Background: In modern healthcare, the role of solidarity, altruism and the natural response to moral challenges in life-threatening situations is still rather unexplored. The COVID-19 pandemic provided an opportunity to obtain a deeper understanding of nurses’ willingness to care for patients during crisis. Objective: To elucidate clinical expressions of ontological situational ethics through nurses’ willingness to work during a pandemic. Research design, participants and context: A qualitative study with an interpretive design was applied. Twenty nurses who worked in intensive care (...) unit at two Swedish hospitals during the first, second, and third waves of the COVID-19 pandemic were interviewed. The analysis was interpretative and applied a theoretical ethics perspective. Ethical considerations: The study was approved by the Swedish Ethical Review Authority and informed consent was obtained from all participants. Findings: From a philosophical perspective, the nurses expressed sovereign life expressions of mercy and compassion, which arose spontaneously in response to seeing vulnerable fellow humans. They referenced ‘‘the nurse inside me’’ and their choice of profession as motives to provide care. Ontological situational ethics in culture and norms were noted in the constructs of competence, responsibility, solidarity with colleagues and organization; and interest and learning were driving forces. Ethical demand was evident when nurses expressed ideas of meaningfulness in helping their fellow humans; but themes of ambiguity, exhaustion and unwillingness were also present. Conclusions: The nurses showed a high willingness to care for patients during a crisis. Responding to the ethical demand and to care for vulnerable human beings while risking their own health and lives could be interpreted as an inter-human vocation. These spontaneous altruistic actions saved the lives of many patients during the pandemic and need to be understood and supported. (shrink)

Climate change and decarbonization raise complex justice questions that researchers and policymakers must address. The distributions of greenhouse gas emissions rights and mitigation efforts have dominated justice discourses within scenario research, an integrative element of the IPCC. However, the space of justice considerations is much larger. At present, there is no consistent approach to comprehensively incorporate and examine justice considerations. Here we propose a conceptual framework grounded in philosophical theory for this purpose. We apply this framework to climate mitigation scenarios (...) literature as proof of concept, enabling a more holistic and multidimensional investigation of justice. We identify areas of future research, including new metrics of service provisioning essential for human well-being. [Can be freely read by clicking the ReadCube link below.]. (shrink)

ObjectiveBreast cancer may profoundly affect a couple’s sex life. The present study examines whether patient-, partner- and relationship-related characteristics are associated with sexual activity of couples following breast cancer diagnosis in the treatment phase and over time.MethodsWomen with breast cancer and their male cohabiting partners participated in a longitudinal study in Denmark. Logistic regression was used to examine associations of patient-, partner- and relationship-related characteristics at baseline with couples’ sexual activity at baseline, 5 and 12 months later. The longitudinal analyses (...) were stratified for couples’ sexual activity status at baseline.ResultsA total of 722, 533 and 471 couples were included in the analyses at baseline, 5- and 12-months follow-up, respectively. Older age, depressive symptoms and lower vitality of patients were associated with lower odds of couples’ sexual activity at baseline; chemotherapy treatment and older age of patients were associated with lower odds at 5-months follow-up in couples who were not sexually active at baseline. Higher ratings of emotional closeness, affectionate behavior and satisfaction with dyadic coping were associated with higher odds for sexual activity at baseline and over time in couples who were sexually active at baseline.ConclusionSexual counseling during cancer treatment and rehabilitation should include a couple perspective. Relationship-related variables may be a protective factor for remaining sexually active after breast cancer diagnosis. Interventions could focus on strengthening these factors. Health professionals also need to consider the patients’ breast cancer treatment, vitality, and emotional distress in counselling on sexuality. (shrink)

