Background There has been little attention paid to research on the outcomes of clinical ethics support or critical reflection on what constitutes a good CES outcome. Understanding how CES users perceive the importance of CES outcomes can contribute to a better understanding, use of and normative reflection on CES outcomes. Objective To describe the perceptions of Dutch healthcare professionals on important outcomes of moral case deliberation, prior to MCD participation, and to compare results between respondents. Methods (...) This mixed-methods study used both the Euro-MCD instrument and semi-structured interviews. Healthcare professionals who were about to implement MCD were recruited from nursing homes, hospitals, psychiatry and mentally disabled care institutions. Results 331 healthcare professionals completed the Euro-MCD instrument, 13 healthcare professionals were interviewed. The outcomes perceived as most important were ‘more open communication’, ‘better mutual understanding’, ‘concrete actions’, ‘see the situation from different perspectives’, ‘consensus on how to manage the situation’ and ‘find more courses of action’. Interviewees also perceived improving quality of care, professionalism and the organization as important. Women, nurses, managers and professionals in mentally disabled care rated outcomes more highly than other respondents. Conclusions Dutch healthcare professionals perceived the MCD outcomes related to collaboration as most important. The empirical findings can contribute to shared ownership of MCD and a more specific use of MCD in different contexts. They can inform international comparative research on different CES types and contribute to normative discussions concerning CES outcomes. Future studies should reflect upon important MCD outcomes after having experienced MCD. (shrink)

Unethical conduct has reached crisis proportions in business :A1–A10, 2011) and on today’s college campuses :58–65, 2007). Despite the evidence that suggests that more than half of business students admit to dishonest practices, only about 5 % of business school deans surveyed believe that dishonesty is a problem at their schools :299–308, 2010). In addition, the AACSB which establishes standards for accredited business schools has resisted the urging of deans and business experts to require business schools to teach an ethics (...) class, and fewer than one-third of businesses schools now teach a business ethics course at the graduate or undergraduate levels. In this paper we briefly introduce the status of business ethics education and report the results of a survey of business students, deans of the top business schools, and business ethics subject matter experts about ten ethical outcomes. We then offer five specific recommendations to encourage business ethics faculty and decision makers to improve the teaching of business ethics. (shrink)

In a series of ten preregistered experiments (N=2043), we investigate the effect of outcome valence on judgments of probability, negligence, and culpability – a phenomenon sometimes labelled moral (and legal) luck. We found that harmful outcomes, when contrasted with neutral outcomes, lead to increased perceived probability of harm ex post, and consequently to increased attribution of negligence and culpability. Rather than simply postulating a hindsight bias (as is common), we employ a variety of empirical means to demonstrate that (...) the outcome-driven asymmetry across perceived probabilities constitutes a systematic cognitive distortion. We then explore three distinct strategies to alleviate the hindsight bias and its downstream effects on mens rea and culpability ascriptions. Not all are successful, but at least some prove promising. They should, we argue, be taken into consideration in criminal jurisprudence, where distortions due to the hindsight bias are likely considerable and deeply disconcerting. (shrink)

Clinical ethics support, in particular Moral Case Deliberation, aims to support health care providers to manage ethically difficult situations. However, there is a lack of evaluation instruments regarding outcomes of clinical ethics support in general and regarding Moral Case Deliberation (MCD) in particular. There also is a lack of clarity and consensuses regarding which MCD outcomes are beneficial. In addition, MCD outcomes might be context-sensitive. Against this background, there is a need for a standardised but flexible outcome (...) evaluation instrument. The aim of this study was to develop a multi-contextual evaluation instrument measuring health care providers’ experiences and perceived importance of outcomes of Moral Case Deliberation. (shrink)

The decision-theoretic account of probability in the Everett or many-worlds interpretation, advanced by David Deutsch and David Wallace, is shown to be circular. Talk of probability in Everett presumes the existence of a preferred basis to identify measurement outcomes for the probabilities to range over. But the existence of a preferred basis can only be established by the process of decoherence, which is itself probabilistic.

