PurposeSocial media has increased as a marketing channel, and Facebook is the biggest social media company globally. Facebook contains both positive and negative information about companies; therefore, it is important for companies to manage their Facebook page to best serve their own interests. Although most users are familiar with business and marketing activities on Facebook, they use it primarily for fun and personal purposes. The most effective methods for companies to use Facebook have not been clear. The personal nature of (...) Facebook presents unique challenges for companies by raising ethical and social responsibility issues that are important to users. The purpose of this paper is to discover how companies can optimize their use of Facebook as a marketing channel.Design/methodology/approachA survey was conducted. The respondents were 158 users of Facebook in Sweden; complete answers were provided by all respondents. In a series of specific questions and comments, the respondents were asked to describe an optimal marketing solution on Facebook for companies. They rated different functions, which were illustrated with pictures, to help in the cognitive process and to avoid misunderstandings.FindingsMost users who have an opinion on the issue accept marketing on Facebook, but only in the right amount. There are basically two groups: those who think that companies have no place on Facebook and those who want companies to be active on Facebook. The latter group emphasizes the importance of meaningful posts without unsolicited sales messages, and would prefer to search for the companies themselves rather than being bombarded by company messages. By far, status updates and pictures/images were found to be the most important functions to respondents.Research limitations/implicationsThe sample consisted of only Swedish users. Another limitation was that, since many Facebook users do not normally think about the implications of being exposed to marketing on Facebook, they have difficulty taking a position on many issues related to the service.Practical implicationsThe results give companies a clear idea of how to effectively use Facebook in their marketing efforts.Originality/valueA large number of companies are currently asking themselves, “How can we use Facebook in an optimal way?” The results in this study answer this question and lead directly to saving time and resources for these companies. (shrink)

Malaria is a Plasmodium parasitic disease transmitted by infected female Anopheles mosquitoes. Climatic factors, such as temperature, humidity, rainfall, and wind, have significant effects on the incidence of most vector-borne diseases, including malaria. The mosquito behavior, life cycle, and overall fitness are affected by these climatic factors. This paper presents the results obtained from investigating the optimal control strategies for malaria in the presence of temperature variation using a temperature-dependent malaria model. The study further identified the temperature ranges in (...) four different geographical regions of sub-Saharan Africa, suitable for mosquitoes. The optimal control strategies in the temperature suitable ranges suggest, on average, a high usage of both larvicides and adulticides followed by a moderate usage of personal protection such as bednet. The average optimal bednet usage mimics the solution profile of the mosquitoes as the mosquitoes respond to changes in temperature. Following the results from the optimal control, this study also investigates using a temperature-dependent model with insecticide-sensitive and insecticide-resistant mosquitoes the impact of insecticide-resistant mosquitoes on disease burden when temperature varies. The results obtained indicate that optimal bednet usage on average is higher when insecticide-resistant mosquitoes are present. Besides, the average bednet usage increases as temperature increases to the optimal temperature suitable for mosquitoes, and it decreases after that, a pattern similar to earlier results involving insecticide-sensitive mosquitoes. Thus, personal protection, particularly the use of bednets, should be encouraged not only at low temperatures but particularly at high temperatures when individuals avoid the use of bednets. Furthermore, control and reduction of malaria may be possible even when mosquitoes develop resistance to insecticides. (shrink)

A standard way to challenge convergence-based accounts of inductive success is to claim that they are too weak to constrain inductive inferences in the short run. We respond to such a challenge by answering some questions raised by Juhl (1994). When it comes to predicting limiting relative frequencies in the framework of Reichenbach, we show that speed-optimal convergence—a long-run success condition—induces dynamic coherence in the short run.

Conditional automated driving [level 3, Society of Automotive Engineers ] requires drivers to take over the vehicle when an automated system’s failure occurs or is about to leave its operational design domain. Two-stage warning systems, which warn drivers in two steps, can be a promising method to guide drivers in preparing for the takeover. However, the proper time intervals of two-stage warning systems that allow drivers with different personalities to prepare for the takeover remain unclear. This study explored the (...) class='Hi'>optimal time intervals of two-stage warning systems with insights into the drivers’ neuroticism personality. A total of 32 drivers were distributed into two groups according to their self-ratings in neuroticism. Each driver experienced takeover under the two-stage warning systems with four time intervals. The takeover performance and subjective opinions for time intervals and situation awareness were recorded. The results showed that drivers in the 5-s time interval had the best takeover preparation. Furthermore, both the 5- and 7-s time intervals resulted in more rapid takeover reactions and were rated more appropriate and useful than the 3- and 9-s time intervals. In terms of personality, drivers with high neuroticism tended to take over immediately after receiving takeover messages, at the cost of SA deficiency. In contrast, drivers with low neuroticism responded safely by judging whether they gained enough SA. We concluded that the 5-s time interval was optimal for drivers in two-stage takeover warning systems. When considering personality, drivers with low neuroticism had no strict requirements for time intervals. However, the extended time intervals were favorable for drivers with high neuroticism in developing SA. The present findings have reference implications for designers and engineers to set the time intervals of two-stage warning systems according to the neuroticism personality of drivers. (shrink)

The global COVID-19 pandemic has triggered a wide variety of psychological crises worldwide. In order to respond rapidly and efficiently to the complex challenges, mental health professionals are required to adopt a multidimensional and integrative view. Rational Emotive Behavior Therapy founded by Albert Ellis promotes rationality and self-acceptance. Logotherapy, pioneered by Viktor Frankl potentiates meaning and resilience. Both approaches are complementary and mutually enriching. The goal of this paper is to propose an integrative model of “optimal sense-making,” a concept (...) that combines both rationality and meaning, as well as the role of self-transcendence and healthy negative emotions. The model offers a theoretical and clinical foundation for efficient and effective psychological intervention plans for those affected by the pandemic. Along with theoretical background, illustrating case studies are presented to support potential application of the integrative model to affected individuals as well as the work of first-line health professionals during these times of pandemic. Implications are considered for utilizing theoretical and applied insights from the model to cultivate resilience in face of adversity and suffering. (shrink)

