There is currently intense interest in the question of the source of our presumed knowledge of truths concerning what is, or is not, metaphysically possible or necessary. Some philosophers locate this source in our capacities to conceive or imagine various actual or non-actual states of affairs, but this approach is open to certain familiar and seemingly powerful objections. A different and ostensibly more promising approach has been developed by Timothy Williamson, according to which our capacity for modal knowledge is just (...) an extension, or by-product, of our general capacity to acquire knowledge of true counterfactual conditionals — a capacity that we deploy ubiquitously in everyday life. Williamson’s account crucially involves a thesis to the effect that modal truths can be explained in terms of counterfactual truths. In this paper, I query Williamson’s account on a number of points, including this thesis. My positive proposal, which owes a debt to the work of Kit Fine on modality and essence, appeals instead to our capacity to grasp essences, understood in a neo-Aristotelian fashion, according to which essences are expressed by ‘real definitions’. (shrink)

Intense scrutiny can raise chimaeras, and Virgil is the most scrutinized of Roman poets, but he may have engineered coincidences in line number (‘stichometric allusions’) between certain of his verses and their Greek models. A handful of potential examples have now accumulated. Scholars have detected Virgilian citations of Homer, Callimachus and Aratus in this manner, as well as intratextual allusions by both Virgil and Ovid, and references to Virgil's works by later Roman poets using the same technique. (For present purposes (...) I disregard the separate, though related, phenomenon of correspondingnumbers of linesin parallel passages: G. Knauer,Die Aeneis und Homer(Göttingen, 1964) suggests several examples of such correspondences between Homer and Virgil, especially in speeches. Another purely formal mode of allusion faintly present in Roman poetry is homophonic translation (the technique which Louis Zukofsky's 1969 translations of Catullus pursuein extenso); thus Virgil'sfagus, beech, corresponds with Theocritus'phagos, oak.) If genuine, the phenomenon lacks any consistent method or regular pattern (and the degree of plausibility varies); if genuine, it is very rare, even if accidents in textual transmission could have obscured some examples; if genuine, it probably originated in the Hellenistic period, although such a case has yet to be made. Virgil presently seems the earliest and most copious practitioner of stichometric allusion. A previously undetected example in theAeneidis proposed below. (shrink)

Facing the possibility of a surge of COVID-19-infected patients requiring ventilatory support in Intensive Care Units, the Singapore Hospice Council and the Chapter of Palliative Medicine Physicians forward its position on the guiding principles that ought to drive the allocation of ICU beds and its role in care of these patients and their families.

Kerridge et al recently published a paper in the journal about organ transplantation and the diagnosis of death.1 Although I appreciate the authors’ efforts to present their arguments about such a controversial issue, I found some inconsistencies in this article that I would like to discussWhen Kerridge and his collaborators discussed the origins of the concept of brain death, they emphasised that after the report of the medical consultants on the diagnosis of death to the US President’s Commission was published (...) in 1981,2 clinicians equated the concept of BD with brainstem death. In fact, the brainstem criterion was first proposed by Mohandas and Chou in Minnesota, in 1971.3 The Minnesota criteria inspired the UK code, which was mainly adopted in UK commonwealth countries.4 This view was afterwards powerfully defended by Christopher Pallis.5 After the US President’s Commission report,2 a lot of countries, and most US states, accepted the whole brain, and not the brainstem, criterion.6Regarding the “dead donor rule”, with the advent of transplant surgery, interest in definitions and diagnosis of death based on brain formulations really acquired a new urgency. None the less, it is important to point out that the concept of BD as death of the individual, did not appear to benefit organ transplantation, but was a consequence of the development of intensive care. As Pallis emphasised, if organ transplant techniques had never been developed, intensive care procedures would have provided the possibility of supplying life support to those cases with destroyed brains and preserved heart function, and physicians would need to face the clinical syndrome called BD.5 When French neurophysiologists and neurologists described the death of the nervous system and coma dépassé, organ transplant techniques were only in the very early stages of development. …. (shrink)

