Today, health systems around the world are under pressure to create greater value for patients and society [81, p. 1, 119]; increasing access, improving client orientation and responsiveness, reducing medical errors and safety, restraining utilization via managed care, and implementing priority allocation of resources for high-burden health problems are examples of strategies towards this end. The quality paradigm by virtue of its strategic consumer focus and its methods for achieving operational excellence has proved an effective approach for creating higher value (...) in many sectors. If applied in a deliberate and holistic manner, the quality paradigm can bring about a more cost-effective organization of the health systems. In this article, we apply quality concepts to healthcare in a conceptual format; we characterize the health system’s customers and outputs with their quality dimensions. The product of this effort is a blueprint for a customer-driven health system which identifies six types of customers, nine types of outputs and the associated operations. As a preliminary step, a new analysis and definition of health and disease is provided. Rethinking the structure of health system in this manner and the related conceptual model can guide medical research, health sciences education, and health services policy, and help the practitioner to integrate all modern trends in healthcare delivery. (shrink)

This qualitative research study with a content analysis approach aimed to explore families’ experiences of an organ donation request after brain death. Data were collected through 38 unstructured and in-depth interviews with 14 consenting families and 12 who declined to donate organs. A purposeful sampling process began in October 2009 and ended in October 2010. Data analysis reached 10 categories and two major themes were listed as: 1) serenity in eternal freedom; and 2) resentful grief. The central themes were peace (...) and honor versus doubt and regret. The findings indicated that the families faced with an organ donation request of a brain-dead loved one experienced a lasting effect long after the patient's demise regardless of their decision to donate or refusal to donate. In conclusion, this study highlights the importance of family support and follow-up in an efficient healthcare system aimed at developing trust with the families and providing comfort during and after the final decision. (shrink)

Dignity is the most fundamental right of every human being, patients in particular. Despite being a fairly disputed concept, dignity is a multidimensional issue, the interpretation of which is affected by a multitude of factors. Semistructured interviews and observation data from 35 patients, their companions, and nurses were performed to highlight their views with regard to patients? dignity in health care centers. Although findings reveal that nearly all patients felt that their dignity had been violated, there is a considerable difference (...) between participants? viewpoints of dignity. Interactions among participants can increase their awareness of dignity and may lead to its maintenance. (shrink)

Publication date: 26 January 2017 Source: Author: Abolfazl Mohammadi, Javad Momeni Angela Carter in her famous short story, The Bloody Chamber, depicts a protagonist whose identity seems to be a predetermined sign in a signifying loop from which she can make no escape. In the first part of our paper, we attempt to show how The protagonist’s ensuing psychological tension is aggravated by the conflict which she feels between her ideal ego and her ego-ideal and which leads her to (...) unrelenting introspection and interior dialogue with her existential states. Such interior dialogue provides the protagonist with an existential ground on which she empties all her life events of their presence by signifying them through Derridean Differance. Therefore, her interior dialogue results in non-identity in her subjectivization both in the realm of signs and of events. Then, we focus on the protaganist’s paradoxical urges spontaneously outflowed from within which, by resisting symbolization, provide her with the possibility of becoming what she thinks she has never been and allow for her moments of self-determination. Finally, we illustrate how such psychological odyssey takes shape in the Gothic setting which arouses, in Lacanian terminology, pre-symbolic tendencies and which involves the coincidence of Gothic horror with the horrors of social reality. (shrink)

The sixteenth-century Cossacks became the favourite topic of Ukrainian authors of the nineteenth century who dealt with national and individual identity issues. Nikolai Gogol, the celebrated Russian author who had Ukrainian origin and was born in a Cossack village, wrote the epic romance of Taras Bulba, which narrated the story of Cossacks and their struggle for preserving their independence. While the work has been previously studied under the light of postcolonial theoretical framework, using the concepts developed by Homi Bhabha to (...) scrutinize the situation and the destiny of the two main hybrid characters, Taras Bulba’s sons, takes a step further and reveals the deeply ingrained anxiety and ambivalence in the Cossack mentality. The article focuses on the two main hybrid characters who choose divergent paths upon encountering the conflict brought to them by the imperial power. (shrink)

Muḥammad Amīn b. Mīrzā Muḥammad Zamān Bukhārī, Muḥīṭ al-Tavārīkh. Edited by Mehrdad Fallahzadeh and Forogh Hashabeiky. Studies in Persian Cultural History, vol. 4. Leiden: Brill, 2014. Pp. ix + 112 + 388. $216, €167.