A simplified relationship between setting of a norm and an individual’s compliance can be characterized by three distinct stages: norm comprehension and processing; the deliberate compliance decision of the individual; and non-deliberate decision-making. On each stage, there is insight from social sciences, experimental psychology and behavioural law and economics making different predictions about individual compliance behaviour. We study the implications of extra-juridical insight as well as normative constitutional requirements on the optimal design of norms. We find considerable variance in (...) norm designs for improving compliance depending on the respective empirical insight. Regarding norm comprehension, there is ambiguity in the relationship between individual’s limited cognitive processing capacity and the constitutional law imperative for norm specificity. The stage of deliberate decision-making relates to the rationality model of human behaviour allowing for economic, reciprocal, communicative human dispositions, each of which requires different law designs to induce individual’s compliance. Homo oeconomicus responds to law design using costs as steering tool. Homo reciprocans can be directed through decentralized self-regulation, governance of small political units and belief management. And compliance of homo communicans can be induced when procedures are perceived as being fair and inclusive. Finally, the existence of non-deliberate decision-making may justify paternalistic legal measures. The findings may inform lawmakers in how to design and draft laws to optimize norm compliance. (shrink)

“Decisions from experience” (DFE) refers to a body of work that emerged in research on behavioral decision making over the last decade. One of the major experimental paradigms employed to study experienced-based choice is the “sampling paradigm”, which serves as a model of decision making under limited knowledge about the statistical structure of the world. In this paradigm respondents are presented with two payoff distributions, which, in contrast to standard approaches in behavioral economics, are specified not in terms of explicit (...) outcome-probability information, but by the opportunity to sample outcomes from each distribution without economic consequences. Participants are encouraged to explore the distributions until they feel confident enough to decide from which they would prefer to draw from in a final trial involving real monetary payoffs. One commonly employed measure to characterize the behavior of participants in the sampling paradigm is the sample size, that is, the number of outcome draws which participants choose to obtain from each distribution prior to terminating sampling. A natural question that arises in this context concerns the “optimal” sample size, which could be used as a normative benchmark to evaluate human sampling behavior in DFE. In this theoretical manuscript, we relate the DFE sampling paradigm to the classical statistical decision theoretic literature and, under a probabilistic inference assumption, evaluate optimal sample sizes for decisions from experience. In our treatment we go beyond analytically established results by showing how the classical statistical decision theoretic framework can be used to derive optimal sample sizes under arbitrary, but numerically evaluable, constraints. Finally, we critically evaluate the value of deriving optimal sample sizes under this framework as testable predictions for the experimental study of sampling behavior in DFE. (shrink)

Emergency services personnel are a high stress occupation, being frequently confronted with highly consequential stressors and expected to perform: without fault; under high pressure; and in unpredictable circumstances. Research often invokes similarities between the experiences of emergency services personnel and elite athletes, opening up the possibility of transferring learnings between these contexts. Both roles involve genuine risks to emotional wellbeing because their occupations involve significant stress. Similarly, both roles face obstacles and injury, and their “success” is dependent on high-quality execution (...) of their skills under pressure. As such, both occupations are required to have resilience and effective coping abilities to ensure psychological well-being. Researchers suggest emotional awareness may be a key variable in the management and maintenance of resilience. This study: explored the experiences of emergency services personnel; characterised connections between emotional awareness and resilience; and reflected on the ways these findings can be extrapolated to elite athletes. We analysed 11 interviews with emergency services personnel. Participants identified resilience as crucial when coping with stress, however, many defined resilience as remaining unaffected by stress rather than, for example, managing and responding to it. Participants defined emotional awareness as understanding their emotions, and they recognised associated benefits for coping, resilience, and burnout. Nevertheless, most participants did not engage in practices to improve their emotional awareness. Barriers, such as maladaptive beliefs and help-seeking stigma, interfered with participants’ ability to cultivate emotional awareness, to promote resilience. In contrast, some participants described profound improvements in resilience and coping following the cultivation of emotional awareness. This finding illustrates that systemic change must target the individual, team, and organisation to correct misperceptions about resilience, emotional awareness, and psychological help-seeking. Developing emotional awareness may help emergency services personnel and other high stress occupations like elite athletes process difficult experiences and enhance their resilience, promoting well-being, and career longevity. (shrink)

This paper attempts to identify behavioral patterns and compare their average success considering several criteria of bounded rationality. Experimentally observed choice behavior in various decision tasks is used to assess heterogeneity in how individual participants respond to 15 randomly ordered portfolio choices, each of which is experienced twice. Treatments differ in granting probability information and in eliciting aspirations. Since in our setting neither other regarding concerns nor risk attitude matter and probability of the binary chance move is choice irrelevant, categorizing (...) decision types relies on parameter dependence and choice adaptations. We find that most participants reduce systematically sub-optimality when following the identified criteria. (shrink)

The following essay responds to a draft article that criticises the theory of libertarian restitution in “Libertarian Rectification: Restitution, Retribution, and the Risk-Multiplier” (LR). The article was freely available to internet search engines. Hence, it seems fair and useful to reply to these very welcome objective criticisms. It is not intellectually relevant that its author might subsequently and subjectively have thought better of them, possibly as a result of the earlier version of this reply. Generally, the article misconstrues the position (...) on retribution in LR. Eventually, it makes apparent qualifications to its own position such that there does not seem to be any clear theoretical difference between the two on the central disputed issue. LR’s position is to explain and defend only the non-normative theory of libertarian restitution: full restoration or compensation to the damaged (initiatedly imposed on) party. But it is argued that this can include a retributive aspect if that is what the victim prefers. Moreover, such restitution will tend to act as a deterrent that maximises both overall interpersonal liberty (theorised as no initiated imposed costs) and human welfare (theorised as preference satisfaction). (shrink)

After years of activism and scholarship concerning patriarchal social structures, many contemporary societies have made substantial progress in women’s rights. The shortfall, and the work ahead, is well known. Even in societies where the most progress has been achieved, males continue to dominate at key levels of power. Yet, essentialism appears to be widely, although not yet entirely, discounted. In helping to illuminate the social ontology of patriarchy and thereby helping to defuse its injustice, scholars have made proposals of patriarchy’s (...) origins; however, these appear not to be optimally consistent with historical and prehistorical facts. This article offers a different account of patriarchy, arguing that this one can not only explain how such a social condition originated and why it persists, but also point to what may be necessary to do in order to undo it. While I do not contend this ontology of patriarchy is the best possible, it provides a good example of the many issues at stake which an account of patriarchy must explain and points to how we should seek the best ontology as a way of both understanding contemporary societies and suggesting how to rectify a long-standing injustice. (shrink)