Mental disorders such as depression and anxiety are increasingly common. Yet there are too few specialists to offer help to everyone, and negative attitudes to psychological problems and their treatment discourage people from seeking it. As a result, many people never receive help for these problems. The Oxford Guide to Low Intensity CBT Interventions marks a turning point in the delivery of psychological treatments for people with depression and anxiety. Until recently, the only form of psychological intervention available for patients (...) with depression and anxiety was traditional one-to-one 60 minute session therapy - usually with private practitioners for those patients who could afford it. Now Low Intensity CBT Interventions are starting to revolutionize mental health care by providing cost effective psychological therapies which can reach the vast numbers of people with depression and anxiety who did not previously have access to effective psychological treatment. The Oxford Guide to Low Intensity CBT Interventions is the first book to provide a comprehensive guide to Low Intensity CBT interventions. It brings together researchers and clinicians from around the world who have led the way in developing evidence-based low intensity CBT treatments. It charts the plethora of new ways that evidence-based low intensity CBT can be delivered: for instance, guided self-help, groups, advice clinics, brief GP interventions, internet-based or book-based treatment and prevention programs, with supported provided by phone, email, internet, sms or face-to-face. These new treatments require new forms of service delivery, new ways of communicating, new forms of training and supervision, and the development of new workforces. They involve changing systems and routine practice, and adapting interventions to particular community contexts. The Oxford Guide to Low Intensity CBT Interventions is a state-of-the-art handbook, providing low intensity practitioners, supervisors, managers commissioners of services and politicians with a practical, easy-to-read guide - indispensible reading for those who wish to understand and anticipate future directions in health service provision and to broaden access to cost-effective evidence-based psychological therapies. (shrink)

Mexico faces a crisis of national sovereignty and independence as it struggles to establish a democracy amidst integration into the world market system and internal demands for social justice. U.S. involvement in Mexican affairs, providing military training and equipment for government troops, contributes to a state-sponsored war against civilians, namely indigenous groups and the middle and lower classes devastated by NAFTA. While resistance movements in Chiapas respond to capitalist practices and repression, Valdez argues the Mexican government minimizes them to displace (...) its indigenousgroups and facilitate their silent annihilation. U.S. policy, the Mexican state, indigenous issues, and free trade are interconnected with Mexico’s larger society. (shrink)

Mexico faces a crisis of national sovereignty and independence as it struggles to establish a democracy amidst integration into the world market system and internal demands for social justice. U.S. involvement in Mexican affairs, providing military training and equipment for government troops, contributes to a state-sponsored war against civilians, namely indigenous groups and the middle and lower classes devastated by NAFTA. While resistance movements in Chiapas respond to capitalist practices and repression, Valdez argues the Mexican government minimizes them to displace (...) its indigenousgroups and facilitate their silent annihilation. U.S. policy, the Mexican state, indigenous issues, and free trade are interconnected with Mexico’s larger society. (shrink)

This essay collects four decades of my own reflections, as an anthropologist and feminist, on gender and coloniality across various contexts in Latin America. It also highlights the decolonial methodology and vocabulary that I have had to develop in my various roles as scholar, public intellectual, and expert witness over the years. Briefly, what I present here is a decolonial feminist perspective that argues for the existence of a patriarchal political order in communal societies before colonization. Yet, in my view, (...) precolonial gender has a dual structure that is plural in essence and differs markedly from the binary gender structure of colonial-modern societies, which works in terms of a One and its marginalized others. As I argue, the capturing and transformation of precolonial dual gender structures by the modern gender system exacerbates inequality, increases violence against women, and disempowers them politically. For that reason, I speak of “low-intensity” and “high-intensity” patriarchal systems. (shrink)

Binaural pitch fusion is the perceptual integration of stimuli that evoke different pitches between the ears into a single auditory image. This study was designed to investigate how steady background noise can influence binaural pitch fusion. The binaural fusion ranges, the frequency ranges over which binaural pitch fusion occurred, were measured with three signal-to-noise ratios of the pink noise and compared with those measured in quiet. The preliminary results show that addition of an appropriate amount of noise can reduce binaural (...) fusion ranges, an effect called stochastic resonance. This finding increases the understanding of how specific noise levels can sharpen binaural pitch fusion in normal hearing individuals. Furthermore, it elicits more pathways for research to explore how this benefit can practically be used to help improve binaural auditory perception. (shrink)

Recently, a friend of one of these writers told her story of using one of a healthcare product to activate her stem cells as part of regenerative medicine. Regenerative medicine is a field of medicine that seeks to repair or replace damaged or diseased tissues and organs. This can be done through a variety of methods, including stem cell therapy, tissue engineering, and gene therapy. This is a short review article on this rapid field called regenerative medicine, in particular via (...) a new method called photobiomodulation, especially by virtue of low-intensity laser pen treatment. Hopefully it will attract more research in this interesting direction, both for laser/photobiomodulation to boost plant growth as well as in healthcare (see also: Christianto & Smarandache, 2022; Christianto, 2023). (shrink)