The prevalence and complexity of local sustainable development challenges require coordinated action from multiple actors in the business, public, and civil society sectors. Large multi-stakeholder partnerships that build capacity by developing and leveraging the diverse perspectives and resources of partner organizations are becoming an increasingly popular approach to addressing such challenges. Multi-stakeholder partnerships are designed to address and prioritize a social problem, so it can be challenging to define the value proposition to each specific partner. Using a resource-based view, this (...) study examines partner outcomes from the perspective of the strategic interest of the partner as distinct from the strategic goal of the partnership. Based on 47 interviews with representatives of partner organizations in four Canadian case studies of community sustainability plan implementation, this article details 10 resources partners can gain from engaging in a multi-stakeholder partnership. (shrink)

In Nigeria, as in other developing countries, access to training in research ethics is limited, due to weak social, economic, and health infrastructure. The project described in this article was designed to develop the capacity of academic staff of the College of Medicine, University of Ibadan, Nigeria to conduct ethically acceptable research involving human participants.

BackgroundThere is a lack of empirical research regarding the outcomes of such clinical ethics support methods as moral case deliberation. Empirical research in how healthcare professionals perceive potential outcomes is needed in order to evaluate the value and effectiveness of ethics support; and help to design future outcomes research. The aim was to use the European Moral Case Deliberation Outcome Instrument instrument to examine the importance of various MCD outcomes, according to healthcare professionals, prior to participation.MethodsA (...) North European field survey among healthcare professionals drawn from 73 workplaces in a variety of healthcare settings in the Netherlands, Norway and Sweden. The Euro-MCD instrument was used.ResultsAll outcomes regarding the domains of moral reflexivity, moral attitude, emotional support, collaboration, impact at organisational level and concrete results, were perceived as very or quite important by 76%–97% of the 703 respondents. Outcomes regarding collaboration and concrete results were perceived as most important. Outcomes assessed as least important were mostly about moral attitude. ‘Better interactions with patient/family’ emerged as a new domain from the qualitative analysis. Dutch respondents perceived most of the outcomes as significantly less important than the Scandinavians, especially regarding emotional support. Furthermore, men, those who were younger, and physician-respondents scored most of the outcomes as statistically significantly less important compared with the other respondents.ConclusionsThe findings indicate a need for a broad instrument such as the Euro-MCD. Outcomes related to better interactions between professionals and patients must also be included in the future. The empirical findings raise the normative question of whether outcomes that were perceived as less important, such as moral reflexivity and moral attitude outcomes, should still be included. In the future, a combination of empirical findings and normative reflection will contribute to the revision of the instrument. (shrink)

The decision-theoretic account of probability in the Everett or many-worlds interpretation, advanced by David Deutsch and David Wallace, is shown to be circular. Talk of probability in Everett presumes the existence of a preferred basis to identify measurement outcomes for the probabilities to range over. But the existence of a preferred basis can only be established by the process of decoherence, which is itself probabilistic.

The paper extends the framework of outcomes in branching space-time (Kowalski and Placek [1999]) by assigning probabilities to outcomes of events, where these probabilities are interpreted either epistemically or as weighted possibilities. In resulting models I define the notion of common cause of correlated outcomes of a single event, and investigate which setups allow for the introduction of common causes. It turns out that a deterministic common cause can always be introduced, but (surprisingly) only special setups permit (...) the introduction of truly stochastic common causes. I analyse next the Bell-Aspect experiment and derive the Bell-CH inequalities. I observe that we postulate there not a common cause for outcomes of a single event but rather a common common cause that accounts for outcomes of many events, where 'events' mean 'measurements with (different) directions of polarization'. Since the inequalities are violated, I claim that no causal story can be told about the Bell correlations, where causality is subliminal and restricted by screening-off condition. Similarly, given certain intuitive principles, no deterministic story can be told about these correlations. (shrink)

The outcome set of a belief change operator is the set of outcomes that can be obtained with it. Axiomatic characterizations are reported for the outcome sets of the standard AGM contraction operators and eight types of base-generated contraction. These results throw new light on the properties of some of these operators.

