Background:Moral distress is a significant concern for nurses as it can lead to burnout and intentions to leave the profession. Pediatric nurses encounter stressful and ethically challenging situations when they care for suspected victims of child maltreatment. Data on pediatric nurses’ moral distress are limited, as most research in this field has been done in adult inpatient and intensive care units.Aim:The purpose of this study was to describe pediatric nurses’ moral distress and evaluate the impact of caring for suspected victims (...) of child maltreatment on nurses’ moral distress, burnout, and intention to leave. Design and method: This descriptive cross-sectional correlational study was conducted in a mid-Atlantic, urban area Magnet pediatric level I trauma center that cares for over 1800 cases of suspected child maltreatment annually. An anonymous electronic survey was sent to all the nurses working at the hospital.Ethical considerations:Institutional Review Board approval was received from the first author’s university and the hospital where the study was conducted.Findings:Overall, nurses ( N = 146) reported low levels of moral distress with a mean score of 59.54 (SD = 49.22) and a range of 0–300 on the Moral Distress Scale Neonatal–Pediatric version. Although the frequency of caring for suspected child maltreatment victims did not affect nurses’ moral distress, caring for victims with fatal maltreatment contributed to nurses’ intention to leave, χ2(1) = 5.35, p = 0.02.Conclusion:The results of this study add to the understanding of moral distress in pediatric nursing. Caring for victims with fatal maltreatment impacts pediatric nurses’ intention to leave. (shrink)

We conducted focus groups to assess patient attitudes toward research on medical practices in the context of usual care. We found that patients focus on the implications of this research for their relationship with and trust in their physicians. Patients view research on medical practices as separate from usual care, demanding dissemination of information and in most cases, individual consent. Patients expect information about this research to come through their physician, whom they rely on to identify and filter associated risks. (...) In general, patients support this research, but worry that participation in research involving randomization may undermine individualized care that acknowledges their unique medical histories. These findings suggest the need for public education on variation in practice among physicians and the need for a collaborative approach to the governance of research on medical practices that addresses core values of trust, transparency, and partnership. (shrink)

During the Covid‐19 pandemic, as resources dwindled, clinicians, health care institutions, and policymakers have expressed concern about potential legal liability for following crisis standards of care (CSC) plans. Although there is no robust empirical research to demonstrate that liability protections actually influence physician behavior, we argue that limited liability protections for health care professionals who follow established CSC plans may instead be justified by reliance on the principle of reciprocity. Expecting physicians to do something they know will harm their patients (...) causes moral distress and suffering that may leave lasting scars. Limited liability shields are both appropriate and proportionate to the risk physicians are being asked to take in such circumstances. Under certain narrow circumstances, it remains unclear that the standard of care is sufficiently flexible to protect physicians from liability. Given this uncertainty, the likelihood that physicians would be sued for such an act, and their desire for such immunity, this limited protection is morally legitimate. (shrink)

First published in 1985, the _Handbook for Achieving Gender Equity Through Education_ quickly established itself as the essential reference work concerning gender equity in education. This new, expanded edition provides a 20-year retrospective of the field, one that has the great advantage of documenting U.S. national data on the gains and losses in the efforts to advance gender equality through policies such as Title IX, the landmark federal law prohibiting sex discrimination in education, equity programs and research. Key features include:_ (...) Expertise_ – Like its predecessor, over 200 expert authors and reviewers provide accurate, consensus, research-based information on the nature of gender equity challenges and what is needed to meet them at all levels of education._ Content Area Focus_ – The analysis of gender equity within specific curriculum areas has been expanded from 6 to 10 chapters including mathematics, science, and engineering._ Global/Diversity Focus_ – Global gender equity is addressed in a separate chapter as well as in numerous other chapters. The expanded section on gender equity strategies for diverse populations contains seven chapters on African Americans, Latina/os, Asian and Pacific Island Americans, American Indians, gifted students, students with disabilities, and lesbian, gay, bisexual, and transgender students. _ Action Oriented_ – All chapters contain practical recommendations for making education activities and outcomes more gender equitable. A final chapter consolidates individual chapter recommendations for educators, policymakers, and researchers to achieve gender equity in and through education._ New Material_ – Expanded from 25 to 31 chapters, this new edition includes: *more emphasis on male gender equity and on sexuality issues; *special within population gender equity challenges ; *coeducation and single sex education; *increased use of rigorous research strategies such as meta-analysis showing more sex similarities and fewer sex differences and of evaluations of implementation programs; *technology and gender equity is now treated in three chapters; *women’s and gender studies; *communication skills relating to English, bilingual, and foreign language learning; and *history and implementation of Title IX and other federal and state policies. Since there is so much misleading information about gender equity and education, this _Handbook_ will be essential for anyone who wants accurate, research-based information on controversial gender equity issues—journalists, policy makers, teachers, Title IX coordinators, equity trainers, women’s and gender study faculty, students, and parents. (shrink)

