BackgroundInformed consent forms for clinical research are several and variable at international, national and local levels. According to the literature, they are often unclear and poorly understood by participants. Within the H2020 project CORBEL—Coordinated Research Infrastructures Building Enduring Life-science Services—clinical researchers, researchers in ethical, social, and legal issues, experts in planning and management of clinical studies, clinicians, researchers in citizen involvement and public engagement worked together to provide a minimum set of requirements for informed consent in clinical studies.MethodsThe template was (...) based on a literature review including systematic reviews and guidelines searched on PubMed, Embase, Cochrane Library, NICE, SIGN, GIN, and Clearinghouse databases, and on comparison of templates gathered through an extensive search on the websites of research institutes, national and international agencies, and international initiatives. We discussed the draft versions step-by-step and then we referred to it as the “matrix” to underline its modular character and indicate that it allows adaptation to the context in which it will be used. The matrix was revised by representatives of two international patient groups.ResultsThe matrix covers the process of ensuring that the appropriate information, context and setting are provided so that the participant can give truly informed consent. It addresses the key topics and proposes wording on how to clarify the meaning of placebo and of non-inferiority studies, the importance of individual participants’ data sharing, and the impossibility of knowing in advance how the data might be used in future studies. Finally, it presents general suggestions on wording, format, and length of the information sheet.ConclusionsThe matrix underlines the importance of improving the process of communication, its proper conditions (space, time, setting), and addresses the participants’ lack of knowledge on how clinical research is conducted. It can be easily applied to a specific setting and could be a useful tool to identify the appropriate informed consent format for any study. The matrix is mainly intended to support multicentre interventional randomized clinical studies, but several suggestions also apply to non-interventional research. (shrink)

BackgroundEverybody has the right to decide whether to receive specific medical treatment or not and to provide their free, prior and informed consent to do so. As dementia progresses, people with Alzheimer’s dementia (PwAD) can lose their capacity to provide informed consent to complex medical treatment. When the capacity to consent is lost, the autonomy of the affected person can only be guaranteed when an interpretable and valid advance directive exists. Advance directives are not yet common in Germany, and their (...) validity is often questionable. Once the dementia diagnosis has been made, it is assumed to be too late to write an advance directive. One approach used to support the completion of advance directives is ‘Respecting Choices’®—an internationally recognised, evidence-based model of Advance Care Planning (ACP), which, until now, has not been evaluated for the target group of PwAD. This study’s aims include (a) to investigate the proportion of valid advance directives in a memory clinic population of persons with suspected AD, (b) to determine the predictors of valid advance directives, and (c) to examine whether the offer of ACP can increase the proportion of valid advance directives in PwAD.MethodWe intend to recruit at leastN = 250 participants from two memory clinics in 50 consecutive weeks. Of these, the first 25 weeks constitute the baseline phase (no offer of ACP), the following 25 weeks constitute the intervention phase (offer of ACP). The existence and validity of an advance directive will be assessed twice (before and after the memory clinic appointment). Moreover, potential predictors of valid advance directives are assessed.DiscussionThe results of this study will enhance the development of consent procedures for advance directives of PwAD based on the ACP/Respecting Choices (R) approach. Therefore, this project contributes towards increasing the autonomy and inclusion of PwAD and the widespread acceptance of valid advance directives in PwAD.Trial RegistrationDRKS, DRKS00026691, registered 15th of October 2021,https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00026691. (shrink)

The ability to be creative is often considered a unique characteristic of conscious beings and many efforts have been directed at demonstrating a relationship between creativity and the personality construct of psychoticism. The present study sought to investigate this link explicitly by focusing on discrete facets of creative cognition, namely the originality/novelty dimension and the practicality/usefulness dimension. Based on Eysenck’s conceptualisation of psychoticism as being characterised by an overinclusive cognitive style, it was expected that higher levels of psychoticism would accompany (...) a greater degree of conceptual expansion and elevated levels of originality in creative imagery, but would be unrelated to the practicality/usefulness of an idea. These hypotheses were confirmed in 80 healthy participants who were contrasted based on their EPQ psychoticism scale scores. Our findings suggest that the link between psychoticism and creativity is based on associative thinking and broader but weak top-down activation patterns rather than on goal-related thinking. (shrink)

