citizens. These proposals rest on the claim that we can expect better political outcomes if we exclude incompetent citizens from participating in political decisions because competent voters are more likely to vote "correctly" than incompetent voters. We develop what we call the objection from selection bias to epistocracy: a procedure that selects voters (...) on the basis of their observed competence---as epistocracy does---will often be "biased" in the sense that competent voters will be, on average, more likely than incompetent voters to possess certain attributes that reduce the probability of voting correctly. Our objection generalizes the "demographic objection" discussed in previous literature, showing that the range of realistic scenarios in which epistocracy is vulnerable to selection bias is substantially broader than previous discussions appreciate. Our discussion also shows that previous discussions have obscured the force of the threat of selection bias. Since we lack reasons to believe that epistocratic proposals can avoid selection bias, we have no reason to seriously entertain epistocracy as a practical proposal. (shrink)

The above-mentioned article was published online with an incorrect title. The correct title reads “Does the Demographic Objection to Epistocracy Succeed?”.

A popular informal argument suggests that statistics about the preponderance of criminal involvement among particular demographic groups partially justify others in making defensive mistakes against members of the group. One could worry that evidence-relative accounts of moral rights vindicate this argument. After constructing the strongest form of this objection, I offer several replies: most demographic statistics face an unmet challenge from reference class problems, even those that meet it fail to ground non-negligible conditional probabilities, even if they (...) did, they introduce new costs likely to cancel out any justificatory contribution of the statistic, but even if they didn’t, demographic facts are the wrong sort to make a moral difference to agents’ negative rights. I conclude that the popular argument should be rejected, and evidence-relative theories do not have the worrisome implication. (shrink)

Valuing the professional literature, the paper highlights in its first part, the main factors that influence the demographic behaviours, especially birth-rate, meaning the cultural, biological, economic, social and political factors. I have tried to focus on a possible supremacy of the religious and political factor in comparison to other factors which have an influence on demographic evolutions. In the second part we approached the religion and the projections regarding the youngsters’ demographic behaviour. Referring these results to statistical (...) data on this issue, that are to be found in the Statistical Annual of Bihor County, we tried to reveal the trends of the evolution of birth-rate and to make the difference between objective statistical data and subjective echoes of 18 year old high school students way of thinking, regarding the potential impact of religion – nowadays studied in the Romanian schools – on the demographic behaviour. (shrink)

Fundamento: Los adolescentes constituyen un grupo vulnerable y la maternidad en esta etapa, una problemática de actualidad. Objetivo: exponer particularidades sociodemográficas y de la maternidad en madres adolescentes del municipio de Cumanayagua, en el período septiembre a mayo del año 2014. Método: estudio descriptivo, corte transversal. Se trabajó con el universo conformado por 35 madres adolescentes y sus hijos. Se operó con un formulario de datos sociodemográficos, el análisis de documentos y la entrevista semiestructurada. Los resultados fueron procesados por el (...) paquete estadístico SPSS 15.0 para Windows y se utilizaron tablas de frecuencia y porcientos. Resultados: predominaron madres adolescentes de la etapa tardía con una media de edad 17,89; deserción escolar, más del 50% conviven con los padres con pareja o sin ella; embarazos deseados ; ocurrencia de nacimiento a términos, partos eutócicos, estados buenos de salud física y psicológica percibidos ; percepción de apoyo familiar. Conclusiones: las madres adolescentes de la etapa tardía que se caracterizaron por una maternidad percibida de manera satisfactoria contaron con apoyo familiar, vínculo de pareja, baja percepción de riesgos para su salud física y psicológica. Basis: Teenagers constitute a vulnerable group and motherhood during this period is a topical problem. Objective: Setting out socio-demographic and motherhood characteristics in teenage mothers from Cumanayagua municipality from September to May 2014. Method: Descriptive study, cross section. The population consisted of 35 teenage mothers and their children. A socio-demographic data form, document analysis as well as semi-structured interview were used. The results were processed by the SPSS statistical package for Windows and frequency and percentage tables were used. Results: Late stage teenage mothers with the average ages of 17, 18 and 19 prevailed; school dropouts ; more than 50 % of them live with their parents with or without a partner; planned pregnancies ; occurrence of full-term births ; ectopic childbirths ; good physical health states ; good psychological states ; family support perception. Conclusions: Those late stage teenage mothers who were characterized by motherhood perceived in a satisfactory way, counted on family support, romantic ties, low physical and psychological health risk perception. (shrink)