If two stimuli need different times to be processed, this difference should in principle be reflected both by response times (RT) and by judgments of their temporal order (TOJ). However, several dissociations have been reported between RT and TOJ, e.g., RT is more affected than TOJ when stimulus intensity decreases. One account for these dissociations is to assume differences in the allocation of attention induced by the two tasks. To test this hypothesis, different distributions of attention were induced in the (...) present study between two stimulus positions (above and below fixation). Only bright stimuli appeared in one position and either bright or dim stimuli in the other. In the two RT experiments, participants had to respond to every stimulus appearing in one of the two positions. Reaction times to bright stimuli were faster when they appeared in the position where dim stimuli were likely to occur. This finding suggests that the allocation of attention was adapted to the asymmetrical arrangement of stimuli, not suggested by explicit instruction. In the two TOJ experiments, the temporal order of stimuli appearing in the two positions had to be judged. Although bright stimuli appearing at the bright-and-dim location were judged to be earlier, this effect was small and insignificant. Further, the intensity dissociation between RT and TOJ was insensitive to random vs blockwise presentations of intensities, therefore was not modified by attentional preferences. Thus, asymmetrical arrangement of stimuli has an impact on the allocation of attention, but only in the RT task. Therefore dissociations between TOJ and response times cannot be accounted for by an attentional bias in the TOJ task but probably by different use of temporal information in the two tasks. (shrink)

There are many real-world applications like healthcare systems, job monitoring, well-being and personal fitness tracking, monitoring of elderly and frail people, assessment of rehabilitation and follow-up treatments, affording Fall Detection (FD) and ADL (Activity of Daily Living) identification, separately or even at a time. However, the two main drawbacks of these solutions are that most of the times, the devices deployed are obtrusive (devices worn on not quite common parts of the body like neck, waist and ankle) and the poor (...) battery life. Thus, this work proposes a low-power classification algorithm based on an Ensemble of KNN and K-Means algorithms (EKMeans) to identify Falls and High-Intensity ADL events such as running, jogging and climbing up stairs. The input of EKMeans are triaxial accelerometer data gathered from wrist-wearable devices. The proposal will be validated on the Fall&ADL publicly available datasets UMAFall, UCIFall and FallAllD, considering two kinds of activity labelling: Two-Class and Multi-Class. An exhaustive comparative study between our proposal, and the baseline algorithms KNN and a feed-forward Neural Network (NN) is deployed, where EKMeans outperformed clearly the Specificity (ADL classification) of the KNN and NN for the three datasets. Finally, a comparative battery consumption study has been included deploying the analyzed algorithms in a WearOS smartwatch, where EKMeans drains the battery from 100% to 0% in 27.45 hours, saving 5% and 21% concerning KNN and NN, respectively. Keywords: Human Activity Recognition, ADL Identification, Fall Detection TS Clustering, TS Classification, Wearable Devices, Low-Power HAR. (shrink)

Time-limited trials of intensive care have arisen in response to the increasing demand for intensive care treatment for patients with a low chance of surviving their critical illness, and the clinical uncertainty inherent in intensive care decision-making. Intensive care treatment is reported by most patients to be a significantly unpleasant experience. Therefore, patients who do not survive intensive care treatment are exposed to a negative dying experience. Time-limited trials of intensive care treatment in patients with a low chance of surviving (...) have both a small chance of benefiting this patient group and a high chance of harming them by depriving them of a good death. A ‘rule of rescue’ for the critically unwell does not justify time-limiting a trial of intensive care treatment and overlooks the experiential costs that intensive care patients face. Offering time-limited trials of intensive care to all patients, regardless of their chance of survival, overlooks the responsibility of resource-limited intensive care clinicians for suffering caused by their actions. A patient-specific risk–benefit analysis is vital when deciding whether to offer intensive care treatment, to ensure that time-limited trials of intensive care are not undertaken for patients who have a much higher chance of being harmed, rather than benefited by the treatment. The virtue ethics concept of human flourishing has the potential to offer additional ethical guidance to resource-limited clinicians facing these complex decisions, involving the balancing of a quantifiable survival benefit against the qualitative suffering that intensive care treatment may cause. (shrink)

Suffering repeated experiences of moral distress in intensive care units due to applications of futility reflects on nurses’ patient care negatively, increases their burnout, and reduces their job satisfaction. This study was carried out to investigate the levels of job satisfaction and exhaustion suffered by intensive care nurses and the relationship between them through the futility dimension of the issue. The study included 138 intensive care nurses. The data were obtained with the futility questionnaire developed by the researchers, Maslach Burnout (...) Inventory and Minnesota Satisfaction Questionnaire. It was determined that nurses who agreed to the proposition that the application of futility demoralizes health-care professionals had low levels of job satisfaction but high levels of depersonalization. It was determined that nurses had moderate levels of job satisfaction, emotional exhaustion, and personal achievements but high levels of sensitivity. Nurses’ job satisfaction and sensitivities are positively affected when they consider that futility does not contradict the purposes of medicine. (shrink)

