_Purpose. _The article is aimed at considering the concept of leisure in the daily practice of Ukrainian refugees in Poland and identifying the main trends in its development. _Theoretical basis._ The author used the quantitative method, the method of online search for respondents, the method of monitoring social networks, and the comparative method. The study was conducted in Poland from 01.08.2022 to 31.01. 2023 as part of grant support from the Polish Institute of Advanced Studies. The study is based on (...) the results of a qualitative and quantitative survey, the analysis of groups and chats of Ukrainian refugees in Poland, and the comparative analysis with the results of other studies. The comparison of these results leads to the assumption that a different understanding of the category of leisure in Polish and Ukrainian culture can result in the violation of intergroup relations. _Originality. _The author deduced the concept of refugees’ leisure beyond the concepts of adaptation, assimilation, and integration. Leisure is proposed to be considered as a connecting link between the past and present life of refugees and determine its place in the structure of national consciousness. _Conclusions._ The modern scientific discourse experiences a certain gap in the study of the leisure sector of Ukrainian refugees, the problematic areas in the leisure anthropology of Ukrainian refugees in Poland were identified, and a working hypothesis was put forward for further research. The misunderstanding in the organization of leisure activities of representatives of two cultures arises at the level of national self-consciousness (codes, traditions, attitudes). Therefore, external communication does not always reach its ultimate objective and leads to misunderstanding. To determine the mechanism of misunderstanding, the place of leisure in the structure of national consciousness should be determined. (shrink)

BackgroundEuthanasia is performed on occasion, even on newborns, but is highly controversial, and it is prohibited by law and condemned by medical ethics in most countries.AimTo characterise and compare the judgments of lay persons, nurses, and physicians of the acceptability of actively ending the life of a damaged newborn.MethodsConvenience samples of 237 lay persons, 214 nurses, and 76 physicians in the south of France rated the acceptability on a scale of 0–10 of giving a lethal injection in 54 scenarios composed (...) of all combinations of 4 within-subject factors: gestational age of 6,7, or 9 months; 3 levels of severity of either perinatal asphyxia or of genetic disease; attitude of the parents about prolonging care unknown, favourable, or unfavourable; and decision made individually by the physician or collectively by the medical team. Overall ratings were subjected to cluster analysis and each cluster to analysis of variance and graphic representation.ResultsLay persons (mean acceptability rating 4.29) were significantly more favourable to euthanasia than nurses (2.84), p<.005, or physicians (2.12), p<.005. Five clusters were found with different judgment rules, i.e., how the information was integrated. More physicians (30 per cent) than nurses (14 per cent), p<.01, or lay persons (11 percent), p<.01, rated euthanasia as never, under any condition, acceptable. Most, however, asserted that it was increasingly acceptable as the factors combined to favour it, especially when the parents desired to stop treatment. More physicians (45 per cent) and nurses (46 per cent) than lay persons (21 per cent), p<.01, used a complex conjunctive rule (level of parent’s attitude x level of severity of damage x consultation with team or not) rather than a simple additive rule.ConclusionsUnlike lawand medical ethics, most of the lay persons. nurses, and physicians judged the acceptability of euthanasia as a function of the circumstances. Most health professionals combined the factors in a conjunctive (multiplicative), rather than additive, fashion in accordance with legislation for adults in the Netherlands and elsewhere that requires a set of criteria to be fulfilled before it is legitimate to end apatient’s life. (shrink)

Objectives To investigate risk perception relating to living kidney donation, to compare the risk donors would accept with current practice and identify influential factors. Design An observational study consisting of questionnaires completed by previous living donors and the general public. Participants selected the risk they would accept from a list of options, in various scenarios. Risk communication was investigated by randomly dividing the sample and presenting risk differently. Setting Primary care (two centres) and secondary care (one centre), London. Participants 175 (...) questionnaires were sent to patients who had previously undergone living-donor nephrectomy and to members of the public consulting a general practitioner. The living-donor sample comprised 77 consecutive donors at Guy's Hospital from May 2003 to January 2005. The general-public sample was recruited from two London healthcare centres. Of the eventual 151 participants, 61 were living donors and 90 were from the general public. Main outcome measure The amount of risk a participant would accept to donate a kidney. Results 74% of participants were willing to accept a risk of death higher than 1/3000. The most commonly accepted risk was 1/2 (29%). Those presented with a ‘chance of survival’ accepted higher risks than those presented with a ‘risk of death’ (p<0.01). Greater risks were accepted when the recipient was closely related and, for some, when the recipient's prognosis was worse. No difference was observed between the living-donor and general-public groups. Conclusions Kidney donors will accept a higher risk of death than is currently quoted, especially if risks are presented in terms of chance of survival. (shrink)

Background: Discussing treatment risks has become increasingly important in medical communication. Still, despite regulations, physicians must decide how much and what kind of information to present. Objective: To investigate patients’ preference for information about a small risk of a complication of colonoscopy, and whether medical and personal factors contribute to such preference. To propose a disclosure policy related to our results. Design: Vignettes study. Setting: Department of Gastroenterology, Academic Medical Centre, the Netherlands. Patients: 810 consecutive colonoscopy patients. Intervention: A home-sent (...) questionnaire containing three vignettes. Vignettes varied in the indication for colonoscopy, complication severity and level of risk. Patients were invited to indicate their wish to be informed and the importance of such information. In addition, sociodemograhic, illness-related and psychological characteristics were assessed. Main outcome measurements: Wish to be informed and importance of information. Results: Of 810 questionnaires, 68% were returned. Patients generally wished to be informed about low-risk complications, regardless of the indication for colonoscopy or the severity of the complication. The level of risk did matter, though (OR = 2.48, SE = 0.28, p = 0.001). The information was considered less important if done for population screening purposes or diagnosis of colon cancer, if the complication was less severe (bleeding) and if the risk was smaller (0.01% and 0.1%). Patients’ information preference was also related to age, mood and coping style. Limitations: Difficulty of vignettes. Conclusions: Patients generally wish to be informed about all possible risks. However, this might become uninformative. A stepwise approach is suggested. (shrink)

Objective:To evaluate the effect of an intervention on the understanding and use of DNR orders by physicians; to assess the impact of understanding the importance of involving competent patients in DNR decisions.Design:Prospective clinical interventional study.Setting:Internal medicine department (70 beds) of the hospital of La Chaux-de-Fonds, Switzerland.Participants:Nine junior physicians in postgraduate training.Intervention:Information on the ethics of DNR and implementation of new DNR orders.Measurements and main results:Accurate understanding, interpretation, and use of DNR orders, especially with respect to the patients’ involvement in the (...) decision were measured. Junior doctors writing DNR orders had an extremely poor understanding of what DNR orders mean. The correct understanding of the definition of a DNR order increased from 31 to 93% (p<0.01) after the intervention and the patients’ involvement went from 17% to 48% (p<0.01). Physicians estimated that 75% of their DNR patients were mentally competent at the time of the decision.Conclusion:An intervention aimed at explaining the ethical principles and the definition of DNR orders improves understanding of them, and their implementation, as well as patient participation. Specific efforts are needed to increase the involvement of mentally competent patients in the decision. (shrink)

Propelled by his own vengeance, N'Jadaka transforms into Erik Killmonger, CIA operative: a master of the weapons wielded by a colonial global empire, who wields these weapons himself in a quest to destroy the system that has oppressed people of color since ships set sail for the Caribbean over 500 years ago. Lorde, a Black lesbian feminist, was critiquing white feminism, suggesting that it failed to dismantle white supremacy (and she was doing this in the 1970s). Yet, her famous words (...) – “For the master's tools will never dismantle the master's house” – get reinterpreted through Killmonger, who has mastered the art of global colonial capitalism. Even Wakanda, whose power is greater than all the tools of the master's house put together, doesn't dismantle it. Wakanda sits on the world council but does nothing about colonial oppression. (shrink)

The origin of Black Panther 's charismatic villain, Killmonger, is the same as that of the historic Black Panther Party: Oakland, California. Director Ryan Coogler begins the film here, in a housing project where N'Jobu, a prince from Wakanda, has been living undercover. Black Panther first appeared in Marvel Comics in the summer of 1966, a few months before the official founding of the Black Panther Party. Killmonger's grudge against Wakanda for ignoring and rejecting him is one that nearly every (...) Black citizen could fairly hold against the United States. Wakanda abandons its traditional separatist position to follow the historical Black Panther Party's lead, pivoting from using the tools of modern warfare to protect Wakandans to channel its energy into uplifting social programs around the world, starting with the neighborhood in Oakland where the orphaned Killmonger grew up. (shrink)

언제까지 답 없는 삶을 살 것인가! 인류의 위대한 스승에게 묻고, 대한민국 대표 지성이 답하다! ◎ 출판사 서평 위대한 스승, 퇴계에게 묻고 싶은 삶에 대한 질문과 답 29 누구나 인생을 살다 보면 삶에 대한 본질적인 질문들을 품게 된다. 이러한 고민들을 인류의 위대한 스승 퇴계에게 묻는다면, 그는 우리에게 어떤 대답을 해줄 수 있을까? 『인생교과서 퇴계』(21세기북스 펴냄)는 퇴계에게 묻고 싶은 29개의 질문을 통해 그의 삶과 철학을 살펴보고, 현대를 살아가는 우리에게 필요한 퇴계의 정신이 무엇인지 알아보고자 한다. ‘퇴계’ 하면 고지식한 유학자, 건조하기 짝이 없는 이기심성론의 (...) 철학자라는 이미지가 있다. 그래서 지금 시대와는 불협화한 인물이라는 선입견을 갖기 쉬우나 그가 강조하는 외경의 정신은 오늘에도 칼날처럼 삶의 본질을 꿰뚫는 성성함을 지니고 있다. 그야말로 ‘어짊’을 삶으로 실천한 그의 면면을 돌이키는 일은 산만 방종하여 공허하고 들뜬 우리들 삶을 치유하는 매우 효과적인 처방책이 될 수 있는 것이다. 사람됨의 크기와 삶의 깊이는 수양 정도에 따라 달라질 것이니, 일상생활에서 마음을 샘물처럼 ‘맑고 깨끗하게’ 유지할 것을 당부한 퇴계가 우리들에게 간곡히 들려주고 싶은 바가 이 책 속에 들어 있다. 퇴계와의 만남이 ‘뜻밖의 나’를 향하는 길이 될 수 있을 것이다. 퇴계가 생각한 인간의 ‘도’란 무엇인가! 사랑과 공경의 정신으로 ‘사람 된 도리’를 밝혀야만 한다! 사람으로 태어났다 해서 모두 사람이 아니다. 퇴계에 따르면 ‘하늘의 소명’을 받들어 실천하려는 노력 속에서만 사람이 될 수 있다. 그러므로 자신의 내면 깊은 곳에서 울려나오는 참자아의 목소리에 귀를 기울여야 한다. 사람됨의 차이가 여기에서 결정난다. 이것은 물론 좌선하듯 가만히 앉아서 되는 일은 아닌바 밥을 먹고 출근길에 나서는 등 일상생활의 모든 자리가 다 수양의 도량이다. 사람됨은 바로 거기에서 드러나기 때문이다. 그리하여 자기 안에 갇혀 입신출세와 부귀영화의 욕망만을 추구하려는 이기심을 ‘닦아내고’, 남들을 나의 품안에 아우르며 그들을 보살피려는 마음을 ‘길러야’ 한다. 이것이 평생에 걸쳐 수행해야 할 사람됨의 과제다. 이러한 사람됨의 과제를 모두가 소중히 여기게 될 때 현대사회의 많은 병폐들이 해소될 수 있을 것이다. 그러니 우리는 퇴계의 정신을 역사의 화석이 아닌 오늘의 문제를 치유하는 자기성찰과 자아향상의 자료로 삼을 필요가 있다. 나는 과연 무엇을 위해 살고 있는가, 근본적으로 인간이란 어떠한 존재인가? 하는 등의 물음을 자신에게 수시로 던져보아야 한다. 거기에는 고통과 방황이 뒤따르겠지만, 그것은 아름다운 인생의 좋은 자양분이 될 것이다. 같은 질문, 다른 해석! 대한민국 대표 학자들이 빚어내는 통찰의 향연 이 책은 삶과 죽음, 나와 우리, 생각과 행동, 철학과 사상이라는 4개의 키워드와 29개의 질문으로 구성되어 있다. 1부는 ‘산다는 것은 무엇인가’, ‘행복이란 무엇인가’ 등의 질문을 통해 퇴계가 바라본 인간 삶의 의미와 죽음에 관한 그의 철학 등을 살펴보고, 2부는 ‘나는 누구인가’ ‘이웃이란 누구인가’의 질문을 중심으로 존재의 근원과 공동체정신에 대해 살펴본다. 3부는 ‘바른 직업윤리는 무엇인가’, ‘의로움이란 무엇인가’ 등 구체적인 삶 속에서의 인간 행위에 관한 퇴계의 생각을 들여다보고, 4부에서는 ‘왜 자기성찰이 필요한가’, ‘윤리란 무엇인가’ 등의 질문을 통해 퇴계가 생각한 삶의 질서에 대해 살펴본다. 이 책의 독특한 점은 같은 질문에 대한 두 저자의 다른 해석을 비교하며 살펴볼 수 있다는 것이다. 퇴계에게 묻고 싶은 29개의 질문 중 한 질문에 두 저자가 답한 경우도 있고, 한 저자가 답한 경우도 있다. 퇴계를 오랜 시간 연구해온 두 저자는 각자의 관점을 반영하여 삶에 대한 통찰과 지혜를 풀어내고 있다. 우주적인 심흉 속에서 사랑과 공경의 정신으로 삶을 산 위대한 인격, 퇴계와의 만남은 분명 독자 여러분들 삶에 적지 않은 울림을 줄 것이다. 『인생교과서』 시리즈 위대한 현자 19人의 삶과 철학을 대한민국 각 계의 대표 학자들이 풀어낸 총 19권의 시리즈이다. 인생을 살면서 누구나 한번쯤은 고민하게 되는 본질적인 질문에 대해 현자들은 어떻게 생각했는지 비교하며 살펴볼 수 있다. 역사상 가장 위대한 멘토 19명의 치열한 사유와 통찰은 삶과 죽음에 대한 질문을 자아내고, 시대를 넘어 현답의 길로 안내할 것이다. 『인생교과서』 시리즈는 호메로스 | 플라톤 | 아리스토텔레스 | 아우구스티누스 | 장자 | 이황 | 간디 | 데카르트 | 니체 | 칸트 | 헤겔 | 미켈란젤로 | 베토벤 | 톨스토이 | 아인슈타인 편으로 총 19권이 발간될 예정이다. 01 예수 | 차정식, 김기석 지음 | 15,000원 | 2015년 7월 10일 02 부처 | 조성택, 미산 스님, 김홍근 지음 | 15,000원 | 2015년 7월 15일 03 공자 | 신정근, 이기동 지음 | 15,000원 | 2015년 7월 15일 04 무함마드 | 최영길 지음 | 13,000원 | 2015년 7월 10일 05 퇴계 | 김기현, 이치억 지음 | 15,000원 | 2015년 12월 28일 14 칸트 | 김진, 한자경 지음 | 15,000원 | 2015년 11월 3010일 ◎ 본문 중에서 우리는 퇴계를 도덕적으로 완벽한 위인으로 상정하는 경향이 있다. 그러나 그의 위대함은 도덕성보다는 오히려 절대자유의 경지에서 자연과 하나 되어 분수를 지킨, 그의 일관된 삶에 있는 것 같다. 그것이 우리로 하여금 삶의 진정한 의미를 더 곰곰이 생각하게 하는 것이 아닐까. - 33쪽 아무리 험한 상황을 만나더라도 자기성찰 속에서 겸손하게 세상사를 배우면서 자신의 존재를 “옥과도 같이 아름답게 성취”하려는 뜻을 버려서는 안 된다. “하늘을 원망하지도 않고 사람들을 탓하지도 않으며, 아래로 세상사를 배워 위로 하늘의 이치를 깨친다”는 공자의 삶의 자세를 배워야 한다. 사람이 꽃보다 아름답다면 그러한 노력 때문일 것이다. - 60쪽 퇴계뿐만 아니라 모든 유학자들 사상에 따르면, 불행에서 벗어날 수 있는 근본적인 능력은 모든 사람의 내면에 갖추어져 있다. 사람은 누구나 우주적 대아의 씨앗을 타고난 존재이기 때문이다. 우리 마음속에 간직된 본성, 어떻게 보면 그것의 다른 이름은 ‘희망’이 아닐까? 그렇다. 불행의 반대말은 ‘행복’이라는 완료형이기보다 ‘희망’이라는 진행형이 가까울 것 같다. - 67쪽 갖가지 욕망으로 ‘흐려진’ 마음이 수많은 번민과 괴로움, 고통을 지어내는 것과 달리 맑은 마음은 깊은 샘의 깨끗하고 시원한 물처럼 삶의 희열을 누리게 해줄 것이다. 우리는 여기에서 퇴계의 좌우명을 큰 교훈으로 삼아봄직도 하다. “생각을 조금도 불순하게 갖지 말고, 마음을 경건하지 않음이 없게 하라.” - 119쪽 즉 나의 근원이 리理임을 알고, 학문을 통해 그것을 이 세상에서 실현하는 일이 바로 나를 알고 삶을 아는 것이 아니었을까? 그렇다면 이로 인해 퇴계는 죽음조차도 극복할 수 있었을 것이다. 대아大我인 나는 시작도 끝도 없이 흘러가는 시간의 어떤 한 시점에 태어나서 살다가 죽어서 사라지는 사람이 아닌, 영원을 사는 사람이기 때문이다. - 146~147쪽 타인의 의견에 뇌동하지 않고 스스로의 생각을 충분히 펼쳤을 때 그것이 모여 옳은 의견이 된다. 그 독립된 생각들이 모였을 때 그것이 세상을 움직이는 가장 정당하고 강한 힘이 된다. 그렇기 때문에 더더욱 자기의 목소리를 내는 것이 중요한 것이다. 옳은 목소리를 낼 수 있도록 나의 수신修身이 바탕이 되어야 함은 물론이다 - 201쪽 모두가 잘사는 세상은 누가 만들어주는 것이 아니라 내가 만드는 것이다. 그렇게 깨어 있는 사람들이 밝힌 빛으로 인해 이 세상은 밝아져왔다. 그러니 앞으로의 세상을 밝히는 것은 또 우리들에게 넘겨진 숙제다. 이는 퇴계가 가장 간절히 바라던 일이기도 하다. - 209쪽 그는 단순히 ‘착한 사람’에 그치지 않고 ‘하늘’이 인간에게 부여한 사람됨의 뜻을, 인간의 고결한 정신을 자신의 삶과 사회에서 밝히려 했다. 오늘날 사람들이 자신의 생명을 보전하고 이익을 쟁취하기 위해 ‘야수’와도 같이 살아가는 ‘정글’사회에서 그의 삶이 위대하게 여겨지는 까닭이 여기에 있다. - 254쪽. (shrink)