Participants studied lists of nonwords that were orthographic-phonologically similar to a nonpresented critical lure, which was also a nonword . Experiment 1 showed a high level of false recognition for the critical lure. Experiment 2 showed that the false recognition effect was also present for forewarned participants who were informed about the nature of the false recognition effect and told to avoid making false recognition judgments. The present results show that false recognition effects can be obtained even when the critical (...) lure itself is not stored during study. This finding is problematic for accounts that attribute false memories to implicit associative responses or spreading activation but is easily explained by global familiarity models of recognition memory. (shrink)

Background The prioritization protocols for accessing adult critical care in the extreme pandemic context contain tiebreaker criteria to facilitate decision-making in the allocation of resources between patients with a similar survival prognosis. Besides being controversial, little is known about the public acceptability of these tiebreakers. In order to better understand the public opinion, Quebec and Ontario’s protocols were presented to the public in a democratic deliberation during the summer of 2022. Objectives (1) To explore the perspectives of Quebec and Ontario (...) citizens regarding tiebreakers, identifying the most acceptable ones and their underlying values. (2) To analyze these results considering other public consultations held during the pandemic on these criteria. Methods This was an exploratory qualitative study. The design involved an online democratic deliberation that took place over two days, simultaneously in Quebec and Ontario. Public participants were selected from a community sample which excluded healthcare workers. Participants were first presented the essential components of prioritization protocols and their related issues (training session day 1). They subsequently deliberated on the acceptability of these criteria (deliberation session day 2). The deliberation was then subject to thematic analysis. Results A total of 47 participants from the provinces of Quebec (n = 20) and Ontario (n = 27) took part in the online deliberation. A diverse audience participated excluding members of the healthcare workforce. Four themes were identified: (1) Priority to young patients - the life cycle - a preferred tiebreaker; (2) Randomization - a tiebreaker of last resort; (3) Multiplier effect of most exposed healthcare workers - a median acceptability tiebreaker, and (4) Social value – a less acceptable tiebreaker. Conclusion Life cycle was the preferred tiebreaker as this criterion respects intergenerational equity, which was considered relevant when allocating scarce resources to adult patients in a context of extreme pandemic. Priority to young patients is in line with other consultations conducted around the world. Additional studies are needed to further investigate the public acceptability of tiebreaker criteria. (shrink)

Productivity—the hallmark of linguistic competence—is typically attributed to algebraic rules that support broad generalizations. Past research on spoken language has documented such generalizations in both adults and infants. But whether algebraic rules form part of the linguistic competence of signers remains unknown. To address this question, here we gauge the generalization afforded by American Sign Language (ASL). As a case study, we examine reduplication (X→XX)—a rule that, inter alia, generates ASL nouns from verbs. If signers encode this rule, then they (...) should freely extend it to novel syllables, including ones with features that are unattested in ASL. And since reduplicated disyllables are preferred in ASL, such rule should favor novel reduplicated signs. Novel reduplicated signs should thus be preferred to nonreduplicative controls (in rating), and consequently, such stimuli should also be harder to classify as nonsigns (in the lexical decision task). The results of four experiments support this prediction. These findings suggest that the phonological knowledge of signers includes powerful algebraic rules. The convergence between these conclusions and previous evidence for phonological rules in spoken language suggests that the architecture of the phonological mind is partly amodal. (shrink)