L(ow) tone in Mandarin Chinese causes both downstep and post-low-bouncing. Downstep refers to the lowering of a H(igh) tone after a L tone, which is usually measured by comparing the H tones in a “H…HLH…H” sentence with a “H…HHH…H” sentence (cross-comparison), investigating whether downstep sets a new pitch register for the scaling of subsequent tones. Post-low-bouncing refers to the raising of a H tone after a focused L tone. The current study investigates how downstep and post-low-bouncing interact with focus and (...) phrasing in Mandarin Chinese. In the experiment, we systematically manipulated (a) the tonal environment by embedding two syllables with either LH or HH tone (syllable X and Y) sentence-medially in the same carrier sentences containing only H tones; (b) boundary strength between X and Y by introducing either a syllable boundary or a phonological phrase boundary; and (c) information structure by either placing a contrastive focus in the HL/HH word (XF), syllable Y (YF), or the sentence-final word (ZF). A wide-focus condition served as the baseline. With systematic control of focus and boundary strength around the L tone, the current study shows that the downstep effect in Mandarin is quite robust, lasting for 3–5 H tones after the L tone, but eventually levelling back again to the register reference line of a H tone. The way how focus and phrasing interact with the downstep effect is unexpected. Firstly, sentence-final focus has no anticipatory effect on shortening the downstep effect; instead, it makes the downstep effect lasts longer as compared to the wide focus condition. Secondly, the downstep effect still shows when the H tone after the L tone is on-focus (YF), in a weaker manner than the wide focus condition, and is overridden by the post-focus-compression. Thirdly, the downstep effect gets greater when the boundary after the L tone is stronger, because the L tone is longer and more likely to be creaky. We further analyzed downstep by measuring the F0 drop between the two H tones surrounding the L tone (sequential-comparison). Comparing it with F0 drop in all-H sentences (i.e., declination), it showed that the downstep effect was much greater and more robust than declination. However, creaky voice in the L tone was not the direct cause of downstep. At last, when the L tone was under focus (XF), it caused a post-low-bouncing effect, which is weakened by a phonological phrase boundary. Altogether, the results showed that although intonation is largely controlled by informative functions, the physical-articulatory controls are relatively persistent, varying within the pitch range of 2.5 semitones. Downstep and post-low-bouncing in Mandarin Chinese thus seem to be mainly due to physical-articulatory movement on varying pitch, with the gradual tonal F0 change meeting the requirement of smooth transition across syllables, and avoiding confusion in informative F0 control. (shrink)

Conservation can occur anywhere regardless of scale, political jurisdiction, or landownership. We present a framework to help managers at protected areas practice conservation at the scale of relationships. We focus on relationships between stakeholders and protected areas and between managers and other stakeholders. We provide a synthesis of key natural resources literature and present a case example to support our premise and recommendations. The purpose is 4-fold: 1) discuss challenges and threats to conservation and protected areas; 2) outline a relationship-scale (...) approach to address conservation threats; 3) describe the tools and techniques that can be used to implement this approach; and 4) present a case example from rural Alaska, USA, to illustrate relationship-scale conservation. Our case example illustrates how aspects of this approach to conservation were applied to address a wildlife population decline. Tools needed to implement relationship-scale conservation include 1) collecting and documenting narratives of place; 2) measuring and monitoring trust and commitment; and 3) identifying and mitigating threats. We recommend that planners and managers, working with their research partners, redefine and refocus their goals and objectives to include these practices. Doing so will enable them to gain substantial applied knowledge about their stakeholders and foster and maintain place relationships as desired outcomes of conservation. The ultimate outcome is a better prognosis for long-term global survival of protected areas and biodiversity. Published 2014. This article is a U.S. Government work and is in the public domain in the USA. (shrink)

