BackgroundThe COVID-19 pandemic has created ethical challenges for intensive care unit (ICU) professionals, potentially causing moral distress. This study explored the levels and causes of moral distress and the ethical climate in Dutch ICUs during COVID-19.MethodsAn extended version of the Measurement of Moral Distress for Healthcare Professionals (MMD-HP) and Ethical Decision Making Climate Questionnaire (EDMCQ) were online distributed among all 84 ICUs. Moral distress scores in nurses and intensivists were compared with the historical control group one year before COVID-19. ResultsThree (...) hundred forty-five nurses (70.7%), 40 intensivists (8.2%), and 103 supporting staff (21.1%) completed the survey. Moral distress levels were higher for nurses than supporting staff. Moral distress levels in intensivists did not differ significantly from those of nurses and supporting staff. “Inadequate emotional support for patients and their families” was the highest-ranked cause of moral distress for all groups of professionals. Of all factors, all professions rated the ethical climate most positively regarding the culture of mutual respect, ethical awareness and support. “Culture of not avoiding end-of-life-decisions” and “Self-reflective and empowering leadership” received the lowest mean scores. Moral distress scores during COVID-19 were significantly lower for ICU nurses (p < 0.001) and intensivists (p < 0.05) compared to one year prior.ConclusionLevels and causes of moral distress vary between ICU professionals and differ from the historical control group. Targeted interventions that address moral distress during a crisis are desirable to improve the mental health and retention of ICU professionals and the quality of patient care. (shrink)

We consider an oscillator subjected to a sudden change in equilibrium position or in effective spring constant, or both—to a “squeeze” in the language of quantum optics. We analyze the probability of transition from a given initial state to a final state, in its dependence on final-state quantum number. We make use of five sources of insight: Bohr-Sommerfeld quantization via bands in phase space, area of overlap between before-squeeze band and after-squeeze band, interference in phase space, Wigner function as quantum (...) update of B-S band and near-zone Fresnel diffraction as mockup Wigner function. (shrink)

It is found that a coherent state of the cavity field can be generated in a micromaser with injected atoms in a coherent superposition of the upper and lower states. The dependence of the density matrix elements of the field on the number of injected atoms indicates that due to the same initial atomic coherence the emission of separately injected single atoms in the cavity is a cooperative process.

Zeit und Zeitlichkeit erscheinen für die Natur und die Existenz des Menschen grundlegend und fordern zugleich sein Denken wesentlich heraus. Das gilt in besonderer Weise für die Epoche des Mittelalters, in der sich Philosophen und Theologen, sowohl in Christentum als auch Islam, intensiv mit dem Thema auseinandergesetzt haben. Das daraus hervorgegangene, vielfältige und interessante Material ist oft als Gefüge aus naturphilosophischen, ethischen und religiösen Komponenten zu charakterisieren und eröffnet überraschende Einblicke - gerade in vergleichender Perspektive. Zu diesem Zweck wurden in (...) der vorliegenden Studie die zwei Denker al-Gazali ( 1111 Tus) und Meister Eckhart ( 1328 Avignon?) ausgewählt und gegenübergestellt. Nach der historischen bzw. ideengeschichtlichen Kontextualisierung beider werden im Detailzugriff auf die Texte die wichtigsten Punkte zu den jeweiligen Zeit- und Ewigkeitsvorstellungen herausgearbeitet und die Kategorien zu ihrer Gruppierung gebildet. Schliesslich werden im Vergleich die Gemeinsamkeiten und Unterschiede benannt. Die zwei Hauptthesen, denen die Arbeit dabei folgt, sind erstens die relative Ähnlichkeit der Referenzautoren, deren Zeitvorstellungen und spiritueller Ausrichtung. Und zweitens daran anknüpfend die Annahme, dass bei intellektueller und lebenspraktischer Vertiefung der Religion kulturelle und religionsspezifische Unterschiede in den Hinter- und universale Motive in den Vordergrund rücken."-- Back cover. (shrink)