The paediatric intensive care unit is a high-stress environment for parents, families and health care professionals alike. Family members experiencing stress or grief related to the admission of their sick child may at times exhibit challenging behaviours; these exist on a continuum from those that are anticipated in context, through to unacceptable aggression. Rare, extreme behaviours include threats, verbal or even physical abuse. Both extreme and recurrent ‘subthreshold’ behaviours can cause significant staff distress, impede optimal clinical care and compromise (...) patient outcomes. The unique PICU environment and model of care may magnify stressors for both families and staff and the family-centred approach to care central to paediatric practice, may also contribute to contextual challenges. Pervasive conflict in paediatric healthcare is harmful for patients, families, PICU staff and the institution more broadly. We propose that caring for children and caring for staff are inseparable goals and the latter has been inadvertently but detrimentally deprioritised as FCC has become a primary focus. A transparent and graded hierarchy of responses to variable levels of challenging behaviour is necessary to ensure that families are supported, while HCPs remain protected in the workplace. This requires establishing firm limits supported by all teams and levels of the institution. As such, we aim to identify and clarify the context and impact of challenging parent and family behaviour in the PICU and to offer potential, proactive mitigation strategies, based on reflections and stakeholder discussion following recent clinical challenges and experiences in our unit. (shrink)

Most people in the United States agree they want some income inequality but debate exactly how much is fair. High‐status people generally prefer more inequality than low‐status individuals. Here we examine how much preferences for inequality are (or are not) driven by self‐interest. Past work has generally investigated this idea in two ways: The first is by stratifying preferences by income, and the second is by randomly assigning financial status within lab‐constructed scenarios. In this paper, we develop a method that (...) combines both experimental control and the social experience of inequality—a simulated society experiment. Across two experiments (N = 138, observations = 690), participants voted on the distribution of rewards—first behind a veil of ignorance, and then when they were randomly assigned a status within a game of chance. Status varied repeatedly across five rounds, allowing us to measure dynamic preferences. Under the veil of ignorance, people preferred inequality favoring the top status. When the veil of ignorance disappeared, self‐interest immediately influenced inequality preferences. Those who randomly landed in top positions were satisfied with the status quo established under the veil of ignorance, whereas those who randomly landed in bottom positions wanted more equality. Yet these preferences were not stable; decisions about the optimal level of inequality changed according to changes in social status. Our results also showed that, when inequality grows in a society, preferences regarding inequality become polarized by social status. Individuals in low‐status positions, particularly, tend to demand more equality. (shrink)

Thomas Piketty’s Capital in the Twenty-First Century makes hardly any reference to the ethics of inequality. Surprisingly, this is an omission shared by most of his critics. In this paper I investigate the literature on which he and his reviewers might have drawn and speculate on the reasons why they did not. I outline the four ‘views of society’ and the related issues in moral philosophy that were presented by Michael Schneider in his book on the distribution of wealth. I (...) then summarise the criticisms of Piketty made by those few reviewers who did show some interest in ethical questions and examine the slightly earlier and quite different case against reducing inequality made by one of these critics, N. Gregory Mankiw. I consider the economic, political and social costs of inequality identified in a book-length study of Piketty’s work by Steven Pressman, and conclude by reflecting on the reasons for the widespread neglect of moral philosophy by mainstream economists. (shrink)

Belief polarization is said to occur when two people respond to the same evidence by updating their beliefs in opposite directions. This response is considered to be “irrational” because it involves contrary updating, a form of belief updating that appears to violate normatively optimal responding, as for example dictated by Bayes' theorem. In light of much evidence that people are capable of normatively optimal behavior, belief polarization presents a puzzling exception. We show that Bayesian networks, or Bayes (...) nets, can simulate rational belief updating. When fit to experimental data, Bayes nets can help identify the factors that contribute to polarization. We present a study into belief updating concerning the reality of climate change in response to information about the scientific consensus on anthropogenic global warming. The study used representative samples of Australian and U.S. participants. Among Australians, consensus information partially neutralized the influence of worldview, with free-market supporters showing a greater increase in acceptance of human-caused global warming relative to free-market opponents. In contrast, while consensus information overall had a positive effect on perceived consensus among U.S. participants, there was a reduction in perceived consensus and acceptance of human-caused global warming for strong supporters of unregulated free markets. Fitting a Bayes net model to the data indicated that under a Bayesian framework, free-market support is a significant driver of beliefs about climate change and trust in climate scientists. Further, active distrust of climate scientists among a small number of U.S. conservatives drives contrary updating in response to consensus information among this particular group. (shrink)

Our senses provide us with information about the world, but what exactly do they tell us? I argue that in order to optimally respond to sensory stimulations, an agent’s doxastic space may have an extra, “imaginary” dimension of possibility; perceptual experiences confer certainty on propositions in this dimension. To some extent, the resulting picture vindicates the old-fashioned empiricist idea that all empirical knowledge is based on a solid foundation of sense-datum propositions, but it avoids most of the problems traditionally associated (...) with that idea. The proposal might also explain why experiences appear to have a non-physical phenomenal character, even if the world is entirely physical. (shrink)

This introduction to The Journal of Clinical Ethics highlights and expands four articles within this issue that propose somewhat new and radical innovations to help and further the interests of patients and families worst off. One article urges us to enable historically marginalized groups to participate more than they have in research; a second urges us to allocate limited resources that can be divided, such as vaccines and even ventilators, in a different way; a third urges us to help families (...) find greater meaning when their loved ones are dying; and a fourth urges us to treat patients who illegally use drugs as caringly as is possible, though there may be limits to what providers can do. This piece also addresses the importance of providers bonding with patients, recognizing that some providers may be better at eliciting patients’ trust than others, and thus the importance of connecting these patients with these providers since this may be the sole way these patients can optimally respond and do well. Finally, providers taking time away from their patients to oppose and reduce social stigma is considered. (shrink)

The rights and wrongs of adaptationism areoften discussed by appeal to what I call theartefact model. Anti-adaptationistscomplain that the use of optimality modelling,reverse engineering and other techniques areindicative of a mistaken and outmoded beliefthat organisms are like well-designedartefacts. Adaptationists (e.g. Dennett 1995)respond with the assertion that viewingorganisms as though they were well designed isa fruitful, perhaps necessary research strategyin evolutionary biology. Anti-adaptationistsare right when they say that techniques likereverse engineering are liable to mislead. This fact does not undermine the artefact (...) modelprecisely because the same techniques misleadus for the same reasons when they are appliedunreflectively to artefacts. Thoseadaptationists who hold only that it isworthwhile to investigate organisms as thoughthey were artefacts and thoseanti-adaptationists who criticise simplisticdesign models have far more in common than thelabels attached to their positions mightsuggest. (shrink)