Photo by Jonathan Ford on Unsplash ABSTRACT Since 2008, an average of twenty million people per year have been displaced by weather events. Climate migration creates a special setting for a duty to rescue. A duty to rescue is a moral rather than legal duty and imposes on a bystander to take an active role in preventing serious harm to someone else. This paper analyzes the idea of expanding a duty to rescue to climate migration. We address who should have (...) the duty and to whom the duty should extend. The paper discusses ways to define and apply the duty to rescue as well as its limitations, arguing that it may take the form of an ethical duty to prepare. INTRODUCTION Climate migration creates a special setting for a duty to rescue. A duty to rescue is a moral rather than legal duty and imposes on a bystander to take an active role in preventing serious harm to someone else. Examples of circumstances range from person-to-person intimate rescue to saving those in poverty, even in distant parts of the world.[1] Since 2008, an average of twenty million people per year have been displaced by weather events.[2] Circumstances like being thrust from homes under the threat of fire, mudslide, and flooding vary greatly from long-term changes like land becoming too arid for crops or temperatures increasing annually gradually pushing up the number of heat-related deaths, with the area slowly becoming uninhabitable. Imminence in fleeing affects resettling and need for rescue with important implications for how the duty to rescue might apply. This paper reevaluates the ethical framing of the duty to rescue and, while it is arguably a stretch, applies it to climate migration. Climate migration has become common and is expected to increase due to rises in sea level, increases in weather events that make areas uninhabitable, and changes to land that preclude farming or other necessary land uses. We argue that a duty to rescue may help highlight who has moral obligations to whom. Because the problem is so large in scope, we suggest a change in the ethical limits to humans' duty to rescue other humans who are in distress. We imagine an expansion or extension of the duty to rescue to meet some of the basic needs created by climate migration. Yet how it should expand, and how much depend on ethical framing and practical limitations. l. Expanding the Geographical Boundaries Two commonly recognized emergencies, Hurricane Katrina in the case of weather events and the current COVID-19 pandemic, provide a historical and current backdrop to evaluate ethical obligations as more disasters displace people. A significant reassessment of the ethical scope of an obligation to rescue in the case of weather events will be limited by the ability to render aid to those in distress in the case of a planet-wide weather catastrophe. The problems may overwhelm the ability to rescue or the reasonableness of attempting rescue. The extent of the moral obligation borne by humans to other humans in the case of a weather event has been largely defined by its locality and limited geographic influence. Whether we are imagining the scope of ethical obligation in the case of hurricane, flood, tornado, drought, or wildfire events, the perceived ethical obligation is significantly defined by the limited impact of these weather events on people outside the zone of the weather event's direct impact, yet close to that zone. A hurricane affecting New Orleans will not have immediate impact on the residents of California or even those on the northeast coast of the United States until a later time. Wildfires in the Pacific Northwest do not impair the ability of those in the rest of the country to come forward with assistance. But as climate migration crosses international borders, and climate events occur simultaneously in many regions, a more expansive duty to rescue may provide the ethical impulse to help those who live afar or migrate long distances. In this respect, the need for help in the event of widespread climate migration due to global warming is more like a pandemic than a weather event. Its broad impact area diminishes the capability of nearly the entire balance of the human population to help due to those populations' awareness that they will, in short order, have the same need for the same resources, from the same cause. Those living near current flood zones may find their historically safe havens are also a flood zone. Those previously best positioned to rescue may find themselves also needing to relocate. Thus, we may observe the need for new rescuers. ll. The Rule of Rescue The Rule of Rescue as defined by Al Jonsen describes the moral impetus or knee jerk reaction to save identifiable people facing death.[3] A duty to rescue has since been expanded beyond imminent death and beyond the near and identifiable. But there are limitations. For example, by most accounts, the ethical duty tends not to require extreme bodily risk or financial depletion. In comparing Good Samaritans to humanitarians, Scott M. James argues the duty to rescue arises from unique dependence, but the ethical obligation to help strangers through humanitarian aid is of a different nature.[4] The wrongness of failing to help is arguably more egregious when one is in a unique position to help. Like in the tragedy of the commons, where there is no unique positioning, when the global community is called upon to help, each individual in it may feel less obliged to do so. Climate migration falls in between—it requires helping strangers, yet it may move forward without anyone seeing themselves as uniquely positioned to help until those strangers become part of communities, at which time, there may be more moral justification to help a community member in need. Generally, arguments about Good Samaritans hinge on extraordinary acts, praiseworthy because they are acts of compassion, not obligation. Now all US states have Good Samaritan laws[5] which protect helpers from liability for help gone wrong or for a failure to succeed once engaged in an act of rescue. Extraordinary help as a moral good is thus somewhat encouraged through legal protection, but not imposed. Conversely, jobs like firefighting, search and rescue, and emergency medical care tend to oblige employees to take on risks that would be extraordinary if undertaken by the average bystander, yet they are rendered ordinary rescue as part of the job. Three states, Minnesota, Rhode Island, and Vermont have a broad duty to rescue, adding legal considerations to an otherwise moral conundrum. The laws do not require bystanders to take on risk for the sake of rescuing strangers.[6] The moral duty will require looking beyond law, but it is unclear how the moral duty to rescue should be distributed in the case of climate migration. A bare minimum would prevent taking advantage of newcomers, paying sub-minimum wage, and discriminating against them. Yet such a minimum is hardly rescue. lll. An Ethical Rather than Legal Duty The difficulty in defining the duty to rescue as a legal obligation is that it is difficult to determine the extent of risk a rescuer ought to be required to take. The nature of this ethical duty is also arguably tied to the experiences of both the rescuer and the rescued. There are subjective aspects like what someone perceives as a danger that make it difficult to write enforceable laws requiring rescue. It is one thing to expect a rescuer to step into several inches of relatively warm water to lift a person lying face down in a pond and enable them to breathe. It is something altogether different to expect that rescuer to dive into frigid water and attempt to extricate someone trapped in a submerged automobile. As the legal philosopher H.L.A. Hart observed, it is always easier to define application of the core intention of any rule, whether law or ethical norm. It is more difficult to create legal certainty about how the law applies to what he described as “penumbra circumstances”. In the case of a hurricane, it is easier to define what surplus resources are available in areas geographically remote from the impact of the storm and demand, as a moral obligation, that those nearby but outside the area provide assistance. It is more difficult to obligate people, organizations, or governments to supply a quantity of medication or some number of ventilators to an adjacent community when they expect to imminently need them for their own community. In the early stages of climate migration, the ethics of extreme weather event assistance, a common application of the duty to rescue, will be useful and appropriate. The rising sea levels first experienced by island nations in the South Pacific[7] will not render those living in other coastal communities, those with greater available “high ground”, unable to supply resources to those in need. But when sea level rise and climate change affect more communities simultaneously, albeit in varying degree, the task of defining what response is ethically obligatory becomes increasingly complicated. Pinpointing the obligations of those communities which are resource rich to those communities which are resource deprived, and of those partly affected to those more severely affected may become necessary. The limitations of the traditional duty to rescue could expand to meet the needs. lV. Contribution to the Problem Many argue that the duty to rescue may depend on any appropriate claim of those needing rescue. One issue is whether preferential claims among those who can identify the source of the harm should call for a greater duty or whether everyone in need should be approached as like candidates for rescue, shaping the duty as equal across those on the receiving end. As climate change does have human-made causes, there are strong arguments to impose a greater ethical duty on any entity that caused the climate-related problems leading to the mass exodus. While the global north is often implicated in pollution that causes migration, industries like energy, transportation, and agriculture are tied to climate change and associated with significant greenhouse gas emissions.[8] Practices like directing agriculture to less sustainable single crop growth generally made land less farmable. Yet it is difficult to place blame and identify specific causal relationships as most migration is due to many factors. A movement toward greater accountability can be reframed as a greater duty to rescue, a duty to engage in the extraordinary. The fossil fuel industry, for example, should have a larger obligation than the average person. Similarly, some may argue anyone unjustly enriching themselves while contributing to climate change or people who over-consume have an elevated duty to rescue.[9] Climate change lawsuits demonstrate an eagerness to hold governments and corporations accountable, despite difficulty proving causation. V. The Most Vulnerable One ethical dimension of climate migration that remains unexplored is how a duty to rescue applies to vulnerable populations who stand to be left behind or unable to migrate without assistance. Researchers from the Global North working across the Global South are increasingly observing the phenomenon of ethics dumping, where the research ethics of some countries are imposed on research subjects in other countries.[10] In that vein, rescuers should be careful not to impose unwelcome cultural standards or exploit people who are in the process of migrating. There is a gap in discussions reflecting voices that have been left out. The duty to rescue is incomplete without an attempt to understand the ethical experiences of those being rescued. The actual people affected by climate migration who are the least likely to have the means to migrate, or to do so without extreme hardship, should have a voice informing the global community including those in a position to carry out rescue. People who have the means and are young and healthy may easily make decisions to avoid the catastrophic consequences that climate migration brings. However, what about those who are left behind? For example, especially recognizing cultural differences, the homeless community, disabled community, refugees, the elderly community, and women[11] and children may suffer differently and call for more attention. In some parts of the world, human rights are severely constrained. An ethical duty to rescue, with many considerations and variables, may be more justified in the case of those most in need. As climate migration continues and increases significantly, it may be reasonable to ask the local and global community to focus on those least well positioned to migrate successfully. In this context, the use of phenomenology to understand the lived experiences of those migrating, sometimes termed “ethical experiences”, may help flesh out how a duty to rescue takes shape. The discussion of duty and obligation requires an articulation of the ethical experiences (how the local community in need of rescue views the proposed rescue). Then, the obligation to interpret the duty as ‘one shall not’ or ‘one must’ can be focused on the migrants’ needs rather than the rescuers’ feelings of obligation.[12] A revised theory of the duty to rescue taking into account the asymmetrical experiences of communities involved could ensure that the needs of people whose living situations, gender, ethnicity, age, or race impact their ability to even begin the migration process are considered. In this discussion, the rescuing is directed toward communities /collectives of persons migrating, whether at once or across a period of time. Often, the climate migrant may not be in a state to articulate the nature of this event when it happens, given its subjective proximity. Yet, when communities are given the space and opportunity to articulate their shared values, the ethical action of rescue derives its meaningfulness from the community rather than the rescuers. In other words, allowing climate migrants to explain their feelings can add complexity to what some see as a binary receiver-giver (of rescue) dynamic. This is necessary because the concept of vulnerable populations is fraught with problematic assumptions. There have been various definitions and criteria to determine what would constitute vulnerable populations.[13] For example, the United Nations Framework Convention on Climate Change[14] identifies and assesses vulnerable populations. These criteria may be helpful. However, they do not provide the full picture. Rather than identifying categorical criteria of vulnerable populations, engaging with people who are experiencing climate migration and listening to their current experiences and concerns helps determine need. Knowing what people need may prevent the kneejerk reaction to label people who are quite resilient yet have appropriate needs “vulnerable”. Proceeding with caution is important because the duty to rescue has hierarchical underpinnings of "us" and "them." Often when people swoop in to save, there are good and bad consequences of the intervention. We should proceed with caution because often the helper misses the actual needs of those in need. The only way to combat this would be to make sure that people are empowered to inform those agencies that are able to help. In addition to more practical approaches, large scale oral histories could allow those who have migrated already to share their experiences. It would be important to capture the lived experiences of people who are already experiencing the consequences of climate migration or of other migration like that due to political or economic extreme events. These experiences could shape our analysis of whether people in fact wish for rescue. If so, further conversations can determine best actions as well as give important insight into what resources might be necessary to empower people now and in the future. Vl. A Duty to Rescue as a Duty to Prepare If we view Good Samaritans as going above and beyond, then a duty to rescue, something ethically compelled, must bring rescue out of the framework of charity and place it in the context of humanity and obligations. Such a view would also support expanding the geographical reach of the otherwise more proximate duty. The duty may be stronger and take shape in a more workable way if it applies to preparing places expecting to see an influx of people due to climate migration and to helping those most in need. The duty may arise out of expectations of what type of community the place welcoming those migrating due to climate should be—does it want to offer good housing, schooling, and medical care as well as economic opportunity to new people? And if so, at what cost, or with which risks? If the newcomers are viewed as community members rather than strangers, a model of acceptance may lead to better preparation. Some considerations like whether the actions will reasonably help the persons in need of rescue[15] will shape the application of a duty to rescue in the context of climate migration. Similarly, ensuring that people have the chance to articulate their values may help communities support the newcomers. New relationships should not be defined as migrant and rescuer. Voluntariness in participation and not forcing any action deemed rescue would help ensure the human rights of those migrating. In the United States, President Biden issued an executive order addressing impending climate migration steeped in a duty to prepare by making plans for resettlement and to address the impact of climate migration.[16] Vll. At What Risk? As we investigate the ethical obligations to meet even basic needs, we must also ask what level of risk is ethically compelled. There is an extraordinary need to integrate newcomers successfully, but it is difficult to stretch an ethical duty to rescue to require all the prerequisites for successful climate migration. Even defining success would create deep ethical arguments. As observed in almost all migrations, extraordinary charitable acts may be the key to success, while an ethical duty to rescue must try to require the important government and community-based basics and ensuring respect for human rights. That is, the migrating people should be rescued from circumstances that contradict basic human rights. Rather than comparing communities to bystanders, mere places where people will arrive and need to hash out how to find housing, jobs, education, and opportunity, a duty of preparation may be the key to rescue those disenfranchised by migration. There are cultural, personal, physical, psycho-social, and geopolitical issues surrounding how to best help those needing to permanently relocate. Ethics arguments will certainly range from “do nothing”, which may fail people, to “do everything”, which could waste taxpayer money in futile over-preparation while failing to actually help. Communities must avoid planning exclusively for one scenario only to have it not take place. Striking the balance, a duty to rescue as it could apply to climate migration should set goals of societal integration, and providing the basics like education, housing, food, health care, and job opportunity, the precursors to flourishing. Recommending the extraordinary, morally preferred but perhaps not compulsory, when charitable actors are participating, or when wrongdoers are compensating, may be more workable than seeing the duty to rescue as compelling people or local governments to take on significant financial and personal risk for newcomers. While humanitarian ethics supports helping everyone, it is likely that people who resettle in advance of a need to flee will find themselves with more choices and opportunities. Help is warranted for those with more dire needs. Preparing for them may do just that. Vlll. Rescue Prior to Migration and Rescue in the Process of Resettlement The duty to enable the migration in the first-place hints to the inadequacy of a duty to prepare. The traditional duty to rescue perhaps steps in if rescue looks like those geographically just out of harm's way rescuing those in danger. That resembles the traditional moral requirement, or duty to rescue according to the Rule of Rescue. Humanitarian aid typically provided by many institutions makes sense and is in place, although financial support for additional humanitarian aid is always needed. Despite having moved to purportedly more capable communities, migrant communities may be able to develop more egalitarian orders of living. Rather than continually being identified as having been rescued, it is important to make sure people keep or make social ties during and after migration. Immigrants often face social isolation.[17] Small shifts in gestural language also have the potential to welcome people and show they are valued. For instance, some migrants may not like questions like “Where are you from?” and “What brings you here?” as they emphasize differences over fitting in. CONCLUSION The ethical duty to rescue should be expanded to better match those in need of relocation with a welcome environment and the resources needed to achieve success and fully integrate socially and culturally. Expanding a dialogue that includes the voices of people who have recently migrated whether due to violence, poverty, or climate, could properly frame the extent of the duty. If we are to apply the duty of rescue to climate migration, rescuers should avoid labeling people vulnerable, dependent, or needy, although there is reason to focus on those whose needs are the most dire. A soft duty to rescue people during the course of climate migration can come in the form of preparation. People will need help finding housing, education, access to food, and employment. Ultimately, to help them help themselves may be the best goal. While the obligations should be borne differently by people, whether due to a special responsibility, or a special relationship that creates a clearer duty, the global community must prepare for its role in rescuing those displaced by climate events. By helping those displaced at the start of the climate migration process according to a more commonly held notion of the duty to rescue, and by preparing to incorporate newcomers successfully according to an expanded duty to rescue, effectively a duty to prepare, countries that take on climate refugees may find themselves rewarded by the cultural diversity and workplace talents that people bring. A duty to those at a distance is a reasonable expansion of the duty to rescue. But what one ought to do in the global community varies somewhat from the traditional Rule of Rescue. - [1] Singer, P. (1972). Famine, Affluence, and Morality. Philosophy and Public Affairs, 1(3): 229-43. [2] Irfan, U. (2022, March 16). Why We Still Don’t Yet Know How Bad Climate Migration Will Get. Vox. https://www.vox.com/2022/3/16/22960468/ipcc-climate-change-migration-migrant-refugee, citing the International Panel on Climate Change (IPCC) (2022). Sixth Assessment Report, Climate Change 2022, Impacts, Adaptation, and Vulnerability. https://www.ipcc.ch/report/ar6/wg2/ [3] McKie, J., Richardson, J. (2003) The Rule of Rescue. Social Science & Medicine, 56(12): 2407-2419. https://doi.org/10.1016/S0277-9536(02)00244-7. [4] James, S.M. (2007). Good Samaritans, Good Humanitarians. Journal of Applied Philosophy, 24(3):238-254. [5] Overview of Good Samaritan laws. https://worldpopulationreview.com/state-rankings/good-samaritan-law-states [6] Fifield, J. (2017, Sept. 19). Why It’s Hard to Punish ‘Bad Samaritans’. Stateline Blog, Pew Charitable Trusts, https://www.pewtrusts.org/en/research-and-analysis/blogs/stateline/2017/09/19/why-its-hard-to-punish -bad-samaritans [7] Cassella, C. (2019). There’s a Climate Threat Facing Pacific Islands That’s More Dire Than Losing Land, Science Alert, https://www.sciencealert.com/pacific-islanders-are-in-a-climate-crisis-as-rising-sea-levels-threaten -water; Hassan, H. R., and Cliff, V. (2019). For Small Island Nations, Climate Change is not a Threat. It’s Already Here, World Economic Forum, https://www.weforum.org/agenda/2019/09/island-nations-maldives-climate-change/ [8] For example, Lyons, K. (2019). Australia Coal use is Existential threat to Pacific Islanders, The Guardian. https://www.theguardian.com/world/2019/aug/12/australia-coal-use-is-existential-threat-to-pacific-is lands-says-fiji-pm [9] Cripps, E. (2013). Climate Change and the Moral Agent: Individual Duties in an Interdependent World. Oxford: Oxford University Press. [10] Schroeder, D., Chatfield, K., Singh, M., Chennells, R., and Herissone-Kelly, P.. Ethics Dumping and the Need for a Global Code of Conduct. In Cham. (Ed.)(2019). Equitable Research Partnerships. SpringerBriefs in Research and Innovation Governance. Springer. 2019. https://doi.org/10.1007/978-3-030-15745-6_1 [11] Giudice L.C., Llamas-Clark E.F., DeNicola N., Pandipati, S., Zlatnik, M.G., Decena, D.C.D., Woodruff, T.J., Conry, J.A. (2021). Climate Change, Women’s Health, and the Role of Obstetricians and Gynecologists in Leadership, International J Gynecol Obstet, 155(3), 345-356. 10.1002/ijgo.13958 [12] See Ferrarello, S. and Zapien, N. (2020). Ethical Experience: A Phenomenology, Bloomsbury. (for understanding phenomenological determinants of ethical action). [13] McLeman, R.A., Hunter, L.M., (2010). Migration in the context of vulnerability and adaptation to climate change: insights from analogues. Wiley Interdiscip Rev Clim Change, 1(3): 450-461. [14] Least Developed Countries Expert Group. (2018). Considerations Regarding Vulnerable Groups, Communities and Ecosystems in the Context of the National Adaptation Plans: United Nations Framework Convention on Climate Change. [15] Jecker, N.S. 2013. "The Problem with Rescue Medicine." J Med Philos, 38(1):64-81. [16] White House Report. (February 9, 2021), Executive Order (E.O.) 14013, “Rebuilding and Enhancing Programs to Resettle Refugees and Planning for the Impact of Climate Change on Migration.” (calls on the National Security Advisor to prepare a report on climate change and its impact on migration. “This report marks the first time the U.S. Government is officially reporting on the link between climate change and migration.” https://www.whitehouse.gov/briefing-room/presidential-actions/2021/01/27/executive-order-on-tackling -the-climate-crisis-at-home-and-abroad/ [17] Torres, J.M., Casey, J.A. (2017) The centrality of social ties to climate migration and mental health. BMC Public Health, 17: 600. https://doi.org/10.1186/s12889-017-4508-0. (shrink)