Next SectionPurpose The importance of recognising patient dignity has been realised in recent years. Despite being a central phenomenon in medicine, dignity is a controversial concept, the definition of which in healthcare centres is influenced by a multitude of factors. The aim of this study was to explore the perspective of Iranian patients on respect for their dignity in healthcare centres. Methods With the use of purposeful sampling, 20 patients were interviewed over an 11-month period in three educational hospitals affiliated (...) with the government. They were questioned about experiences related to respect for their dignity during their hospital encounter. Data were processed by qualitative content analysis. Results Data analysis identified nine categories and four themes. Respondents expressed their expectations and attitudes about dignity by the following themes: seeking a haven; disrespecting privacy; communicating in a vacuum; and disregard for secondary caregivers. They described how respect for their privacy, effective communication, access to facilities, and a regard for the requirements of their companions made them feel that their dignity had been conserved. Conclusions The findings indicate that almost no patient is satisfied with the quality of services with respect to maintenance of their dignity. Regardless of their hospital location and state of health, most participants had common complaints. These findings agree with the literature and confirm that grounds should be provided for conserving dignity in the healthcare system. To reach this goal, healthcare professionals should be aware of the factors that violate or preserve dignity from the patient's perspective. (shrink)

Introduction: Maintaining dignity is one of patients is one of the main ethical responsibilities of caregivers. However, in many cases, the dignity of patients, especially autistic teenagers is not maintained. The extent to which dignity needs are met for this group within the Iranian care system is difficult to determine as dignity is an abstract concept, and there are few related research studies reported. Objectives: The objective of this study is to find out caregivers perspectives on dignity in teenagers with (...) autistic spectrum disorder. Research design: This study uses a qualitative research design. The data were collected through individual, semi-structured interviews and field notes developed during the interviews. In order to analyze the data, qualitative conventional content analysis was used. Participants and research context: In all, 16 professional caregivers for autistic teenagers working in public hospitals were recruited based on a targeted sampling method to reach data saturation from February 2016 to July 2017. Findings: The findings of this study were presented in three main themes, “privacy,” “respecting individual identity,” and “comprehensive support,” and 11 categories. Ethical consideration: This study’s protocol was approved by the Research Ethics Committee of medical universities located in Southeast of Iran and the required ethical principles were followed throughout. Discussion and conclusion: Based on the findings of this study from the perspective of caregivers, autistic teenagers need to be cared for and educated in a respectful environment where their privacy is maintained, their individual identities are respected, and they receive comprehensive familial, social, and financial support. These conditions would maintain the dignity of such teenagers and would result in appropriate behavioral outcomes. Therefore, it is suggested that a cultural, professional and institutional background in which all components of the autistic teenager’s dignity are protected and emphasized be provided. (shrink)

Introduction: Maintaining patient dignity in a caregiving environment is one of the most important moral responsibilities for caregivers. Nonetheless, there are vulnerable groups, specifically teenagers, who in their final stages of life are prone to their dignity being threatened. Moreover, dignity is an abstract concept and there is no studies done on teenagers’ dignity in the final stages of life available in Iran.Purpose: The purpose of this study is to describe the caregivers’ experiences regarding teenagers’ dignity in the final stages (...) of life.Research design: This study is a descriptive phenomenological qualitative research project. The data was collected using deep individual and semi-structured interviews as well as taking notes. The Colaizzi analysis method was used to analyze the data.Participants and research context: 22 caregivers working with teenagers in the final stages of life in a public health centers in Iran who had the criteria to enter the study were selected using a purposeful sampling method and invited to join the study from August 2018 to June 2019. The sampling continued until data saturation.Findings: The findings of the present study were presented in the form of three main themes including “private,” “respecting individual identity,” and “attention to teenagers’ needs” and an additional eight categories.Ethical Considerations: The study’s protocol was approved by the Research Ethics Committee of the Shiraz University of Medical Sciences and all ethical principles were followed throughout the study.Discussion and conclusion: Based on the present study from the caregivers’ point of view, teenagers in their final stages of life required to be cared for and taught in an environment that their privacy was maintained and their individual identity was respected as well as getting attention from the caregivers and companions. In such situations, the teenagers felt calm and their dignity was maintained; therefore, providing a cultural, professional, and organizational setting where all the components of maintaining dignity in teenagers are supported and prioritized is necessary. (shrink)

