Machine learning-driven clinical decision support systems (ML-CDSSs) seem impressively promising for future routine and emergency care. However, reflection on their clinical implementation reveals a wide array of ethical challenges. The preferences, concerns and expectations of professional stakeholders remain largely unexplored. Empirical research, however, may help to clarify the conceptual debate and its aspects in terms of their relevance for clinical practice. This study explores, from an ethical point of view, future healthcare professionals’ attitudes to potential changes of responsibility and decision-making (...) authority when using ML-CDSS. Twenty-seven semistructured interviews were conducted with German medical students and nursing trainees. The data were analysed based on qualitative content analysis according to Kuckartz. Interviewees’ reflections are presented under three themes the interviewees describe as closely related: (self-)attribution of responsibility, decision-making authority and need of (professional) experience. The results illustrate the conceptual interconnectedness of professional responsibility and its structural and epistemic preconditions to be able to fulfil clinicians’ responsibility in a meaningful manner. The study also sheds light on the four relata of responsibility understood as a relational concept. The article closes with concrete suggestions for the ethically sound clinical implementation of ML-CDSS. (shrink)

Decision-making capacity is the gatekeeping element for a patient’s right to self-determination with regard to medical decisions. A DMC evaluation is not only conducted on descriptive grounds but is an inherently normative task including ethical reasoning. Therefore, it is dependent to a considerable extent on the values held by the clinicians involved in the DMC evaluation. Dealing with the question of how to reasonably support clinicians in arriving at a DMC judgment, a new tool is presented that fundamentally differs from (...) existing ones: the U-Doc. By putting greater emphasis on the judgmental process rather than on the measurement of mental abilities, the clinician as a decision-maker is brought into focus, rendering the tool more of an evaluation guide than a test instrument. In a qualitative study, the perceived benefits of and difficulties with the tool have been explored. The findings show on the one hand that the evaluation aid provides basic orientation, supports a holistic perspective on the patient, sensitizes for ethical considerations and personal biases, and helps to think through the decision, to argue, and to justify one’s judgment. On the other hand, the room for interpretation due to absent operationalisations, related ambiguities, and the confrontation with one’s own subjectivity may be experienced as unsettling. (shrink)

In most U.S. jurisdictions, clinicians providing informal “curbside” consults are protected from medical malpractice liability due to the absence of a doctor-patient relationship. A recent Minnesota Supreme Court case, Warren v. Dinter, offers the opportunity to reassess whether the majority rule is truly serving the best interests of patients.

Još od 2001., nakon što je Kina odabrana za domaćina Olimpijskih igara 2008., taj je izbor bio izvorom niza kontroverzi koje su se većinom usredotočile na pitanja ljudskih prava. Na ove kritičke ocjene odgovoreno je mjerama kineskih vlasti: od 2003. godine ustavnim amandmanom koji se referira na »azijske vrijednosti« i uvođenje Hu Jintaovog programa »harmoničnog društva«. Rad se pretežno usredotočuje na međukulturne aspekte rasprave o statusu ljudskih prava u Kini. Prvo se analiziraju glavna pitanja i uspoređuju različiti načini na koje (...) se pristupalo ljudskim pravima kako u Kini tako i u inozemstvu. Zatim se analiziraju neusklađenosti tih ocjena unutar dvaju osnovnih okvira: doktrine univerzalnih ljudskih prava i doktrine harmoničnog društva, zasnovanog na konfucijanskom svjetonazoru. Završno se preispituju aktualne rasprave o problemima ljudskih prava pomoću međukulturne supostavljenosti navedenih dvaju okvira i mogućnosti dijaloga tih dviju ocijenjenih pozicija. (shrink)