This article responds to Professor Romano’s piece in this issue. It concerns our ongoing debate with regard to the desirability of permitting issuers to choose the securities regulation regime by which they are bound. Romano favors issuer choice, arguing that it would result in jurisdictional competition to offer issuers share value maximizing regulations. I, in contrast, believe that abandoning the current mandatory system of federal securities disclosure would likely lower, not increase, U.S. welfare. Each issuer, I argue, would select a (...) regime requiring a level of disclosure less than is socially optimal because its private costs of disclosure would be greater than the social costs of such disclosure. Professor Romano and I agree on most of the basic analytic building blocks for deciding whether issuer choice is a desirable reform: belief in analyzing the problem in terms of the broadly accepted principles of modern financial economics; recognition that disclosure has costs as well as benefits; and acknowledgment that incentives exist for issuers to provide at least some disclosure. We nevertheless reach the opposite conclusion on the desirability of issuer choice. To start, Romano believes that issuers’ private costs of disclosure will not generally be greater than the social costs of such disclosure, whereas I show they will be. Romano argues as well that this is a special case in which any divergence of private and social costs that does exist will not lead to a market failure, at least one possibly correctable by public regulation. I show her argument to be unpersuasive. Finally, Romano interprets the existing empirical evidence as proving mandatory disclosure’s lack of social value, while I show that the evidence in fact does not point in either direction. Where, as here, the theoretical case for the existence of a market failure is strong and the current program for dealing with it is widely admired, the advocate of change should have the burden of proof. Professor Romano has not met this burden. If she is serious about advancing her proposal for issuer choice, she needs to show that despite the market failure inherent in issuer choice, there is inevitably an even greater failure in the regulatory response. Absent such a showing, mandatory disclosure should be retained. (shrink)

One way of responding to the question of what PPE is involves mobilizing the tools that PPE involves. That is the exercise attempted in this article. The object is to use PPE as a method to analyze PPE as a subject matter. PPE is, whatever else, an interdisciplinary enterprise; so the point of departure involves analyzing the role and properties of disciplines within the institutional organization of enquiry. The basic idea is that enquiry is governed by a ‘division of (...) epistemic labour’ in Adam Smith’s sense, and that that division of labour depends for its working on institutions for the reliable certification of claims. Disciplines are such ‘institutions’. As such, they are indispensable. But they impose centripetal forces within the organization of enquiry that stand against interdisciplinary work. Understanding these forces offers some hope of securing an ‘optimal’ compromise between the benefits and costs that disciplines entail. Examples are offered from each of the disciplines involved in PPE separately, and some observations are offered about the architecture of the three disciplines’ interrelationships. (shrink)

Many bacteria respond in a coordinate manner to environmental changes. External stimuli, sensed by receptors, are transduced to regulatory proteins which participate in well defined pathways of gene expression by varying their structure and mode of action. The network of environmental signal transduction is responsible for a fine and continuous communication between the host and the pathogenic bacteria. As a result, the gene expression machinery of the pathogen is modified continuously, in order to establish the optimal conditions for bacterial (...) survival and multiplication. (shrink)

BackgroundThe quality of ethics consults is notoriously difficult to measure. Survey-based assessments cannot capture nuances of consultations. To address this gap, we conducted interviews with health professionals who requested ethics consults during the initial phase of the COVID-19 pandemic.MethodHealthcare professionals requesting ethics consultation between March 2020 and May 2020 at a tertiary academic medical centre were eligible to participate. We asked participants to comment on the consults they called and thematically analysed responses to identify features associated with optimal quality (...) consultations.ResultsOf 14 healthcare providers, 8 (57%) were women and professions were as follows: 11 (79%) medical doctors, 1 (7%) social worker, 1 (7%) physician assistant and 1 (7%) nurse practitioner. Two aspects of quality emerged: satisfaction and value. Themes within the domain of satisfaction included: responsiveness of the ethics consultant, willingness to consult, institutional role of the ethics service and identifying areas for improvement. When describing value, respondents spoke of the intrapersonal and interpersonal worth of consultation.ConclusionParticipants were generally satisfied with ethics consultation services, similar to opinions of those found in pre-COVID-19 survey studies. Our qualitative approach allowed for a richer exploration of the value of ethics consultation during the pandemic and has implications for ethics consultation services more broadly. Ethics consultation—emphasising both the process and outcome—created valuable moral spaces, promoting thoughtful and ethical responses to dilemmas in patient care. Future assessments should incorporate patient and family/surrogate perspectives and explore the domain of education as an additional quality measure. (shrink)

We present a theory of human artistic experience and the neural mechanisms that mediate it. Any theory of art has to ideally have three components. The logic of art: whether there are universal rules or principles; The evolutionary rationale: why did these rules evolve and why do they have the form that they do; What is the brain circuitry involved? Our paper begins with a quest for artistic universals and proposes a list of ‘Eight laws of artistic experience’ -- a (...) set of heuristics that artists either consciously or unconsciously deploy to optimally titillate the visual areas of the brain. One of these principles is a psychological phenomenon called the peak shift effect: If a rat is rewarded for discriminating a rectangle from a square, it will respond even more vigorously to a rectangle that is longer and skinnier that the prototype. We suggest that this principle explains not only caricatures, but many other aspects of art. Example: An evocative sketch of a female nude may be one which selectively accentuates those feminine form-attributes that allow one to discriminate it from a male figure; a Boucher, a Van Gogh, or a Monet may be a caricature in ‘colour space’ rather than form space. Even abstract art may employ ‘supernormal’ stimuli to excite form areas in the brain more strongly than natural stimuli. Second, we suggest that grouping is a very basic principle. The different extrastriate visual areas may have evolved specifically to extract correlations in different domains , and discovering and linking multiple features into unitary clusters -- objects -- is facilitated and reinforced by direct connections from these areas to limbic structures. In general, when object-like entities are partially discerned at any stage in the visual hierarchy, messages are sent back to earlier stages to alert them to certain locations or features in order to look for additional evidence for the object . Finally, given constraints on allocation of attentional resources, art is most appealing if it produces heightened activity in a single dimension rather than redundant activation of multiple modules. This idea may help explain the effectiveness of outline drawings and sketches, the savant syndrome in autists, and the sudden emergence of artistic talent in fronto-temporal dementia. In addition to these three basic principles we propose five others, constituting a total of ‘eight laws of aesthetic experience’. (shrink)