La infección por el virus del papiloma humano (VPH) constituye la causa necesaria, aunque no suficiente, de la enfermedad de transmisión sexual más frecuente en el mundo, responsable del 4,5 % de todos los cánceres en ambos sexos. La vacunación frente al VPH, con niveles de eficacia y seguridad similares en ambos sexos, está dirigida básicamente a mujeres, para reducir la incidencia de infección y sus consecuencias, como el cáncer de cérvix. La transmisibilidad del virus en ambos sexos y la (...) inmunidad colectiva que proporciona la vacunación universal hace que su extensión al sexo masculino constituya una cuestión no solo de salud pública, sino también un dilema bioético relacionado con la protección de la salud y la equitativa distribución de los recursos. Este trabajo aborda el análisis bioético de la extensión de la vacunación contra VPH a ambos sexos. (shrink)

Written by two of the leading figures in the field, this is a lucid and systematic introduction to semantics as applied to transformational grammars of the ...

The editors of the JRE solicited short essays on the COVID‐19 pandemic from a group of scholars of religious ethics that reflected on how the field might help them make sense of the complex religious, cultural, ethical, and political implications of the pandemic, and on how the pandemic might shape the future of religious ethics.

In Lewin et al. 359–386) the authors proved that certain systems of annotated logics are algebraizable in the sense of Block and Rigozzi 396). Later in Lewin et al. the study of the associated quasi-varieties of annotated algebras is initiated. In this paper we continue the study of the these classes of algebras, in particular, we report some recent results about the free annotated algebras.

In dieser Schrift begründet Dante die Priorität der Volks- und Muttersprache vor der lateinischen Gelehrtensprache und fordert eine italienische Hochsprache. Er untermauert seine Ausführungen durch eine anthropologische Erörterung der menschlichen Sprachfähigkeit. Dank einer originellen Interpretation des biblischen Mythos vom Turmbau von Babel legt er eine vernünftig begründete Neubewertung der Vielfalt und der historischen Entwicklung der Sprachen vor. Das Problem der Sprache stellt sich im Denken Dantes in zweifacher Weise: als Problem der Sprache der Philosophie und unter dem Gesichtspunkt der Philosophie (...) der Sprache. In "De vulgari eloquentia" bietet Dante ein ganzes Arsenal metaphysischer Paradigmen auf, um der sprachlichen Verständigung der Menschen eine unvordenkliche Dignität zu geben. Er stellt die gesamte Philosophie in den Dienst des Menschen als sprechendes Wesen. Auch wenn Dante die Doppelbestimmung der Sprache als sinnliches Zeichen, das den Gedanken des einen Menschen einem andern zu vermitteln fähig ist, von der Tradition übernimmt, setzt er andere Akzente. Die Sprache der Menschen ist nicht nur eine im Vergleich zur Transparenz der reinen Geister unvollkommenere Form der Kommunikation, sondern sie wird positiv als die dem Menschen gänzlich angemessene und entsprechende Form der Kommunikation interpretiert: Das Sprechen ist der "herausragende Akt des menschlichen Geschlechts". Mit dem Erscheinen von "De vulgari eloquentia" liegt die vierbändige Ausgabe der Philosophischen Werke Dante Alighieris vollständig vor. Bislang erschienen Bd. 1: Das Schreiben an Cangrande (PhB 463) Bd. 2: Disputation über das Wasser und die Erde (PhB 464) Bd. 4: Das Gastmahl I-IV (PhB 466a-d). (shrink)