Researchers have considered individual and organizational factors of ethical decision making. However, they have little interest in situational factors :101–125, 2013) which is surprising given the many situations sales persons face. We address this issue using two pilot qualitative studies successively and a 2 by 2 within-subject experiment with sales scenarios. Qualitative and quantitative data are obtained from front-line employees of the main French retail banks that serve low-income customers. We show that the recognition of an ethical issue differs depending (...) on the role behavior salespersons are engaged in and the nature of the conflict of interest they face. Moreover, the combined effect of these two situational characteristics is mediated by moral intensity. This study not only adds evidence on situational factors affecting ethical decision but also extends empirical research on sales ethics by revealing sales situations that are not considered in the empirical literature. The research implications of the findings are discussed along with the study’s limitations and suggestions for future research. (shrink)

Following an extensive review of the moral intensity literature, this article reports the findings of two studies (one between-subjects, the other within-subject) that examined the effect of manipulated and perceived moral intensity on ethical judgment. In the between-subjects study participants judged actions taken in manipulated high moral intensity scenarios to be more unethical than the same actions taken in manipulated low moral intensity scenarios. Findings were mixed for the effect of perceived moral intensity. Both probable magnitude of consequences (a factor (...) consisting of magnitude of consequences, probability of effect, and temporal immediacy) and social consensus had a significant effect; proximity did not. In the within-subject study manipulated moral intensity had a significant effect on ethical judgment, but perceived moral intensity did not. Regression of ethical judgment on age, gender, major, and the three perceived moral intensity factors was significant between-subjects, but not within-subject. Ethical judgment was found to be a more robust predictor of intention than perceived moral intensity using a within-subject design. (shrink)

Background:Moral distress is a common problem among professionals working in the field of healthcare. Moral distress is the distress experienced by a professional when he or she cannot fulfill the correct action due to several obstacles, although he or she is aware of what it is. The level of moral distress experienced by nurses working in intensive care units varies from one country/culture/institution to another. However, in Turkey, there is neither a measurement tool used to assess moral distress suffered by (...) nurses nor a study conducted on the issue.Aim/objective:The study aims to (a) validate the Turkish version of the Moral Distress Scale–Revised to be used in intensive care units and to examine the validity and reliability of the Turkish version of the scale, and (b) explore Turkish intensive care nurses’ moral distress level.Method:The sample of this methodological, descriptive, and cross-sectional design study comprises 200 nurses working in the intensive care units of internal medicine and surgical departments of four hospitals in three cities in Turkey. The data were collected with the Socio-Demographic Characteristics Form and The Turkish Version of Moral Distress Scale–Revised.Ethical considerations:The study proposal was approved by the ethics committee of the Faculty of Medicine, Cumhuriyet University. All participating nurses provided informed consent and were assured of data confidentiality.Results:In parallel with the original scale, Turkish version of Moral Distress Scale–Revised consists of 21 items, and shows a one-factor structure. It was determined that the moral distress total and item mean scores of the nurses participating in the study were 70.81 ± 48.23 and 3.36 ± 4.50, respectively.Conclusion:Turkish version of Moral Distress Scale–Revised can be used as a reliable and valid measurement tool for the evaluation of moral distress experienced by nurses working in intensive care units in Turkey. In line with our findings, it can be said that nurses suffered low level of moral distress. However, factors which caused the nurses in our study to experience higher levels of moral distress are inadequate communication within the team, working with professionals they considered as incompetent, and futile care. (shrink)

Background:Moral distress is a common problem among professionals working in the field of healthcare. Moral distress is the distress experienced by a professional when he or she cannot fulfill the correct action due to several obstacles, although he or she is aware of what it is. The level of moral distress experienced by nurses working in intensive care units varies from one country/culture/institution to another. However, in Turkey, there is neither a measurement tool used to assess moral distress suffered by (...) nurses nor a study conducted on the issue.Aim/objective:The study aims to (a) validate the Turkish version of the Moral Distress Scale–Revised to be used in intensive care units and to examine the validity and reliability of the Turkish version of the scale, and (b) explore Turkish intensive care nurses’ moral distress level.Method:The sample of this methodological, descriptive, and cross-sectional design study comprises 200 nurses working in the intensive care units of internal medicine and surgical departments of four hospitals in three cities in Turkey. The data were collected with the Socio-Demographic Characteristics Form and The Turkish Version of Moral Distress Scale–Revised.Ethical considerations:The study proposal was approved by the ethics committee of the Faculty of Medicine, Cumhuriyet University. All participating nurses provided informed consent and were assured of data confidentiality.Results:In parallel with the original scale, Turkish version of Moral Distress Scale–Revised consists of 21 items, and shows a one-factor structure. It was determined that the moral distress total and item mean scores of the nurses participating in the study were 70.81 ± 48.23 and 3.36 ± 4.50, respectively.Conclusion:Turkish version of Moral Distress Scale–Revised can be used as a reliable and valid measurement tool for the evaluation of moral distress experienced by nurses working in intensive care units in Turkey. In line with our findings, it can be said that nurses suffered low level of moral distress. However, factors which caused the nurses in our study to experience higher levels of moral distress are inadequate communication within the team, working with professionals they considered as incompetent, and futile care. (shrink)