We reconsider the nonlocal aspects of quantum mechanics with special reference to the EPR argument. We first confine our considerations to the correlations between the outcomes of measurements on spatially distant constituents, without worrying about the measurement problem. We pay particular attention to the relativistic aspects of the problem. Our first conclusion is that, when developed along the lines we follow, the EPR inference that quantum correlations and locality together imply incompleteness, is appropriate. We then investigate whether the other (...) common conclusion from the EPR argument, i.e. that standard quantum theory implies a spooky action at a distance, is correct. We emphasize the crucial role played by the locality assumption and we discuss the use of counterfactuals in the ‘relativistic’ reformulation of the EPR argument. We show that the above conclusion is false if understood as saying that standard quantum theory exhibits, at least with reference to possessed elements of physical reality, some sort of parameter dependence. Thus, in a sense, the coexistence of quantum mechanics with relativity is even more peaceful than commonly thought. We then go through a similar analysis by taking explicitly into account the measurement process. We point out the difficulties which one meets when confronting reduction mechanisms with relativistic requirements. This leads us to recognize the necessity of reconsidering the criteria for attributing objective properties to individual physical systems. Our final conclusion is that, in principle, it is perfectly possible to build up theories leading to the objectification of macroscopic properties which do not imply any spooky action at a distance. (shrink)

The paper intends to provide an algebraic framework in which subluminal causation can be analysed. The framework merges Belnap's 'outcomes in branching time' with his 'branching space-time' (BST). it is shown that an important structure in BST, called 'family of outcomes of an event', is a boolean algebra. We define next non-stochastic common cause and analyse GHZ-Bell theorems. We prove that there is no common cause that accounts for results of GHZ-Bell experiment but construct common causes for two (...) other quantum mechanical setups. Finally, we investigate why some setups allow for common causes whereas other setups do not. (shrink)

Outcome-adaptive randomization has been proposed as a corrective to certain ethical difficulties inherent in the traditional randomized clinical trial using fixed-ratio randomization. In particular, it has been suggested that OAR redresses the balance between individual and collective ethics in favour of the former. In this paper, I examine issues of welfare and autonomy arising in relation to OAR. A central issue in discussions of welfare in OAR is equipoise, and the moral status of OAR is crucially influenced by the way (...) in which this concept is construed. If OAR is based on a model of equipoise that demands strict indifference between competing interventions throughout the trial, such equipoise is disturbed by accruing data favouring one treatment over another; OAR seeks to redress this by weighting randomization to the seemingly superior treatment. However, this is a partial response, as patients continue to be allocated to the inferior therapy. Moreover, it rests upon considerations of aggregate harms and benefits, and does not therefore uphold individual ethics. Issues of fairness also arise, as early and late enrollees are randomized on a different basis. Fixed-ratio randomization represents a fuller and more consistent response to a loss of equipoise, as so construed. With regard to consent, the complexity of OAR poses challenges to adequate disclosure and comprehension. Additionally, OAR does not offer a remedy to the therapeutic misconception—participants’ tendency to attribute treatment allocation in an RCT to individual clinical judgments, rather than to scientific considerations—and, if anything, accentuates rather than alleviates this misconception. In relation to these issues, OAR fails to offer ethical advantages over fixed-ratio randomization. More broadly, the ethical basis of OAR can be seen to lie more in collective than in individual ethics, and overall it fares worse in this territory than fixed-ratio randomization. (shrink)

Data from medical research are typically summarized with various types of outcome measures. We present three arguments in favor of absolute over relative outcome measures. The first argument is from cognitive bias: relative measures promote the reference class fallacy and the overestimation of treatment effectiveness. The second argument is decision-theoretic: absolute measures are superior to relative measures for making a decision between interventions. The third argument is causal: interpreted as measures of causal strength, absolute measures satisfy a set of desirable (...) properties, but relative measures do not. Absolute outcome measures outperform relative measures on all counts. (shrink)

Models of intertemporal choice draw on three evaluation rules, which we compare in the restricted domain of choices between smaller sooner and larger later monetary outcomes. The hyperbolic discounting model proposes an alternative-based rule, in which options are evaluated separately. The interval discounting model proposes a hybrid rule, in which the outcomes are evaluated separately, but the delays to those outcomes are evaluated in comparison with one another. The tradeoff model proposes an attribute-based rule, in which both (...) outcomes and delays are evaluated in comparison with one another: People consider both the intervals between the outcomes and the compensations received or paid over those intervals. We compare highly general parametric functional forms of these models by means of a Bayesian analysis, a method of analysis not previously used in intertemporal choice. We find that the hyperbolic discounting model is outperformed by the interval discounting model, which, in turn, is outperformed by the tradeoff model. Our cognitive modeling is among the first to offer quantitative evidence against the conventional view that people make intertemporal choices by discounting the value of future outcomes, and in favor of the view that they directly compare options along the time and outcome attributes. (shrink)