To our knowledge, this is one of the first studies to test different theoretical models of working memory in childhood based on a computerized assessment. We tested this across several countries: Argentina, Brazil, Canada, Italy, and UK. The present study addressed the wider macro-cultural context and how this impacts working memory. We used two economic indices to characterize the participating countries and ranked the countries based on the Global Index of Cognitive Skills and Educational Attainment. Children between 5 and 10 (...) years completed the same set of short-term and working memory tests. There were two main findings. First, there was a similar pattern in verbal working memory across countries, which suggests that this skill may be relatively consistent across different cultural groups. In contrast, the pattern for visuo-spatial working memory was different across countries, which may explained by cultural differences and educational rankings of the countries. The second main finding was that both a domain-general model and a domain-specific model provided a reasonably good fit with the data, there was the high relationship between the verbal and visuo-spatial working memory constructs across the countries in the latter model. Thus, it may be a more parsimonious choice to rely on a three-factor model. The data also suggest culture-similar patterns in a computerized assessment of working memory. (shrink)

The COVID-19 pandemic challenged countries, regions, schools, and individuals. School closures due to lockdowns forced changes in the teaching practices and the learning support provided to children at home. This study aimed to provide insights on the changes between the first and the second lockdowns in Portugal, concerning remote teaching practices and family support to children's education. A self-report questionnaire was filled by 144 parents of third grade students. The results show that, between the two lockdowns, there was a significant (...) decrease in the amount of support provided at home to school assignments and activities, as well as in the amount of time spent by students in TV broadcasted lessons and in reading training supported by the family. Inversely, families reported a significant increase in the amount of time spent by students in independent reading activities and in the time spent in training reading guided by teachers. The number of synchronous lessons with a teacher and the number of times students trained reading during a synchronous lesson also increased in the second lockdown. Additionally, in the second lockdown, parents perceived synchronous lessons to be more effective at improving their child's reading skills and perceived themselves as more capable of supporting their child in reading acquisition. These findings are used to discuss school responses and remote teaching and learning practices during the COVID-19 pandemic. (shrink)

BackgroundWork stress is a serious problem in primary education. Decades of research underline the importance of participatory, organizational-level work stress prevention approaches. In this approach, measures are planned to tackle causes of work stress in a participatory manner and implemented by a working group consisting of members of the organization. This approach can only be effective if the measures contain effective ingredients to decrease work stress risks and are successfully implemented. The aim of this paper is to present an outline (...) of a work stress prevention approach that is evaluated in primary education. To ensure the appropriateness of measures, a logic model of change is built as part of the risk assessment to facilitate the selection of appropriate measures. Progression on target behaviors as well as implementation factors are real-time monitored during implementation and fed back to the working groups, to provide the opportunity to adjust action plans when needed to optimize implementation.MethodsThe approach consists of five steps: preparation: installing an advisory board and working groups, risk assessment: inventory of work stress risks. In addition, a behavioral analysis is performed to build a logic model of change to facilitate selection of measures, action planning: conducting an action plan with appropriate measures, implementation: implementing the action plan. During implementation progression on target behaviors and implementation factors are monthly monitored and fed back to the working groups, and evaluation: effects of the approach are studied in a controlled trial with measurements at baseline, 1 year, and 2 years follow-up. A process evaluation is carried out using quantitative and qualitative data to study the implementation process of all steps of the work stress approach.DiscussionWe believe that building a logic model of change and real-time monitoring of implementation could be of added value to improve the success of the work stress prevention approach. With this study, we aim to provide more insights into work stress intervention research, especially in primary education.Clinical Trial RegistrationThe study is registered in Netherlands Trial Register. (shrink)

The study of anarchism as a philosophical, political, and social movement has burgeoned both in the academy and in the global activist community in recent years. Taking advantage of this boom in anarchist scholarship, Nathan J. Jun and Shane Wahl have compiled twenty-six cutting-edge essays on this timely topic in New Perspectives on Anarchism.