Artificial intelligence (AI) systems are increasingly being used in healthcare, thanks to the high level of performance that these systems have proven to deliver. So far, clinical applications have focused on diagnosis and on prediction of outcomes. It is less clear in what way AI can or should support complex clinical decisions that crucially depend on patient preferences. In this paper, we focus on the ethical questions arising from the design, development and deployment of AI systems to support decision-making around (...) cardiopulmonary resuscitation and the determination of a patient’s Do Not Attempt to Resuscitate status (also known as code status). The COVID-19 pandemic has made us keenly aware of the difficulties physicians encounter when they have to act quickly in stressful situations without knowing what their patient would have wanted. We discuss the results of an interview study conducted with healthcare professionals in a university hospital aimed at understanding the status quo of resuscitation decision processes while exploring a potential role for AI systems in decision-making around code status. Our data suggest that (1) current practices are fraught with challenges such as insufficient knowledge regarding patient preferences, time pressure and personal bias guiding care considerations and (2) there is considerable openness among clinicians to consider the use of AI-based decision support. We suggest a model for how AI can contribute to improve decision-making around resuscitation and propose a set of ethically relevant preconditions—conceptual, methodological and procedural—that need to be considered in further development and implementation efforts. (shrink)

Making good decisions in extremely complex and difficult processes and situations has always been both a key task as well as a challenge in the clinic and has led to a large amount of clinical, legal and ethical routines, protocols and reflections in order to guarantee fair, participatory and up-to-date pathways for clinical decision-making. Nevertheless, the complexity of processes and physical phenomena, time as well as economic constraints and not least further endeavours as well as achievements in medicine and healthcare (...) continuously raise the need to evaluate and to improve clinical decision-making. This article scrutinises if and how clinical decision-making processes are challenged by the rise of so-called artificial intelligence-driven decision support systems (AI-DSS). In a first step, this article analyses how the rise of AI-DSS will affect and transform the modes of interaction between different agents in the clinic. In a second step, we point out how these changing modes of interaction also imply shifts in the conditions of trustworthiness, epistemic challenges regarding transparency, the underlying normative concepts of agency and its embedding into concrete contexts of deployment and, finally, the consequences for (possible) ascriptions of responsibility. Third, we draw first conclusions for further steps regarding a ‘meaningful human control’ of clinical AI-DSS. (shrink)

Case, agreement, and A-movement dependencies across finite clause boundaries, such as Hyperraising or Long-Distance Case or Agreement [LDA], are available in many typologically diverse languages. The research on such dependencies typically distinguishes between cross-linguistically restricted true A-dependencies across finite clauses, and generally available binding-like A′-dependencies as found in Prolepsis. In this paper, we investigate both types of configurations in parallel and refer to this as the A-domain. Since the diagnostics to distinguish A-configurations vary across languages and often cannot be compared (...) directly, we define four characteristic properties: whether the construction is restricted by matrix predicate selection, whether movement in the embedded clause is involved, whether the dependency shows locality restrictions, and whether there are semantic restrictions on the relevant DP. By combining different values of the characteristic properties, we show, differently from previous approaches, that the A-domain does not simply consist of two types of configurations, but that the empirical landscape represents a continuum of five A-constructions. We suggest a theoretical implementation of our empirical findings, which is built on a predicational relator phrase above the embedded CP and propose that, in some of the constructions, these two projections fuse into one. We employ a minimalist probing approach which relies on differences in the base-generated position of the relevant DP, differences in the feature composition of the embedded C, a composite probe hierarchy yielding three types of feature-dependencies of composite probes, and, resulting from that, different probing mechanisms. Lastly, this paper also contributes methodological tools for disentangling constructions of the A-domain. (shrink)

This study investigates the increased commercialization of African indigenous vegetables (AIV)—former subsistence crops such as African nightshade, cowpea leaves and amaranth species grown mainly by women—from a feminist economics perspective. The study aims to answer the following research question: How does AIV commercialization affect the gendered division of labor, women’s participation in agricultural labor, their decision-making power, and their access to resources? We analyze commercialization’s effects on gender relations in labor and decision-making power and also highlight women’s agency. Based on (...) a mixed method design and analyzing household-level panel data and qualitative focus groups from Kenya, we observe an economic empowerment of women that we relate to women’s individual and collective strategies as well as their retention of control over AIV selling and profits. Yet, while we see economic empowerment of women through commercialization—how they broaden their scope of action and are empowered by generating revenue—that does not contribute to a redistribution of labor or land rights, which are key for gender equality, instead it increases women’s labor burden. (shrink)