Over recent decades, developments in network governance have seen governments around the world cede considerable authority and responsibility to commercial migration intermediaries for recruiting and managing temporary migrant labour. Correspondingly, a by-product of network governance has been the emergence of soft employment regulation in which voluntary codes of conduct supplement hard legal employment standards. This paper explores these developments in the context of temporary migrant workers employed in Australian horticulture. First the paper analyses the growing use of temporary migrant labour (...) in this industry. It then describes how different types of intermediaries interact with this workforce. The paper then outlines both hard and soft employment regulations, and contrasts them with actual employment conditions, questioning how a network governance approach has affected this vulnerable workforce. The paper concludes that changes in network governance of migration and employment relations have emasculated formal legal regulation, leaving market forces to operate without effective or ethical constraints at the expense of the public good. (shrink)

It has been argued that infants possess a rich, sophisticated theory of mind that is only revealed with tasks based on spontaneous responses. A mature theory of mind implies the understanding that mental states are person-specific. Previous studies on infants’ understanding of motivational mental states such as goals and preferences have revealed that, by 9 months of age, infants do not generalize these motivational mental states across agents. However, it remains to be determined if infants also perceive epistemic states as (...) person-specific. Therefore, the goal of the present study was to use a switch agent paradigm with the classic false belief violation-of-expectation task. Results revealed that 16-month-old infants attributed true and false beliefs to a naïve agent—they did not perceive beliefs as person-specific. These findings indicate that infants’ understanding of beliefs is not as sophisticated as the rich mentalistic view suggests. (shrink)

A. NATURAL. HISTORY. OF. THE. SENSES. “This is one of the best books of the year—by any measure you want to apply. It is interesting, informative, very well written. This book can be opened on any page and read with relish.... thoroughly  ...

This book provides an introduction to postphenomenology, an emerging school of thought in the philosophy of technology and science and technology studies, which addresses the relationships users develop with the devices they use.

Over the history of research on sign languages, much scholarship has highlighted the pervasive presence of signs whose forms relate to their meaning in a non-arbitrary way. The presence of these forms suggests that sign language vocabularies are shaped, at least in part, by a pressure toward maintaining a link between form and meaning in wordforms. We use a vector space approach to test the ways this pressure might shape sign language vocabularies, examining how non-arbitrary forms are distributed within the (...) lexicons of two unrelated sign languages. Vector space models situate the representations of words in a multi-dimensional space where the distance between words indexes their relatedness in meaning. Using phonological information from the vocabularies of American Sign Language and British Sign Language, we tested whether increased similarity between the semantic representations of signs corresponds to increased phonological similarity. The results of the computational analysis showed a significant positive relationship between phonological form and semantic meaning for both sign languages, which was strongest when the sign language lexicons were organized into clusters of semantically related signs. The analysis also revealed variation in the strength of patterns across the form-meaning relationships seen between phonological parameters within each sign language, as well as between the two languages. This shows that while the connection between form and meaning is not entirely language specific, there are cross-linguistic differences in how these mappings are realized for signs in each language, suggesting that arbitrariness as well as cognitive or cultural influences may play a role in how these patterns are realized. The results of this analysis not only contribute to our understanding of the distribution of non-arbitrariness in sign language lexicons, but also demonstrate a new way that computational modeling can be harnessed in lexicon-wide investigations of sign languages. (shrink)

The judgement of human ability is ubiquitous, from school admissions to job performance reviews. The exact make-up of ability traits, however, is often narrowly defined and lacks a comprehensive basis. We attempt to simplify the spectrum of human ability, similar to how five personality traits are widely believed to describe most personalities. Finding such a basis for human ability would be invaluable since neuropsychiatric disease diagnoses and symptom severity are commonly related to such differences in performance. Here, we identified four (...) underlying ability traits within the National Institutes of Health Toolbox normative data (n= 1, 369): (1) Motor-endurance, (2) Emotional processing, (3) Executive and cognitive function, and (4) Social interaction. We used the Human Connectome Project young adult dataset (n= 778) to show that Motor-endurance and Executive and cognitive function were reliably associated with specific brain functional networks (r2= 0.305 ± 0.021), and the biological nature of these ability traits was also shown by calculating their heritability (31 and 49%, respectively) from twin data. (shrink)

This book provides practical and research-based chapters that offer greater clarity about the particular kinds of teacher reflection that matter and avoids talking about teacher reflection generically, which implies that all kinds of reflection are of equal value.