SCHOFIELD I, TOLSON D and FLEMING V. Nursing Inquiry 2012; 19: 165–176 [Epub ahead of print]How nurses understand and care for older people with delirium in the acute hospital: a Critical Discourse AnalysisDelirium is a common presentation of deteriorating health in older people. It is potentially deleterious in terms of patient experience and clinical outcomes. Much of what is known about delirium is through positivist research, which forms the evidence base for disease‐based classification systems and clinical guidelines. There is little (...) systematic study of nurses’ day‐to‐day practice of nursing patients with delirium. The aim was to uncover the kinds of knowledge that informs nurses’ care and to explicate the basis of that knowledge. Critical Discourse Analysis is underpinned by the premise that powerful interests within society mediate how social practices are constructed. Links were made between the grammatical and lexical features of nurses’ language about care in interviews and naturalistic settings, and the healthcare context. Care focused on the continuous surveillance of patients with delirium by nurses themselves or vicariously through other patients, and containment. Nurses influenced by major discourses of risk reduction and safety, constructed patients with delirium as risk objects. The philosophy of person‐centred and dignified care advocated in nursing literature and government policy is an emerging discourse, though little evident in the data. The current dominant discourses on safety must give space to discourses of dignity and compassion. (shrink)

This essay is a critical review of two recent collections, Feminism and Foucault: Reflections on Resistance, edited by Irene Diamond and Lee Quinby and Feminism as Critique: On the Politics of Gender, edited by Seyla Benhabib and Drucilla Cornell. While the collections differ in their manner of addressing the critical sources that have inspired them-the former relying upon a single theorist, the latter attempting to move through some of the philosophical history that constitutes our present theoretical terrain-both attempt to think (...) through and thus revisualize some of the categories of difference which we have inherited. Though the best essays from these collections are celebrated for demonstrating how "feminism as critique" can work to move us toward a clearer and more inclusive feminist theory, questions are raised about what the inattention to race in these volumes suggests about our own role in the construction of power and knowledge, and the erasures that help to secure them both. (shrink)

The influence of stakeholders, organisational commitment, personal values, goals of the organisation and socio-demographic characteristics of individuals on the ethical dimension of behavioural intentions of employees in various organisations are investigated. The research results show that employees working for the public sector or in educational institutions take more ethical aspects into account than employees working in the "private" sector. The influence of stakeholders and organisational commitment do not significantly affect the ethical behaviour of employees, and only some personal values and (...) goals of the organisation have a significant influence on ethical behaviour. The most significant explanatory factor of ethical decision making seems to be what may be called "stage in the career of the employee": "ethical" employees can be described as young, with a relatively low income, limited work experience and a low level of responsibility in the company. (shrink)

Background The aim was to explore how the clinical ethics committees in Norway have worked and functioned within mental health care and addiction treatment services. Methods Analysis of 256 annual reports from clinical ethics committees from 2003 to 2012 and a survey to clinicians who had used a clinical ethics committee. Results Dilemmas related to coercion, confidentiality, information, and patient autonomy dominated. The committees established only for psychiatric hospitals, had received more cases from mental health and addiction services than the (...) committees also serving somatic services. Many of the case discussions involved both somatic and mental health care, complicated legal issues as well as ethical dilemmas. Mental health care professionals that have used the clinical ethics committees evaluated the clinical ethics committees deliberation as useful. Conclusion Given the many difficult ethical dilemmas in mental health care ethics work need to be strengthened. The complexity of the cases requires varied and interdisciplinary competence and training among the clinical ethics committee members. (shrink)

With the increased use of Artificial Intelligence (AI) in wildlife conservation, issues around whether AI-based monitoring tools in wildlife conservation comply with standards regarding AI Ethics are on the rise. This review aims to summarise current debates and identify gaps as well as suggest future research by investigating (1) current AI Ethics and AI Ethics issues in wildlife conservation, (2) Initiatives Stakeholders in AI for wildlife conservation should consider integrating AI Ethics in wildlife conservation. We find that the existing literature (...) weakly focuses on AI Ethics and AI Ethics in wildlife conservation while at the same time ignores AI Ethics integration in AI systems for wildlife conservation. This paper formulates an ethically aligned AI system framework and discusses pre-eminent on-demand AI systems in wildlife conservation. The proposed framework uses agile software life cycle methodology to implement guidelines towards the ethical upgrade of any existing AI system or the development of any new ethically aligned AI system. The guidelines enforce, among others, the minimisation of intentional harm and bias, diversity in data collection, design compliance, auditing of all activities in the framework and ease of code inspection. This framework will inform AI developers, users, conservationists, and policymakers on what to consider when integrating AI Ethics into AI-based systems for wildlife conservation. (shrink)