Number processing abilities are important for academic and personal development. The course of initial specialization of ventral occipito-temporal cortex sensitivity to visual number processing is crucial for the acquisition of numeric and arithmetic skills. We examined the visual N1, the electrophysiological correlate of vOTC activation across five time points in kindergarten, middle and end of first grade, second grade, and fifth grade. A combination of cross-sectional and longitudinal EEG data of a total of 62 children at varying familial risk for (...) dyslexia were available to form groups of 23, 22, 27, 27, and 42 participants for each of the five time points. The children performed a target detection task which included visual presentation of single digits, false fonts, and letters to derive measures for coarse and fine digit sensitive processing across development. The N1 amplitude analyses indicated coarse and fine sensitivity characterized by a stronger N1 to digits than false fonts across all five time points, and stronger N1 to digits than letters at all but the second time point. In addition, lower arithmetic skills were associated with stronger coarse N1 digit sensitivity over the left hemisphere in second grade, possibly reflecting allocation of more attentional resources or stronger reliance on the verbal system in children with poorer arithmetic skills. To summarize, our results show persistent visual N1 sensitivity to digits that is already present early on in pre-school and remains stable until fifth grade. This pattern of digit sensitivity development clearly differs from the relatively sharp rise and fall of the visual N1 sensitivity to words or letters between kindergarten and middle of elementary school and suggests unique developmental trajectories for visual processing of written characters that are relevant to numeracy and literacy. (shrink)

The ability to learn sequential contingencies of actions for predicting future outcomes is indispensable for flexible behavior in many daily decision-making contexts. It remains open whether such ability may be enhanced by transcranial direct current stimulation. The present study combined tDCS with functional near-infrared spectroscopy to investigate potential tDCS-induced effects on sequential decision-making and the neural mechanisms underlying such modulations. Offline tDCS and sham stimulation were applied over the left and right dorsolateral prefrontal cortex in young male adults in a (...) double-blind between-subject design using a three-state Markov decision task. The results showed an enhanced dlPFC hemodynamic response during the acquisition of sequential state transitions that is consistent with the findings from a previous functional magnetic resonance imaging study; a tDCS-induced increase of the hemodynamic response in the dlPFC, but without accompanying performance-enhancing effects at the behavioral level; and a greater tDCS-induced upregulation of hemodynamic responses in the delayed reward condition that seems to be associated with faster decision speed. Taken together, these findings provide empirical evidence for fNIRS as a suitable method for investigating hemodynamic correlates of sequential decision-making as well as functional brain correlates underlying tDCS-induced modulation. Future research with larger sample sizes for carrying out subgroup analysis is necessary in order to decipher interindividual differences in tDCS-induced effects on sequential decision-making process at the behavioral and brain levels. (shrink)

Die Sprachlichkeit des Glaubens ist von Anfang an zentrales Thema protestantischer Theologie. Der Glaube, als Vertrauen auf das biblisch bezeugte und lebendig gepredigte Evangelium, lebt in der Sprache, weil er aus dem Horen kommt: Er vollzieht sich im Modus des Verstehens. Seit jeher sind daher theologische Hermeneutik und Homiletik Orte, an denen die Sprachlichkeit des Glaubens reflektiert wird. Diese Reflexion setzen die Beitrage des vorliegenden Bandes in je unterschiedlicher Facherperspektive fort.

Suppose we have a persistent disagreement about a particular set of policy options, not because of an underlying moral disagreement, or a mere conflict of interest, but rather because we disagree about a crucial non-normative factual assumption underlying the justification of the policy choices. The main question in the paper is what political legitimacy requires in such cases, or indeed whether there are defensible answers to that question. The problem of political legitimacy in fact-dependent policy disagreements has received almost no (...) attention in political philosophy, which has focused mostly on value disagreements and proposed theories of legitimate coercive legislation in valuedependent disagreements. The paper presents an argument showing that under certain plausible assumptions regarding legitimacy, there are serious difficulties in identifying legitimate choices in fact-dependent policy disagreements. This may be unsurprising to political philosophers preoccupied with value-based disagreements, perhaps because it has been assumed that legitimacy-related concerns are irrelevant to fact-dependent policy disagreements. The paper argues that this response is premature. If we should care about legitimacy et al.l, then it is by no means clear why we should ignore issues of legitimacy in policy-disputes that depend on factual disagreements. The paper ends by defining a set of possibilities that merit further exploration in search of a theory of legitimacy in fact-dependent policy disagreements. (shrink)