Faster R-CNN architecture is used to solve the problems of moving path uncertainty, changeable coverage, and high complexity in cold-air induced large-scale intensive temperature-reduction detection and classification, since those problems usually lead to path identification biases as well as low accuracy and generalization ability of recognition algorithm. In this paper, an improved recognition method of national ITR path in China based on faster R-CNN in complicated meteorological systems is proposed. Firstly, quality control of the original dataset of strong cooling processes (...) is carried out by means of data filtering. Then, according to the NITR standard and the characteristics of NITR, the NITR dataset in China is established by the intensive temperature-reduction areas located through spatial transformation. Meanwhile, considering that the selection of regularization parameters of Softmax classification method will cause the problem of probability calculation, support vector machine is used for path classification to enhance the confidence of classification. Finally, the improved faster R-CNN model is used to identify, classify, and locate the path of NITR events. The experimental results show that, compared to other models, the improved faster R-CNN algorithm greatly improves the performance of NITR’s path recognition, especially for the mixed NITR paths and single NITR paths. Therefore, the improved faster R-CNN model has fast calculation speed, high recognition accuracy, good robustness, and generalization ability of NITR path recognition. (shrink)

This study investigated the differences in morphometry and functional plasticity characteristics of the brain after long-term training of different intensities. Results showed that an aerobic group demonstrated higher gray matter volume in the cerebellum and temporal lobe, while an anaerobic group demonstrated higher gray matter volume in the region of basal ganglia. In addition, the aerobic group also showed significantly higher fractional amplitude of low-frequency fluctuation and degree centrality in the motor area of the frontal lobe and parietal lobe, (...) and the frontal gyrus, respectively. At the same time, the anaerobic group demonstrated higher fALFF and DC in the cerebellum posterior lobe. These findings may further prove that different brain activation modes respond to different intensities of physical activity and may help to reveal the neural mechanisms that can classify athletes from different intensity sports. (shrink)

Children dependent on life-prolonging medical technology are often subject to a constant background risk of sudden death or catastrophic complications. Such children can be cared for in hospital, in an intensive care environment with highly trained nurses and doctors able to deliver specialised, life-saving care immediately. However, remaining in hospital, when life expectancy is limited, can considered to be a harm in of itself. Discharge home offers the possibility for an improved quality of life for the child and their family (...) but comes with significant medical risks.When making decisions for children, two ethical models predominate, the promotion of the child’s best interests or the avoidance of harm. However, in some circumstances, particularly for children with life-limiting and/or life-threatening illness, all options may be associated with risk. There are no good options, only potentially harmful choices.In this paper, we explore decisions made by one family in such circumstances. We describe a model adopted from risk management programmes beyond medicine, which offers a potential framework for identifying risks to the child that are morally permissible. Some risks and harms to a child, not ordinarily permitted, may be acceptable when undertaken in the pursuit of a specified desired good, so long as they are as low as reasonably practicable. (shrink)

Low Power Society is a new approach to social complexes. It is not about slow scale but fast, it is not about absence of power but intense power. It is a possible answer to the negative aspects of our present globalization. The archetype (C.G. Jung) of this concept-paradigm is Eros or, from another point of view, HermAfrEros - a synthesis of Hermes, Aphrodite and Eros.

Opportunities for practical, hospital-based training in those skills demanded by clinical ethics consultation (CEC) have been limited. Given the number of individuals who provide part-time CEC, greater access to condensed, practical training such as the clinical ethics immersion course offered by the Washington Hospital Center, is necessary.Two participants in the initial cohort evaluate their CE training at a busy, urban referral center, exploring prior expectations, perceptions of its utility and suggestions for improvement. Such training will prove valuable not only for (...) bioethicists who lack practical CEC experience “at the bedside” but also for ethics consultants whose ethics services have a low consult volume who wish to sharpen their skills. (shrink)