Araştırmada lise öğrencilerinin geleneksel ve kültürel din algılarını belirlemek için uygun bir ölçek geliştirilmesi amaçlanmaktadır. Çalışma AFA için 324 ve DFA için 320 olmak üzere toplam 644 lise öğrencisiyle yürütülmüştür. Verileri toplamak için geleneksel ve kültürel din algısı ölçek formu (GEKDÖ) ile kişisel bilgi anketi kullanılmıştır. Uzman görüşleri ve pilot uygulama sonuçlarına göre AFA öncesi 35 maddeden oluşan bir ölçek formuna ulaşılmış ve uygulanmıştır. AFA sonrası 20 maddeden oluşan ölçek formu elde edilmiştir. DFA sonucu 4 madde ölçekten çıkarılarak 16 maddeli (...) son yapıya ulaşılmıştır. GEKDÖ, üç boyut (Kaynak ve Belirleyicilik Boyutu, Rehberlik ve Eğitim Boyutu ve Kültürel Boyut) ve 16 maddeden oluşmaktadır. Ölçeğin toplam varyansı %58,13 olarak bulunmuştur. Ölçeğin KMO değeri,938; Barlett test değeri, 4212,113’tür. Güvenirlik çalışmaları sonucunda Cronbach Alpha güvenirlik katsayısı,931; ikiye ayırma güvenirlik analiz değeri,833 ve boyutların ayırt edicilik düzeylerini belirlemek için %27’lik alt-üst grup puanları arasında yapılan t-test sonuçları sırasıyla t(88) = –43,51 –38,90 – 36,47 –30,94 p<,01 olarak tespit edilerek anlamlı bir farklılık olduğu görülmüştür. DFA sonuçları temel ölçüt olan model uyum indekslerini oldukça iyi düzeyde karşıladığı için oluşturulan yapının istatistiksel ve kuramsal açılardan da uygun olduğu değerlendirilmektedir. Sonuç olarak lise öğrencilerine yönelik geliştirilen 16 maddelik GEKDÖ’nün geçerli ve güvenilir olduğu belirlenmiştir. (shrink)

