Background: To place a dependent with severe dementia in a nursing home is a painful and difficult decision to make. In collectivistic oriented societies or families, children tend to be socialised to care for ageing parents and to experience guilt and shame if they violate this principle. Leaving the care to professional caregivers does not conform with the cultural expectations of many ethnic groups and becomes a sign of the family’s moral failure. Research design: Qualitative design with individual in-depth interviews (...) with nurses, family members and dementia care coordinators in Norway, Montenegro, Serbia and South Africa. Braun and Clarke’s six analytic phases were used. Ethical considerations: The project was approved by the Regional Committee for Research, South-Eastern Norway; the Norwegian Centre for Research Data; the Ethics Committee; University of Limpopo, MEDUNSA Campus, South Africa; and by the local heads of the respective nursing homes or home care services. Interviewees were informed orally and in writing and signed an informed consent form. Findings: Healthcare professionals tend to be contacted only when the situation becomes unmanageable. Interviewees talked about feelings of obligation, shame and stigma in their societies regarding dementia, particularly in connection with institutionalisation of family members. Many lacked support during the decision-making process and were in a squeeze between their own needs and the patients’ need of professional care, and the feeling of duty and worry about being stigmatised by their surroundings. This conflict may be a source of pre-decision regret. Conclusion: Family caregivers need help to understand the behaviours of persons with dementia and how to access the formal and informal services available. Thus, they may provide effective support to patients and family carers alike. Supportive interventions for caregivers need to be tailored to meet the individual needs of both the caregiver and the persons with dementia. (shrink)

Measuring responsiveness to gain accurate diagnosis in populations with disorders of consciousness (DOC) is of central concern because these patients have such complex clinical presentations. Due to the uncertainty of accuracy for both behavioral and neurophysiological measures in DOC, combined assessment approaches are recommended. A number of standardized behavioral measures can be used with adults with DOC with minor to moderate reservations relating to the measures’ psychometric properties and clinical applicability. However, no measures have been standardized for use with pediatric (...) DOC populations. When adapting adult measures for children, confounding factors include developmental considerations for language-based items included in all DOC measures. Given the lack of pediatric DOC measures, there is a pressing need for measures that are sensitive to the complex clinical presentations typical of DOC and that can accommodate the developmental levels of pediatric populations. The music therapy assessment tool for awareness in disorders of consciousness (MATADOC) is a music-based measure that has been standardized for adults with DOC. Given its emphasis on non-language based sensory stimuli, it is well-suited to pediatric populations spanning developmental stages. In a pre-pilot exploratory study, we examined the clinical utility of this measure and explored trends for test-retest and inter-rater agreement as well as its performance against external reference standards. In several cases, MATADOC items in the visual and auditory domains produced outcomes suggestive of higher level functioning when compared to outcomes provided by other DOC measures. Preliminary findings suggest that the MATADOC provides a useful protocol and measure for behavioral assessment and clinical treatment planning with pediatric DOC. Further research with a larger sample is warranted to test a version of the MATADOC that is refined to meet developmental needs of pediatric DOC populations. (shrink)

Code-based cryptography is currently the second most promising post-quantum mathematical tool for quantum-resistant algorithms. Since in 2022 the first post-quantum standard Key Encapsulation Mechanism, Kyber (a latticed-based algorithm), was selected to be established as standard, and after that the National Institute of Standards and Technology post-quantum standardization call focused in code-based cryptosystems. Three of the four candidates that remain in the fourth round are code-based algorithms. In fact, the only non-code-based algorithm (SIKE) is now considered vulnerable. Due to this landscape, (...) it is crucial to update previous results about these algorithms and their functioning. The Fujisaki-Okamoto transformation is a key part of the study of post-quantum algorithms and in this work we focus our analysis on Classic McEliece, BIKE and HQC proposals, and how they apply this transformation to obtain IND-CCA semantic security. Since after security the most important parameter in the evaluation of the algorithms is performance, we have compared the performance of the code-based algorithms of the NIST call considering the same architecture for all of them. (shrink)

The innovative field of Regenerative Medicine (RM) is expected to extend the possibilities of prevention or early treatment in healthcare. Increasingly, clinical trials will be developed for people at risk of disease to investigate these RM interventions. These individuals at risk are characterised by their susceptibility for developing clinically manifest disease in future due to the existence of degenerative abnormalities. So far, there has been little debate about the ethical appropriateness of including such individuals at risk in clinical trials. We (...) discuss three main challenges of selecting this participant model for testing RM interventions: the challenge of achieving a proportional risk–benefit balance; complexities in the trial design in terms of follow-up and sample size; and the difficulty of obtaining informed consent due to the many uncertainties. We conclude that selecting the model is not ethically justifiable for first-in-man trials with RM interventions due to the high risks and uncertainties. However, the model can be ethically appropriate for testing the efficacy of RM interventions under the following conditions: interventions should be low risk; the degenerative abnormalities (and other risk factors) should be strongly related with disease within a short time frame; robust preclinical evidence of efficacy needs to be present; and the informed consent procedure should contain extra safeguards with regard to communication on uncertainties. (shrink)