This article examines the phenomenon of the “global circulation of low-end expertise” through an exploration of the social dynamics surrounding American oil drillers who migrated from the Pennsylvania oil region to British colonial Burma during the early 1900s to the mid-1930s. These working-class drillers, with practical knowledge in oil drilling acquired through familial and community networks, played a crucial role in operating mechanized oil wells and providing geological expertise in colonial Burma. Positioned between labor-intensive agricultural economies in colonial Asia and (...) the higher echelons of British colonial society, these drillers occupied an intermediate social location. Despite their indispensable expertise, they were marginalized due to their lower social standing, leading to their expertise being disregarded by their superiors and forgotten over time. By understanding the complexities of the “global circulation of low-end expertise,” this study sheds light on the social construction and erasure of the expertise held by these working-class drillers, revealing overlooked aspects of global histories of science and labor and highlighting the need to reassess dominant historical narratives on knowledge-labor. (shrink)

This study explores the relationship between moral intensity and the use of different sensemaking strategies in military critical incidents. First, narratives of military personnel were used to select prototypical high/low moral intensity critical incidents. In a follow-up, a scenario study was conducted with active duty military personnel to examine the relationship between moral intensity and the use of sensemaking tactics. This study offers three main conclusions. First, the use of sensemaking tactics is strongly tied to the level of moral intensity (...) in the situation. In high-intense situations, the servicemen draw on previous experiences, prediction of consequences, and help of others to recognize and interpret the situation. Less attention goes out to higher level critical thinking. Thus, it seems that in these critical incidents, the servicemen react without giving room for thorough consideration and deliberation. Second, the number of deployments a serviceman experienced influences the perceived seriousness and harmfulness of the situation negatively in low-intense situations. Finally, and in line with earlier studies, the results indicate that the concept of moral intensity is formed out of three rather than the six dimensions originally proposed by Jones. The implications of these findings are discussed. (shrink)

Background:Ethical conflict is a barrier to decision-making process and is a problem derived from ethical responsibilities that nurses assume with care. Intensive care unit nurses are potentially exposed to this phenomenon. A deep study of the phenomenon can help prevent and treat it.Objectives:This study was aimed at determining the frequency, degree, level of exposure, and type of ethical conflict among nurses working in the intensive care units.Research design:This was a descriptive cross-sectional research.Participants and research context:In total, 382 nurses working in (...) the intensive care units in Iranian hospitals were selected using the random sampling method. Data were collected using the Ethical Conflict in Nursing Questionnaire-Critical Care Version (Persian version).Ethical considerations:This study was approved by the Medical Research Ethics Committee. Ethical considerations such as completing the informed consent form, ensuring confidentiality of information, and voluntary participation were observed.Findings:The results showed that the average level of exposure to ethical conflict was 164.39 ± 79.06. The most frequent conflict was related to “using resources despite believing in its futility,” with the frequency of at least once a week or a month (68.6%, n = 262). The most conflictive situation was violation of privacy (76.9%, n = 294). However, the level of exposure to ethical conflict according to the theoretical model followed was the situation of “working with incompetent staff.” The most frequently observed type of conflict was moral dilemma.Conclusion:The moderate level of exposure to ethical conflict was consistent with the results of previous studies. However, the frequency, degree, and type of ethical conflict were different compared to the results of other studies. Recognizing ethical conflict among intensive care unit nurses can be useful as it allows to consolidate those measures that favor low levels of ethical conflict, design appropriate strategies to prevent ethical conflicts, and improve the nursing work environment. (shrink)

Many countries have adopted new triage recommendations for use in the event that intensive care beds become scarce during the COVID‐19 pandemic. In addition to establishing the exact criteria regarding whether treatment for a newly arriving patient shows a sufficient likelihood of success, it is also necessary to ask whether patients already undergoing treatment whose prospects are low should be moved into palliative care if new patients with better prospects arrive. This question has led to divergent ethical guidelines. This paper (...) explores the distinction between withholding and withdrawing medical treatment during times of scarcity. As a first central point, the paper argues that a revival of the ethical distinction between doing and allowing would have a revisionary impact on cases of voluntary treatment withdrawal. A second systematic focus lies in the concern that withdrawal due to scarcity might be considered a physical transgression and therefore more problematic than not treating someone in the first place. In light of the persistent disagreement, especially concerning the second issue, the paper concludes with two pragmatic proposals for how to handle the ethical uncertainty: (1) triage protocols should explicitly require that intensive care attempts are designed as time‐limited trials based on specified treatment goals, and this intent should be documented very clearly at the beginning of each treatment; and (2) lower survival prospects can be accepted for treatments that have already begun, compared with the respective triage rules for the initial access of patients to intensive care. (shrink)

ABSTRACTEmotions influence cognitive processes involved in memory. While some research has suggested that cognitive scope is determined by affective valence, recent models of emotion–cognition interactions suggest that motivational intensity, rather than valence, influences these processes. The present research was designed to clarify how negative affects differing in motivational intensity impact memory for centrally or peripherally presented information. Experiments 1 & 2 found that, relative to a neutral condition, high intensity negative affect enhances memory for centrally presented information. Experiment 3 replicated (...) this effect using another high intensity negative affect. Experiment 4 extended this by finding that, relative to a neutral condition, low intensity negative affect enhanced memory for peripherally presented information. Finally, in Experiment 5, the effects of sadness and threat on scope of memory were directly compared, finding that threat narrowed scope of... (shrink)