Problem: Medical student mistreatment, as well as patient and staff mistreatment by all levels of medical trainees and faculty, is still prevalent in U.S. clinical training. Largely missing in interventions to reduce mistreatment is acknowledgement of the abuse of power produced by the hierarchical structure in which medicine is practiced. Approach: Beginning in 2001, Yale School of Medicine has held annual “Power Day” workshops for third year medical students and advanced practice nursing students, to define and analyse power dynamics within (...) the medical hierarchy and hidden curriculum using literature, guest speakers, and small groups. During rotations, medical students write narratives about the use of power witnessed in the wards. In response to student and small group leader feedback, workshop organizers have developed additional activities related to examining and changing the use of power in clinical teams. Outcome: Emerging narrative themes included the potential impact of small acts and students feeling “mute” and “complicit” in morally distressing situations. Small groups provided safe spaces for advice, support, and professional identity formation. By 2005, students recognized residents that used power positively with Power Day awards and alumni served as keynote speakers on the use of power in medicine. By 2010, departments including OB/GYN, surgery, psychiatry, and paediatrics, had added weekly team Power Hour discussions. Next Steps: The authors highlight barriers, benefits, and lessons learned. Barriers include the notion of clinical irrelevance and resistance to the word “power” due to perceived accusation of abuse. Benefits include promoting open dialogue about power, fostering inter-professional collaboration, rewarding positive role modelling by residents and faculty, and creating a network of trainee empowerment and leadership. Furthermore, faculty have started to ask that issues of power be addressed in a more transparent way at their level of the hierarchy as well. (shrink)

Este trabajo aborda el pacto librepensador suscri­to por las autoras Rosario de Acuña y Ángeles López de Ayala. Se examinan sus contribuciones en la prensa librepensadora y su activismo feminista a través de un análisis de sus colabora­ciones en Las dominicales del librepensamiento, El gladiador: órgano de la “Sociedad progresiva femenina” y El gladiador del librepensamiento. La ideología de estas publicaciones les permitió vincular la lucha feminista con la agenda política de ideología progresista. Se parte de dos ejes complementarios cuya (...) intersección permite abordar su pacto de compromiso y transgresión: la lucha por la igualdad social y por la igualdad de género. Se estudian sus reflexiones sobre la explotación del pueblo por las castas, el empoderamiento de la mujer como agente constructor del progreso y la denuncia vehemente de su sometimiento. Se concluye que los escritos de Acuña y Ayala evidencian con el paso de los años una radicalización que pro­picia una postura cada vez más trasgresora y un feminismo más combativo, reflejando así su descontento con la actitud pater­nalista u hostil del librepensamiento y el republicanismo mas­culino en lo que respecta a los derechos de la mujer. (shrink)

Este escrito es un esfuerzo investigativo de corte crítico que se mueve argumentativamente entre paradojas, en el que se describe una tendencia actual en la sociedad como patológica y deshumanizante. A tal tendencia le hemos llamado sedentarismo-nómada, primera paradoja, que no es más que la tendencia del hombre a ser sedentario de un lugar u objeto tecnológico de moda, mientras que está en la posibilidad de conocer el mundo mediante tal objeto, haciendo un clic, sin salir de su casa o (...) lugar de trabajo, pero al mismo tiempo viajando por todo el mundo. Tendencia que se da entre actores sociales caracterizados como singularidades-plurales-narrativas, segunda paradoja, que a su vez obedece a una política de la homogenización, un proceso de estandarización social en masa; una ética comerciante, un proceso de regulación y caracterización comportamental bajo la lógica del mercado en la instauración de una nueva forma de relacionarse con la vida, con el sí mismo y con el otro, una relación mercantil; como expresiones de una cultura pornográfica audio-visual, el otro hecho objeto de consumo; y una pedagogía del consumo, una cultura que educa por y para comprar y vender a través de objetos tecnológicos. La consideración de un mundo trágico y sin sentido pero al que, hay que hallarle razón de ser, es la última de las paradojas. Radiografía social que deja al hombre transformado en la única cosa que puede ser institucionalmente, mercancía de consumo, objeto prostituido. (shrink)

Pulmonary rehabilitation has demonstrated patients’ physiological and psychosocial improvements, symptoms reduction and health-economic benefits whilst enhances the ability of the whole family to adjust to illness. However, PR remains highly inaccessible due to lack of awareness of its benefits, poor referral and availability mostly in hospitals. Novel models of PR delivery are needed to enhance its implementation while maintaining cost-efficiency. We aim to implement an innovative community-based PR programme and assess its cost-benefit. A 12-week community-based PR will be implemented in (...) primary healthcare centres where programmes are not available. Healthcare professionals will be trained. 73 patients with CRD and their caregivers will compose the experimental group. The control group will include dyads age- and disease-matched willing to collaborate in data collection but not in PR. Patients/family-centred outcomes will be dyspnoea, fatigue, cough and sputum, impact of the disease, emotional state, number of exacerbations, healthcare utilisation, health-related quality of life and family adaptability/cohesion. Other clinical outcomes will be peripheral and respiratory muscle strength, muscle thickness and cross sectional area, exercise capacity, balance and physical activity. Data will be collected at baseline, at 12 weeks, at 3- and 6-months post-PR. Changes in the outcome measures will be compared between groups, after multivariate adjustment for possible confounders, and effect sizes will be calculated. A cost-benefit analysis will be conducted. This study will enhance patients access to PR, by training healthcare professionals in the local primary healthcare centres to conduct such programmes and actively involving caregivers. The cost-benefit analysis of this intervention will provide an evidence-based insight into the economic benefit of community-based PR in chronic respiratory diseases. The trial was registered in the ClinicalTrials. gov U.S. National Library of Medicine, on 10th January, 2019. (shrink)