For more than sixty years, surgeons have used bioethical strategies to promote patient self‐determination, many of these now collectively described as “informed consent.” Yet the core framework—understanding, risks, benefits, and alternatives—fails to support patients in deliberation about treatment. We find that surgeons translate this framework into an overly complicated technical explanation of disease and treatment and an overly simplified narrative that surgery will “fix” the problem. They omit critical information about the goals and downsides of surgery and present untenable options (...) as a matter of patient choice. We propose a novel framework called “better conversations.” Herein, surgeons provide context about clinical norms, establish the goals of surgery, and comprehensively delineate the downsides of surgery to generate a deliberative space for patients to consider whether surgery is right for them. This paradigm shift meets the standards for informed consent, supports deliberation, and allows patients to anticipate and prepare for the experience of treatment. (shrink)

Background Inadequate knowledge among health care providers (HCPs) and parents of affected children limits the understanding and utility of secondary genetic findings (SFs) in under-represented populations in genomics research. SFs arise from deep DNA sequencing done for research or diagnostic purposes and may burden patients and their families despite their potential health importance. This study aims to evaluate the perspective of both groups regarding SFs and their choices in the return of results from genetic testing in the context of orofacial (...) clefts.Methods Using an online survey, we evaluated the experiences of 252 HCPs and 197 parents across participating cleft clinics in Ghana and Nigeria toward the return of SFs across several domains.Results Only 1.6% of the HCPs felt they had an expert understanding of when and how to incorporate genomic medicine into practice, while 50.0% agreed that all SFs should be returned to patients. About 95.4% of parents were willing to receive all the information from genetic testing (including SFs), while the majority cited physicians as their primary information source (64%).Conclusions Overall, parents and providers were aware that genetic testing could help in the clinical management of diseases. However, they cited a lack of knowledge about genomic medicine, uncertain clinical utility, and lack of available learning resources as barriers. The knowledge gained from this study will assist with developing guidelines and policies to guide providers on the return of SFs in sub-Saharan Africa and across the continent. (shrink)

Purpose. The research is devoted to the analysis of the urgent problem of the information society: the overload of a person with information and, as a result, the impossibility of adequate formation and development of the personality; as well as the problem of "digitization" of human existence and the formation of a new reality of dataism. Theoretical basis. A lot of modern scientific works are devoted to the analysis of the information society, its problems and features. The information society is (...) a logical continuation of the scientific and technological revolution, which led to the rapid growth of scientific knowledge and the technology development. In the 20th century, technologies have touched the sphere of knowledge and information, as a result of which the formation and development of the information society, or "knowledge society", takes place. Information becomes the main resource in it, and, one way or another, a person’s life is inextricably connected with the information space. With the information society formation, the problem of information search and processing becomes one of the most urgent. It turns out that despite the abundance and availability of information, it is very difficult to determine its relevance. A lot of effort is spent on developing information retrieval algorithms. Another problem is related to the person’s inability to process large amounts of data. This situation begins to influence not only the education process and professional activity, but also the formation of a person’s personality. A person is "lost" in the information space and gradually loses his/her "I". Algorithms for data analysis come to the rescue, but gradually, instead of giving a person material for thought, they begin to make decisions on their own, and therefore, live life instead of a person. With the advent of Big Data processing algorithms, a new ideological paradigm appears – dataism, which predicts the merger of a person with the general data flow. Originality. The authors make assumptions that the dataistic future is "natural". A lot of works, including in the framework of philosophy, are focused on the problem of "dissolving" a person in the information space and finding ways to overcome it. But, in our opinion, this process is a completely logical continuation of human evolution. Conclusions. Existence of a person as a data flow is not a problem and a threat, but a new dimension of his/her being, and, therefore, requires a careful study and formulation of the main principles of this form of existence. (shrink)