Ex ante predicted outcomes should be interpreted as counterfactuals (potential histories), with errors as the spread between outcomes. But error rates have error rates. We reapply measurements of uncertainty about the estimation errors of the estimation errors of an estimation treated as branching counterfactuals. Such recursions of epistemic uncertainty have markedly different distributial properties from conventional sampling error, and lead to fatter tails in the projections than in past realizations. Counterfactuals of error rates always lead to fat tails, regardless of (...) the probability distribution used. A mere .01% branching error rate about the STD (itself an error rate), and .01% branching error rate about that error rate, etc. (recursing all the way) results in explosive (and infinite) moments higher than 1. Missing any degree of regress leads to the underestimation of small probabilities and concave payoffs (a standard example of which is Fukushima). The paper states the conditions under which higher order rates of uncertainty (expressed in spreads of counterfactuals) alters the shapes the of final distribution and shows which a priori beliefs about conterfactuals are needed to accept the reliability of conventional probabilistic methods (thin tails or mildly fat tails). (shrink)

Objective: To evaluate the effect of an intervention on the understanding and use of DNR orders by physicians; to assess the impact of understanding the importance of involving competent patients in DNR decisions. Design: Prospective clinical interventional study. Setting: Internal medicine department (70 beds) of the hospital of La Chaux-de-Fonds, Switzerland. Participants: Nine junior physicians in postgraduate training. Intervention: Information on the ethics of DNR and implementation of new DNR orders. Measurements and main results: Accurate understanding, interpretation, and use of (...) DNR orders, especially with respect to the patients’ involvement in the decision were measured. Junior doctors writing DNR orders had an extremely poor understanding of what DNR orders mean. The correct understanding of the definition of a DNR order increased from 31 to 93% (p<0.01) after the intervention and the patients’ involvement went from 17% to 48% (p<0.01). Physicians estimated that 75% of their DNR patients were mentally competent at the time of the decision. Conclusion: An intervention aimed at explaining the ethical principles and the definition of DNR orders improves understanding of them, and their implementation, as well as patient participation. Specific efforts are needed to increase the involvement of mentally competent patients in the decision. (shrink)

Bullying often results in negative coping in victims, including an increased consumption of alcohol. Recently, however, an increase in alcohol use has also been reported among perpetrators of bullying. The factors triggering this pattern are still unclear. We investigated the role of empathy in the interaction between bullying and alcohol use in an adolescent sample (IMAGEN) at age 13.97 (±0.53) years (baseline (BL), N = 2165, 50.9% female) and age 16.51 (±0.61) years (follow-up 1 (FU1), N = 1185, 54.9% female). (...) General empathic distress served as a significant moderator of alcohol use in perpetrators (F9, 493 = 17.978, p < 0.01), which was specific for males and FU1. Male perpetrators, who are generally less sensitive to distress, might thus be more vulnerable to alcohol abuse. (shrink)

Objectives To conduct an independent evaluation of the first phase of the Health Foundation’s Safer Patients Initiative (SPI), and to identify the net additional effect of SPI and any differences in changes in participating and non-participating NHS hospitals. Design Mixed method evaluation involving five substudies, before and after design. Setting NHS hospitals in the United Kingdom. Participants Four hospitals (one in each country in the UK) participating in the first phase of the SPI (SPI1); 18 control hospitals. Intervention The SPI1 (...) was a compound (multi-component) organisational intervention delivered over 18 months that focused on improving the reliability of specific frontline care processes in designated clinical specialties and promoting organisational and cultural change. Results Senior staff members were knowledgeable and enthusiastic about SPI1. There was a small (0.08 points on a 5 point scale) but significant (P<0.01) effect in favour of the SPI1 hospitals in one of 11 dimensions of the staff questionnaire (organisational climate). Qualitative evidence showed only modest penetration of SPI1 at medical ward level. Although SPI1 was designed to engage staff from the bottom up, it did not usually feel like this to those working on the wards, and questions about legitimacy of some aspects of SPI1 were raised. Of the five components to identify patients at risk of deterioration—monitoring of vital signs (14 items); routine tests (three items); evidence based standards specific to certain diseases (three items); prescribing errors (multiple items from the British National Formulary); and medical history taking (11 items)—there was little net difference between control and SPI1 hospitals, except in relation to quality of monitoring of acute medical patients, which improved on average over time across all hospitals. Recording of respiratory rate increased to a greater degree in SPI1 than in control hospitals; in the second six hours after admission recording increased from 40% (93) to 69% (165) in control hospitals and from 37% (141) to 78% (296) in SPI1 hospitals (odds ratio for “difference in difference” 2.1, 99% confidence interval 1.0 to 4.3; P=0.008). Use of a formal scoring system for patients with pneumonia also increased over time (from 2% (102) to 23% (111) in control hospitals and from 2% (170) to 9% (189) in SPI1 hospitals), which favoured controls and was not significant (0.3, 0.02 to 3.4; P=0.173). There were no improvements in the proportion of prescription errors and no effects that could be attributed to SPI1 in non-targeted generic areas (such as enhanced safety culture). On some measures, the lack of effect could be because compliance was already high at baseline (such as use of steroids in over 85% of cases where indicated), but even when there was more room for improvement (such as in quality of medical history taking), there was no significant additional net effect of SPI1. There were no changes over time or between control and SPI1 hospitals in errors or rates of adverse events in patients in medical wards. Mortality increased from 11% (27) to 16% (39) among controls and decreased from 17% (63) to 13% (49) among SPI1 hospitals, but the risk adjusted difference was not significant (0.5, 0.2 to 1.4; P=0.085). Poor care was a contributing factor in four of the 178 deaths identified by review of case notes. The survey of patients showed no significant differences apart from an increase in perception of cleanliness in favour of SPI1 hospitals. Conclusions The introduction of SPI1 was associated with improvements in one of the types of clinical process studied (monitoring of vital signs) and one measure of staff perceptions of organisational climate. There was no additional effect of SPI1 on other targeted issues nor on other measures of generic organisational strengthening. (shrink)

We study for each computably bounded $\Pi ^0_1$ class P the set of degrees of c.e. paths in P. We show, amongst other results, that for every c.e. degree a there is a perfect $\Pi ^0_1$ class where all c.e. members have degree a. We also show that every $\Pi ^0_1$ set of c.e. indices is realized in some perfect $\Pi ^0_1$ class, and classify the sets of c.e. degrees which can be realized in some $\Pi ^0_1$ class as exactly (...) those with a computable representation. (shrink)

Academic ethical values, having the well-deserved place by nursing and other scientific fields, and developing of the nursing science are proportionate to obeying the academic ethical values and internalizing those values. This study was carried out to determine the nurse academicians’ attitudes related to ethical values and related factors. The descriptive research was carried out between the dates of May and June 2017. The scope of the research consisted of nurse academicians working for two universities in Turkey and the sample (...) of the study consisted of 103 nurse academicians who had accepted to participate in the research. Data were collected by using “Descriptive Characteristics Information Form” and “Academic Ethics Values Scale”. Ethical considerations: Ethic approval from the institution, the Training and Research Hospital Noninvasive Clinical Studies Ethics Committee at the University of İzmir Katip Çelebi, and written approval from the owner of the scale were taken in order to carry out the study. The average age of the participants was 35.7 ± 9.6, 95% of them were female, and 51.5% of them were working as research assistants. The nurse academicians’ total item point average was 177,99 ± 11,01 and the attitudes of nurse academicians towards academic ethical values were positively. When the sub-dimension item point averages of the scale were examined, the lowest item point average was determined for the sub-dimension of “Scientific Research” as the highest item point average were being determined for the sub-dimension of “Teaching Process”. In this study that the participants’ attitudes towards academic ethical values were found meaningful at a high level, it was seen that academic assignment and age were important factors for the nurse academicians’ attitudes towards the colleagues and the teaching process. (shrink)

Data hiding and watermarking are considered one of the most important topics in cyber security. This article proposes an optimized method for embedding a watermark image in a cover medium (color image). First, the color of the image is separated into three components (RGB). Consequently, the discrete wavelet transform is applied to each component to obtain four bands (high–high, high–low, low–high, and low–low), resulting in 12 bands in total. By omitting the low–low band from each component, a new square matrix (...) is formed from the rest bands to be used for the hiding process after adding keys to it. These keys are generated using a hybrid approach, combining two chaotic functions, namely Gaussian and exponential maps. The embedding matrix is divided into square blocks with a specific length, each of which is converted using Hessenberg transform into two matrices, P and H. For each block, a certain location within the H-matrix is used for embedding a secret value; the updated blocks are assembled, and the reverse process is performed. An optimization method is applied, through the application of the firework algorithm, on the set of the initial values that generate keys. Using an optimization procedure to obtain keys requires performing lowest possible change rate in an image and maintain the quality of the image. To analyze and test the efficiency of the proposed method, mean-square error (MSE) and peak signal-to-noise ratio (PSNR) measurements are calculated. Furthermore, the robustness of the watermark is computed by applying several attacks. The experimental results show that the value of the MSE is reduced by about 0.01 while the value of the PSNR is increased by about 1.25 on average. Moreover, the proposed method achieved a high-retrieval rate in comparison with the non-optimization approach. (shrink)

L’espace esthétiqueLe « renversement du cartésianisme » chez Deleuze et Merleau-PontyCet essai se propose de développer le rapport entre Deleuze et Merleau-Ponty à partir de la tentative des deux philosophes français d’aller au-delà du courantde pensée qu’on pourrait qualifi er, comme le fait Merleau-Ponty lui-même, de « cartésianisme ».Nous commençons notre itinéraire avec la critique que les deux philosophes adressent à la notion cartésienne de « ligne » – passage obligé pour penser, à travers Leibniz et sa notion de « (...) point », la ligne en tant qu’« ensemble de points ». On cherche ensuite à penser une ligne qui ne serait plus tracée dans un espace objectif présupposé, mais plutôt qui « se trace » dans un « espace expressif ».Un tel renversement de la « ligne cartésienne » produit, comme on le verra, des effets qui intéressent également la représentation de la ligne du temps. Émanciper cette dernière du modèle cartésien signifi e la penser par-delà toute référence chronologique, toute dépendance du temps de Kronos. On peut lire dans ce sens la tentative des deux philosophes pour penser le temps de l’événement, le temps de l’Aion. On verra enfin comment, d’un espace et d’un temps anticartésiens, doit naître, pour Merleau-Ponty et Deleuze, une nouvelle grammaire porteuse d’une nouvelle compréhension de la métaphore. Ni l’idée de métaphore proposée par Merleau-Ponty, ni le concept de devenir créé par Deleuze ne concernent une ressemblance fondée sur une identité donnée. Si la métaphore merleau-pontienne et le devenir deleuzien doivent être en mesure de restituer l’essence d’une chose, une telle essence se trouve, ou mieux se crée,à partir d’un mouvement vers « ce que la chose n’est pas ». C’est précisément dans ce sens que Merleau-Ponty lit la métaphore proustienne et que Deleuze cherche à rendre compte des ressemblances créées dans l’oeuvre de Gombrowicz.The Aesthetic SpaceThe “Reversal of Cartesianism” in Deleuze and Merleau-PontyThe present essay proposes to explore the relationship between Deleuze and Merleau-Ponty from the attempt they make to go beyond the current of thought thatwe may qualify, like Merleau-Ponty does it himself, as Cartesianism. We begin our itinerary with the critique that both philosophers direct at the Cartesian notion of the line. The passage through the Cartesian notion of the line is “obligated” in order to think – by means of Leibniz and his notion of point -- the line as a “set of points.” The Cartesian passage is obligated moreover in order to think a line which could no longer be drawn in a presupposed objective space but, rather, which would be “drawn” in an “expressive space.” Such a reversal of the Cartesian line, as we shall see, produces effects that concern also the representation of the line of time. To emancipate the line of time from the Cartesian model means we must think beyond all chronological references, beyond all dependence on the time of Chronos. We are able to read, in this way, both philosophers’ attempt to think the time of the event, the time of Aion. Finally we shall see how, for Merleau-Ponty and Deleuze, a new grammar carrying a new understanding of the metaphor must be born from an anti-Cartesian space and time. Neither the idea of metaphor proposed by Merleau-Ponty nor the concept of becoming created by Deleuze speaks of a resemblance founded upon an identity that is given ahead of time. If Merleau-Ponty’s idea of metaphor and Deleuze’s concept of becoming must be able to produce the essence of a thing, such an essence finds, or better, it iscreated on the basis of a movement toward “what the thing is not.” It is precisely in this sense that Merleau-Ponty reads Proust’s metaphors and that Deleuze will seek to give an account of created resemblances in the work of Gombrowicz. (shrink)

En el ámbito de la lógica matemática existe un problema sobre la relación lógica entre dos versiones débiles del Axioma de elección (AE) que no se ha podido resolver desde el año 2000 (aproximadamente). Tales versiones están relacionadas con ultrafiltros no principales y con Propiedades Ramsey (Bernstein, Polarizada, Subretículo, Ramsey, Ordinales flotantes, etc). La primera versión débil del AE es la siguiente (A): “Existen ultrafiltros no principales sobre el conjunto de los números naturales (ℕ)”. Y la segunda versión débil del (...) AE es la siguiente (B): “Existen ultraflitros sobre ℕ”. Se sabe que A implica B, pero se desconoce si B implica A. Di Prisco y Henle conjeturan en los artículos ([1], [2]) que esto no ocurre, es decir, conjeturan que B no implica A, en otras palabras, conjeturan que A es más fuerte estrictamente que B, que A es independiente de B, pero esto no se ha podido demostrar todavía aunque se ha intentado hacer desde hace aproximadamente 21 años. Una descripción detallada de este problema abierto puede encontrarse en esta ponencia (dictada en el marco del Día Mundial de la Lógica 14-01-2022) y en el artículo [3]. [1] C. Di Prisco y H. Henle. “Doughnuts, Floating Ordinals, Square Brackets, and Ultraflitters”. Journal of Symbolic Logic 65 (2000) 462-473. [2] C. Di Prisco y H. Henle. “Partitions of the reals and choice”. En “Models, algebras and proofs”. X. Caicedo y C.M. Montenegro. Eds. Lecture Notes in Pure and Appl. Math, 203, Marcel Dekker, 1999. [3] F. Galindo. “Tópicos de ultrafiltros”. Divulgaciones Matemáticas. Vol. 21, No 1-2, 2020. (shrink)

Presentation to the ethic@'s issue: n. 01, v. 19, (2020).