BackgroundBurn patients are among the most vulnerable groups of patients requiring principled ethical care. Caring for these patients often brings various ethical challenges for the members of the health care teams, especially nurses, which affect the clinical decisions made for these patients. A limited number of studies have addressed the ethical challenges of caring for burn patients for the responsible caregivers, so the present study attempted to identify these challenges. The present study aimed to explore the health professionals' experiences of (...) the ethical challenges during caring for burn patients.MethodsThis was a qualitative study with a descriptive, phenomenological design. 22 health professional practiced in public burn centers in Iran who met the inclusion criteria of the study were selected via purposeful sampling to participate in the study from June to August 2019. Data were collected using semi-structured, in-depth interviews with the individuals as well as field notes. Sampling was continued up to the data saturation. Thereafter, the collected data were analyzed using Colaizzi's method.ResultsThe findings of the study yielded 3 themes, including respect for the patient's privacy, respect for the patient's personal identity, and care challenges, as well as 9 categories.ConclusionThe findings of this study showed that the burn patients’ caregivers face some challenges in the domains of maintaining the patient's privacy, respecting the patient’s personal identity, and making the best clinical decision. Thus, providing the cultural, professional, and organizational requirements of meeting the challenges of caring for burn patients can consequently result in the caregivers’ inner peace and the improved performance. (shrink)

Defining the Perian word, ‘Fotowat’ or ‘Chivalry’ is not an easy task; in the rite of ‘Fotowat’, before entering any profession, one must set one’s soul free and pay attention to the moral teaching...

The later Wittgenstein presents all kinds of knowledge in the form of language games based on forms of life. One of the implications of his later views is that certain language games and forms of life are incommensurable. Since each person can know the world only through his/her own form of life and language game, those who subscribe to entirely different language games cannot have a proper understanding of the forms of life of others. They are not able to critique (...) and evaluate their knowledge of reality unless they abandon their own customary forms of life and internalize other forms of life that they want to know about, that is, to become a member of a society based on those different forms of life. In contrast, Popper emphasizes the objective nature of knowledge by considering external reality as a major criterion of objectivity. Popper maintains that the growth of human knowledge takes place through a never-ending process of critical evaluation of previous knowledge claims and a continuous supply of new conjectures for capturing reality and their critical appraisal incessantly. In this article, following a brief description of the philosophical approaches of Wittgenstein and Popper (Sections 1 and 2), and a brief explanation of the anti-relativist attitude of critical rationalism (Section 3), we turn to a critical assessment of Wittgenstein's relativist approach through the prism of Critical Rationalism (Section 4). The last chapter of the article (Section 5) is dedicated to a brief recap of the topics discussed in the earlier sections. (shrink)

Has the theory of rationality as ‘openness to criticism’ solved the problem of ‘rational belief in reason’? This is the main question the present article intends to address. I respond to this question by arguing that the justified true belief account of knowledge has prevented Karl Popper’s critical and William Bartley’s pan-critical rationalism from solving the problem of rational belief in reason. To elaborate this response, the article presents its arguments in three stages: First, it argues that the idea of (...) objective knowledge as justified true belief leads to the equation of objective knowledge with justification. Hence, if we base the theory of critical rationalism, as openness to criticism, upon such a conception of knowledge, our theory of rationality involves in infinite regress of proofs. Second, it argues that Popper describes critical rationalism as an ‘irrational attitude’ of openness to criticism because the rationalist cannot justify his belief in reason by argument or experience. Thus, since Popper assumes that ‘a belief in reason’ must be justified in order to be ‘rational’ he cannot lead to a solution for the problem of rational belief in reason. Third, it argues that, like Popper’s critical rationalism, Bartley’s pan-critical rationalism originates in the justified true belief account of knowledge, however, not because Bartley defines critical rationalism as irrational faith in reason, but because his theory does not tell us how an ‘open’ belief in reason is to be refuted logically. The reason for this failure is that Bartley uses Popper’s epistemology of science to define the conception of criticism. While Popper and Bartley are recognized as the non-justificationist philosophers of science and rationality, this article tries to reveal that the idea of objective knowledge as justified true belief has prevented them from showing how ‘a rational belief in reason’ can be defended by argument. The article also briefly shows the consequence of this study for a notable change in the logical foundations of science. (shrink)