Current local and national demographic trends have deepened the existing and formed new global demographic processes that have received a new historical reasoning that requires deep scientific research taking into account the influence of the multifactorial global dimension of the modern society development. The purpose of the article is to study the development of global demographic processes and to define the causes of their occurrence, manifestations, implications and prospects for implementation in the first half of the 21st (...) century. The authors have identified and characterized four global demographic processes, namely population growth, migration, increase of tourism, and change in population structure. It is projected that in the 30’s of the 21st century, the number and growth rates of the world population will reach the objective growth and these dynamics over the next two decades will begin to change in the direction of reducing the growth rates, which will lead to gradual stabilization, and eventually reduce the size of the world population. By the middle of the 21st century, one can observe the preservation of the growth rates of international and domestic migration, the growth of international migration flows from the South to the North and from the East to the West, the strengthening of new economically developed centers of gravity (Canada, Australia and New Zealand), the increase in migration of rural population to cities, as well as urbanization and activation of the metropolises development. The share of international tourists in comparison with the world population will be constantly increasing, and the annual growth rate of the number of international tourists will significantly depend on the world economy and may vary at the several percent level. Permanent change will occur in the age, religious-cultural and socio-economic structure of the population. (shrink)

This study has two objectives – to provide a Korean form of the workaholism analysis questionnaire, and to analyze workaholic tendencies in South Korea by using a nationally representative data. Using 4,242 samples (2,497 men and 1,745 women), exploratory and confirmatory factor analyses were conducted to develop a Korean form (K-WAQ). The four-factor structure of K-WAQ in this study seemed to adequately represent the underlying dimensions of work addiction in Korea. The study also analyzed the prevalence of workaholism among Koreans (...) and its differences according to socio-demographic variables. Both mean difference analyses and logistic regressions were conducted. The overall result indicated that the prevalence of workaholism in Korea can be estimated to be 39.7% of the employees. The workaholic tendencies in Korea differ significantly according to gender, age, work hours, and voluntariness of choosing employment type. Practical as well as theoretical implications and future research directions are discussed. (shrink)

Freedom of Religion, Institution of Conscientious Objection and Political Practice in Post-Communist Slovakia1 The example of Slovakia is used to show how one of the post-socialist countries failed in fulfilling the demanding task of securing freedom of religious belief (including the right to conscientious objection) and, at the same time, securing all other human rights. An analysis of the methods used for changing the policies of pluralism and neutrality of the state into a policy of discrimination (e.g. concerning (...) the registration duty for churches) was carried out, followed by an analysis of a mechanism used for guaranteeing freedom of conscience of the members of the Catholic Church (the so-called Vatican Treaty). The treaty violates the prohibition of discrimination against women, because it makes it more difficult for them to have access to some health care services. Our hypothesis states that the hurriedly introduced right to conscientious objection is misused in this context as a means of regulating the politics of reproduction. In general, the re-Catholisation of the Slovak Republic follows two aims—to help in the fight for votes in the elections (because 70 % of Slovaks declare their religion to be Catholic), and to improve demographic development in the Slovak Republic (declared to be catastrophic by the Catholic Church), through hindering free access to abortions. (shrink)