In his Tractatus, Wittgenstein maintained that arithmetic consists of equations arrived at by the practice of calculating outcomes of operations$\Omega ^{n}(\bar {\xi })$defined with the help of numeral exponents. Since$Num$(x) and quantification over numbers seem ill-formed, Ramsey wrote that the approach is faced with “insuperable difficulties.” This paper takes Wittgenstein to have assumed that his audience would have an understanding of the implicit general rules governing his operations. By employing the Tractarian logicist interpretation that theN-operator$N(\bar {\xi })$and recursively defined arithmetic (...) operators$\Omega ^{n}(\bar {\xi })$are not different in kind, we can address Ramsey’s problem. Moreover, we can take important steps toward better understanding how Wittgenstein might have imagined emulating proof by mathematical induction. (shrink)

For each of the N-values 2, 4, 8, 16, 32, 64, 128, 256, 512, and 1,024, 50,000 samples of size N were drawn from an L-shaped population, and for each sample the Z and t statistics were calculated. The resulting distributions of 50,000 Z or t values at each sample size were then used to study the robustness of left-tailed, right-tailed, and two-tailed Z and t tests at α levels of.05,.01, and.001 (and, for Z only,.0001). The actually obtained proportion, ρ, (...) of Type I errors was often far greater or far smaller than the nominal proportion, α. Furthermore, although α is the expected value of ρ at infinite N, no N-value below 512 ever brought the deviation of p from α to within 10% of α for any t tests or one-tailed Z tests. (shrink)

Bu çalışmanın amacı, İmam Hatip Lisesi öğrencilerinin İmam Hatip Lisesi, İmam Hatip Lisesi meslek dersi öğretmeni ve İmam Hatip Lisesi idaresine ilişkin algılarını metaforlar yoluyla tespit etmektir. Araştırma, nitel araştırma desenlerinden fenomenolojik (olgubilim) desende tasarlanmıştır. Amaçlı örnekleme yöntemlerinden ölçüt örnekleme yoluyla belirlenen çalışma grubu, 2018-2019 eğitim öğretim yılında 5 farklı İmam Hatip Lisesinde 9. ve 12. sınıfta öğrenim gören 412 öğrenciden oluşmaktadır. Araştırmanın verileri katılımcıların, “İmam Hatip Lisesi…gibidir; çünkü…”, “İmam Hatip Lisesi Meslek dersi öğretmeni… gibidir; çünkü…”, “İmam Hatip Lisesi idaresi…gibidir; (...) çünkü…” cümlelerini tamamlamaları yoluyla toplanmıştır. Elde edilen verilerin analizinde tümevarımcı içerik analizi yöntemi kullanılmıştır. İçerik analizi sonucu oluşturulan temalar/kategoriler SPSS programında frekans, yüzde ve çapraz tablo olarak analiz edilmiştir. Araştırma sonucuna göre, öğrencilerin “imam hatip lisesi” ile “imam hatip lisesi meslek dersleri öğretmenlerine” ilişkin algılarının olumlu olduğu, fakat İmam Hatip Lisesi idarecilerine ilişkin algılarının ise olumsuz olduğu belirlenmiştir. Bunun yanında erkek öğrencilerin, imam hatip ortaokulundan mezun öğrencilerin ve 9. Sınıf öğrencilerinin metaforik algılarının daha olumlu olduğu görülmüştür. Özet: Bu çalışmanın temel amacı, İmam Hatip Lisesi öğrencilerinin İmam Hatip Lisesi, İmam Hatip Lisesi meslek dersi öğretmeni ve İmam Hatip Lisesi idaresine ilişkin algılarını metaforlar yoluyla tespit etmektir. Türk eğitim sistemi içerisinde yer alan İmam Hatip Liseleri 1924 yılında açılmış, hem mesleğe hem de yükseköğretime öğrenci yetiştiren bir ortaöğretim kurumudur. Öğretim programında yer alan derslerin ortalama %40’ı dini mesleki dersler, %60’ı ise kültür derslerinden oluşmaktadır. Meslek derslerini meslek dersleri öğretmenleri vermektedir. Bu okulların yönetiminde, meslek dersi öğretmenlerinin yanında farklı branşlara ait idareciler de bulunmaktadır. Türkiye’de 2018-2019 eğitim öğretim yılı itibariyle ortaöğretime devam eden öğrencilerin %11’i bu okulları tercih etmektedir. Bu araştırma, nitel araştırma desenlerinden fenomenolojik (olgubilim) desende tasarlanmıştır. Amaçlı örnekleme yöntemlerinden ölçüt örnekleme yoluyla belirlenen çalışma grubu, 2018-2019 eğitim öğretim yılında 5 farklı İmam Hatip Lisesinde 9. ve 12. sınıfta öğrenim gören 412 öğrenciden oluşmaktadır. Araştırmanın verileri nitel araştırmada veri toplama tekniği olarak kullanılan metaforlar yoluyla toplanmıştır. Araştırmanın verileri katılımcıların, “İmam Hatip Lisesi…gibidir; çünkü…”, “İmam Hatip Lisesi Meslek dersi öğretmeni… gibidir; çünkü…”, “İmam Hatip Lisesi idaresi…gibidir; çünkü…” cümlelerini tamamlamaları yoluyla elde edilmiştir. Elde edilen verilerin analizinde tümevarımcı içerik analizi yöntemi kullanılmıştır. İçerik analizi sonucu oluşturulan temalar/kategoriler (olumlu-olumsuz) SPSS programında frekans, yüzde ve çapraz tablo olarak analiz edilmiştir. Araştırmada, öğrencilerin, İmam Hatip Lisesine ilişkin 140, meslek dersi öğretmenlerine ilişkin 147, idarecilere ilişkin 161 metafor ürettikleri görülmüştür. Ürettikleri metaforların analiz edilmesi sonucunda, temelde olumlu ve olumsuz olmak üzere iki kategoride toplandığı anlaşılmıştır. Araştırmaya katılan öğrencilerin ortalama üçte ikisi (%63,3) İmam Hatip Lisesine ilişkin olumlu metafor (93) üretirken, üçte biri (%36,7) ise olumsuz (47) metafor üretmiştir. Olumlu olarak üretilen metaforlar içerisinde en sık tekrarlanan metaforların “Evimiz (33/%8,01)”, “Aile ( 24/% 5,83) ve “Kur’an Kursu (14/%3,40)” metaforlarının olduğu; olumsuz olarak en sık tekrarlanan metaforların ise “Cezaevi/hapishane (76/%18,45)”, “Düz lise (12/%18,45)”, “Kötü bir yer (6/%6)” şeklinde olduğu görülmüştür. Bu bulgulara göre öğrencilerin yarıdan fazlasının İmam Hatip Lisesine ilişkin olumlu metaforik algıya sahip oldukları söylenebilir. Araştırmada kız öğrencilerin erkek öğrencilere göre İmam Hatip Lisesini daha fazla olumsuz algıladıkları görülmüştür. Araştırmaya katılan öğrencilerin dörtte üçü (%77,4) meslek dersi öğretmenlerine ilişkin olumlu (98) metafor üretirken, beşte birlik kısmın (%22,6) ise olumsuz (49) metafor ürettikleri belirlenmiştir. Olumlu olarak üretilen metaforlar içerisinde en sık tekrarlanan metaforların “İyi biri (34/%8,25)”, “Abla-abi (32/%7,77)”, “Aile (31/%7,52)”, metaforlarının olduğu; olumsuz olarak en sık tekrarlanan metaforların ise “Kötü biri (10/%2,42)”, “Diğer öğretmen (7/%1,70)”, “Sıkıcı (6/%1,46)” şeklinde olduğu görülmüştür. Bu bulgu öğrencilerin büyük çoğunluğunun meslek dersi öğretmenlerine ilişkin olumlu metaforik algıya sahip olduğunu göstermektedir. Araştırmaya katılan öğrencilerin üçte biri (%35) idarecilere ilişkin olumlu (67) metafor üretirken, üçte ikisinin (%65) ise olumsuz (94) metafor ürettikleri belirlenmiştir. Olumlu olarak üretilen metaforlar içerisinde en sık tekrarlanan metaforun “Aile (22/%5,34)”, “İyi biri (14/%3,40))”, “Disiplinli (7/%1,70)” metaforlarının olduğu; olumsuz olarak en sık tekrarlanan metaforların ise “Gardiyan (32/%7,77)”, “Aşırı disiplinli (30/%7,28)”, “Kötü (30/%7,28)” şeklinde olduğu görülmüştür. Öğrencilerin oluşturduğu diğer metaforların “diktatör, baskıcı, polis, hapishane, hapishane müdürü, sert, baskıcı baba, mahkeme salonu, komutan, dedektif, askerlik” gibi baskı ifade eden metaforlar olması dikkat çekicidir. Bu veriler idarecilerin öğrencilerin yarıdan fazlası tarafından olumsuz olarak algılandığı; idarecilerin öğrencilerin zihninde baskı yapan eğitimci imajı bıraktığı söylenebilir. Araştırmada kız öğrencilerin (%77) erkek öğrencilere (%41,3) göre okul idaresini daha fazla olumsuz algıladıkları görülmüştür. Sonuç olarak, İHL öğrencilerinin okullarına ve meslek dersi öğretmenlerine ilişkin metaforik algılarının olumlu yönde olduğu, fakat okul idarecilerine karşın olumsuz olduğu görülmektedir. Bu bağlamda öğrencilerin idareci algıları üzerine farklı çalışmaların yapılması gerektiği söylenebilir. (shrink)

Akademik yayın hayatının 20. yılına ulaşan Cumhuriyet Üniversitesi İlahiyat Fakültesi Dergisi, son yıllarda ulusal ve uluslararası akademik yayıncılık alanında önemli mesafeler kat etti. 15 Aralık 2016 tarihinde yayımladığımız 19. cilt 2. sayımızdan itibaren sağlanan ilerlemeleri, siz değerli okuyucularımızla paylaşmak istiyoruz. 1996 yılından itibaren Cumhuriyet Universitesi Ilahiyat Fakultesi Dergisi [Cumhuriyet University Journal of Faculty of Theology] adıyla yayınlanan dergimizin adının çok uzun olması ve atıf tespitinde yaşanan zorluklar sebebi ile Cumhuriyet ilahiyat dergisi [Cumhuriyet theology journal] olarak değiştirilmesi kararlaştırılmıştır. Dergimiz, 20. cilt, (...) 1. sayıdan itibaren bu adla yayın hayatına devam edecektir. Dergimiz, TÜBİTAK - ULAKBİM’in sunduğu elektronik dergi yönetim sistemi DergiPark Akademik’ın yeni versiyonunun güçlü açık erişim ve online akademik yayıncılık alt yapısını kullanabilmek amacıyla gerekli teknik çalışmaları tamamladı. Bu kapsamda 01 Haziran 2016 tarihi itibariyle yeni web sayfamız hizmete girdi. (shrink)

Background Clinical papers so flawed that they are eventually retracted may put patients at risk. Patient risk could arise in a retracted primary study or in any secondary study that draws ideas or inspiration from a primary study. Methods To determine how many patients were put at risk, we evaluated 788 retracted English-language papers published from 2000 to 2010, describing new research with humans or freshly derived human material. These primary papers—together with all secondary studies citing them—were evaluated using ISI (...) Web of Knowledge. Excluded from study were 468 basic science papers not studying fresh human material; 88 reviews presenting older data; 22 case reports; 7 papers retracted for journal error and 23 papers unavailable on Web of Knowledge. Overall, 180 retracted primary papers (22.8%) met the inclusion criteria. Subjects enrolled and patients treated in 180 primary studies and 851 secondary studies were combined. Results Retracted papers were cited over 5000 times, with 93% of citations being research related, suggesting that ideas promulgated in retracted papers can influence subsequent research. Over 28 000 subjects were enrolled—and 9189 patients were treated—in 180 retracted primary studies. Over 400 000 subjects were enrolled—and 70 501 patients were treated—in 851 secondary studies which cited a retracted paper. Papers retracted for fraud (n=70) treated more patients per study (p<0.01) than papers retracted for error (n=110). Conclusions Many patients are put at risk by retracted studies. These are conservative estimates, as only patients enrolled in published clinical studies were tallied. (shrink)

This study seeks to trace the boundaries of the sign in the phenomenological tradition of Edmund Husserl. The approach adopted here is largely historical and has no other ambition that to identify those questions that pertain to the sign and have been of interest for phenomenology. The article is divided in four parts : the first examines an essay from 1890 entitled Semiotik and situates it in the context of the young Husserl's work in the philosophy of mathematics ; the (...) second part concerns the first section of the Logical Investigations ; the third one seeks to account for the changes that testify to the evolution of Husserl's thinking regarding the sign between the Logical Investigations (1900-01) and "Origins of Geometry" (1936) ; the last part considers the contribution of post-Husserlian phenomenology, from Martin Heidegger to Merleau-Ponty and beyond, to semiotics. -/- Résumé. Notre étude vise à délimiter l'espace dans lequel la question du signe s'est posée à la tradition phénoménologique depuis Edmund Husserl. Cette étude est largement historique et elle n'a d'autres ambitions que d'identifier certains aspects de la question du signe qui ont suscité l'intérêt de la phénoménologie. Elle se divise en quatre parties : dans la première, nous examinons le texte de 1890 intitulé Semiotik en le situant dans le contexte des recherches du jeune Husserl sur la philosophie des mathématiques ; la deuxième section est principalement consacrée à l'étude de la première des Recherches logiques ; la troisième partie vise à rendre compte des chan-gements qui ont marqué l'évolution de la pensée de Husserl sur le signe, des Recher-ches logiques (1900/1) à "Origine de la géométrie" (1936) ; finalement, nous esquis-serons à grands traits la contribution de la phénoménologie post-husserlienne à la sémiotique, de Martin Heidegger à Maurice Merleau-Ponty, et au-delà. (shrink)