Existential phenomenologists hold that the two most basic forms of intelligent behavior, learning, and skillful action, can be described and explained without recourse to mind or brain representations. This claim is expressed in two central notions in Merleau-Ponty's Phenomenology of Perception: the intentional arc and the tendency to achieve a maximal grip. The intentional arc names the tight connection between body and world, such that, as the active body acquires skills, those skills are “stored”, not as representations in the mind, (...) but as dispositions to respond to the solicitations of situations in the world. A phenomenology of skill acquisition confirms that, as one acquires expertise, the acquired know-how is experienced as finer and finer discriminations of situations paired with the appropriate response to each. Maximal grip names the body's tendency to refine its responses so as to bring the current situation closer to an optimal gestalt. Thus, successful learning and action do not require propositional mental representations. They do not require semantically interpretable brain representations either.Simulated neural networks exhibit crucial structural features of the intentional arc, and Walter Freeman's account of the brain dynamics underlying perception and action is structurally isomorphic with Merleau-Ponty's account of the way a skilled agent is led by the situation to move towards obtaining a maximal grip. (shrink)

The annual volume of ethics consultations (ECs) has been a topic of interest in the bioethics literature, in part because of its presumed relationship to quality. To better understand factors associated with EC volume, we used multiple linear regression to model the number of case consultations performed in the last year based on a national survey. We found that hospital bed size, academic affiliation, and urban/rural location were all associated with EC volume, but were not the primary drivers. Instead, these (...) variables affected EC volume through three other variables, all of which relate to ethics staffing: the percentage of case consultations performed by a single individual; whether the survey respondent’s main role at the hospital contained the word “ethics”; and especially, the number of full-time ethics program staff. We conclude that EC is an example of supply-sensitive care, and further research is needed to determine the optimal level of EC activity. (shrink)

Existential phenomenologists hold that the two most basic forms of intelligent behavior, learning, and skillful action, can be described and explained without recourse to mind or brain representations. This claim is expressed in two central notions in Merleau-Ponty's Phenomenology of Perception: the intentional arc and the tendency to achieve a maximal grip. The intentional arc names the tight connection between body and world, such that, as the active body acquires skills, those skills are “stored”, not as representations in the mind, (...) but as dispositions to respond to the solicitations of situations in the world. A phenomenology of skill acquisition confirms that, as one acquires expertise, the acquired know-how is experienced as finer and finer discriminations of situations paired with the appropriate response to each. Maximal grip names the body's tendency to refine its responses so as to bring the current situation closer to an optimal gestalt. Thus, successful learning and action do not require propositional mental representations. They do not require semantically interpretable brain representations either.Simulated neural networks exhibit crucial structural features of the intentional arc, and Walter Freeman's account of the brain dynamics underlying perception and action is structurally isomorphic with Merleau-Ponty's account of the way a skilled agent is led by the situation to move towards obtaining a maximal grip. (shrink)

Existential phenomenologists hold that the two most basic forms of intelligent behavior, learning, and skillful action, can be described and explained without recourse to mind or brain representations. This claim is expressed in two central notions in Merleau-Ponty's Phenomenology of Perception: the intentional arc and the tendency to achieve a maximal grip. The intentional arc names the tight connection between body and world, such that, as the active body acquires skills, those skills are stored, not as representations in the mind, (...) but as dispositions to respond to the solicitations of situations in the world. A phenomenology of skill acquisition confirms that, as one acquires expertise, the acquired know-how is experienced as finer and finer discriminations of situations paired with the appropriate response to each. Maximal grip names the body's tendency to refine its responses so as to bring the current situation closer to an optimal gestalt. Thus, successful learning and action do not require propositional mental representations. They do not require semantically interpretable brain representations either.Simulated neural networks exhibit crucial structural features of the intentional arc, and Walter Freeman's account of the brain dynamics underlying perception and action is structurally isomorphic with Merleau-Ponty's account of the way a skilled agent is led by the situation to move towards obtaining a maximal grip. (shrink)

In some situations a number of agents each have the ability to undertake an initiative that would have significant effects on the others. Suppose that each of these agents is purely motivated by an altruistic concern for the common good. We show that if each agent acts on her own personal judgment as to whether the initiative should be undertaken, then the initiative will be undertaken more often than is optimal. We suggest that this phenomenon, which we call the (...) unilateralist’s curse, arises in many contexts, including some that are important for public policy. To lift the curse, we propose a principle of conformity, which would discourage unilateralist action. We consider three different models for how this principle could be implemented, and respond to an objection that could be raised against it. (shrink)

Critical-care decision making is highly complex, given the need for health care providers and organizations to consider, and constructively respond to, the diverse interests and perspectives of a variety of legitimate stakeholders. Insights derived from an identified set of ethics-related considerations have the potential to meaningfully inform inclusive and deliberative policy development that aims to optimally balance the competing obligations that arise in this challenging, clinical decision-making domain. A potential, constructive outcome of such policy engagement is the collaborative development of (...) an as-fair-as-possible dispute resolution process that incorporates an appropriated-justified, defensible critical-care obligation threshold. (shrink)

The goal of perceptual systems is to allow organisms to adaptively respond to ecologically relevant stimuli. Because all perceptual inputs are ambiguous, perception needs to rely on prior knowledge accumulated over evolutionary and developmental time to turn sensory energy into information useful for guiding behavior. It remains controversial whether the guidance of perception extends to cognitive states or is locked up in a “cognitively impenetrable” part of perception. I argue that expectations, knowledge, and task demands can shape perception at multiple (...) levels, leaving no part untouched. The position advocated here is broadly consistent with the notion that perceptual systems strive to minimize prediction error en route to globally optimal solutions :181–204, 2013). On this view, penetrability should be expected whenever constraining lower-level processes by higher level knowledge is minimizes global prediction error. Just as Fodor feared cognitive penetration of perception threatens theory-neutral observation and the distinction between observation and inference. However, because theories themselves are constrained by the task of minimizing prediction error, theory-laden observation turns out to be superior to theory-free observation in turning sensory energy into useful information. (shrink)

Cognitive control has long been one of the most active areas of computational modeling work in cognitive science. The focus on computational models as a medium for specifying and developing theory predates the PDP books, and cognitive control was not one of the areas on which they focused. However, the framework they provided has injected work on cognitive control with new energy and new ideas. On the occasion of the books' anniversary, we review computational modeling in the study of cognitive (...) control, with a focus on the influence that the PDP approach has brought to bear in this area. Rather than providing a comprehensive review, we offer a framework for thinking about past and future modeling efforts in this domain. We define control in terms of the optimal parameterization of task processing. From this vantage point, the development of control systems in the brain can be seen as responding to the structure of naturalistic tasks, through the filter of the brain systems with which control directly interfaces. This perspective lays open a set of fascinating but difficult research questions, which together define an important frontier for future computational research. (shrink)