Die Entwicklung des Schalenmodells, deren Skizzierung an dieser Stelle abgebrochen wird, unterteilt sich deutlich in mehrere zeitlich voneinander getrennte Phasen. Ausgangspunkt der Entstehung des Schalenmodells ist die Betrachtung der bekannten Isotope, die erst mit der Entdeckung des Neutrons die schon vorhandene Idee des Kernschalenaufbaus quantitativ erfaßbar macht, und zwar durch noch ungenau bekannte ausgezeichnete Zahlen . Wie oft in der Geschichte der Naturwissenschaften wird eine solche erste Phase durch verschiedene spekulative Annahmen begleitet, die sich auf wenige Anhaltspunkte stützen müssen. Bereits (...) 1933 setzt eine andere Entwicklung ein, die neben der Darstellung empirischer Ergebnisse durch den Versuch gekennzeichnet ist, eine theoretische Begründung des Schalenmodells mit verschiedenen Kernpotentialen zu lieform. Es gelingt jedoch nicht, alle aufgetretenen Fragen befriedigend zu klären.Deutlich getrennt von der Entwicklung der ersten Jahre beginnt erst 1948 eine weitere Entstehungsphase des Schalenmodells. Im Unterschied zur den Jahren 1932–35 liegt 1948 eine Fülle empirischen Materials vor, dessen Erklärung erneut zur Betrachtung eines Schalenmodells anregt. Damit gelingt es, die meisten der offenen Fragen im wesentlichen mit Hilfe der Kernpotentiale und einer starken Spin-Bahn-Wechselwirkung zu beantworten. (shrink)

Michel Foucault’s later concept of parrhesia presents a number of potential interpretive problems with respect to his work as a whole and his conception of truth. This article presents an alternative reading of parrhesia , which develops its concept through Foucault’s earlier pronouncements on truth and fiction. Seen this way, parrhesia becomes a means whereby one enacts useful fictions within the context of one’s life. As a practice, which demands self-mastery, orientation towards truth, and a command of one’s life, parrhesia (...) becomes crucial to an aesthetics of existence. (shrink)

It is often claimed that the use of depth psychology in the interpretation of ancient texts is irrelevant and methodologically unsound. Several typical Jungian archetypes, such as the shadow, the primordial mother, and the hero, were identified, interpreted and commented on from a post-Jungian perspective. The apocryphal Book of Baruch has typically been studied as a prime example of penitential prayer in the late Second Temple Period. In this study, the book was approached from the perspective of post-Jungian literary criticism. (...) While Jungian literary criticism has become unfashionable as a result of Jung’s anti-feminist and anti-Semitic ideas, the usefulness of his theory to criticise itself was demonstrated. Although Jung’s work is haunted by racism, anti-feminism, and antisemitism, his work may still be useful for literary criticism from a psychological perspective.Contribution: The article demonstrated the value of the depth psychological approach to the interpretation of biblical material. (shrink)

In this contribution, we will discuss the opportunities and challenges arising from memory institutions' need to redefine their archival strategies for contemporary collecting in a world of big data. We will reflect on this topic by critically examining the case study of the UK Web Archive, which is made up of the six UK Legal Deposit Libraries: the British Library, National Library of Scotland, National Library of Wales, Bodleian Libraries Oxford, Cambridge University Library and Trinity College Dublin. The UK Web (...) Archive aims to archive, preserve and give access to the UK web space. This is achieved through an annual domain crawl, first undertaken in 2013, in addition to more frequent crawls of key websites and specially curated collections which date back as far as 2005. These collections reflect important aspects of British culture and events that shape society. This commentary will explore a number of questions including: what heritage is captured and what heritage is instead neglected by the UK Web archive? What heritage is created in the form of new data and what are its properties? What are the ethical issues that memory institutions face when developing these web archiving practices? What transformations are required to overcome such challenges and what institutional futures can we envisage? (shrink)

Provability, Computability and Reflection.