Background Providing care to children with cancer is one of the most challenging areas of ethical care for nurses. Few studies have addressed nurses’ perception of the barriers to giving ethical care in oncology departments. Thus, it is essential that the ethical challenges in caregiving as perceived by oncology nurses be investigated. Objective The present study was conducted to investigate the ethical challenges as perceived by nurses in pediatric oncology units in the south of Iran. Research design The present study (...) is a qualitative work of research with a conventional content analysis design. Data were collected via individual semi-structured interviews. The collected data were analyzed using the qualitative content analysis method. Participants and research context The participants were 21 nurses from pediatric oncology units in state hospitals who were selected by purposeful sampling. Sampling continued until the data were saturated. The study lasted from April to October 2022. Findings Three main themes, promoting psychological safety in the children, respect for the dignity of the children, and expansion of support for families, and nine subthemes were extracted from the data. Ethical considerations The study’s protocol was approved by the Research Ethics Committee of the University of Medical Sciences and ethical principles were followed throughout the study. Discussion and conclusion From the nurses’ perspective, the major ethical challenges in providing ethical care in pediatric oncology units were reducing tension toward promoting the patients’ psychological safety, showing respect for the identity and dignity of the children with cancer, and expanding support of the patients’ families. By creating the right cultural and professional context and establishing proper protocols, healthcare policymakers and administrators can take effective steps toward eliminating the barriers to providing ethical care. (shrink)

This study examined the longitudinal associations among children’s direct aggression, prosocial behaviors, and peer group acceptance in middle childhood. Children’s co-occurring aggressive and prosocial behaviors were assessed in order to identify distinct trajectory subgroups. Subsequently, variations in the development in peer acceptance were examined for each of the identified subgroups. The sample consisted of 784 children who were ethnically and socioeconomically diverse who were followed longitudinally from Grades 1 to 4. Results revealed several distinct trajectory subgroups, including children who were (...) primarily aggressive or prosocial, as well as children who exhibited co-occurring aggression and prosocial behaviors. Comparing these subgroups, the use of co-occurring prosocial behaviors appeared to have some protective effect on aggressive children’s peer acceptance. However, aggression was nonetheless associated with lower peer acceptance. The findings provide insights pertaining to the heterogeneity among aggressive children, the protective effects of prosocial behaviors on peer acceptance, and the differential effects of moderate versus high aggression. (shrink)

"Certainty" occupies an important place in Wittgenstein’s epistemology: it does not belong to the category of knowledge but constitutes its foundation. In his view, knowledge boils down to language games, and language games are based on indubitable certainties. According to Wittgenstein, scepticism is meaningless, and if there is no certainty, then even doubt would be meaningless. Wittgesntein maintains that [relative] doubt and knowledge are epistemic categories, whereas absolute doubt and certainty are non-epistemic categories. Epistemic categories are meaningful and when expressed (...) by means of statements could be either true or false. In contrast, non-epistemic categories are meaningless and when expressed by means of statements the properties of truth and falsehood do not apply to them. The aim of the present paper is two fold: 1- Providing an explanation of the status of certainty in comparison to categories such as doubt and knowledge in Wittgenstein’s thought; 2- Providing a critical assessment of Wittgenstein's approach to certainty through the prism of critical rationalism. The main arguments of the paper are as follows: 1. Although Wittgenstein considers certainty to be meaningless and therefore not on a par with epistemological categories, he regards it as an objective concept that functions as the foundation upon which all human knowledge is based; 2. Wittgenstein's efforts to show the objectivity of certainty have not been entirely successful, partly due to his reliance on a defective notion of ‘objectivity’ and partly as a result of the prominence he assigns to the category of ‘meaning’ at the expense of the category of ‘truth’. (shrink)