Humans naturally perceive visual patterns in a global manner and are remarkably capable of extracting object shapes based on properties such as proximity, closure, symmetry, and good continuation. Notwithstanding the role of these properties in perceptual grouping, studies highlighted differences in disembedding performance across individuals, which are summarized by the field dependence dimension. Evidence suggests that age and educational attainment explain part of this variability, whereas the role of sex is still highly debated. Also, which stimulus features primarily influence inter-individual (...) variations in perceptual grouping has still to be fully determined. Building upon these premises, we assessed the role of age, education level, and sex on performance at the Leuven Embedded Figure Test—a proxy of disembedding abilities—in 391 cisgender individuals. We also investigated to what extent shape symmetry, closure, complexity, and continuation relate to task accuracy. Overall, target asymmetry, closure, and good continuation with the embedding context increase task difficulty. Simpler shapes are more difficult to detect than those with more lines, yet context complexity impairs the recognition of complex targets to a greater extent. Concerning demographic data, we confirm that age and educational attainment are significantly associated with disembedding abilities and reveal a perceptual advantage in males. In summary, our study further highlights the role of shape properties in disembedding performance and unveils sex differences not reported so far. (shrink)

Road traffic carnages are global concerns and seemingly on the rise in Ghana. Several risk factors have been studied as associated with road traffic fatalities. However, inadequate road traffic fatality data and inconsistent probability outcomes for RTF remain major challenges. The objective of this study was to illustrate and estimate probability models that can predict road traffic fatalities. We relied on 66,159 recorded casualties who were involved in road traffic accidents in Ghana from 2015 to 2019. Three generalized linear models, (...) namely, logistic regression, probit regression, and linear probability model, were used for the analysis. We found that gender and age groups have significant effects in predicting the probability of road traffic fatality for all three models. Through a likelihood ratio test, however, it was determined that the logit regression model produced consistent probabilities of traffic fatalities which are very close to the actual probability values across the age groups and gender, compared to the other two models. Thus, we recommend intensified campaign for the use of seat belts in vehicles, targeted at the aged and male users of road transport, to reduce the possibility of death in any RTA. (shrink)

BackgroundCognitive frailty includes reversible and potentially reversible subtypes; the former is known as concurrent physical frailty and pre-mild cognitive impairment subjective cognitive decline, whereas the latter is known as concurrent PF and MCI. The diagnoses of pre-MCI SCD and MCI are based on clinical criteria and various subjective cognitive decline questionnaires. Heterogeneous assessment of cognitive impairment results in significant variability of CI, CF, and their subtype prevalence in various population-based studies.ObjectiveThis study aimed to compare the classification differences in CI and (...) CF subtypes from PF and normal cognition by applying clinical and objective cognitive criteria. Clinical criteria comprised Fried PF and clinical MCI criteria combined with the SCD questionnaire, whereas objective criteria comprised Fried PF and objective cognitive criteria based on the norm-adjusted six neuropsychological test scores.MethodsOf the 335 volunteers in this study, 191 were diagnosed with CI based on clinical cognitive diagnosis criteria, and 144 were identified as robust normal based on objective cognitive assessment from the community-dwelling older adult cohort. Individuals with clinical CI, including 94 with MCI and 97 with pre-MCI SCD, were reclassified into different z-score-derived MCI, pre-MCI SCD, and normal subgroups based on objective cognitive criteria. The classification diagnostic accuracy of normal cognition, PF, pre-MCI, MCI, CF, and CF subtypes based on clinical and objective criteria was compared before and after adjusting for age, sex, and education level.ResultsThe reclassification of objective assessments indicated better performance than that of clinical assessments in terms of discerning CI severity among different subgroups before adjusting for demographic factors. After covariate adjustment, clinical assessments significantly improved the ability to cognitively discriminate normal individuals from those with pre-MCI SCD and MCI but not the z-score-derived pre-MCI SCD and MCI groups from the robust normal group. Furthermore, the adjustment did not improve the ability to discriminate among individuals with reversible CF from those with potentially reversible CF and pre-MCI only SCD from MCI only SCD.ConclusionsObjective criteria showed better performance than clinical criteria in the diagnosis of individuals with CI or CF subtypes. Rapid clinical cognitive screening in combination with normative z-scores criteria is cost effective and sustainable in clinical practice. (shrink)