The seemingly innocuous description of Leah as having ‘soft’ eyes in Genesis 29:17 has captivated scholars and readers for centuries. This article advances an ironic interpretation, suggesting that Leah’s ‘soft’ eyes were not a sign of weakness but, rather, an indication of envy and malevolence, potentially contributing to fertility issues faced by her sister Rachel in terms of the ancient Near Eastern evil eye belief complex. In this context, the article delves into ancient belief systems that entwined beauty, fertility, and (...) the malevolent gaze.Contribution: Drawing from biblical texts, historical sources, and contemporary scholarship, this article reveals the intricate layers of meaning within this minor detail. (shrink)

v. 1. Cosmogenesis.--v. 2. Anthropogenesis.

I draw lessons from experimental economics. I argue that the lack of mathematical formalism cannot be usefully thought as the cause of the underappreciation of contextual and generalizability considerations. Instead, this lack is problematic because it hinders a clear relationship between theory and quantitative predictions. I also advocate a pragmatic policy-focused approach as a partial remedy to the generalizability problem.

Pierre Bourdieu is arguably one of the twentieth century’s greatest socio-philosophical thinkers and his writings have much to offer anyone interested in the ways that people value, consume and produce architecture. Bourdieu spent much of his life attempting to understand cultural consumption and production through detailed empirical research that included studies of dwellings, art, museums, photography and aesthetics. This book introduces the architectural reader to Bourdieu’s key writings on culture and outlines the ways in which they offer powerful practical tools (...) and novel conceptual frameworks for understanding architectural value, taste, and practice. (shrink)

The Covid-19 induced United Kingdom-wide lockdown in 2020 saw choirs face a unique situation of trying to continue without being able to meet in-person. Live networked simultaneous music-making for large groups of singers is not possible, so other “virtual choir” activities were explored. A cross sectional online survey of 3948 choir members and facilitators from across the United Kingdom was conducted, with qualitative analysis of open text questions, to investigate which virtual choir solutions have been employed, how choir members and (...) facilitators experience these in comparison to an “in-person” choir, and whether the limitations and opportunities of virtual choir solutions shed light on the value of the experience of group singing as a whole. Three virtual choir models were employed: Multi-track, whereby individuals record a solo which is mixed into a choral soundtrack; Live streamed, where individuals take part in sessions streamed live over social media; Live tele-conferencing, for spoken interaction and/or singing using tele-conferencing software. Six themes were identified in the open text responses: Participation Practicalities, encompassing reactions to logistics of virtual models; Choir Continuity, reflecting the responsibility felt to maintain choir activities somehow; Wellbeing, with lockdown highlighting to many the importance of in-person choirs to their sense of wellbeing; Social Aspects, reflecting a sense of community and social identity; Musical Elements, whereby the value of musical experience shifted with the virtual models; Co-creation through Singing, with an overwhelming sense of loss of the embodied experience of singing together in real-time, which is unattainable from existing virtual choir models. The experiences, activities and reflections of choir singers during lockdown present a unique perspective to understand what makes group singing a meaningful experience for many. Co-creation through Singing needs further investigation to understand the impact of its absence on virtual choirs being able re-create the benefits of in-person choirs. (shrink)

The social construction of space -- The anatomy of taste -- Towards a theory of cultural practice --Fields of cultural production -- Cultural practice, reflexivity and political action.