Migraine is a chronic and idiopathic disorder leading to cognitive and affective problems. However, the neural basis of migraine without aura is still unclear. In this study, dynamic amplitude of low-frequency fluctuations analyses were performed in 21 patients with migraine without aura and 21 gender- and age-matched healthy controls to identify the voxel-level abnormal functional dynamics. Significantly decreased dALFF in the bilateral anterior insula, bilateral lateral orbitofrontal cortex, bilateral medial prefrontal cortex, bilateral anterior cingulate cortex, and left middle frontal cortex (...) were found in patients with migraine without aura. The dALFF values in the anterior cingulate cortex were negatively correlated with pain intensity, i.e., visual analog scale. Finally, support vector machine was used to classify patients with migraine without aura from healthy controls and achieved an accuracy of 83.33%, sensitivity of 90.48%, and specificity of 76.19%. Our findings provide the evidence that migraine influences the brain functional activity dynamics and reveal the neural basis for migraine, which could facilitate understanding the neuropathology of migraine and future treatment. (shrink)

Contextual affective information influences the processing of facial expressions at the relatively early stages of face processing, but the effect of the context on the processing of facial expressions with varying intensities remains unclear. In this study, we investigated the influence of emotional scenes on the processing of fear expressions at different levels of intensity during the early stages of facial recognition using event-related potential technology. EEG data were collected while participants performed a fearful facial expression recognition task. The (...) results showed that the recognition of high-intensity fear expression was higher than that of medium- and low-intensity fear expressions. Facial expression recognition was the highest when faces appeared in fearful scenes. Emotional scenes modulated the amplitudes of N170 for fear expressions with different intensities. Specifically, the N170 amplitude, induced by high-intensity fear expressions, was significantly higher than that induced by low-intensity fear expressions when faces appeared in both neutral and fearful scenes. No significant differences were found between the N170 amplitudes induced by high-, medium-, and low-intensity fear expressions when faces appeared in happy scenes. These results suggest that individuals may tend to allocate their attention resources to the processing of face information when the valence between emotional context and expression conflicts i.e., when the conflict is absent or is low. (shrink)

A sociological conceptualisation of space moves beyond the material to the relational, to consider space as a social process. This paper draws on research that explored the reproduction of legitimated knowledge and power structures in intensive care units during encounters, between patients, who were experiencing mental illness, and their nurses. Semi‐structured telephone interviews with 17 intensive care nurses from eight Australian intensive care units were conducted in 2017. Data were analysed through iterative cycling between participants' responses, the literature and the (...) theoretical framework. The material and relational aspects of space in this context constitute a dynamic process that is concerned with the reproduction of everyday life, the preservation of the biomedical authority of intensive care, and the social othering of people experiencing mental illness. The work of theorists such as Löw, Harvey and Foucault underpins the exploration of space as a multi‐dimensional, malleable social process that both produces and is the product of social interaction and the social world. In this paper, we argue that the performative work of knowledge and power production and reproduction, considered here in relation to intensive care spaces, enables ongoing othering and disenfranchisement of people experiencing mental illness. (shrink)

Drawing on the behavioral theory, this study examines how the misalignment between a firm's environmental effort and the level of subsidies received from the government in affecting the firm's investment in non-environmental R&D. Based on a sample of Chinese A-share listed firms from 2008 to 2019 and using polynomial regression techniques, our findings reveal that firms in the “low effort-high subsidies” group exhibit lower non-environmental R&D intensity compared to firms in the “high effort-low subsidies” group. This study contributes to the (...) literature by shedding light on the interplay between corporate environmental efforts, government subsidies, and non-environmental R&D investment. The findings suggest the importance of aligning the environmental efforts of firms with subsidy levels from the government to effectively allocate resources for different types of R&D. The implications of this research suggest that firms should carefully consider aligning their environmental efforts with government subsidies to optimize their investment in non-environmental R&D and overall innovation strategy. Furthermore, the study indicates that firms and governments should prudently balance the relationship between environmental R&D and non-environmental R&D to avoid any negative impact on the latter. (shrink)