Publication date: 11 June 2018 Source: Author: Fatemeh Nemati Sogolitappeh, Amjad Hedayat, Mehrdad Rezaee Arjmand, Mohamad Khaledian The purpose of the present study is to investigate the relationship between spiritual intelligence and emotional intelligence with resilience in undergraduate students. The population of the study included all students of Payam Noor University in Ghorveh during 2016-2017 academic years. According to the principles of statistical methodology for correlational studies, 100 students from different disciplines were selected as sample of the study using (...) simple random sampling method. In this research, King's Spiritual Intelligence Questionnaire, Bar-Ann 90-questions Emotional Intelligence Questionnaire, and Conner and Davison resilience questionnaire were used. Descriptive statistics and inferential statistics were used to analyze the data. The results of this study showed that there is a significant positive correlation between spiritual intelligence and emotional intelligence and resilience. Regression coefficients showed that spiritual intelligence and emotional intelligence predict 53.9% of the variation in resiliency. (shrink)

Background Maintaining the dignity of patients who attempted suicide is one of the caregivers’ main ethical duties. Yet, in many cases, these patients are not treated with dignity. The concept of dignity is abstract, and there is no research on the dignity of suicidal patients. So, the present study is done to investigate psychiatric nurses’ perception of dignity in patients who attempted suicide. Objective The present study explores the concept of dignity in patients who attempted suicide from the perspective of (...) psychiatric nurses. Research design The present study is a qualitative, descriptive work of research Participants and research context A total of 20 psychiatric nurses from 2 hospitals affiliated with a university of medical sciences in the southeast of Iran were selected via purposeful sampling. Ethical considerations The Research Ethics Committee of the Hamadan University of Medical Sciences approved the study’s protocol, and ethical principles were followed in general. Findings From the findings of the study, three main themes, namely “ respect for personal; identity,” “management of psychological tension,” and “compassion-focused therapy,” with 12 sub-themes were extracted. Discussion and conclusion In the perspective of caregivers, patients who attempted suicide need to be cared for in supportive environments with compassionate and respectful behaviors to control their psychological tensions. These conditions would maintain such patients’ dignity and result in appropriate behavioral outcomes. Policy-makers and administrators can use the present study’s findings to create an appropriate clinical environment in which the dignity of patients who attempted suicide is properly maintained. (shrink)

Flooding is one of the most damaging natural hazards globally. During the past three years, floods have claimed hundreds of lives and millions of dollars of damage in Iran. In this study, we detected flood locations and mapped areas susceptible to floods using time series satellite data analysis as well as a new model of bagging ensemble-based alternating decision trees, namely, bag-ADTree. We used Sentinel-1 data for flood detection and time series analysis. We employed twelve conditioning parameters of elevation, normalized (...) difference’s vegetation index, slope, topographic wetness index, aspect, curvature, stream power index, lithology, drainage density, proximities to river, soil type, and rainfall for mapping areas susceptible to floods. ADTree and bag-ADTree models were used for flood susceptibility mapping. We used software of Sentinel application platform, Waikato Environment for Knowledge Analysis, ArcGIS, and Statistical Package for the Social Sciences for preprocessing, processing, and postprocessing of the data. We extracted 199 locations as flooded areas, which were tested using a global positioning system to ensure that flooded areas were detected correctly. Root mean square error, accuracy, and the area under the ROC curve were used to validate the models. Findings showed that root mean square error was 0.31 and 0.3 for ADTree and bag-ADTree techniques, respectively. More findings illustrated that accuracy was obtained as 86.61 for bag-ADTree model, while it was 85.44 for ADTree method. Based on AUC, success and prediction rates were 0.736 and 0.786 for bag-ADTree algorithm, in order, while these proportions were 0.714 and 0.784 for ADTree. This study can be a good source of information for crisis management in the study area. (shrink)

Background: Certain factors may facilitate or inhibit the formation of moral sensitivity in nurses performing cardiopulmonary resuscitation (CPR). The identification of these factors in the context can help develop strategies to promote nurses’ moral sensitivity and offer new insights into the consequences of their moral decisions. Objective: Taking into account the possibly multi-factorial nature of moral sensitivity, this study aimed to identify the factors affecting the formation of nurses’ moral sensitivity in CPR settings. Research design and methods: This study performed (...) a conventional qualitative content analysis. Twenty-one participants were selected via purposive and theoretical sampling. The data were collected through in-depth semi-structured interviews and simultaneously analyzed via content analysis. Participants and research context: In total, twenty-one participants (fourteen clinical care nurses, three head nurses, two educational supervisors, and two faculty members) from different cities of Iran were interviewed. Ethical considerations: The research was approved by the Ethics Committee of Urmia University of Medical Sciences in Iran (IR.UMSU.REC.1399.337). Findings: Four categories (underlying factors, professional factors, organizational inhibitors of ethics, and professional limitations) and 13 sub-categories were extracted. Discussion: The formation of moral sensitivity requires a range of ethical standards and their maintenance, not only at the individual level but also at the profession, organization, and community levels. So eliminating inhibitors of ethics in these contexts can improve nurse’s ethical performance in CPR settings. Conclusion: Any measures taken or decisions made by nurses in CPR are driven by numerous ethical issues to which nurses must be morally sensitive. Some factors facilitate and some inhibit the formation of moral sensitivity in nurses. (shrink)