Autism spectrum disorder (ASD) is a psychopathological condition characterized by persistent deficits in social interaction and communication, and restricted, repetitive patterns of behavior and interests. To build an ecological-enactive account of autism, I propose we should endorse the affordance-based approach of the skilled intentionality framework (SIF). In SIF, embodied cognition is understood as skilled engagement with affordances in the sociomaterial environment of the ecological niche by which an individual tends toward the optimal grip. The human econiche offers a whole (...) landscape of affordances, and situated individuals respond to a field of relevant affordances. An important part of SIF is an ecological-enactive interpretation of the free energy principle and predictive processing. Predictive processing accounts indicate that in ASD too much precision is assigned to prediction errors. Autistic persons depend heavily on current sensory information and less on prior beliefs and cannot attune to stable regularities. To reduce uncertainty, they over-rely on routines, strict habits, and a familiar environment—a predictable ecological niche they construct. I argue that skilled intentionality gives us the framework from which to analyze the autistic field of affordances. Autistic patterns of affordance-related bodily states of action readiness are only sensitive to very specific solicitations in the environment and achieve optimal grip in well-known situations. Autism is to be understood as a disorder of bodily normativity. Taking this approach helps us figure out what neurotypical people can do to attune their environment in order to scaffold the needs of autistic individuals by redesigning the landscape of affordances. (shrink)

Recent studies have used methods designed to obtain a precise quantitative assessment of sexual aggression, but these are based on the presumption of a normative psychological understanding of what the questionnaire items mean to respondents. This article takes a novel approach that is appropriate for analysing the ‘grey zone’ between wanted and unwanted sex as the key to obtaining a deeper understanding of the data on sexual violence. Stenner and Clinch (2013) developed the concept of “liminal hotspots”, which refer to (...) liminal situations in which a rite of passage occurs from one recognised ‘structure’ to another. The article draws on in-depth interviews to examine the optimal and pessimal sexual encounters and contexts participants encounter in their sex lives. The main research question concerns how the boundary between wanted and unwanted sex is constructed. One important finding is that the concept of liminal hotspots can be used effectively to investigate the boundary between wanted and unwanted sex. (shrink)

Background: As actors with the key responsibility for the protection of human research participants, Research Ethics Committees (RECs) need to be competent and well-resourced in order to fulfil their roles. Despite recent programs designed to strengthen RECs in Africa, much more needs to be accomplished before these committees can function optimally.Objective: To assess training needs for biomedical research ethics evaluation among targeted countries.Methods: Members of RECs operating in three targeted African countries were surveyed between August and November 2007. Before implementing (...) the survey, ethical approvals were obtained from RECs in Switzerland, Cameroon, Mali and Tanzania. Data were collected using a semi-structured questionnaire in English and in French.Results: A total of 74 respondents participated in the study. The participation rate was 68%. Seventy one percent of respondents reported having received some training in research ethics evaluation. This training was given by national institutions (31%) and international institutions (69%). Researchers and REC members were ranked as the top target audiences to be trained. Of 32 topics, the top five training priorities were: basic ethical principles, coverage of applicable laws and regulations, how to conduct ethics review, evaluating informed consent processes and the role of the REC.Conclusion: Although the majority of REC members in the targeted African countries had received training in ethics, they expressed a need for additional training. The results of this survey have been used to design a training program in research ethics evaluation that meets this need. (shrink)

Freedom is first apprehended as the pursuit of an activity which implies the choice to defend a thesis among other possible ones. This translation of the problem of freedom in an articulate language presupposes a complex nervous system and sensory apparatuses which we take for granted. In this study, I try to explore the undergrounds of the problem of freedom along with the suggestion that the notion of coding could enable one to bridge nature and the mind. When organisms invent, (...) are they doing it in a spontaneous manner, inscribing in their hereditary and mnemonic instructions a stochastic contrivance of random accidents, or are they attempting to select among a limited number of schemes endowed with some optimality of functioning? If we consider them as submitted to physical forces, it is to the extent that we make them part of a strategy to extend the "laws" of a nature understood to respond passively. I suggest in this study that the epistemological understanding must regionalize itself and admit a hierarchy of dispositions in relation to the phenomenon of selection. I end by suggesting the pursuit of affirmation instead of negation, as this alone contains the requirement of integration to the knowing subject as well as the form in its act of understanding, without giving it a spontaneist position. (shrink)

We suggest an equilibrium concept for a strategic model with a large number of players in which each player observes the actions of only a small number of the other players. The concept fits well situations in which each player treats his sample as a prediction of the distribution of actions in the entire population, and responds optimally to this prediction. We apply the concept to a strategic voting model and investigate the conditions under which a centrist candidate can win (...) the popular vote although his strength in the population is smaller than the strengths of the right and left candidates.  2003 Elsevier Inc. All rights reserved. (shrink)

Scientific progress in the areas of health and biological science is phenomenal. Still, current health policies limit optimal benefit for our peoples. Our present system costs too much, delivers too little, is not comprehensive, coherent, or cost-effective, does not allow choice, is not equitable, and is not universal. We must overcome many crises if we are to create a healthy people fro the twenty-first century in the US. We will need to use multiple strategies to achieve the nation's goals (...) of Healthy People 2010, which are to: 1) increase the quality and years of healthy live; 2) eliminate health disparities; 3) provide access to primary preventive care for all citizens. We are the richest country in the world and the only industrialized country that does not provide health care for its entire people. Health care costs are escalating and insurance is out of reach for many. Public policy changes are necessary to provide universal access to basic health care. We have advances in sciences; now we need the science delivered to our people in an equitable way. Politicians will respond proportionately to the insistence of the people. Healthcare professionals and scientists should lead the way. (shrink)

The paper presents a further articulation and defence of the view on prediction and accommodation that I have proposed earlier. It operates by analysing two accounts of the issue-by Patrick Maher and by Marc Lange-that, at least at first sight, appear to be rivals to my own. Maher claims that the time-order of theory and evidence may be important in terms of degree of confirmation, while that claim is explicitly denied in my account. I argue, however, that when his account (...) is analysed, Maher reveals no scientifically significant way in which the time-order counts, and that indeed his view is in the end best regarded as a less than optimally formulated version of my own. Lange has also responded to Maher by arguing that the apparent relevance of temporal considerations is merely apparent: what is really involved, according to Lange, is whether or not a hypothesis constitutes an "arbitrary conjunction." I argue that Lange's suggestion fails: the correct analysis of his and Maher's examples is that provided by my account. (shrink)