It is often claimed that the use of depth psychology in the interpretation of ancient texts is irrelevant and methodologically unsound. Several typical Jungian archetypes, such as the shadow, the primordial mother, and the hero, were identified, interpreted and commented on from a post-Jungian perspective. The apocryphal Book of Baruch has typically been studied as a prime example of penitential prayer in the late Second Temple Period. In this study, the book was approached from the perspective of post-Jungian literary criticism. (...) While Jungian literary criticism has become unfashionable as a result of Jung’s anti-feminist and anti-Semitic ideas, the usefulness of his theory to criticise itself was demonstrated. Although Jung’s work is haunted by racism, anti-feminism, and antisemitism, his work may still be useful for literary criticism from a psychological perspective. Contribution: The article demonstrated the value of the depth psychological approach to the interpretation of biblical material. (shrink)

In this article, we explore the learning of newcomers in a religious community through a micro-sociological approach, making use of Jean Lave and Etienne Wenger’s (1991) notion of “legitimate peripheral participation” to conceptualize initial stages of inclusion and involvement in social practice. Our case study concerns Orthodox Christianity and is based on material gathered through fieldwork in a course targeting potential new members organized by a Finnish Orthodox parish. In the analysis, we inquire into how beginners learn skilful participation in (...) Orthodox liturgical life, and specifically embodied ritual conduct. This learning takes place primarily through participation in real-life divine services. The article highlights challenges faced by beginners in acquiring the embodied repertoire of Orthodox ritual, including adapting to the artistic use of ritual gestures, and negotiating the meanings produced through them. Furthermore, it also illustrates how nuanced dynamics between newcomers and old-timers influence the learning process. (shrink)

v. 1. Psicologia experimental -- v. 2. Fundamentos da educação -- v. 3. Educação do excepcional -- v. 4. Educação rural -- v. 5. A educação do bem-dotado.

Purpose The purpose of this paper is to report on empirical work conducted to open up algorithmic interpretability and transparency. In recent years, significant concerns have arisen regarding the increasing pervasiveness of algorithms and the impact of automated decision-making in our lives. Particularly problematic is the lack of transparency surrounding the development of these algorithmic systems and their use. It is often suggested that to make algorithms more fair, they should be made more transparent, but exactly how this can be (...) achieved remains unclear. Design/methodology/approach An empirical study was conducted to begin unpacking issues around algorithmic interpretability and transparency. The study involved discussion-based experiments centred around a limited resource allocation scenario which required participants to select their most and least preferred algorithms in a particular context. In addition to collecting quantitative data about preferences, qualitative data captured participants’ expressed reasoning behind their selections. Findings Even when provided with the same information about the scenario, participants made different algorithm preference selections and rationalised their selections differently. The study results revealed diversity in participant responses but consistency in the emphasis they placed on normative concerns and the importance of context when accounting for their selections. The issues raised by participants as important to their selections resonate closely with values that have come to the fore in current debates over algorithm prevalence. Originality/value This work developed a novel empirical approach that demonstrates the value in pursuing algorithmic interpretability and transparency while also highlighting the complexities surrounding their accomplishment. (shrink)

The European Commission has recently proposed the introduction of legally binding quotas for women on corporate boards of European companies. This proposal has put the spotlight on the question of whether increasing female representation on the board brings economic benefits to the firm. In order to shed light on the issue, this study investigates the direct and indirect effects of women on the board on firm value. We use a simultaneous equation model to estimate the effects of women on the (...) board on firm value, financial performance, and compliance with ethical and social principles adopted by the firm. We find no evidence that a higher female representation on the board directly affects firm’s value. However, we find indirect effects. Women on the board are positively related with financial performance (measured in terms of return on assets and return on sales) and with ethical and social compliance, which in turn are positively related with firm value. The findings in this study suggest that greater female representation on corporate boards of large European firms can increase firm value indirectly. Further, part of the indirect effect comes from stronger compliance with ethical principles, something that is not captured by accounting-based financial performance. (shrink)

Servant leadership offers a compelling ideal of self-sacrificing individuals who put the needs of others before their own and cultivate a culture of growth in their organisations. Although the theory’s attempts to emphasise the moral, emotional and relational dimensions of leadership are laudable, it has primarily assumed a decontextualised view of leadership untouched by power. This article aims to problematise servant leadership by undertaking an intersectional analysis of an Asian cis-male heterosexual senior manager in Australia. Through in-depth interviews with the (...) manager and his staff, the article shows how his attempts to practice servant leadership were informed by intersecting power dynamics of race, gender, sexuality, age and class that subordinated him to white power. The findings demonstrate the ways servant leadership is necessarily embedded in wider power structures that shape who gets to be a “servant leader” and who remains merely a “servant”. (shrink)

Storchak, Ehlis, and Fallgatter provide an extensive literature review on electrophysiological measurements, which indicate that general predictive deficits in self‐monitoring are associated with various positive symptoms in patients with schizophrenia.