The purpose of the present study was to compare differential functioning of Iranian English versus Persian teachers in responding to compliments and to investigate the possibility of sociolinguistic transmission of speech act of responding to compliments from English culture to native Iranian Persian speakers. Following Chen and Yang (2010), we hypothesized that exposure to English would affect the complimenting behavior of Persian speakers, leading to more acceptance of compliments compared to those with little or no exposure to English. Participants of (...) the study were 50 English teachers, regarded as “exposed-to-English” or E group, and 50 Persian teachers, considered as “unexposed-to-English” or U group. The participants’ age ranged from 20 to 35 and they were selected through non-randomized convenience sampling. A Discourse Completion Test (DCT) comprising eight complimenting situations was developed in two versions, i.e. English and Persian, in light of Mane’s (1983) taxonomy. The results revealed a significant difference in performance between groups and that Iranian English teachers’ Compliment Response (CR) behavior changed due to exposure to English and approached English culture. Further findings and implications are discussed in the paper. (shrink)

Background Discrimination in health care is an international challenge and a serious obstacle to justice and equality in health. Research objective The purpose of this study was to design a grounded theory of discrimination in health care based on the experiences and perceptions of Iranian healthcare providers and patients. Research design This qualitative study was conducted using by the grounded theory method. Participants and research context Data were collected through semi-structured interviews with 18 healthcare providers including 11 nurses, two physicians, (...) two nurse’s assistants, and three patients in two general hospitals in Tehran, Iran. Participants were selected through purposeful sampling and analyzed simultaneously using the Corbin and Strauss (2015) approach. Ethical considerations The study was approved by the Research Ethics Committee of the University of Social Welfare and Rehabilitation Sciences (Ethics code: IR.USWR.REC.1398.023). Also, after explaining the objectives of the study, all the participants completed and signed the written consent form. Findings The “culture of discrimination” was the study’s core category, reflecting the nature of discrimination in health care. The theory of “culture of discrimination in health care” is the result of five main categories: “individual social stimuli,” “culture of discrimination,” “unintentional discrimination,” “conflict with discrimination,” and “dissatisfaction with discriminatory behavior.” These categories cover the underlying factors, strategies, and outcomes of the discrimination process in health care. Discussion The results of the study showed that nurses and other health care providers experience unintentional discrimination. Unintentional discrimination refers to discriminatory behaviors and practices of health care providers. Conclusion The theory of culture of discrimination in health care can be used as a practical guide to describe and understand the role of health care providers, especially nurses. Further studies with a quantitative approach to applying this theory in medical settings are recommended. (shrink)

Background: One of the main concerns in critical care units is the development of humanistic approaches. In this regard, recognizing the factors affecting humanistic nursing can contribute to humanizing nursing care in these units. Objective: The objective was to recognize the influential factors of humanistic nursing in critical care units. Research design: This qualitative study was carried out using a phenomenology method. Thirty-nine in-depth unstructured interviews were performed. The data were analyzed using the phenomenological nursology approach. To guarantee trustworthiness, prolonged (...) engagement, member check, triangulation of resources, and maximum variation sampling were used. Participants and research context: Purposeful sampling was employed to select 10 nurses, 8 patients, and 4 patient’s relatives from the intensive care unit and critical care unit departments. Ethical consideration: This study was approved by the ethics committee of Lorestan University of Medical Sciences with the code of LUMS.REC.1395.121. Finding: The participants’ experiences were reflected in the following three main concepts: moral, educational, and existential nature of the two humans involved in the interaction; maintenance of the nurses’ dignity; and interactions in the cultural and social context. Discussion: The nurse and patient, organizational environment, and society give rise to a set of intertwined characteristics which influence the realization of humanistic nursing. By affecting the nurses’ educational background and maintaining their dignity, the atmosphere of the hospital and cultural readiness of the society pave the way for delivering the humanistic care. (shrink)

We present a rooted hypersequent calculus for modal propositional logic S5. We show that all rules of this calculus are invertible and that the rules of weakening, contraction, and cut are admissible. Soundness and completeness are established as well.