Background End-of-life decisions for neonates with adverse prognosis are controversial and raise ethical and legal issues. In Greece, data on physicians’ profiles, motivation, values and attitudes underlying such decisions and the correlation with their background are scarce. The aim was to investigate neonatologists' attitudes in Neonatal Intensive Care Units and correlate them with self-reported practices of end-of-life decisions and with their background data. Methods A structured questionnaire was distributed to all 28 Neonatal Intensive Care Units in Greece. One hundred and (...) sixty two out of 260 eligible physicians answered anonymously the questionnaire. Demographic and professional characteristics, self-reported practices and opinions were included in the questionnaire, along with a questionnaire of 12 items measuring physicians’ attitude and views ranging from value of life to quality of life approach. Results Continuation of treatment in neonates with adverse prognosis without adding further therapeutic interventions was the most commonly reported EoL practice, when compared to withdrawal of mechanical ventilation. Physicians with a high attitude score were more likely to limit, while those with a low score were more likely for continuation of intensive care. Physicians’ educational level, involvement in research, religion and position on the existing legal framework were factors that affected the attitude score. Conclusions Physicians presented with varying end-of-life practices. Limiting interventions in neonates with poor prognosis was strongly related to their attitudes. The most important predictors for physicians' attitudes were religiousness and belief for Greek legal system reform. (shrink)

The emotion of anger, when chronic, is especially problematic. Frequent and intense experiences of anger predict quite a few adverse health outcomes and are especially implicated in cardiovascular...

Given the prevalence of corporate frauds and the significance of whistle blowing as a mechanism to report about the frauds, the present study explores the impact of ethical leadership and leader–member exchange (LMX) on whistle blowing. Additionally, the article also explores the moderating role of the moral intensity [studied as magnitude of consequences (MOC)] of the issue on this relationship. The article reports results of three experimental studies conducted on the postgraduate students of a premier technology institute in India. Ethical (...) leadership, LMX, and moral intensity are manipulated through scenarios. Study one ( n = 81) manipulates ethical leadership (ethical/unethical) and quality of LMX (low and high) as independent variables; study two ( n = 80) manipulates ethical leadership and moral intensity (high and low MOC), and study three ( n = 87) manipulates LMX and MOCs to assess their individual and joint effects on whistle blowing. Results show that not only do ethical leadership and LMX predict whistle blowing, but these relationships get moderated by the moral intensity of the issue as well. (shrink)

Developmental Dyslexia significantly interferes with children’s academic, personal, social, and emotional functioning. Nevertheless, therapeutic options need to be further validated and tested in randomized controlled clinical trials. The use of transcranial direct current stimulation has been gaining ground in recent years as a new intervention option for DD. However, there are still open questions regarding the most suitable tDCS protocol for young people with DD. The current crossover study tested the effectiveness of a short and intensive tDCS protocol, including the (...) long-term effects, as well as the influence of age and neuropsychological processes at baseline on reading improvements. Twenty-four children and adolescents with DD were randomly assigned to receive active tDCS during the first slot and sham tDCS during the second slot or vice versa. Five consecutive daily sessions of left anodal/right cathodal tDCS set at 1 mA for 20 min were administered over the parieto-occipital regions. Reading measures and neuropsychological measures were collected before, immediately after, 1 week and 1 month later the treatment. Our results showed that only the active tDCS condition improved non-word reading speed immediately after and 1 month later the end of the treatment compared with baseline. In addition, the improvement in non-word reading speed was significantly correlated with age and with neuropsychological measures at baseline but only in the active tDCS condition. The current crossover study contributed to enforce previous effects of tDCS, including long-term effects, on non-word reading speed and to understand the effect of age and neuropsychological processes on reading outcomes. Our findings showed that tDCS could be a low-cost and easy-to-implement treatment option with long-term effects for children and adolescents with DD. (shrink)

The goal of this study was to construct a valid new instrument to measure the effect of moral intensity on managers' propensity to manage earnings. More specifically, this study is a pilot study of the impact of moral intensity on financial accountants' propensity to manage earnings. The instrument, once validated, will be used in a full-study of managers in the hotel industry. Different ethical scenarios were presented to respondents in the survey; each ethical scenario was designed in both high or (...) low moral intensity form, to reflect the importance of the moral dilemma at hand. The results were analysed by factor analysis. The findings of this study have positively validated the instrument, with three of the five moral intensity components identified as having appropriate eigenvalues. This indicates that they have a significant influence in the study. The first factor captures the social consensus dimension and one scenario of the proximity dimension. The second factor indicates an interaction between the temporal immediacy and the magnitude of consequences dimension. The third dimension is probability of effect and one scenario of the proximity dimension. In addition, t-tests indicated that the manipulation of high and low conditions within each scenario were also successful. One limitation of the study might be the use of undergraduate accounting students as manager proxies, although prior evidence suggests use of accounting students as proxies is a valid approach in this type of study. This is a highly novel project as most prior studies have focussed on moral intensity and the general ethical decision-making process. (shrink)