What kind of reference (if any) do terms such as “pencil,” “chair,” “television,” and so on have? On the matter, a de-bate between directly referential theorists and descriptiv-ist theorists is open. It is largely acknowledged that natural kind terms (such as “water,” “gold,” “tiger,” etc.) are directly referential expressions (cf. Putnam,1975). That is, they are expressions whose reference is determined by their refer-ents' nature, independent of whether we know or will ever know what this nature is. However, it does not (...) seem like-wise convincing that all artifactual kind terms (like “pen-cil,” “chair,” “television,” etc.) semantically behave the same. Terms for artifactual kinds seem more likely to be subjected to a descriptivist view, that is, definable not by links to their extensions' nature but in terms of conjunctions or clusters of properties. In his celebrated “The Meaning of ‘Meaning’” (1975), Hilary Putnam originated the mentioned debate by arguing that artifactual kind terms also refer directly. Thus, the discussion ultimately revolves around establishing whether artifactual and natural kind terms are both directly referential expressions. The authors engaged in this debate have tried to argue in favor of (or against) Putnam's proposal by highlighting the similarities (or differences) between nat-ural vis-à-vis artifactual kind words and their respective ref-erents. This paper aims to provide a thorough and reasoned overview of the debate at stake, pointing out trends and problems associated with each proposed account. (shrink)

ArgumentThe Ashkenazi grammars of Hebrew written between roughly 1600 and 1800 fill a modest and largely forgotten shelf in the Jewish scholarly library. At first sight, especially when compared with the medieval Jewish and contemporary Christian Hebrew traditions, they seem to lack technical sophistication. As this paper hopes to demonstrate, however, this apparent lack of sophistication was not so much an intrinsic flaw as a deliberate choice. For the earliest Ashkenazi textbooks were not about studying grammar, but about teaching Hebrew. (...) By adapting the existing descriptive models to the needs of the classroom and the gemeyne leytn, Jewish scholars and teachers in such cities as Prague, Wilhelmsdorff, and Amsterdam hoped to find and instruct new audiences. Depending on context and target audience, they either relied on Hebrew, Yiddish, or on an intricate interplay of the two for maximum success and efficiency. It was this innovative combination of didactic simplification and functional bilingualism that allowed them not only to reach a new readership, but also to equip that readership to henceforth read their Bible and prayers with unprecedented autonomy. (shrink)

The “nature” of an artifact is often equated with its function. Clearly, an artifactual function must be an extrinsic property. This feature of functions has important implications on the semantics of artifactual kind terms: it enables us to vindicate that artifactual kind terms have an externalist semantics. Any alleged externalist theory, indeed, must show that the referents of the considered terms share a common nature (i.e., an extrinsic property), whether we know or could possibly ever know what that nature is. (...) However, the state of the art shows that function is not enough to represent such “nature”: function does not exhaustively account for important phenomena that characterize artifacts and artifactual kinds, nor does it thoroughly define what they are. Thus, extending the scope of externalism to artifactual kind terms seems doomed to fail. Pace opposite views, it could even be argued that artifacts are a sub-class of social kinds. If so, not only social but also artifactual kind terms cannot refer externalistically, since their referents constitutively depend on human intentions and norms. Either way, externalism fails to apply to those kinds of terms. (shrink)