İslami finans, klasik iktisadi düzenin temel taşı sayılabilecek faizi finansal sistemin dışında bırakarak adil, kapsayıcı ve sömürüden uzak alternatif bir finansal sistem olarak ortaya çıkmıştır. Sistemin temelinde faizsizlik ve işlemlerin İslam hukukuna uygun şekilde gerçekleştirilmesi yatmaktadır. İslami finans bugün dünya çapında bir finansal büyüklüğe ulaşmış olup bu finansal yapının en büyük birimini de katılım bankaları oluşturmaktadır. Ancak tüm ayrışma çabalarına rağmen katılım bankaları, hem konvansiyonel bankalarla aynı hukuki çerçevede hareket etme zorunluluğu hem de aynı piyasada rekabet etme durumu nedeniyle zaman (...) zaman benzeşmeye çokça yaklaşmaktadır. Bu benzeşme noktalarından biri de katılım bankalarının kullandırdıkları kredilerin geri ödeme sorunları ile karşılaştığı alanlarda gerçekleşmektedir. Bugün katılım bankaları sorunlu kredilerinin çözümü noktasında konvansiyonel bankalara çok benzeyen aksiyonlar almaktadır ki bunlardan biri de sorunlu kredi dosyalarının varlık yönetim şirketlerine satılmasıdır. Bu durum sistemin “İslami” oluşunu tehdit etmektedir. Bu çalışmada ülkemizdeki katılım bankalarında sorunlu krediler ve katılım bankalarının varlık yönetim şirketleri ile ilişkileri incelenmiş olup İslami finansın ana akım finansal sistem olarak kullanıldığı bazı ülkeler ile çeşitli sosyoekonomik kıstaslar açısından ülkemizle benzeşen bazı ülkelerde sorunlu kredilerin nasıl çözümlendiği incelenerek ülkemizdeki uygulamalara yönelik öneriler sunmak amaçlanmıştır. (shrink)

An overview of the current epistemic literature concerning conspiracy theories, as well as indications for future research avenues on the topic.

The starting point of my analysis is the complexity of contemporary society. Complexity here refers more in particular to social complexity: the type of complexity that emerges from the relationships between human beings and the myriad of options and possibilities that exist in our society. A systems theoretical account of complexity elicits that this 'social abundance' necessitates selections. One way of enabling selections, and hence the reduction of complexity, is the formulation of norms. The central thesis of this account follows (...) from this observation: social complexity is a source of normativity, in the sense that social complexity generates – among others – normativity. Dealing with social complexity requires selections and a considerable range of selections, at their turn, require norms. From a somewhat different angle, we could say that social complexity entails both freedom of choice and force of choice. It is this combination of freedom and force that confronts our society with a profound problem. It translates, so to speak, social complexity into uncertainty: how to deal with all these options and possibilities, how to shape our interactions? An important aspect of the problem is the abundance of colliding heteronymous norms and a simultaneous lack of ethical norms that do not compromise our individual autonomy. The analysis of this ethical state of affairs draws upon the work of Zygmunt Bauman. The paper tentatively seeks to outline the social theoretical requirements of an ethic that takes issue with the uncertainty of choice. (shrink)

The article aims to show the value of taking ecclesiology – the theology of the church – into account in the study of British imperial ideology by describing how Anglican intra-ecclesiological debates shaped mid-nineteenth-century discourse about the British Empire. It highlights the impact of the Oxford Movement on the mind of the British colonial administrator Sir Frederic Rogers, Lord Blachford (1811-1889), by revealing the connections between his imperial thought and concepts arising from Tractarian ecclesiology. In particular, it argues that Rogers’ (...) understanding of British colonial development builds on Tractarian ideas of balance and consistency. By retaining a sense of the importance of the historic connection with the colonies of settlement while respecting their right to be free, Rogers constituted the imperial relationship as a _ via media. _. (shrink)

The authors conducted a baseline survey of baccalaureate and graduate degree health humanities programs in the United States and Canada. The object of the survey was to formally assess the current state of the field, to gauge what kind of resources individual programs are receiving, and to assess their self-identified needs to become or remain programmatically sustainable, including their views on the potential benefits of program accreditation. A 56-question baseline survey was sent to 111 institutions with baccalaureate programs and 20 (...) institutions with graduate programs. Respondents were asked about three areas: (1) program administration (managing unit, paid director, faculty lines, paid staff, funding sources); (2) educational program (curricular structure, CIP code usage, completion rates); and (3) views on accreditation for the field. A clear majority of respondents agreed that some form of accreditation or consultation service could address resource and sustainability issues. Overall, the survey responses to staffing, curricular structure, and support suggest the need for developing a sustainable infrastructure for health humanities. (shrink)