Sedlakova and Trachsel (2023) argue that on the one hand, conversational artificial intelligence (CAI) does not fulfill the necessary conditions for full attribution of agency, such as having consc...

BackgroundMoral distress is one of the most important problems that nurses face in their care of patients. Various studies have reported the frequency and severity of moral distress in nurses. However, to date, a comprehensive study that shows the results of these research across the world was not found, therefore due to the importance of this issue, its role in the health of nurses and patients, and the lack of general statistics about it worldwide, the present study was conducted to (...) determine the frequency and severity of moral distress in nurses through a systematic review and meta-analysis.MethodsIn this review study, searching national and international databases of SID, MagIran, IranMedex, IranDoc, Google Scholar, Embase, ScienceDirect, Scopus, CINHAL, PubMed, and Web of Science between 2005 and February 2020 were extracted. The random-effects model was used for analysis, and the heterogeneity of studies with the I2 index was investigated. Data were analyzed using Comprehensive Meta-Analysis.ResultsThe frequency of moral distress in 9 articles with a sample size of 1576 persons was 1.7 ± 0.5 from, in 13 articles with a sample size of 1870 persons, 3.07 ± 0.1 from, in 6 articles with a sample size of 1316 persons, 3.2 ± 0.29 from, in 18 articles with a sample size of 1959 persons, 4.6 ± 0.518 from and in 35 articles with a sample size of 3718 persons, 81.1 ± 4.6 from, and the severity of moral distress in 4 articles with a sample size of 1116 persons, 1.7 ± 0.37 from, in 5 articles with a sample size of 1282 persons, 2.6 ± 0.28 from, in 5 articles with a sample size of 944 persons, 3.9 ± 0.63 from and in 8 articles with a sample size of 901 persons was 82.3 ± 5.4.ConclusionThe results of this study showed that the frequency and severity of moral distress in nurses are high and are a serious problem in nurses. Therefore, policymakers in this field should consider its role in the health of nurses and patients. (shrink)

As a spiritual autobiography, Kierkegaard's The Point of View for My Work as an Author stands among such great works as Augustine's Confessions and Newman's Apologia pro Vita Sua. Yet Point of View is neither a confession nor a defense; it is an author's story of a lifetime of writing, his understanding of the maze of greatly varied works that make up his oeuvre. Upon the imminent publication of the second edition of Either/Or, Kierkegaard again intended to cease writing. Now (...) was the time for a direct "report to history" on the authorship as a whole. In addition to Point of View, which was published posthumously, the present volume also contains On My Work as an Author, a contemporary substitute, and the companion piece Armed Neutrality. (shrink)

Patients have the right to refuse their treatment; however, this refusal should be informed. We evaluated the quality of the informed refusal process in Iranian hospitals from patients' viewpoints. To this end, we developed a questionnaire that covered four key aspects of the informed refusal process including; information disclosure, voluntariness, comprehension, and provider-patient relationship. A total of 284 patients who refused their treatment from 12 teaching hospitals in the Isfahan Province, Iran, were recruited and surveyed to produce a convenience sample. (...) Patients' perceptions about the informed refusal process were scored and the mean scores of the four components were calculated. The findings showed that the practice of information disclosure was perceived to be moderate, however, comprehension, voluntariness and provider–patient relationship were perceived to be relatively good. We found that patients, who refused their care before any treatment had commenced, reported a lower quality of information disclosure and voluntariness. Patients informed by nurses and those who had not had a previous related admission, reported lower scores for comprehension and relationship. In conclusion, the process of obtaining informed refusal was relatively satisfactory except for levels of information disclosure. To improve current practices, Iranian patients need to be better informed about; different treatment options, consequences of treatment refusal, costs of not continuing treatment and follow-ups after refusal. Developing more informative refusal forms is needed. (shrink)

An able and clear defense of Bradley's principal theses and the underlying conception of metaphysical enterprise. "This is a book about a metaphysician, about metaphysics, and, most importantly, it attempts to develop elements of a metaphysical position long the lines of what is called Absolute Idealism." The Introduction takes up the Verificationists [[sic]] argument and two recent accounts of metaphysics. Part I devotes ten Chapters to the elucidation and defense of Bradley's conception of reality. It culminates in examining three alternative (...) accounts of "Real". Part II considers "the major philosophical theories of the self in order to defend Bradley's Theory of the self within his metaphysical scheme."--A. S. C. (shrink)

Name der Zeitschrift: Der Islam Jahrgang: 91 Heft: 2 Seiten: 374-409.