During the 1990s, international society increasingly recognised that states who abuse their citizens in the most egregious ways ought to lose their sovereign inviolability and be subject to humanitarian intervention. The emergence of this norm has given renewed significance to the debate concerning what it is about humanitarian intervention that makes it legitimate. The most popular view is that it is humanitarian motivations that legitimise intervention. Others insist that humanitarian outcomes are more important that an actor's motivations, pointing for (...) instance to the ousting of the Khmer Rouge by Vietnam. Given the centrality of this debate, this article reinvestigates the ?motives versus outcomes? debate and suggests an alternative reading based on the classic Just War tradition. It argues that an actor's intentions are vital to assessing the legitimacy of an intervention. (shrink)

How do people respond to others' accidental behaviors? Reward and punishment for accidents might be depend on the actor's intentions, or instead on the unintended outcomes she brings about. Yet, existing paradigms in experimental economics do not include the possibility of accidental monetary allocations. We explore the balance of outcomes and intentions in a two-player economic game where monetary allocations are made with a "trembling hand": that is, intentions and outcomes are sometimes mismatched. Player 1 allocates $10 (...) between herself and Player 2 by rolling one of three dice. One die has a high probability of a selfish outcome, another has a high probability of a fair outcome, and the third has a high probability of a generous outcome. Based on Player 1's choice of die, Player 2 can infer her intentions. However, any of the three die can yield any of the three possible outcomes. Player 2 is given the opportunity to respond to Player 1's allocation by adding to or subtracting from Player 1's payoff. We find that Player 2's responses are influenced substantially by the accidental outcome of Player 1's roll of the die. Comparison to control conditions suggests that in contexts where the allocation is at least partially under the control of Player 1, Player 2 will punish Player 1 accountable for unintentional negative outcomes. In addition, Player 2's responses are influenced by Player 1's intention. However, Player 2 tends to modulate his responses substantially more for selfish intentions than for generous intentions. This novel economic game provides new insight into the psychological mechanisms underlying social preferences for fairness and retribution. (shrink)

To improve the value of pharmaceutical spending, some manufacturers and payers have introduced outcomes-based contracts, where rebates are tied to specified outcomes. We reviewed the literature and interviewed key experts to assess these contracts' potential to slow pharmaceutical spending. We found that while outcomes-based contracts are increasingly common in the US, they are still limited by multiple factors — including the lack of meaningful outcomes data. Moreover, there is no evidence to date that they slow pharmaceutical (...) spending or increase access. Experts favored having CMS test and rigorously evaluate this model to achieve a better understanding of the implications. (shrink)

Case-based instruction has been regarded by many as a viable alternative to traditional lecture-based education and training. However, little is known about how case-based training techniques impact training effectiveness. This study examined the effects of two such techniques: (a) presentation of alternative outcome scenarios to a case, and (b) conducting a structured outcome evaluation. Consistent with the hypotheses, results indicate that presentation of alternative outcome scenarios reduced knowledge acquisition, reduced sensemaking and ethical decision-making strategy use, and reduced decision ethicality. Conducting (...) a structured outcome evaluation had no impact on these outcomes. Results indicate that those who use case-based instruction should take care to use clear, less complex cases with only a singular outcome if they are seeking these types of outcomes. (shrink)