The objective of the research was to check whether False Consensus Effect (FCE), shown in much research,is also valid for ontological decisions. Test participants, faced with an ontological dilemma, made a choice three times,which of the 3 item set (Cracow City, Me myself, the Universe) refers to something most real. The research conducted first among psychology students (N=116), then replicated on mathematics students (N=126) and middle-aged people (N=106). Results: 1) All groups chose the Universe most seldom (4%-11% subjects), the remaining (...) two “objects” were chosen with similar frequency, 2) FCE occurred in all groups and in reference to each choice, 3) with people who made inconsequent choices (16% of test participants), FCE was notably higher (p <.001) in comparison to people making consequent choices,4)FCE with inconsequent people turned out to be higher (p <.01) even in comparison with “the smallest minority”, people who (consequently) chose the Universe. (shrink)

Citation: Christodoulou, Marina. “‘To be dead is an unthinkable anomaly’ Reversed Necropolitics and the Death Imaginary.” Lo Sguardo - rivista di filosofia N. 23, 2017 (I) - Reinventare il reale. Jean Baudrillard (2007-2017) a cura di Eleonora de Conciliis, Enrico Schirò, Daniela Angelucci, pp. 127-137. Articolo sottoposto a peer review. Ricevuto il 14/10/2016. Accettato il 12/01/2017. ISSN: 2036-6558 -/- --------- -/- The concept or the theory of Death in the thought of Jean Baudrillard is not given the particular attention it (...) needs. When one speaks of the thought of Baudrillard, one rarely will mention ‘death’ as one of the keywords of his corpus. I think, though, that it deserves such a key place, for three reasons. Firstly, because the theme of Death is a gargantuan concept in the history of Philosophy and it even emerges with the definition of Philosophy itself, since, at least, Plato. Every philosopher, more or less is preoccupied with it, as an archetypical necessity of both human culture and of philosophy in particular. It is always interesting to see how each philosopher or each person thinks on it, as their thoughts on Death are a departure point and an indication of their whole philosophical system or, for non-philosophers, of their whole way of life. Secondly, it is important to examine this theme in Baudrillard because it inseparably interconnects, explains, and is explained by all the other, key, and the less prominent themes in his philosophy. Baudrillard’s thinking might take new dimensions when viewed through his thoughts on Death. Finally, Baudrillard is considered a difficult thinker, because, unlike other philosophers, he grasps themes which people are used to seeing as the pre-occupation or within the realm of fiction, even science-fiction. I would like to show, using simple language, that his philosophy, especially surrounding the subject of Death, is completely naked of any metaphysical, romanticised, fantastic, or fiction-like properties; it is realistic and political. (shrink)

Background: Low rates of participation of adolescents and young adults (AYAs) in clinical oncology trials may contribute to poorer outcomes. Factors that influence the decision of AYAs to participate in health research and whether these factors are different from those that affect the participation of parents of children with cancer. Methods: This is a secondary analysis of data from validated questionnaires provided to adolescents (>12 years old) diagnosed with cancer and parents of children with cancer at 3 sites in Canada (...) (Halifax, Vancouver, and Montreal) and 2 in the United States (Atlanta, GA, and Memphis, TN). Respondents reported their own research participation and cited factors that would influence their own decision to participate in, or to provide parental authorization for their child to participate in health research. Results: Completed questionnaire rates for AYAs and parents were 86 (46.5%) of 185 and 409 (65.2%) of 627, respectively. AYAs (n = 86 [67%]) and parents (n = 409 [85%]) cited that they would participate in research because it would help others. AYAs perceived pressure by their family and friends (16%) and their physician (19%). Having too much to think about at the time of accrual was an impediment to both groups (36% AYAs and 47% parents). The main deterrent for AYAs was that research would take up too much time (45%). Nonwhite parents (7 of 56 [12.5%]) were more apt to decline than white parents (12 of 32 [3.7%]; P < .01). Conclusions: AYAs identified time commitment and having too much to think about as significant impediments to research participation. Addressing these barriers by minimizing time requirements and further supporting decision-making may improve informed consent and impact on enrollment in trials. (shrink)

Ce texte a déjà paru dans Projets de paysage le 18/01/2011. Nous remercions Éliane Escoubas de nous avoir autorisé à le reproduire ici. Résumé : L'investigation de la spatialité prend son point de départ de la notion de “phénomène” qui est “l'apparaître” de ce qui apparaît. L'apparaître n'apparaît pas parmi les choses apparaissantes, il est leur surgissement, lui-même inapparent. Quotidiennement nous nous contentons de “voir” les choses, de voir ce qui est – seul l'art, sous ses diverses formes, - Philosophie (...) – Nouvel article. (shrink)

Background Ethical decision‑making and behavior of nurses are major factors that can affect the quality of nursing care. Moral development of nurses to making better ethical decision-making is an essential element for managing the care process. The main aim of this study was to examine and comparison the effect of training in ethical decision-making through lectures and group discussions on nurses’ moral reasoning, moral distress and moral sensitivity. Methods In this randomized clinical trial study with a pre- and post-test design, (...) 66 nurses with moral reasoning scores lower than the average of the community were randomly assigned into three equal groups (n = 22) including two experimental groups and one control group. Ethical decision-making training to experimental groups was provided through the lectures and group discussions. While, the control group did not receive any training. Data were collected using sociodemographic questionnaire, the nursing dilemma test (NDT), the moral distress scale (MDS) and the moral sensitivity questionnaire (MSQ). Unadjusted and adjusted binary logistic regression analysis was reported using the odds ratio (OR) and 95% confidence intervals. Results Adjusted regression analysis showed that the probability of increasing the nursing principle thinking (NPT) score through discussion training was significantly higher than lecture (OR: 13.078, 95% CI: 3.238–15.954, P = 0.008), as well as lecture (OR: 14.329, 95% CI: 16.171–2.005, P < 0.001) and discussion groups compared to the control group (OR: 18.01, 95% CI: 22.15–5.834, P < 0.001). The possibility of increasing moral sensitivity score through discussion training was significantly higher than lecture (OR: 10.874, 95%CI: 6.043–12.886, P = 0.005) and control group (OR: 13.077, 95%CI: 8.454–16.774, P = 0.002). Moreover, the moral distress score was significantly reduced only in the trained group compared to the control, and no significant difference was observed between the experimental groups; lecture group vs. control group (OR: 0.105, 95% CI: 0.015–0.717, P = 0.021) and discussion group vs. control group (OR: 0.089, 95% CI: 0.015–0.547, P = 0.009). Conclusions The results of this study indicate that ethical decision-making training is effective on empowerment of ethical reasoning. Whereas the group discussion was also effective on increasing the ethical sensitivity, it is recommended the training plan provided in this study to be held as workshop for all nurses in health and treatment centers and placed in curricular plan of nursing students. Registration This randomized clinical trial was registered in Iranian Registry of Clinical Trials under code (IRCT2015122116163N5) in 02/07/2016. (shrink)

BackgroundBioethics can play an important role in addressing diversity both in and outside of academia, setting precedents for meaningful contributions to public discourse, research, teaching, training, and policy development. However, in order to do so, these conversations also need to reflect on the issue of diversity within the field of bioethics across the globe. This study aims to examine current gender representation and diversity at medical ethics and humanities institutes in Germany, the German-speaking areas of Switzerland, and Austria.MethodsA total of (...) forty-nine medical ethics and humanities institutes from Germany (n=42), the German-speaking areas of Switzerland (n=5), and Austria (n=2) were included in the study. Institutes websites were reviewed in the first week of March 2021 and the details of each staff member listed on the website recorded.ResultsOverall, a total of 964 staff members were identified at the forty-nine German-speaking medical ethics and humanities institutes. Just over half (530/964; 55%) of all staff were female. There were significant differences between gender in some staff positions: 64.6 per cent (31/48) of directors were male (χ2(1)=4.1, P=.04); 62.7 per cent (84/134) of student assistants were female (χ2(1)=8.6, P=.003); and 83.7 per cent (77/92) of administrative staff were female (χ2(1)=41.8, P<.001). There were no significant differences between staff gender for researchers and lecturers, or associated researchers. In addition, 65.5 per cent (19/29) of researchers and lecturers who had a professor title were male, but the difference between genders was not found to be significant. However, significantly more of the researchers and lecturers who had completed a habilitation were male (75.8% (25/33); χ2(1)=8.8, P=.003). When comparing the institute director’s gender presentation with staff gender presentation, it was found that male-led institutes had 53.4 per cent (286/536) female staff overall but had 52.7 per cent (136/258) male researchers and lecturers. However, the difference between genders were not found to be significant. On the other hand, female-led institutes had significantly more female staff overall (59.9% (223/372); χ2(1)=14.7, P<.001) and also significantly more female researchers and lecturers (58.9% (119/202; χ2(1)=6.4, P=.01).ConclusionsThere has been a significant push to address gender diversity in German-speaking academia, and this study finds overall good gender parity in medical ethics and humanities institutes. However, there has not been a similar openness to discussing issues of systemic racism or how other forms of inequality affect academic diversity. Taking diversity seriously requires opening up conversations around intersectionality, including difficult conversations around race and cultural background that have long been taboo in German-speaking countries. (shrink)

Resumo: A inclusão no Ensino Superior é uma premissa de âmbito social, educacional e político. Muitos passos têm sido trilhados para que os discursos sobre equidade e igualdade possam ser proferidos e perspectivados, reconhecendo que o ajustamento dos estudantes com Necessidades Educativas Especiais (NEE) precede-se de inúmeros fatores, entre eles, das políticas educativas. Para possibilitar algumas reflexões, o presente estudo, de natureza qualitativa, objetivou conhecer as percepções de colaboradores (n=85) de Instituições de Ensino Superior portuguesas sobre o papel das políticas (...) educativas em prol da inclusão. Os dados, provenientes de um questionário online, foram tratados sob a técnica de análise de conteúdo, com apoio do software webQDA. Os resultados evidenciaram 60 referências na categoria de potencialidades, refletidas na garantia da efetivação do percurso acadêmico de estudantes com NEE no Ensino Superior e concretização dos seus direitos. Verificou-se que 91,7% dos participantes compreendem que as políticas educativas são importantes para o seu país, pelo que 88,2% dos colaboradores acreditam que estas políticas potenciam a inclusão e a permanência de estudantes com NEE no Ensino Superior, na qual 40,7% verificaram ações de apoio e incentivo, ao nível político, em prol da inclusão em Portugal. Palavras-chave: Políticas Educativas; Inclusão; Ensino Superior; Portugal; Necessidades Educativas Especiais. Educational policies and inclusion in Higher Education: perceptions about the Portuguese context Abstract: Inclusion in Higher Education is a social, educational and political premise. Many steps have been taken so that the discourses on equity and equality can be delivered and envisaged, recognizing that the adjustment of students with Special Educational Needs (SEN) is preceded by numerous factors, among them, educational policies. To enable some reflections, the present study, of a qualitative nature, aimed to know the perceptions of employees (n = 85) of Portuguese Higher Education Institutions about the role of educational policies on behalf of inclusion. The data, from an online survey, were treated using the content analysis technique, with the support of the webQDA software. The results revealed 60 references in the potentialities category, reflected in the guarantee of the effectiveness of the academic path of students with SEN in Higher Education and the realization of their rights. It was found that 91.7% of participants understand that educational policies are important for their country, so 88.2% of employees believe that these policies enhance the inclusion and permanence of students with SEN in Higher Education, in which 40.7% verified support and incentive actions, at the political level, in favor of inclusion in Portugal. Keywords: Educational Policies; Inclusion; Higher Education; Portugal; Special Educational Needs. Políticas educativas e inclusión en la educación superior: percepciones sobre el contexto portugués Resumen: La inclusión en la Educación Superior es una premisa en el marco social, educativo y político. Se han dado muchos pasos para que los discursos sobre equidad e igualdad puedan ser pronunciados y verificados, reconociendo que la adaptación de los estudiantes con Necesidades Educativas Especiales (NEE) está precedida por numerosos factores, entre ellos, las políticas educativas. Para posibilitar algunas reflexiones, el presente estudio, de carácter cualitativo, tuvo como objetivo conocer las percepciones de los colaboradores (n = 85) de las Instituciones de Educación Superior portuguesas sobre la función de las políticas educativas a favor de la inclusión. Los datos, provenientes de una encuesta online, fueron tratados mediante la técnica de análisis de contenido, con el apoyo del software webQDA. Los resultados evidenciaron 60 referencias en la categoría de potencialidades, reflejadas en la garantía de la efectividad de la trayectoria académica de los estudiantes con NEE en la Educación Superior y la realización de sus derechos. Se constató que el 91,7% de los participantes entiende que las políticas educativas son importantes para su país, por lo que el 88,2% de los empleados cree que estas políticas potencian la inclusión y permanencia de los estudiantes con NEE en la Educación Superior, en la que el 40,7% verificó acciones de apoyo e incentivo, a nivel político, a favor de la inclusión en Portugal. Palabras clave: Políticas Educativas; Inclusión; Educación superior; Portugal; Necesidades Educativas Especiales. Data de registro: 16/04/2021 Data de aceite: 01/12/2021. (shrink)