One of the main objections to life extension is that life extension will cause severe overpopulation. This objection presents both moral and demographic issues. To explore the demographic issue, we present an updated and improved version of the formula in chapter six of _New Methuselahs_ for projecting the demographic impact of life extension. The new version includes additional demographical factors such as non-aging related causes of death. According to projections generated with this revised formula, moderate life (...) extension (a life expectancy of 120 years) will not significantly increase population at the fertility rates current in the developed world, but radical life expectancy (halting aging completely, leading to an average life expectancy of 1000 years) can lead to severe overpopulation even at very low fertility rates. This formula also enables us to ascertain what fertility rate and birth spacing will prevent life extension from causing severe overpopulation. The moral issues arise if radical life extension causes overpopulation severe enough to outweigh the benefits it brings. _New Methuselahs_ proposed a reproductive policy for avoiding severe overpopulation by limiting reproduction for those who use life extension. We then consider a moral objection to this policy that was not discussed in _New Methuselahs_: it is not likely that society will succeed in imposing limits to reproduction, therefore, it is likely that radical life extension is morally wrong. We respond to this objection and defend our response against two further objections. (shrink)

A comprehensive analysis of the evolving conditions that provided for the emergence and autonomization of the field of bioethical inquiry, as well as the social, cultural and political background against which its birth can be set, should enlighten us about the problematic nature that characterises it from its very onset. Those conditions are: abuses in experimentation on human subjects, availability of new biomedical technologies, the challenging of prevalent medical paradigms and the ultimate meaning and purpose of medical care, new scientific (...) and social fields of concern dealing with ecology and environmental health, genetic engineering and biotechnologies, demographics, behavioural manipulation, reproductive medicine, etc., the upsurge of social movements raising issues of medical importance, and the need for an ethics for the technological age. The scope and meaning of bioethics is best defined by the overriding questions that open up the field of both theoretical and practical bioethical inquiry rather than by the individual responses given to such questions by the most prominent spokesmen in bioethics. (shrink)

This article argues that bodily awareness is a basic form of self-consciousness through which perceiving agents are directly conscious of the bodily self. It clarifies the nature of bodily awareness, categorises the different types of body-relative information, and rejects the claim that we can have a sense of ownership of our own bodies. It explores how bodily awareness functions as a form of self-consciousness and highlights the importance of certain forms of bodily awareness that share an important epistemological property with (...) canonical forms of self-consciousness such as introspection. (shrink)

It may be that the appropriate demographic objective of Israel as a country in which the Jewish people realize their right to self-determination is the existence of a Jewish public in Israel in numbers sufficient to allow its members to live in the framework of their culture. It may also be that the appropriate demographic objective of Israel should be the existence of a Jewish majority within it. While I discussed this issue elsewhere; here I discuss the legitimate (...) means for the realization of these goals. Israel’s principal means for realizing these objectives thus far has been its Law of Return and its Citizenship Law. These laws afford every Jew anywhere in the world the right to immigrate to Israel and become a citizen of the State of Israel. Many liberals and left-wingers consider these laws to be tainted with racism, because they regard any nationally-based preference with regard to immigration to be a form of racism. In the first part of my paper I argue against this position. I offer three justifications for nationality-based preferences in immigration. However, the fact that nationality-based priorities in immigration are not necessarily racist and that there are legitimate human interests justifying such priorities, does not entail that the specific priorities manifested by Israel’s Law of Return and its other immigration and citizenship policies are just. These policies in effect mean that all Jews and only Jews have the right to immigrate to Israel and to become fully integrated in Israeli life. In the second part of the paper, I argue that these two aspects of Israel’s immigration policies, namely, its almost categorical inclusion of all Jews and its almost categorical exclusion of all non-Jews, are somewhat problematic. In addition to the Law of Return, a number of additional ways to ultimately increase the number of Jews in relation to the number of Arabs have been proposed and even adopted in Israel in recent years. During the incumbency of the fifteenth Knesset, right-wing Member of Knesset Michael Kleiner tabled a draft bill intended “to encourage people that do not identify with the Jewish character of the state [i.e., Palestinian citizens of Israel C.G.] to leave.” The Israeli Government later tabled a bill—that was eventually passed—to amend the Israeli Citizenship Law in a manner that would deny Arabs who are Israeli citizens and have married Palestinian residents of the Occupied Territories the right to live in Israel with their spouses and children. In the third part of the paper, I clarify why in contrast to granting Jews priority in immigration, both the aforementioned laws, namely, Kleiner’s law and the law pertaining to family unification are racist and are therefore morally unacceptable. (shrink)