Research from behavioural sciences shows that people reach decisions in a much less rational and well-considered way than was often assumed. The doctrine of informed consent, which is an important ethical principle and legal requirement in medical practice, is being challenged by these insights into decision-making and real-world choice behaviour. This article discusses the implications of recent insights of research on decision-making behaviour for the informed consent doctrine. It concludes that there is a significant tension between the often non-rational choice (...) behaviour and the traditional theory of informed consent. Responsible ways of dealing with or solving these problems are considered. To this end, patient decisions aids are discussed as suitable interventions to support autonomous decision-making. However, current PDAs demand certain improvements in order to protect and promote autonomous decision-making. Based on a conception of autonomy, we will argue which type of improvements are needed. (shrink)

This article uses a conversation analytic framework to describe a type of wh-question used to challenge a prior utterance, specifically to challenge the basis for or right to do an action done by the prior utterance. These wh-questions are able to do challenging because, rather than asking for new information, they are used to convey a strong epistemic stance of the questioner, a negative assertion. The utterances are designed as requests for an account for a prior claim or action, but (...) by conveying a negative assertion, they suggest that there is no adequate account available and, thus, that there are no grounds for the prior claim or action. The use of these questions in institutional settings can display participants' orientation to institutional goals, norms and roles, showing that institutional roles can thus be enacted, and goals accomplished, by means of practices of talk which are not, themselves, institutionally specific. (shrink)

Kevin Smith's utilitarian argument against homeopathy1 is flawed because he did not review and refute the relevant basic science literature on ultra-high dilutions. He also failed to appreciate that allopathic medicine is based on a deductive-nomothetic method and that homeopathic medicine is based on an inductive-idiographic method, and thus that the implications for clinical research are very different. His misunderstanding of provings and of the holism of homeopathic medicine also demonstrated his failure to understand the history, philosophy and method of (...) homeopathy. Finally, I questioned the value of introducing ethical judgment into an ongoing scientific debate. (shrink)

The concept of sustainability was developed in response to stakeholder demands. One of the key mechanisms for engaging stakeholders is sustainability disclosure, often in the form of a report. Yet, how reporting is used to engage stakeholders is understudied. Using resource dependence and stakeholder theories, we investigate how companies within the same industry address different dependencies on stakeholders for economic, natural environment, and social resources and thus engage stakeholders accordingly. To achieve this objective, we conducted our research using qualitative research (...) methods. Our findings suggest that the resource dependencies on different stakeholders lead to development of different stakeholder relationships and thus appropriate resources within the company to execute engagement strategies that are informing, responding, or involving. Our research explains why diversity exists in sustainability disclosure by studying how it is used to engage stakeholders. We find that five sustainability reporting characteristics are associated with the company’s stakeholder engagement strategy: directness of communication, clarity of stakeholder identity, deliberateness of collecting feedback, broadness of stakeholder inclusiveness, and utilization of stakeholder engagement for learning. Our study develops the literature by providing insight into companies’ choices of stakeholder engagement strategy thus explaining diversity in sustainability reporting based on the characteristics and relationships with specific stakeholders. (shrink)

There are several conceptions of truth, such as the classical correspondence conception, the coherence conception and the pragmatic conception. The classical correspondence conception, or Aristotelian conception, received a mathematical treatment in the hands of Tarski (cf. Tarski [1935] and [1944]), which was the starting point of a great progress in logic and in mathematics. In effect, Tarski's semantic ideas, especially his semantic characterization of truth, have exerted a major influence on various disciplines, besides logic and mathematics; for instance, linguistics, the (...) philosophy of science, and the theory of knowledge. The importance of the Tarskian investigations derives, among other things, from the fact that they constitute a mathematical, formal mark to serve as a reference for the philosophical (informal) conceptions of truth. Today the philosopher knows that the classical conception can be developed and that it is free from paradoxes and other difficulties, if certain precautions are taken. We believe that is not an exaggeration if we assert that Tarski's theory should be considered as one of the greatest accomplishments of logic and mathematics of our time, an accomplishment which is also of extraordinary relevance to philosophy, as we have already remarked. In this paper we show that the pragmatic conception of truth, at least in one of its possible interpretations, has also a mathematical formulation, similar in spirit to that given by Tarski to the classical correspondence conception. (shrink)