Background Research on the impact of ethics reflection groups (ERG) (also called moral case deliberations (MCD)) is complex and scarce. Within a larger study, two years of ERG sessions have been used as an intervention to stimulate ethical reflection about the use of coercive measures. We studied changes in: employees’ attitudes regarding the use of coercion, team competence, user involvement, team cooperation and the handling of disagreement in teams. Methods We used panel data in a longitudinal design study to measure (...) variation in survey scores from multidisciplinary employees from seven departments within three Norwegian mental health care institutions at three time points (T0–T1–T2). Mixed models were used to account for dependence of data in persons who participated more than once. Results In total, 1068 surveys (from 817 employees who did and did not participate in ERG) were included in the analyses. Of these, 7.6% (N = 62) responded at three points in time, 15.5% (N = 127) at two points, and 76.8% (N = 628) once. On average, over time, respondents who participated in ERG viewed coercion more strongly as offending (p < 0.05). Those who presented a case in the ERG sessions showed lower scores on User Involvement (p < 0.001), Team Cooperation (p < 0.01) and Constructive Disagreement (p < 0.01). We observed significant differences in outcomes between individuals from different departments, as well as between different professions. Initial significant changes due to frequency of participation in ERG and case presentation in ERG did not remain statistically significant after adjustment for Departments and Professions. Differences were generally small in absolute terms, possibly due to the low amount of longitudinal data. Conclusions This study measured specific intervention-related outcome parameters for describing the impact of clinical ethics support (CES). Structural implementation of ERGs or MCDs seems to contribute to employees reporting a more critical attitude towards coercion. Ethics support is a complex intervention and studying changes over time is complex in itself. Several recommendations for strengthening the outcomes of future CES evaluation studies are discussed. CES evaluation studies are important, since—despite the intrinsic value of participating in ERG or MCD—CES inherently aims, and should aim, at improving clinical practices. (shrink)

Değerli okuyucularımız, Cumhuriyet İlahiyat Dergisi’nin 24. Cilt 1. Sayısına hoşgeldi-niz. Bu sayımızla birlikte 23 yılı geride bırakmanın gururunu ve mutluluğunu yaşıyoruz. Akademi dünyasında değerli bilimsel çalışmalar yapmak kadar yapılan çalışmaları geniş bir okuyucu kitlesine ulaştırmak da önemlidir. Günümüzde neredeyse tüm bilimsel birikime online erişim vasıtasıyla ulaşmak mümkündür. Türkiye’de din bilimleri alanında yapılan araştırmalar da kütüphanelerin sınırlarını aşıp tüm dünyaya ulaşmayı hak etmekte-dir. Cumhuriyet İlahiyat Dergisi sahip olduğu format ve yayın ilkeleriyle uluslararası yayın kriterlerini karşılayarak son beş yılda çok hızlı bir (...) ivme kazanmış ve ilim dünyasının dikka-tini çekmeyi başarmıştır. Dergimiz bünyesinde geliştirilen İsnad Atıf Sistemi ve dergimizin öncülüğünde gerçekleştirilen çalıştaylar ile de İlahiyat Alan Dergilerine örneklik teşkil et-mektedir. Bu anlamda dergimizin hem yeni bir ekol oluşturduğunu hem de yazarlarımızdan aldığımız çok sayıda olumlu geri bildirimlere dayanarak akademik yayıncılığın kalitesini artıran bir okul vazifesi gördüğünü söylemek mümkündür. Dergimizin yeni sayısının yayınlanması vesilesi ile sizlerle iki güzel haberi paylaş-maktan mutluluk duyuyoruz. İlki Cumhuriyet İlahiyat Dergisi Scopus’ta taranan Türkiye menşeili ilahiyat dergileri arasında uluslararası atıf puanı ile 1. Sıraya yükselmiştir. Şu anda ilgili Indexte Türkiye menşeili üç ilahiyat dergisi bulunmaktadır. İkinci olarak ESCI indekste yer alan Dergimizin Web of Science tarafından izlenmesine devam edilmektedir. Yaklaşık iki yıldır süren izleme sürecinin sonunda dergimizin AHCI veya SSCI indekslere kabul edilme durumu bu yılın sonuna kadar sonuçlanacaktır. Web of Science temsilcileriyle görüşmele-rimiz ve dergi olarak akademik, etik ve teknik her türlü gerekliliği yerine getirmiş olmamız nedeni ile olumlu bir sonuç beklemekteyiz. 15 Haziran ve 15 Aralık’ta olmak üzere yılda 2 sayı ve 1 özel sayı yayınlamayı mis-yon edinmiş olan dergimiz yeni yayın döneminde de yoğun bir ilgiye mazhar olmuştur. 1ocak – 15 Mart 2020 döneminde Din Bilimlerinin birçok alanından 86 makale değerlendi-rilmek üzere dergimize ulaşmıştır. Yayın ilkelerimiz ve İsnad Atıf Sistemi gözönünde bulun-durularak gerçekleştirilen ön kontrolden sonra makaleler intihal tespit programı kullanıla-rak kontrol edilmiştir. Ön kotrolü tamamlanan ve benzerlik oranı %15’in altında olan maka-leler hakem değerlendirme sürecine gönderilmiştir. Bu sayımızda, söz konusu 86 çalışma içinden ön değerlendirme ve intihal taramasın-dan geçen, hakemlerimizin de akademik içerik açısından yayımlanmasını uygun bulduğu 25 orijinal araştırma makalesi sizlerin dikkatine sunulmuştur. Ayrıca bu sayımızda hakem süreci tamamlanan 14 makale Dergi Yayın Kurulumuz tarafından Aralık sayımızda yayın-lanmak üzere kabul edilmiştir. 15 Haziran 2020 itibariyle dergimizi tarayan ulusal ve uluslararası indeksler hakkın-da da sizlere bilgi sunmak istiyoruz. Dergimizi tarayan başlıca indeksler ve taramaya başla-ma tarihleri şöyledir: WORLDCAT (Başlangıç: 15/12/1996) ULAKBİM TR DİZİN (Kabul: 13/11/2015; 2012 Yılı 16. Cilt 1. Sayıdan itibaren) CROSSREF DOI (Başlangıç: 15/06/2014) OAJI / Open Academic Journals Index (Kabul: 08/08/2015) SHERPA/RoMEO (Kabul: 21/08/2015) INDEX COPERNICUS INTERNATIONAL (Kabul: 08/12/2015) OPENAIRE (Başlangıç: 15/12/2015) ERIH PLUS: The European Reference Index for the Humanities and the Social Scien-ces (Kabul: 25/03/2016) TEI: Türk Eğitim İndeksi (Kabul: 20/04/2015) DRJI: Directory of Research Journals Indexing (Kabul: 25/04/2016) ESJI: Eurasian Scientific Journal Index (Kabul: 29/04/2016) SIS: Scientific Indexing Services (Kabul: 04/05/2016) SAIF / Scholar Article Impact Factor (Kabul: 05/05/2016) SOBIAD: Sosyal Bilimler Atıf Dizini (Kabul: 07/05/2016) ATLA RDB©: ATLA Religion Database© - EBSCO (Başlangıç: 20/05/2016) PKP INDEX: Public Knowledge Project Index (Kabul: 09/06/2016) ASOS: Academia Social Science Index (Kabul: 15/06/2016) BROWZINE Academic Journal Collections (Kabul: 07/07/2016) J-GATE: E-Journal Gateway (Kabul / Accepted: 07/07/2016) ROAD: Directory Of Open Access Scholarly Resources (Kabul: 24/08/2016) DOAJ: Directory of Open Access Journals (Kabul: 02/09/2016) MLA International Bibliography -EBSCO ve ProQuest (Başlangıç: 14/06/2016) İDEALONLİNE: Türkçe Online Kütüphane (Kabul: 21/09/2016) CEEOL: Central and Eastern European Online Library (Kabul: 06/10/2016) EBSCO Humanities International Index (Başlangıç: 07/01/2016) EBSCO Humanities Source Ultimate (Başlangıç: 07/01/2016) RESEARCH BIB: Academic Resource Index (Kabul: 25/01/2017) CORE Database (Kabul: 30/01/2017) PHILPAPERS: Bibliography of Philosophy (Kabul: 01/02/2017) ROOT INDEXING: Journal Abstracting and Indexing (Kabul: 12/02/2017) SWI: Scientific World Index (Kabul: 17/03/2017) ESCI: Emerging Sources Citiation Index (Başlangıç: 01/01/2016) ProQuest (Kabul: 27/10/2017) EuroPub (Kabul: 08/11/2017) Index Islamicus (Kabul: 13/12/2017) Scopus (Başlangıç: 01/01/2016; 20/1; Kabul: 23/01/2018) Dergimizin 24. Cilt 1. Sayı’sında Din Bilimleri alanından birçok güncel ve ilgi çekici araştırmayı sizlere sunmaktan heyecan ve mutluluk duyuyoruz. Bize emanet edilen değerli çalışmaları uluslararası alana taşımak için geniş bir ekiple tüm gayretimizi gösterdiğimizi ifade etmek isteriz. Yeni sayımızda başta makale sahibi değerli bilim insanlarımıza, yayın, danışma ve hakem kurullarımıza, Rektörlüğümüz Basımevi personeline ve özellikle dergimizin yayın aşamasında değerli emekleri olan alan editörlerimiz Dr. Öğr. Üyesi Adem Çiftçi, Arş. Gör. Maruf Çakır, Arş. Gör. Esma Güneş, Arş. Gör. Bayram Ünce, Arş. Gör. Sena Kaplan, Arş. Gör. Gülistan Aktaş, Arş. Gör. Hamit Demir, Arş. Gör. Merve Yetim, Arş. Gör. Rukiye Göğen, Arş. Gör. Ömer Faruk Özbek, Arş. Gör. Salime Bera Kemikli, Arş. Gör. Naim Yaman, Arş. Gör. Sema Tombul, Arş. Gör. Nurgül Akdoğan, Arş. Gör. Ayşe Mine Akar, Arş. Gör. İlknur Bahadır, Arş. Gör. Mustafa Said Akdoğan, Arş. Gör. Adil Koyucu ile Arapça dil editörü Prof. Dr. Ömer Faruk Yavuz ve İngilizce dil kontrolü sorumluluğunu üstlenen alan editörlerimiz Dr. Öğr. Gör. Miyase Yavuz Altıntaş, Dr. Öğr. Üyesi Zuhal Ağılkaya Şahin, Dr. Metin Güven, Dr. Öğr. Üyesi Kenan Tekin ve Dr. Öğr. Gör. Hakime Reyyan Yaşar’a teşekkürlerimizi sunarız. 15 Aralık 2020’de yayınlanacak bir sonraki sayımız için makale kabul tarihlerinin yayın kurulumuz tarafından 1 Temmuz -1 Eylül olarak değiştirildiğini hatırlatır çalışmaları-nızda kolaylıklar dileriz. (shrink)

Cet article a déjà paru dans les Annales Littéraires de l'Université de Franche-Comté N° 16, Besançon, Presses Universitaires de Franche-Comté, 2003, p. 59-88 et mis en ligne un première fois sur Semen le 01 mai 2007 ici. Nous remercions chaleureusement Jacques-Philippe Saint-Gérand de nous en avoir autorisé la reproduction [1]. Nom, fiction et diction du rythme… les dictionnaires… Les dictionnaires sont objets de référence ambigus. Outre leur situation définie dans l'espace et le temps des évolutions - XVIIIe siècle – Nouvel (...) article. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:_Russell_ journal (home office): E:CPBRRUSSJOURTYPE2602\REVIEWS.262 : 2007-01-24 01:12 eviews THE DENOTING CENTURY, 1 19 90 05 5– –2 20 00 05 5 Michael Scanlan Philosophy / Oregon State U. Corvallis, or 97331, usa [email protected] Guido Imaguire and Bernard Linsky, eds. On Denoting: 1905–2005. Munich: Philosophia Verlag, 2005. Pp. 451. 98.00. isbn 3-88405-091-5. his anniversary collection of papers connected with Russell’s 1905 publiTcation of “On Denoting” reflects both the almost (...) mythic status that paper has achieved in analytic philosophy and the quite variegated nature of the significance that philosophers have seen in it. The papers in this collection break down roughly into two sorts. There are those which take a historical approach and attempt to explicate various aspects of the content of the OD article. The other sort might be labelled “application” papers in which Russell’s analysis in OD is seen as a tool or a model for subsequent philosophical work, in the spirit of Ramsey’s much quoted “paradigm of philosophy” remark. The volume opens with a reprint of the OD text with pagination indicated for the original Mind printing, for the text in Collected Papers 4 and for the widely referenced Logic and Knowledge Russell collection edited by R. C. Marsh. The Mind and Papers texts use the American convention of single quotation marks within double quotation marks. The Marsh edition (and the text given here) uses the inverse British convention. Readers need to be aware that paper authors here, and elsewhere, vary in which text they cite. The end of the volume has a comprehensive 21-page bibliography of the secondary literature. In between there are thirteen papers. I will be rather brief with the “application” papers, since I believe that Russell readers will tend to favour the more historically oriented papers. Some of the application papers wander quite far afield from Russell’s treatment of definite descriptions. For instance the paper by Thomas Mormann on “Description, Construction and Representation from Russell and Carnap to Stone” takes off from Russell’s assertion that his theory of descriptions was an early version of his subsequent interest in substituting “constructions” for “inferred entities” such as space-time points. The paper is almost exclusively a (worthwhile and mathematically astute) analysis of Russell’s efforts along these lines in Our russell: the Journal of Bertrand Russell Studies n.s. 26 (winter 2006–07): 167–90 The Bertrand Russell Research Centre, McMaster U. issn 0036-01631 _Russell_ journal (home office): E:CPBRRUSSJOURTYPE2602\REVIEWS.262 : 2007-01-24 01:12 168 Reviews Knowledge of the External World and The Analysis of Matter. The author argues that Russell’s constructions did not actually achieve the effects he wanted, but that (curiously) they can be properly developed within the later framework of topological spaces developed by Marshall Stone in 1937. The paper by Guido Imaguire, “Theory of Descriptions and Inferential Semantics”, explicitly eschews an “exegetical” approach and allies itself with a “systematical approach, in which one analyses possible new features and extensions of the proposed theory” (p. 397). The extension considered here is to “inferential semantics”, especially that of Robert Brandom. The spirit of this approach is to take the semantics of a language to be determined by the set of allowed inferences within that language. Imaguire takes as an essential lesson of Russell’s theory of descriptions that definite descriptions and proper names cannot be treated as singular terms of a language in the same manner. He goes on to argue for a criterion for distinguishing proper names from definite descriptions based on inferences allowed between sentences containing them, and he takes this distinction to argue for a modification of Brandom’s treatment of singular terms in his inferential semantics. Elena Tatievskaya’s paper on “Russell’s Theory of Descriptions and Wittgenstein on Internal Properties of Propositions” is another paper that is mainly about something other than Russell and his theory of descriptions. It is a very detailed study of Wittgenstein’s attempt to make good on his claim that the logical symbols of propositional logic notation, such as v and ~, do not correspond to “logical” components of propositions (Tractatus... (shrink)