Objectives Older adults are considered one of the most vulnerable groups to COVID-19. However, previous studies on emotion and aging have found that older adults report better well-being than younger adults in global survey and daily report. To better understand older adults’ well-being during the COVID-19 outbreak, we examined age differences in daily affective experiences in this study. Method Two hundred and thirty-one participants from mainland China aged 18 to 85 were recruited to participate in the 14-day daily diary study, (...) after a pretest. Their trait affect and demographic information were measured in the pretest. Their daily affect and stress levels were measured in the daily assessments. Results We found that older adults reported lower perceived stress related to COVID-19 in daily life, compared to younger adults. The negative relationship between daily perceived stress and high arousal positive affect and the positive relationship between daily perceived stress and high arousal negative affect was weaker in older than younger adults. Discussion These results provide initial evidence of daily affective well-being across different age groups in adulthood during the COVID-19 outbreak. Such information is important for developing interventions to promote better well-being during the COVID-19 outbreak. (shrink)

Objective. Study of the Covid-19 related quarantine concept as an emerging category of linguistic consciousness of Ukrainians. -/- Materials & Methods. The strategy of the study is based on the logical and methodological concept of inductivism. Respondents were asked to write down their own understanding of the quarantine, formulate an appropriate definition and describe the situation, which in their opinion is the exact opposite to quarantine. Respondents also assessed how much their psychological well-being, their daily lifestyle during quarantine had changed, (...) and ranked their preferences for the quarantine strategies proposed to them. A discursive analysis was applied to the obtained texts, as a result of which nine discourses were identified. These data, along with some socio-demographic characteristics were subjected to multidimensional mathematical and statistical processing. -/- Results. Covid-19 related quarantine is represented in the linguistic consciousness of Russian-speaking Ukrainians by a discursive field, which includes at least nine recognizable, semantically autonomous discourses. Empirically discovered such phenomenon as – inter-discourse semantic dissociation. Its essence is a statistically significant reduction in the probability of some discourses appearing in the texts when others are being actualized there. This feature is associated with the innate negativity of the language and determines the semantic biasing of the quarantine concept. Inter-discourse semantic dissociation, as well as the influence of non-discursive factors constitute the discursive formation of the quarantine concept, which is qualitatively characterized by the hierarchical relationship of its components. At the same time, it was revealed that part of the discourses interacting “horizontally” are indirectly associated “vertically”, which forms the stable semantic core of the quarantine concept. Partial empirical confirmation has been found of the previously put forward assumptions about: a) the existence of such a relationship between discourses and psychological defense mechanisms (as character-forming factors) that contributes to the hierarchical structure construction of discursive formations; b) the differential nature of discourses and mechanisms of psychological defenses interaction, which makes it possible to single out the discursive aspect in a characterological profile and consider a discourse as an operator of characterological semantics. -/- Conclusions. An empirical study made it possible to form a primary idea of the substantive and structural semantic features of the quarantine concept, as an emerging category of linguistic consciousness of Ukrainians. The results obtained have a potentially useful application perspective. Thus, when implementing anti-epidemiological measures, it is important to consider the studied features of the discursive formation hierarchical structure of the quarantine concept, since discursive semantics are associated with cognitive focusing, which, in turn, affects the behavior direction and its upshots. (shrink)