Reflecting upon the lies that are tied to rebukes is a fundamental step in the analysis of interactions between health-care professionals and their clients. Our research focuses on questions that incite people to lie, namely, those for which a lying response avoids a rebuke or a judgment based on some type of behaviour. Our objectives are: 1) to characterize the `question/response' exchange that is interpreted as a `potential rebuke/ lie' exchange, and the questions that may induce lying; 2) to identify (...) the strategies that health-care professionals implement in order to obtain the information they seek when questioning their clients; and 3) to identify themes that refer to behavioural norms that clients might be inclined to lie about. The results are based on the assumption that there are ties between behaviour and speech acts, in this case between the transgression of behavioural norms and lying. (shrink)

Forschung an und mit Menschen muss sich legitimieren, d. h. sie muss ihre wissenschaftliche Qualität, Rechtmäßigkeit und ethische Vertretbarkeit aufzeigen. Zu den Rechtfertigungsbedingungen zählt ein „günstiges“ Verhältnis von Nutzen- und Schadenpotenzialen des Forschungsvorhabens. Unabhängige Ethikkommissionen sind den Forschenden zur Seite gestellt, um sie bei der Prüfung und Sicherstellung der genannten Erfordernisse zu unterstützen. Eine zum Gebrauch durch Ethikkommissionen und Forschende entwickelte Nutzen- und Schadentaxonomie sowie ein Schema zur Systematisierung von Chancen-Risiken-Bewertungen wurde nachträglich auf alle Ethikanträge des Jahres 2006 an die (...) Ethikkommission der Medizinischen Fakultät der Universität zu Lübeck angewandt. Unter den 206 analysierten Studienvorhaben lassen 46 % die Chance eines direkten Eigennutzens für die Studienteilnehmer erkennen. Als gruppennützig wurden 12 % der Studienprojekte eingestuft. Sie lassen unmittelbar nach Studienabschluss oder nach wenigen weiteren Studien ein Nutzenpotenzial für Personen mit den gleichen demographischen und klinischen Merkmalen wie die Studienteilnehmer erwarten. 42 % der Ethikanträge bezogen sich auf fremdnützige Studienvorhaben mit Nutzenchancen für die Heilkunde und/oder medizinische Wissenschaft. Das Risiko eines mehr als geringfügigen Eigenschadens wurde bei 53 % der Studien identifiziert. Die Analyse der jeweiligen Nutzenchancen und Schadenrisiken führte bei insgesamt 33 der 206 Studien (16 %) zu einem negativen Ergebnis: Im Urteil der nachträglich durchgeführten Bewertung übertreffen die Nutzenchancen nicht die Schadenrisiken. Studien mit einem mehr als geringfügigen Eigenschadenpotenzial sowie nicht-eigennützige Studien weisen besonders häufig eine negative Gesamtbilanz auf. Eine Prozeduralisierung der Analyse von Chancen und Risiken kann die Transparenz vorgenommener Analyse- und Vergleichsprozesse steigern. Die Kommunikation zwischen Forschenden und Ethikkommissionen sowie unter Ethikkommissionsmitgliedern bei strittigen Studienvorhaben wird erleichtert, die Standardisierung und Harmonisierung der Beratungsabläufe der Ethikkommissionen unterstützt. (shrink)

Discipline and passion: meaning, masochism and mythology in popular medical romancesThis paper is an interpretive analysis of the discourses within popular romance literature, with a particular focus on the genre that includes constructions of the images of nurses and nursing. An historical contrast is made along with examinations of the uses and meanings encompassed within this body of literature, and its messages for women as nurses as it reflectdcreates societal change. Deviations from the formulaic nature of these works are explored. (...) Discipline and passion are the recurring themes evident throughout in juxtapositions of romance and power differentials in the hospital/medical scene. The soft‐core, sado‐masochistic images evident in many titles are explored in a way that raises questions about sexuality, romance, nursing mythology, and the future of this sub‐genre of the popular romance. (shrink)