To evaluate the moral awareness of college students regarding artificial intelligence (AI) systems, we have examined 467 surveys collected from 152 Japanese and 315 non-Japanese students in an international university in Japan. The students were asked to choose a most significant moral problem of AI applications in the future from a list of ten ethical issues and to write an essay about it. The results show that most of the students (n = 269, 58%) considered unemployment to be the major (...) ethical issue related to AI. The second largest group of students (n = 54, 12%) was concerned with ethical issues related to emotional AI, including the impact of AI on human behavior and emotion and robots’ rights and emotions. A relatively small number of students referred to the risk of social control by AI (6%), AI discrimination (6%), increasing inequality (5%), loss of privacy (4%), AI mistakes (3%), malicious AI (3%), and AI security breaches (3%). Calculation of the z score for two population proportions shows that Japanese students were much less concerned about AI control of society (− 3.1276, p < 0.01) than non-Japanese students, but more concerned about discrimination (2.2757, p < 0.05). Female students were less concerned about unemployment (− 2.6108, p < 0.01) than males, but more concerned about discrimination (2.4333, p < 0.05). The study concludes that the moral awareness of college students regarding AI technologies is quite limited and recommends including the ethics of AI in the curriculum. (shrink)

Institutional discrimination matters. The purpose of this longitudinal community‐based participatory research study was to examine institutional procedural discrimination, institutional racism, and other institutional discrimination, and their relationships with participants' health during a maternal and child health program in a municipal initiative. Twenty participants from nine multilingual, multicultural community‐based organizations were included. Overall reported incidences of institutional procedural discrimination decreased from April 2019 (18.6%) to November 2019 (11.8%) although changes were not statistically significant and participants reporting incidences remained high (n = (...) 15 in April and n = 14 in November). Participants reported experiencing significantly less “[when] different cultural ways of doing things were shared, the project did not support my way” from April 2019 (23.5%, n = 4) to November 2019 (0%, n = 0), Wilcoxon signed‐rank test Z = −2.00, p < 0.05. Some participants reported experiencing institutional racism (29.4%, n = 5) and other institutional discrimination (5.9%, n = 1). Participants experiencing institutional racism, compared to those who did not, reported a higher impact of the Initiative's program on their quality of life (t = 3.62, p < 0.01). Participatory survey designs enable nurse researchers to identify hidden pathways of institutional procedural discrimination, describe the impacts experienced, and examine types of institutional discrimination in health systems. (shrink)

Compared to institutional and area-based ethics committees, little is known about the structure and activities performed by ethics committees at national medical organizations and societies. This five year follow-up study aimed to determine (1) the creation and function of ethics committees at medical organizations in Japan, and (2) their general strategies to deal with ethical problems. The study sample included the member societies of the Japanese Association of Medical Sciences (n=92 in 1998, n=96 in 2003). Instruments consisted of two sections: (...) (1) the structure, function and activities of ethics committees, and (2) the strategies for dealing with ethical problems. Response rates were 84.4% in 1998 and 64.4% in 2003. Findings showed a significant increase of ethics committees at medical organizations between 1998 (25.6%) and 2003 (50.0%). Members were mostly male, medical doctors in clinical or basic medicine, and members of the organization. The major functions of ethics committees were ethical reviews of research protocols, policy making and ethical reviews of manuscripts submitted for journal publication. Among organizations that did not have an ethics committee, a significant decrease was found in organizations that replied that they had never experienced an ethical problem which needed further investigation (p<0.01). Findings suggested an overall rise in awareness of the importance of ethical issues and also highlighted an increase in recognition of responsibility regarding ethical problems. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:russell: the Journal of Bertrand Russell Studies n.s. 33 (winter 2013–14): 173–90 The Bertrand Russell Research Centre, McMaster U. issn 0036–01631; online 1913–8032 c:\users\kenneth\documents\type3302\rj 33,2 114 red.docx 2014-01-31 8:29 PM oeviews MODES AND LEVELS OF PERPLEXITY I. Grattan-Guinness Middlesex U. Business School Hendon, London nw4 4bt, uk [email protected] John Ongley and Rosalind Carey. Russell: a Guide for the Perplexed. London: Bloomsbury, 2013. Pp. ix, 212. isbn: 978-0-8264-9753-6. £45 (hb), (...) £14.99 (pb); us$80 (hb), us$24.95 (pb). i his book is the 41st in a series of guides to the work of various philosophers and philosopher groups, written at a level of readability for students. The authors survey the course of Bertrand Russell’s philosophical career, starting out with his work on logic and mathematics. The main philosophical tools are presented: in logic, they are term, proposition, proposition function, relation, paradox, and first- vis-à-vis higher-order logic. Then, moving on to epistemology, the principal philosophical notions are presented, such as sense-data, facts related to language, Russell’s overriding preference for positivistic philosophies and suspicions of metaphysics, knowledge by acquaintance and by description, theories of truth, logical atomism, percept, events, meaning, and inference in the context of scientific theories. It is nice to have many of the principal components of Russell’s philosophy exhibited together, including the later works An Inquiry into Meaning and Truth and Human Knowledge. The perplexed reader would like to be given precise references for Russell’s assertions on various points, especially when he was so prolific. A cited short item does not need more precision; but the two main chapters that cover the logic and epistemology story often seem to invoke The Principles of Mathematics or Principia Mathematica and yet contain only one precise citation of a longer text in their 64 pages (p. 85). The other chapters of the book are somewhat better in this respect. The index is excellent, though W. V. Quine was missed at pp. 29–30. The table of contents would have benefited from including the titles of the sections. q= 174 Reviews c:\users\kenneth\documents\type3302\rj 33,2 113 red.docx 2014-01-15 10:04 ii Much ground is covered; however, the account is mitigated by the failure to provide a biographical factual survey that should have constituted the opening chapter. Little or no description or explanation is given of, among others, Cambridge University, its mathematical tripos, Russell’s research fellowship in 1895, the philosophical journals Mind and The Monist, Russell’s conversion from neo-Hegelian to positivistic philosophy following G. E. Moore around 1899, the start of personal contacts with Giuseppe Peano in 1900, the gradual involvement of A. N. Whitehead from around 1902, the financial rescue of Principia Mathematica by the grant from the Royal Society in 1909, the serious mistake in Volume 2 detected by Whitehead in 1911 while it was in press, the initial contact with Ludwig Wittgenstein from 1911, Russell’s switch from logic to epistemology in the early 1910s, Whitehead’s intentions for the fourth volume of Principia that was abandoned in 1918, the circumstances of the second edition published in the mid-1920s, Russell’s partial return to serious philosophical writings from the mid-1930s onwards, or the Trinity fellowship from 1944. Presumably the authors have made most of these omissions intentionally ; but the target audience is the loser. The opening “introduction” does mention some of these events and publications ; but its purpose is to provide a preliminary look at some of the main features of Russell’s logic, including the comprehension axiom “that every predicate defines a class” (p. 3), type theory, definite descriptions, “the noclass theory of classes” (p. 10), and the status and role of “analysis”. Why do these features need prologues when the others do not? When they are re-discussed in the later chapters on logic and epistemology, several near-repetitions occur. Furthermore, quantification does not receive sufficient consideration in the book; and the logical connectives and rules of inference none at... (shrink)

Background and PurposeMany critically ill patients in intensive care units (ICUs) are unable to communicate their wishes about goals of care, particularly about the use of life-sustaining treatments. Surrogates and clinicians struggle with medical decisions because of a lack of clarity regarding patients’ preferences, leading to prolonged hospitalizations and increased costs. This project focused on the development and implementation of a tool to facilitate a better communication process by (1) assuring the early identification of a surrogate if indicated on admission (...) and (2) clarifying the decision-making standards that the surrogate was to use when participating in decision making. Before introducing the tool into the admissions routine, the staff were educated about its use and value to the decision-making process.Project and MethodsThe study was to determine if early use of a simple method of identifying a patient’s surrogate and treatment preferences might impact length of stay (LOS) and total hospital charges. A pre- and post-intervention study design was used. Nurses completed the surrogacy information tool for all patients upon admission to the neuroscience ICU. Subjects (total N=203) were critically ill patients who had been on a mechanical ventilator for 96 hours or longer, or in the ICU for seven days or longer. The project included staff education on biomedical ethics, critical communication skills, early identification of families and staff in crisis, and use of a simple tool to document patients’ surrogates and previously expressed care wishes. Data on hospital LOS and hospital charges were collected through a retrospective review of medical records for similar four-month time frames pre- and post-implementation of the assessment tool.ResultsSignificant differences were found between pre- and post-groups in terms of hospital LOS (F=6.39, p=.01) and total hospital charges (F=7.03, p=.009).ConclusionsProject findings indicate that the use of a simple admission assessment tool, supported by staff education about its completion, use, and available resources, can decrease LOS and lower total hospital charges. The reasons for the difference between the pre- and post-intervention groups remain unclear. Further research is needed to evaluate if the quality of communications between patients, their legally authorized representatives, and clinicians—as suggested in the literature—may have played a role in decreasing LOS and total hospital charges. (shrink)

ContextPeople with mental disorders can acquire long-term disabilities, which could impair their functioning and quality of life (QoL), requiring permanent care and social support. Systematic data on QoL and functioning, which could support a better management of these people, were not available.ObjectiveTo analyze the QoL, level of functioning and their association with sociodemographic and clinical factors of people with mental disorders who underwent deinstitutionalization using assisted living facilities.MethodsA Cross-sectional study was conducted between July 2018 and July 2019, through interviews using (...) the World Health Organization Quality of Life (WHOQOL-BREF) to determine the QoL scores, and the World Health Organization Disability Assessment Schedule (WHODAS 2.0) to determine the level of functioning. All adults (≥18 years old) with mental disorders, who underwent deinstitutionalization, users of assisted living facilities and assisted by the Psychosocial Assistance Centers III, in a city in the state of São Paulo, Brazil, were selected. For statistical analysis of the associated factors, Student’st-test was used for dichotomous variables and ANOVA for polynomial variables. Pearson correlation coefficient was used to measure the association between QoL and functioning scores.ResultsOut of 359 people who underwent deinstitutionalization with mental disorders, 147 met the eligibility criteria. The mean total score for the WHOQOL-BREF was 66.5 ± 13.4 and the mean score for WHODAS 2.0 was 10.4 ± 7.6. An association was found between people who were studying (n= 65.8; 95%CI, 63.5–68.1vs. n= 73.9; 95%CI, 67.5–80.3;p= 0.04) and better WHOQOL-BREF QoL scores or WHODAS 2.0 levels of functioning (n= 10.9; 95%CI, 9.6–12.2vs. n= 5.1; 95%CI, 2.5–7.7;p= 0.01). A weak negative correlation (r= 0.41) emerged between higher QoL scores and functioning improvement.ConclusionThis study indicates that the QoL of the sample is associated by their functioning levels, which, in turn, may reflect on their social interactions. Public policies that favor interventions increasing socialization of this population can result in better health outcomes. The QoL and functioning scores provide valuable insights to develop public policies more suited to this population profile. (shrink)

Objectives: To investigate the current situation of completing the informed consent for do-not-resuscitate (DNR) orders among the competent patients with terminal illness and the ethical dilemmas related to it. Participants: This study enrolled 152 competent patients with terminal cancer, who were involved in the initial consultations for hospice care. Analysis: Comparisons of means, analyses of variance, Student’s t test, χ2 test and multiple logistic regression models. Results: After the consultations, 117 (77.0%) of the 152 patients provided informed consent for hospice (...) care and DNR orders. These included 21 patients (17.9%) who signed the consent by themselves, and 96 (82.1%) whose consent sheet was signed only by family members. The reasons why patients were not involved in the discussions toward the consent (n = 82) included poor physical or psychological condition (44.9%), concerns of the consultant hospice team (37.2%), and the family’s refusal (28.2%). On a multivariate analysis, patients’ awareness of their poor prognosis (odds ratio = 4.07, 95% confidence interval = 2.05 to 8.07) and their understanding of hospice care (2.27, 1.33 to 3.89) were two independent factors (p<0.01) that influenced their participation in the discussions or their personal signature in the informed consent. Conclusion: The family-oriented culture in Asian countries may violate the principles of the Patient Self-Determination Act and the requirements of the Hospice Care Law in Taiwan, which inevitably poses an ethical dilemma. Earlier truth-telling and continuing education of the public by hospice care workers will be helpful in solving such ethical dilemmas. (shrink)

The alleged robustness of Z, t, and F tests against nonnormality and, when sample sizes are equal, of t and F tests against heterogeneity as well was investigated in a large-scale sampling study under conditions realistic to experimentation and testing in the behavioral sciences. Factors varied were: population shape (L or bell), σ1/σ2 (1/2, 1, or 2), size N of smallest sample (2, 4, 8, 16, 32, 64, 128, 256, 512, or 1,024), N1/N2 (1/3,1/2,1, 2, or 3), α (.05,.01, or.001), (...) and test tailedness (left, right, or two). In about 25% of the situations investigated, the test failed to meet a very lax criterion for robustness at every examined N value less than 100, and in 8% at every value less than 1,000; no test met the criterion in all of the situations studied before N=512. Robustness was strongly influenced by all of the factors investigated, and interactions among the influencing factors were often strong and complex. (shrink)