Objective: Mindfulness disposition is associated with various psychological factors and prevent emotional distress in chronic diseases. In the present study, we analyzed the key role of mindfulness dispositions in protecting the individual against psychological distress consequent to COVID-19 social distancing and quarantining. Methods: An online survey was launched on March 13, 2020, with 6,412 responses by April 6, 2020. Socio-demographic information, exposure to the pandemic, and quarantining were assessed together with psychological distress and mindfulness disposition. Multivariate linear regression analysis (...) was performed to study the influence of predictive factors on psychological distress and quality of life in Italian responders during the early days of lockdown. Pearson correlations were calculated to study the relations between mindfulness and psychiatric symptoms. Results: Multivariate linear regression run on socio-demographics, COVID-19-related variables, and mindfulness disposition as moderators of overall psychological distress showed that mindfulness was the best predictor of psychological distress (β = -0.504; p =.000). High negative correlations were found between mindfulness disposition and overall Global Severity Index (r = -.637; p =.000), while moderate to high associations were found between mindfulness and all SCL-90 sub-scales. Discussion: Findings showed that high dispositional mindfulness enhances well-being and helps in dealing with stressful situations such as the COVID-19 pandemic. Mindfulness-based mental training could represent an effective intervention to stem the post-traumatic psychopathological beginnings and preventing the onset of chronic mental disorders. (shrink)

Objectives—While clinical practice is complicated by many ethical dilemmas, clinicians do not often request ethics consultations. We therefore investigated what triggers clinicians' requests for ethics consultation. Design—Cross-sectional telephone survey.Setting—Internal medicine practices throughout the United States.Participants—Randomly selected physicians practising in internal medicine, oncology and critical care.Main measurements—Socio-demographic characteristics, training in medicine and ethics, and practice characteristics; types of ethical problems that prompt requests for consultation, and factors triggering consultation requests. Results—One hundred and ninety of 344 responding physicians (55%) reported requesting (...) ethics consultations. Physicians most commonly reported requesting ethics consultations for ethical dilemmas related to end-of-life decision making, patient autonomy issues, and conflict. The most common triggers that led to consultation requests were: 1) wanting help resolving a conflict; 2) wanting assistance interacting with a difficult family, patient, or surrogate; 3) wanting help making a decision or planning care, and 4) emotional triggers. Physicians who were ethnically in the minority, practised in communities under 500,000 population, or who were trained in the US were more likely to request consultations prompted by conflict. Conclusions—Conflicts and other emotionally charged concerns trigger consultation requests more commonly than other cognitively based concerns. Ethicists need to be prepared to mediate conflicts and handle sometimes difficult emotional situations when consulting. The data suggest that ethics consultants might serve clinicians well by consulting on a more proactive basis to avoid conflicts and by educating clinicians to develop mediation skills. (shrink)

Objective—To report the ethical development of medical students across four years of education at one medical school.Design and setting—A questionnaire was distributed to all four classes at the Wake Forest University School of Medicine during the Spring of 1996. Participants—Three hundred and three students provided demographic information as well as information concerning their ethical development both as current medical students and future interns. Main measurements—Results were analyzed using cross-tabulations, correlations, and analysis of variance.Results—Results suggested that the observation of and (...) participation in unethical conduct1 may have disparaging effects on medical students' codes of ethics with 35% of the total sample (24% of first years rising to 55% of fourth years) stating that derogatory comments made by residents/attendings, either in the patient's presence or absence, were “sometimes” or “often” appropriate. However, approximately 70% of the sample contended that their personal code of ethics had not changed since beginning medical school and would not change as a resident. Conclusions—Results may represent an internal struggle that detracts from the medical school experience, both as a person and as a doctor. Our goal as educators is to alter the educational environment so that acceptance of such behaviour is not considered part of becoming a physician. (shrink)

ABSTRACT The disparity in the venezuelan demographic transition is a fact known by experts. On this setting, there are four municipalities in Falcón State with a high elder population, one of them is Tocópero. This research had as general objectives to study the estimations of demographic risks and the social politics for elders, people who are 75 and more, from Tocópero Municipality, considering that specialists indicate that, once the demographic oldness has arrived, it is important to study (...) thoroughly the elder population in order to design relevant politics and programs, taking into consideration that it is a vulnerable group. It was an exploratory and descriptive study, with a field-no experimental-transectional design. The sample was intentional. Structured interviews and questionnaires were applied to elders and municipal officials. The data processing was carried out by using quantitative methods. The conclusions indicated that the elder population in Tocópero Municipality had a marked female tendency. In general terms, the adverse effects associated to the estimations of demographic risk were not present in the studied sample. There was no relation between the demographic reality of this municipality and the social politics and programs implemented. The programs concentrated the elder and suppressed the intergenerational contact; the centralism was the key element to understand the present politics of the Venezuelan state towards the oldness. The demographic oldness of this municipality was determined by the way in which the birth of the municipality was approved. (shrink)