In this article, a mixed integer linear program model is proposed for the production, lot sizing, and scheduling of automotive plastic components to minimize the setup, inventory, stockout, and backorder costs, by taking into account injection molds as the main index to schedule on parallel flexible injection machines. The proposed MILP considers the minimum and maximum inventory capacities and penalizes stockout. A relevant characteristic of the modeled problem is the dependence between mold setups to produce plastic components. The lot sizing (...) and scheduling problem solution results in the assignment of molds to machines during a specific time period and in the calculation of the number of components to be produced, which is often called lot size, following a sequence-dependent setup time. Depending on the machine on which the mold is setup, the number of units to be produced will be distinct because machines differ from one another. The stock coverage, defined in demand days, is also included in the MILP to avoid backorders, which is highly penalized in the automotive supply chain. Added to this, the proposed model is extended by considering setup common operators to respond to and fulfill the constraints that appear in automotive plastic enterprises. In this regard, the MILP presented solves a lot-sizing and scheduling problem, emerged in a second-tier supplier of a real automotive supply chain. Finally, this article validates the MILP by performing experiments with different sized instances, including small, medium, and large. The large-sized dataset is characterized by replicating the amount of data used in the real enterprise, which is the object of this study. The goodness of the model is evaluated with the computational time and the deviation of the obtained results as regards to the optimal solution. (shrink)

Background Institutional review board (IRB) expertise is necessarily limited by maintaining a manageable board size. IRBs are therefore permitted by regulation to rely on outside experts for review. However, little is known about whether, when, why, and how IRBs use outside experts.Methods We conducted a national survey of U.S. IRBs to characterize utilization of outside experts. Our study uses a descriptive, cross-sectional design to understand how IRBs engage with such experts and to identify areas where outside expertise is most frequently (...) requested.Results The survey response rate was 18.4%, with 55.4% of respondents reporting their institution’s IRB uses outside experts. Nearly all respondents who reported using outside experts indicated they do so less than once a month, but occasionally each year (95%). The most common method of identifying an outside expert was securing a previously known subject matter expert (83.3%). Most frequently, respondents sought consultation for scientific expertise not held by current members (69.6%). Almost all respondents whose IRBs had used outside experts reported an overall positive impact on the IRB review process (91.5%).Conclusions Just over half of the IRBs in our sample report use of outside experts; among them, outside experts were described as helpful, but their use was infrequent overall. Many IRBs report not relying on outside experts at all. This raises important questions about what type of engagement with outside experts should be viewed as optimal to promote the highest quality review. For example, few respondents sought assistance from a Community Advisory Board, which could address expertise gaps in community perspectives. Further exploration is needed to understand how to optimize IRB use of outside experts, including how to recognize when expertise is lacking, what barriers IRBs face in using outside experts, and perspectives on how outside expert review impacts IRB decision-making and review quality. (shrink)

Uncertainty and instability haunt us every day in today’s new reality. The purpose is a theoretical justification and empirical study of the hardiness of the personality in critical conditions of life. Psychodiagnostic complex of hardiness is indicated as a factor of personality adaptation. High average and high levels of hardiness are characteristics of an independently developed personality with a high ability to adapt. It has been established that the average level of hardiness contributes to the optimal experience of situations (...) of uncertainty and involves a person’s choice of coping strategies to counteract the new difficulties in professional and personal life. It has been substantiated that respondents who have high rates of hardiness have a higher level of adaptation efficiency. It has been stated that “risk acceptance” as the component of hardiness of participants of the “Work and Travel” program is more pronounced than in the respondents of other samples. It has been proved that empirical research of semantic psychological parameters of personality hardiness in critical conditions of life allowed to draw significant conclusions. It is noted that the results of the study need to be operationalized in training, educational and developmental and psycho-correctional practices. It is emphasized that the obtained empirical results should be used in the training of applicants for psychological specialties. (shrink)

Future population growth is uncertain and matters for climate policy: higher growth entails more emissions and means more people will be vulnerable to climate-related impacts. We show that how future population is valued importantly determines mitigation decisions. Using the Dynamic Integrated Climate-Economy model, we explore two approaches to valuing population: a discounted version of total utilitarianism (TU), which considers total wellbeing and is standard in social cost of carbon dioxide (SCC) models, and of average utilitarianism (AU), which ignores population size (...) and sums only each time period’s discounted average wellbeing. Under both approaches, as population increases the SCC increases, but optimal peak temperature decreases. The effect is larger under TU, because it responds to the fact that a larger population means climate change hurts more people: for example, in 2025, assuming the United Nations (UN)-high rather than UN-low population scenario entails an increase in the SCC of 85% under TU vs. 5% under AU. The difference in the SCC between the two population scenarios under TU is comparable to commonly debated decisions regarding time discounting. Additionally, we estimate the avoided mitigation costs implied by plausible reductions in population growth, finding that large near-term savings ($billions annually) occur under TU; savings under AU emerge in the more distant future. These savings are larger than spending shortfalls for human development policies that may lower fertility. Finally, we show that whether lowering population growth entails overall improvements in wellbeing—rather than merely cost savings—again depends on the ethical approach to valuing population. (shrink)

This paper outlines a multi-agent architecture for regulated information exchange of crime investigation data between police forces. Interactions between police officers about information exchange are analysed as negotiation dialogues with embedded persuasion dialogues. An architecture is then proposed consisting of two agents, a requesting agent and a responding agent, and a communication language and protocol with which these agents can interact to promote optimal information exchange while respecting the law. Finally, dialogue policies are defined for the individual agents, (...) specifying their behaviour within a negotiation. Essentially, when deciding to accept or reject an offer or to make a counteroffer, an agent first determines whether it is obligatory or permitted to perform the actions specified in the offer. If permitted but not obligatory, the agent next determines whether it is in his interest to accept the offer. (shrink)

BackgroundBurnout is a recognized challenge among the oncology workforce. It affects both genders with a higher frequency among women. This study examined the factors contributing to the development of burnout among female oncologists from the Middle East and North Africa.MethodsAn online cross-sectional survey was distributed to oncology professionals from different countries in the MENA region. The validated Maslach Burnout Inventory of emotional exhaustion, Depersonalization, and Personal Achievement plus questions about demography/work-related factors and attitudes toward oncology were included. Data were analyzed (...) to measure BO prevalence and related factors.ResultsBetween 10 February and 15 March 2020, 545 responses were submitted by female oncologists. The responses pre-dated the COVID-19 pandemic emergence in the region. BO prevalence was 71% among female professionals. Women aged 25% on administrative work daily. Nearly half of the respondents expressed a recurring thought of quitting oncology and 70% had no burnout support or education. Inability to deliver optimal care was reported as distressing for career development in 82%. Factors significantly influencing the BO risk were identified. Marital status, having children, academia and years in practice did not impact the risk of BO among female oncologists from MENA.ConclusionFemale oncologists from the Middle East and North Africa were found to have a high prevalence of BO. In this cohort, the majority of women oncology workers were young and in their early to mid-career stages. Burnout was linked to being younger, practicing in North African nations, having a heavy administrative load, and having persistent thoughts of quitting. Practicing a hobby and engaging in oncology communication, on the other hand, reduced the chance of BO. Burnout support and education, specifically for oncology women, is required. (shrink)