AimsIn this pilot mixed-methods study, we examined the participants experiences of engaging in virtual drawing tasks and the impact of an olfactory stimulus on outcomes of affect, stress, self-efficacy, anxiety, creative agency, and well-being.MethodsThis study used a parallel mixed-methods, simple block randomization design. The study participants included 24 healthy adults aged 18 to 54 years, including 18 women and six men. The participants completed two 1-h immersive virtual art making sessions and were randomly assigned to receive either a fragrance (...) or a non-fragrance condition for the first session. Quantitative and qualitative datasets were collected concurrently and integrated during data analysis.ResultsThe quantitative results indicated that the fragrance condition demonstrated a significant reduction in negative affect, namely, reduced feelings of negativity when compared to the non-fragrance condition. A trend toward improvement in self-efficacy was also seen in the fragrance condition. No significant changes were found for fragrance or non-fragrance conditions for positive affect, anxiety, and creative agency. The qualitative findings included five themes related to art making experiences in virtual reality in both conditions: fun and joy; novelty of virtual media, experimentation, and play; relaxation and calm; learning curve; and physical discomfort and disorientation. Four themes were identified for virtual art content and visual qualities: nature imagery, references to memories and personal symbols, fantasy and play within imagery, and depiction of everyday objects.ConclusionsOverall, the participants reported positive responses to the novel virtual art making experiences which were further heightened by the inclusion of the fragrance stimulus for negative affect. These preliminary findings need to be replicated with larger sample sizes to confirm the outcomes and the trends that were seen in this pilot study. Further research is recommended to examine the differences between experiences of virtual and traditional art media and to examine different olfactory stimuli promoting focus and concentration. (shrink)

The term ‘intelligence’ as used in this paper refers to items of knowledge collected for the sake of assessing and maintaining national security. The intelligence community (IC) of the United States (US) is a community of organizations that collaborate in collecting and processing intelligence for the US. The IC relies on human-machine-based analytic strategies that 1) access and integrate vast amounts of information from disparate sources, 2) continuously process this information, so that, 3) a maximally comprehensive understanding of world actors (...) and their behaviors can be developed and updated. Herein we describe an approach to utilizing outcomes-based learning (OBL) to support these efforts that is based on an ontology of the cognitive processes performed by intelligence analysts. Of particular importance to the Cognitive Process Ontology is the class Representation that is Warranted. Such a representation is descriptive in nature and deserving of trust in its veridicality. The latter is because a Representation that is Warranted is always produced by a process that was vetted (or successfully designed) to reliably produce veridical representations. As such, Representations that are Warranted are what in other contexts we might refer to as ‘items of knowledge’. (shrink)

This article is a response to some of the criticisms made of How Revolutionary were the Bourgeois Revolutions? by Gerstenberger, Post and Riley. In particular, it focuses on two issues of definition – that of capitalism and the capitalist nation-state – which arise from the book’s ‘consequentialist’ claim that bourgeois revolutions are defined by a particular outcome: the establishment of nation-states dedicated to the accumulation of capital.

This article introduces the concept of a Moment of Equal Opportunity (MEO): a point in an individual’s life at which equal opportunity must be applied and after which it need not. The concept of equal opportunity takes many forms, and not all employ an MEO. However, the more egalitarian a theory of equal opportunity is, the more likely it is to use an MEO. The article discusses various theories of equal opportunity and argues that those that employ an MEO are (...) problematic. Unjust inequalities, those that motivate the use of equal opportunity, occur throughout people’s lives and thus go unrectified after an MEO. However, it is not possible to abandon the MEO approach and apply more egalitarian versions of equal opportunity throughout a person’s life, since doing so entails problems of epistemology, efficiency, incentives, and counter-intuitive results. The article thus argues that liberal egalitarian theories of equality of opportunity are inconsistent if they support an MEO and unrealizable if they do not. (shrink)

The primary purpose of this study is to identify differences in at­tainment of learning outcomes for ethics courses delivered using two distinct teaching approaches. The first approach uses a case based method in the context of applied moral issues within medical practice. The second approach surveys moral theories in the context of applied moral issues. Significant differences are found in the attainment of learner outcomes between the two groups. In particular, attainment of outcomes related to moral decision-making (...) is higher in those students who take the course with a case based method. In contrast, attainment of outcomes related to personal beliefs about applied moral issues is higher in those students who take an introductory ethics course surveying moral theories in the context of applied issues. Neither of these results is especially surprising. What may be surprising, however, is that students in the case-based course do not appear attain learner outcomes with regard to applied moral issues despite studying those issues in detail. Finally, the assessment tool developed and refined through this study may be of use for assessment in a variety of ethics courses. (shrink)

Learning outcomes currently play an increasingly important role in higher education. This paper identifies a number of key issues that need to be taken into account in identifying and making use of them. It includes a review of the background from which learning outcomes have emerged. It also highlights the behaviourist approach underlying their use in teaching and assessment and identifies key issues that need to be taken into account in adopting such an approach.