This paper investigates what choices teachers made and what rationales they offered related to the inclusion and exclusion of primary source photographs for a hypothetical unit about the U.S. Civil Rights Movement in order to better understand teachers’ curricular decision-making as it relates to representing the histories of oppressed people. Elementary and secondary social studies/history teachers from three different in-service and pre-service cohorts ( n=62) selected and discarded images from a bank of 25 famous and lesser-known photographs. Their decisions and (...) explanations were coded for emergent themes. Findings reveal that these teachers tended to be guided by criteria both technical (how they might teach using a particular photograph) and philosophical (why they might teach about a particular photograph), with narrow definitions of what they deemed relevant and appropriate for their students. Their choices constructed a sanitized narrative of the Civil Rights Movement that largely avoided a discussion of racism. (shrink)

Purpose. Based on the study of philosophical anthropological concepts, to highlight the project of personality in different historical periods, to reveal the meaning of humanistic issues in the postmodern epoch, to identify the essential features of the image of human of the second half of the XX the beginning of the XXI century. Theoretical basis. The methodological basis of the article is the principles of historicism, integrity, objectivity regarding the mastery of the issue of person’s image in postmodernism. The research (...) applied comparative-historical, culturological, analytical, axiological approaches to reveal the problem of individuality in the second half of the XX the beginning of the XXI century. The theoretical basis of the article consists of scientific works in the field of philosophical anthropology, history, cultural studies, and aesthetics. Originality. The author revealed the peculiarities of transformation of the personality model from antiquity to postmodernism, specified the image of man of the second half of the XX the beginning of the XXI century. Conclusions. The analysis of anthropological ideas of Western philosophy of different ages shows the variety of views about understanding the nature of the person, its complexity and ambiguity. In the epoch of postmodernism humanistic issues are of particular relevance, which is connected with social and political uncertainty, domination of mass consciousness, loss of national and cultural identity. The image of a person of this period is deprived of a solid foundation, it is blurred and relative. The destruction of faith in the absolute in the context of the second half of the twentieth century contributed to the formation of confidence in the interdependence of all things, raised the problem of the personality image to a new ontological level. Orientation in the achievements of European civilization, perception of its anthropological experience, intercultural dialogue contribute to the productive use of the achievements of mankind in order to understand the modern person and to form its adequate image. In its essence, postmodernism does not set the goal to realize a retrospection of subject type. However, separating from the cultural memory the excerpts of ideas about a person, by certain styles and directions, it builds on their formations its own eclectic image of the individual. (shrink)

The first critical edition of the _Syncategoreumata_ by the thirteenth-century philosopher Peter of Spain, accompanied by a facing-page English translation to make its contents accessible to modern readers. The introduction gives an account of all the manuscripts used for the edition. Extensive indexes have been added to facilitate the reader's orientation in the book.

In his target article, Yarkoni prescribes descriptive research as a potential antidote for the generalizability crisis. In our commentary, we offer four guiding principles for conducting descriptive research that is generalizable and enduring: prioritize context over control; let naturalistic observations contextualize structured tasks; operationalize the target phenomena rigorously and transparently; and attend to individual data.

Checklists have been used to improve quality in many industries, including healthcare. The use of checklists, however, has not been extensively evaluated in clinical ethics consultation. This article seeks to fill this gap by exploring the efficacy of using a checklist in ethics consultation, as tested by an empirical investigation of the use of the checklist at a large academic medical system (Cleveland Clinic). The specific aims of this project are as follows: (1) to improve the quality of ethics consultations (...) by providing reminders to ethics consultants about process steps that are important for most patient-centered ethics consultations, (2) to create consistency in the ethics consultation process across the medical system, and (3) to establish an effective educational tool for trainers and trainees in clinical ethics consultation. The checklist was developed after a thorough literature review and an iterative process of revising and testing by a group of experienced ethics consultants. To pilot test the checklist, it was distributed to 46 ethics consultants. After a six-month pilot period in which ethics professionals used the checklist during their clinical activities, a survey was distributed to all of those who used the checklist. The 10-item survey examined consultants’ perceptions regarding the three aims listed above. Of the 25 survey respondents, 11 self-reported as experts in ethics consultation, nine perceived themselves to have mid-level expertise, and five self-reported as novices. The majority (68 percent) of all respondents, regardless of expertise, believed that the checklist could be a “helpful” or “very helpful” tool in the consultation process generally. Novices were more likely than experts to believe that the checklist would be useful in conducting consultations. The limitations of this study include: reduced generalizability given that this project was conducted at one medical system, utilized a small sample size, and used self-reported quality outcome measures. Despite these limitations, to the authors’ knowledge this is the first investigatation of the use of a checklist systematically to improve quality in ethics consultation. Importantly, our findings shed light on ways this checklist can be used to improve ethics consultation, including its use as an educational tool. The authors hope to test the checklist with consultants in other healthcare systems to explore its usefulness in different healthcare environments. (shrink)