Interim measures are procedural means that allow persons or States to have their rights preserved when a case is pending. Application of these measures especially in environmental cases is very important. In many of these cases (e.g. cases dealing with territorial planning, IPPC permits, environmental impact assessment, etc.) the claims deal with the protection of environment or its components (water, air, soil, etc.) as well as with the protection of public interest. Legal regulation of application of interim measures provided by (...) Lithuanian Law on Administrative Proceedings is not optimal. That is why the first part of the article is dedicated to the analysis of the possibilities and problems of application of interim measures in the administrative proceedings in Lithuania, paying special attention to environmental cases. The second part of the article reflects the findings of a workshop of the Association of European Administrative Judges on „Interim relief in environmental matters” held in Vilnius on 22 September 2011. It briefly describes various national rules on interim relief procedures, especially in the German and the French legislation, with an assessment from the German point of view. This part of the article focuses on provisional legal protection where a permit is challenged by a third party whose rights are allegedly afflicted. In such a constellation the rights of the plaintiff compete with the rights of the operator. The article concludes that, when deciding on the necessity of interim measures, it is vital to ensure the balance of interests: both by ensuring effective access to justice and by protecting the respondent and the third party (in environmental cases - usually the operator) from the violation of their rights and the damage caused by the abuse of the right to request interim measures. In such cases short time limits for procedural steps both of the parties and the court are not advisable and a prima facie prognosis on the outcome in the main proceedings meets the interests of the parties. (shrink)

Objectives: To characterise UK undergraduate medical ethics curricula and to identify opportunities and threats to teaching and learning.Design: Postal questionnaire survey of UK medical schools enquiring about teaching and assessment, including future perspectives.Participants: The lead for teaching and learning at each medical school was invited to complete a questionnaire.Results: Completed responses were received from 22/28 schools . Seventeen respondents deemed their aims for ethics teaching to be successful. Twenty felt ethics should be learnt throughout the course and 13 said ethics (...) teaching and learning should be fully integrated horizontally. Twenty felt variety in assessment was important and three tools was the preferred number. A shortfall in ethics core competencies did not preclude graduation in 15 schools. The most successful aspects of courses were perceived to be their integrated nature and the small group teaching; weaknesses were described as a need for still greater integration and the heavily theoretical aspects of ethics. The major concerns about how ethics would be taught in the future related to staffing and staff development.Conclusions: This study describes how ethics was taught and assessed in 2004. The findings show that, although ethics now has an accepted place in the curriculum, more can be done to ensure that the recommended content is taught and assessed optimally. (shrink)

The relationship between a doctor and a patient is taken to be one of the most ethically significant dimensions of good medical care. After all, it is within the interactions that constitute this relationship that information is shared, that choices get determined, that reassurances are provided, that decisions are made and, ultimately, that care is given. Medical ethicists have devoted considerable effort to identifying different types of relationships, and in specifying their ideal components, most usually in general or abstract terms. (...) Indeed, I would suggest that medical ethicists are most comfortable when we are comparing different models of this relationship, or perhaps when advancing one account of this relationship that can provide the foundations for the most optimal approach to shared decision-making, for example by Sandman and Munthe.2 But, in truth, the doctor–patient relationship is most ethically interesting—and intellectually challenging—when scrutinised in its non-ideal forms. Ethicists who turn their attention to the front line of practice have demonstrated a tendency to see this relationship as one that is creaking at the seams, subject to manipulation or side-tracked entirely. So, is it the case that the doctor–patient relationship is under threat in contemporary medical practice? The answer to this question ought, I think, to be answered in the affirmative, though tentatively so. The role of medical ethicists is to identify precisely how such threats are materialising and to capture these in rich, detailed accounts of everyday medical encounters. Medical ethicists then also have a vital role to play in identifying and responding to these changes in a carefully reasoned way. Sometimes this is likely to involve pushing back and protecting those elements of the doctor–patient relationship that have fundamental value, regardless of context, changing social values, …. (shrink)

It is well established, following Menzies' work, that nursing practice produces considerable anxiety. Like Menzies, we bring a psychoanalytic perspective to a theorization of anxiety in nursing and do so in order to consider nursing practice in the light of psychoanalytic theory, although from a Lacanian perspective. We also draw on Bataille's notion of ‘surplus’. These concepts provide the theoretical framework for a study investigating how some clinical nurses are able to remain in clinical practice rather than leave the profession (...) or seek work at a distance from the bedside. We conducted focus groups and present here an analysis of two fragments of nurses' speech. We found the nurses responded from one of two positions. In the first position, the nurses focus on doctors, complain about the surplus afforded them, and call for it to be eliminated. In this way, the nursing group is similar to other groups, considered by Bataille, who also attempt to get rid of a surplus. However, in the second position, the nurses stay with the surplus, tolerating it as they nurse the patient. This latter position is one where the nurse practises with a focus on the patient rather than being distracted by their dispute over the doctor's privilege. The importance of this paper is in its illustration of two distinct positions from which the nurse can practise: one that is not optimal because the nurse is distracted and the other that is more focused on practice, and thus the nurse is in a position to provide the best care possible to patients. (shrink)

The increasing use of pharmacotherapy raises specific ethical concerns for psychologists working with vulnerable populations. Due to a shortage of trained specialists, professionals without training in mental health, such as primary care providers, are increasingly prescribing and monitoring psychotropic medications. Vulnerable populations face additional barriers to mental health treatment and are at heightened risk when these factors intersect. Hence, these patients experience unique barriers to receiving optimal psychopharmacological care and are differentially vulnerable to deleterious outcomes associated with misdiagnosis and (...) overmedication. Taken together, these factors fuel inequities in the access, quality, and utilization of mental health care. Psychologists working with these patients are ethically mandated to protect patients from harm and ensure equitable care across patient populations. Specifically, psychologists must respond to the dilemma of how to effectively treat patients within these vulnerable populations who have been misdiagnosed or poorly medicated while remaining within the bounds of their competence. This article recommends pathways to address these dilemmas through education, training, research, and advocacy. (shrink)