This edition replaces the earlier translation by Walter Lowrie that appeared under the title The Concept of Dread. Along with The Sickness unto Death, the work reflects from a psychological point of view Søren Kierkegaard's longstanding concern with the Socratic maxim, "Know yourself." His ontological view of the self as a synthesis of body, soul, and spirit has influenced philosophers such as Heidegger and Sartre, theologians such as Jaspers and Tillich, and psychologists such as Rollo May. In The Concept of (...) Anxiety, Kierkegaard describes the nature and forms of anxiety, placing the domain of anxiety within the mental-emotional states of human existence that precede the qualitative leap of faith to the spiritual state of Christianity. It is through anxiety that the self becomes aware of its dialectical relation between the finite and the infinite, the temporal and the eternal. (shrink)

"One basic and underlying assumption of this investigation will be that there is a distinct continuity and development in Berkeley's thought which can be traced through all of his reflective analyses of the problem of perception." The essay argues for Berkeley's theory of perception as a "prototype of the phenomenalists." It argues also for Berkeley's incorporation of elements from the representative theory of perception. Of special interest is the treatment of Berkeley's doctrine of "suggestion" and its connection with the role (...) of imagination in the perception of physical objects. The linguistic aspect of Berkeley's work is minimized. Berkeley's theory of notions receives only a passing reference. The last third of the book is a clear and useful discussion of Berkeley and contemporary phenomenalism. It is suggested, though not shown, that Berkeley has affinity with contemporary phenomenology of perception.--A. S. C. (shrink)

Early Polemical Writings covers the young Kierkegaard's works from 1834 through 1838. His authorship begins, as it was destined to end, with polemic. Kierkegaard's first published article touches on the theme of women's emancipation, and the other articles from his student years deal with freedom of the press. Modern readers can see the seeds of Kierkegaard's future career these early pieces. In "From the Papers of One Still Living," his review of Hans Christian Andersen's novel Only a Fiddler, Kierkegaard rejects (...) the notion that environment is decisive in determining the fate of genius. He also puts forward his belief that each person needs a life-view or life for which and by which to live, a thought he explores further in the comic play The Battle between the Old and the New Soap-Cellars. (shrink)

Søren Kierkegaard published an extraordinary number of works during his lifetime, but he left behind nearly as much unpublished writing, most of which consists of what are called his "journals and notebooks." Volume 3 of this 11-volume edition of Kierkegaard's Journals and Notebooks includes Kierkegaard's extensive notes on lectures by the Danish theologian H. N. Clausen and by the German philosopher Schelling, as well as a great many other entries on philosophical, theological, and literary topics. In addition, the volume includes (...) many personal reflections by Kierkegaard, notably those in which he provides an account of his love affair with Regine Olsen, his onetime fiancée. (shrink)

Søren Kierkegaard, the nineteenth-century Danish philosopher rediscovered in the twentieth century, is a major influence in contemporary philosophy, religion, and literature. He regarded Either/Or as the beginning of his authorship, although he had published two earlier works on Hans Christian Andersen and irony. The pseudonymous volumes of Either/Or are the writings of a young man and of Judge William. The ironical young man's papers include a collection of sardonic aphorisms; essays on Mozart, modern drama, and boredom; and "The Seducer's Diary." (...) The seeming miscellany is a reflective presentation of aspects of the "either," the esthetic view of life. Part II is an older friend's "or," the ethical life of integrated, authentic personhood, elaborated in discussions of personal becoming and of marriage. The resolution of the "either/or" is left to the reader, for there is no Part III until the appearance of Stages on Life's Way. The poetic-reflective creations of a master stylist and imaginative impersonator, the two men write in distinctive ways appropriate to their respective positions. (shrink)