Objective:The purpose of this study was to describe the current situation of moral distress and to explore its influencing factors among Chinese nurses.Methods:This is an exploratory, descriptive design study. A total of 465 clinical nurses from different departments in three Grade-III, Level-A hospitals in Jinan, Shandong Province, completed the questionnaires, including demographics questionnaire, Chinese version of Moral Distress Scale–Revised, and Job Diagnostic Survey.Ethical considerations:The study was approved by the university ethics board and the local health service director.Results:The total score of (...) Moral Distress Scale–Revised was 36.01 ± 24.02 points. The mean frequency and intensity scores of moral distress were 1.13 ± 0.49 and 1.09 ± 0.58, respectively. The level of moral distress among Chinese clinical nurses was low, and the frequency and intensity of moral distress were on low to moderate level. The level of moral distress experienced by clinical nurses is associated with demographics features and job characteristics, including age, education degree, department, task significance, autonomy, and dealing with others.Conclusion:Our conclusion suggests that hospital and organizational administrations should attach much importance to the moral distress experienced by clinical nurses in China. Further studies should focus on interventions about how to reduce the levels of the frequency and intensity of moral distress among clinical nurses. (shrink)

Objective: Loneliness is the subjective distress of feeling alone and has a strong impact on wellbeing and health. In addition to well-known predictors like isolation and poor health, a better understanding of the psychological determinants of loneliness would offer effective targets for future complementary interventions.Methods: In this cross-sectional observational study, we compared the explanatory power of several important risk factors of loneliness with the affective, motivational, and cognitive aspects of the Meaning in Life construct. Different nested linear models were compared (...) including socio-demographic, lifestyles, social-connectedness, and self-rated health variables, to assess the overlapping and non-overlapping explanatory power of each of them.Results: Health status and MiL were found to be the most important predictors of loneliness, followed by social connectedness and, with a much lower weight, lifestyles, and socio-demographic factors. Within the MiL factor, the most cognitive component, sense of coherence, had a greater explanatory power than the more affective and motivational ones.Conclusion: Reduced MiL, the capacity of an individual to attach “value and significance” to life, is a crucial predictor to the feeling of loneliness. These results suggest that programs aiming to combat loneliness should go well beyond situational interventions and include more cognitive, value-centered interventions that enable individuals to define and pursue a meaningful vital plan. (shrink)

Objective: Obtaining informed consent for resuscitation research, especially in the newborn, is problematic. This study aimed to evaluate parental preferences for hypothetical consent procedures in neonatal resuscitation research.Design: Mail-out survey questionnaire.Setting/participants: Randomly selected parents who had received obstetrical or neonatal care at a tertiary perinatal centre.Main outcome measures: Parental levels of comfort regarding different methods of obtaining consent in hypothetical resuscitation research scenarios.Results: The response rate was 34%. The respondents were a group of highly educated women with a higher family (...) income than would be expected in the general population. In terms of results, parents valued the impact the research would have on their baby and the importance of a positive interaction with the physicians conducting the research study. Parents felt most comfortable with prospective consent in the setting of prenatal classes or prenatal visits with a physician, but they were somewhat uncomfortable with prospective consent upon admission to hospital after labour had begun. Parents were uncomfortable with waived consent, deferred consent, and opting out, no matter when during the pregnancy consent was requested.Conclusion: This pilot study reports parental preferences for prenatal information and consent for such research trials of neonatal resuscitation. A low response rate and potentially skewed demographics of the respondents prevent generalisability of this result. Interview studies should be performed to better determine parental preferences for informed consent in a more representative population. (shrink)