Despite the growing population of youth identifying with a transgender or nonbinary gender identity, research on gender-diverse individuals’ educational outcomes is limited. This study takes advantage of the first nationally representative, population-based data set that includes measures of gender identity and educational outcomes: the High School Longitudinal Study of 2009. Using minority stress and structural symbolic interactionist frameworks, we examine the association between gender identity and high school and college educational outcomes. We compare the educational outcomes (...) of gender-diverse youth—binary transgender, nonbinary, and gender unsure—with those of cisgender youth, and also examine differences within the gender-diverse population. Given the strong link between minority stress and educational experiences among gender-diverse youth, we examine differences in outcomes before and after accounting for school belonging and emotional distress. We also account for individuals’ social-structural location, arguing that social positionality shapes both gender identity and educational outcomes. Results indicate important differences in educational outcomes within the gender-diverse population: Whereas binary transgender and gender-unsure youth exhibit educational disadvantage, relative to cisgender youth, nonbinary youth do not. The gender-unsure disadvantage remains even after accounting for differences in social-structural location and social-psychological factors associated with minority stress. (shrink)

BackgroundIn paediatric oncology, healthcare professionals face moral challenges. Clinical ethics support services, such as moral case deliberation, aim to assist them in dealing with these challenges. Yet, healthcare professionals can have different expectations and goals related to clinical ethics support services.MethodsIn this study, the perceptions held by healthcare professionals regarding the importance of possible outcomes of MCDs, prior to implementation of MCDs, were investigated. A multisite, cross-sectional, quantitative study was performed at all six Paediatric Oncology Centres in Sweden. Healthcare (...) professionals answered the Euro-MCD instrument with 26 potential MCD outcomes using a scale from Not important to Very important. Descriptive and comparative statistical analyses were carried out.ResultsAll outcomes were rated high, i.e., between 3.12 and 3.78. More open communication, developing skills to analyse ethically difficult situations, better mutual understanding, and deciding on concrete actions were rated as most important. Understanding of ethical theories and critical examination of policies were rated less important. Most often nursing assistants rated higher and physicians lower than the other professions did. Women and participants without previous experience of MCDs perceived outcomes as more important. There were differences between centres as one centre had significantly higher, and one centre had significantly lower ratings compared to the others.ConclusionIt is clear that healthcare professionals want MCDs to improve teamwork and skills in order to analyse and manage ethically difficult situations. When comparing to previous research about important MCD outcomes, there were similarities in what healthcare professionals consider to be important when handling moral challenges regardless of country and potential differences in healthcare settings and systems, such as paediatric vs. adult care. (shrink)

In a typical comparative clinical trial the randomization scheme is fixed at the beginning of the study, and maintained throughout the course of the trial. A number of researchers have championed a randomized trial design referred to as ‘outcome-adaptive randomization.’ In this type of trial, the likelihood of a patient being enrolled to a particular arm of the study increases or decreases as preliminary information becomes available suggesting that treatment may be superior or inferior. While the design merits of outcome-adaptive (...) trials have been debated, little attention has been paid to significant ethical concerns that arise in the conduct of such studies. These include loss of equipoise, lack of processes for adequate informed consent, and inequalities inherent in the research design which could lead to perceptions of injustice that may have negative implications for patients and the research enterprise. This article examines the ethical difficulties inherent in outcome-adaptive trials. (shrink)

Intrauterine insemination is one of many treatments provided to infertility patients. Many factors such as, but not limited to, quality of semen, the age of a woman, and reproductive hormone levels contribute to infertility. Therefore, the aim of our study is to establish a statistical probability concerning the prediction of which groups of patients have a very good or poor prognosis for pregnancy after IUI insemination. For that purpose, we compare the results of two analyses: Cluster Analysis and Kohonen Neural (...) Networks. The k-means algorithm from the clustering methods was the best to use for selecting patients with a good prognosis but the Kohonen Neural Networks was better for selecting groups of patients with the lowest chances for pregnancy. (shrink)

In the introduction to a recent anthology of contemporary issues in philosophy of psychiatry, editors Jeffrey Poland and Şerife Tekin declare this to be a moment of crisis within the field. They suggest that the state of psychiatry today reflects Thomas Kuhn's conception of a period of extraordinary science, which occurs when anomalies begin to build up, confidence in the dominant paradigm is shook, competing theories arise, and philosophical questions come to the fore. Although perhaps not all would agree that (...) the field is in crisis, there is certainly an abundance of pessimism. Within the realm of research, a mood of explanatory pessimism has been growing, characterized by a... (shrink)