Zu den elementaren Rechtfertigungsbedingungen der medizinischen Forschung an und mit Menschen zählt die informierte Einwilligungserklärung („informed consent“) des Probanden/Patienten. Für die Gewährleistung eines „informed consent“ sind dem potenziellen Studienteilnehmer u. a. qualitativ hochwertige schriftliche Aufklärungsmaterialien zur Verfügung zu stellen. Wir entwickelten eine Liste von Prüfpunkten, um mit ihnen die Qualität schriftlicher Aufklärungsmaterialien zu bestimmen und zu bewerten. Mithilfe eines Kriterienkataloges bestehend aus über 100 Prüfpunkten wurde die Qualität von 128 zufällig ausgewählten schriftlichen Aufklärungsmaterialien zu Forschungsvorhaben beurteilt, die der Ethikkommission der (...) Universität zu Lübeck im Jahr 2006 vorgelegt worden waren. Jeder Prüfpunkt ist einem von sechs Qualitätsbereichen zugeordnet (z. B. Lesbarkeit und Verständlichkeit, Nutzen-/Schadenpotenziale). Die untersuchten Aufklärungsmaterialien erfüllten im Durchschnitt die Hälfte der 117 abgefragten Qualitätskriterien, die Spannweite reichte dabei von 20 % bis 76 %. Der höchste Qualitätsscore wurde für den Bereich „Einwilligungserklärung“ beobachtet (64 % der Kriterien erfüllt), am schlechtesten schnitt der Bereich „Nutzen- und Schadenpotenziale“ ab (35 % der Kriterien erfüllt). Aufklärungsmaterialien zu klinischen Prüfungen von Arzneimitteln zeigten dabei eine signifikant höhere Qualität als die Aufklärungsmaterialien zu anderen Studientypen. Nur 21 der 117 analysierten Qualitätskriterien wurden in mehr als 80 % der einschlägigen Aufklärungsmaterialien umgesetzt. Die vorliegende Arbeit zeigt deutliche Defizite in der Qualität der untersuchten Aufklärungsmaterialien auf. Forscherinnen und Forscher benötigen Hilfestellung bei der Erstellung von Materialien, die eine informierte Entscheidung für oder gegen eine Studienteilnahme ermöglichen. Der von uns eingesetzte Kriterienkatalog könnte u. a. im Rahmen von Doktorandenseminaren dazu genutzt werden, den Blick für die Vielfalt der Anforderungen zu schärfen. (shrink)

This article argues that rhetorical theory will never dominate a quasi-originary and ontolgising rhetoricity that nonetheless calls for it. This rhetoricity is not simply a game played ‘in the world’, to borrow Derrida's phrasing; it is—like writing, like metaphoricity, like the ‘yes-yes’ or (en)gage—one more name for ‘the game of the world’. To get some traction on this undeclinable yet unmasterable rhetoricity, we’ll examine what Derrida calls ‘a danger of rhetoricism’ in de Man's work, a tendency to overestimate the authority (...) of the linguistic, the verbal, the discursive. The goal is not so much to substantiate Derrida's suspicions about de Man's ‘rhetoricism’ as it is to get on the tail of a rhetorical force that is irreducible to it, an ineluctable affectability or responsivity that is bound up in the very structure of sur-vival. (shrink)

Kant Trouble offers a highly original and incisive reading of some of the lesser known and less lucid aspects of Kantian thought. Diane Morgan focuses her investigation on a radical reappraisal of Kant's writings on architecture, monarchy and faith in progress. She challenges the widely held view of Kant as the exponent of concrete and rigid rationality, and argues that his airtight "architectonic" mode of reasoning, which Kant identified in The Critique of Pure Reason, overlooks certain topics which destabilize (...) it. Exploring such topics as temporary forms of architecture and the concept of radical evil, Morgan arrives at a fresh and ground-breaking perspective on Kant not as a concrete rationalist but as a daring thinker--willing to entertain subversive themes that threaten his own system and the humanistic legacy of the Enlightenment. (shrink)

Some students do not cheat. Students high in measures of bravery, honesty, and empathy, our defining characteristics of heroism, report less past cheating than other students. These student heroes also reported that they would feel more guilt if they cheated and also reported less intent to cheat in the future than nonheroes. We find general consensus between students and professors as to reasons for the nonreporting of cheating, suggesting a general impression of insufficient evidence, lack of courage, and denial. Suggested (...) interventions in academia are based in positive psychology and an understanding of academic heroes. (shrink)

Over-time variability characterizes not only individual-level emotions, but also group-level emotions, those that occur when people identify with social groups and appraise events in terms of their implications for those groups. We discuss theory and research regarding the role of emotions in intergroup contexts, focusing on their dynamic nature. We then describe new insights into the causes and consequences of emotional dynamics that flow from conceptualizing emotions as based in group membership, and conclude with research recommendations.