For public health professionals, traumatic brain injury and its possible protracted repercussions are a significant source of worry. In opposed to patient neurorehabilitation with developed brain abnormalities of different etiologies, neurorehabilitation of affected persons has several distinct features. The clinical repercussions of the various types of TBI injuries will be discussed in detail in this paper. During severe TBI, the medical course frequently follows a familiar first sequence of coma, accompanied by disordered awareness, followed by agitation and forgetfulness, followed by (...) return of function. Clinicians must be aware of common medical issues that might occur throughout the various stages of neurorehabilitation, for example, posttraumatic hydrocephalus, paroxysmal sympathetic hyperactivity and posttraumatic neuroendocrine disorders, at each step of the process. Furthermore, we address problems about the scheduling of various rehabilitation programs as well as the availability of current data for comprehensive rehabilitative neuropsychology techniques. (shrink)

This paper presents an axiomatization of the principle of maximizing expected utility that does not rely on the independence axiom or sure-thing principle. Perhaps more importantly the new axiomatization is based on an ex ante approach, instead of the standard ex post approach. An ex post approach utilizes the decision maker's preferences among risky acts for generating a utility and a probability function, whereas in the ex ante approach a set of preferences among potential outcomes are on the input (...) side of the theory and the decision maker's preferences among risky acts on the output side. (shrink)

We build on limited research concerning the mediation processes associated with the relationship between ethical culture and employee outcomes. A multidimensional measure of ethical culture was examined for its relationship to overall Person-Organization (P–O) fit and employee response, using a sample of 436 employees from social economy and commercial banks in Spain. In line with previous research involving unidimensional measures, ethical culture was found to relate positively to employee job satisfaction, affective commitment, and intention to stay. New to the (...) literature, ethical culture was also found to be associated positively with employee willingness to recommend the organization to others. These effects were observed even when perceptions of P–O fit were controlled. Importantly, ethical culture was also positively related to overall P–O fit, which in turn, partially mediated the relationship between ethical culture and employee outcomes. Our findings add to studies that focus on the importance of the degree of ethical congruence between the individual employee and the organization. They suggest that ethical culture, with its expected impact on virtuousness and emotional well-being, will positively influence outcomes independently of the degree to which there is a match between employee and organizational values. (shrink)

The dropout rate among Spanish university students is very high compared to the European mean, creating a pressing need for the introduction of policies and programmes aimed at increasing rates of persistence. In this article, we study this problem by combining students? perceived learning outcomes with their dropout intentions, and we propose a research model that considers subjective factors that might impact this decision. The model is estimated for two degree courses: Business Administration and Nursing. The estimation method uses (...) structural equations based on the partial least squares algorithm. This allows the construction of indices for the variables of interest, enabling us to make comparisons between courses and over time. To reduce dropout intentions, efforts need to be focused on obtaining better cognitive outcomes, as well as on achieving a higher level of student satisfaction with their university experience. (shrink)

Learning outcomes currently play an increasingly important role in higher education. This paper identifies a number of key issues that need to be taken into account in identifying and making use of them. It includes a review of the background from which learning outcomes have emerged. It also highlights the behaviourist approach underlying their use in teaching and assessment and identifies key issues that need to be taken into account in adopting such an approach.

In the traditional fix-it model of medical decision making, the identified problem is typically characterized by a diagnosis that indicates a deviation from normalcy. When a medical problem is multifaceted and the available interventions are only partially effective, a broader vision of the health care endeavor is needed. What matters to the patient, and what should matter to the practitioner, is the patient's future possibilities. More specifically, what is important is the character of the alternative futures that the patient could (...) have and choosing among them so as to achieve the best future possible, with the ranking of outcomes determined by the patient's preferences. This paper describes the fix-it model, presents and defends the outcomes-based model, and demonstrates that the latter is useful in developing normative conceptions of informed consent and decision making and in establishing a basis for societal involvement in the decision making process. Finally, several shortcomings of the model will be acknowledged. (shrink)