BackgroundBiobanking biospecimens and consent are common practice in paediatric research. We need to explore children and young people’s (CYP) knowledge and perspectives around the use of and consent to biobanking. This will ensure meaningful informed consent can be obtained and improve current consent procedures.MethodsWe designed a survey, in co-production with CYP, collecting demographic data, views on biobanking, and consent using three scenarios: 1) prospective consent, 2) deferred consent, and 3) reconsent and assent at age of capacity. The survey was disseminated (...) via the Young Person’s Advisory Group North England (YPAGne) and participating CYP’s secondary schools. Data were analysed using a qualitative thematic approach by three independent reviewers (including CYP) to identify common themes. Data triangulation occurred independently by a fourth reviewer.ResultsOne hundred two CYP completed the survey. Most were between 16–18 years (63.7%, N = 65) and female (66.7%, N = 68). 72.3% had no prior knowledge of biobanking (N = 73).Acceptability of prospective consent for biobanking was high (91.2%, N = 93) with common themes: ‘altruism’, ‘potential benefits outweigh individual risk’, 'frugality', and ‘(in)convenience’.Deferred consent was also deemed acceptable in the large majority (84.3%, N = 86), with common themes: ‘altruism’, ‘body integrity’ and ‘sample frugality’. 76.5% preferred to reconsent when cognitively mature enough to give assent (N = 78), even if parental consent was previously in place. 79.2% wanted to be informed if their biobanked biospecimen is reused (N = 80).ConclusionProspective and deferred consent acceptability for biobanking is high among CYP in the UK. Altruism, frugality, body integrity, and privacy are the most important themes. Clear communication and justification are paramount to obtain consent. Any CYP with capacity should be part of the consenting procedure, if possible. (shrink)

Experiences of discrimination such as everyday racism can negatively affect the mental and physical health of children and adolescents with an immigrant background and impair their integration process in the host societies. Although experiences of racism are part of the everyday life of many minors affected by the process of “Othering”, an overview of empirical findings is missing for this age group worldwide. A systematic review was conducted to identify and analyze international research on the impact of discrimination on the (...) developmental outcomes and integration of immigrant children and adolescents. Three scientific databases were systematically searched up to June 11, 2021. A total of k = 4,769 identified publications were reviewed based on inclusion and exclusion criteria in terms of the PICOS format by independent reviewers. Thirty-four primary studies published between 1998 and 2021 met all inclusion criteria. The samples examined were mainly migrant youth, with only k = 2 studies assessing refugee youth and k = 1 study assessing both migrant and refugee youth. The majority of included studies assessed perceived discrimination, with only k = 1 study directly assessing experiences of racism. The association between discrimination or racism and developmental outcomes was assessed by the included studies within the three main topics of mental and physical health-related outcomes, school-related outcomes, and other developmental outcomes. Data collection procedures were implemented, and findings on minors’ developmental outcomes and integration process who experience discrimination and racism were summarized and discussed. The current review suggests experienced discrimination as a negative predictor of children and adolescents’ health-related outcomes, while no clear results could be found for the association between discrimination and school-related outcomes. A need for more empirical research focusing on the path and indirect link between discrimination and children and adolescents’ school-related outcomes as well as resulting school recommendations and the chosen career path was derived.Systematic Review Registration[https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=260291], identifier [CRD42021260291]. (shrink)

Scholarship flourishes in inclusive environments where open deliberations and generative feedback expand both individual and collective thinking. Many researchers, however, have limited access to such settings, and most conventional academic conferences fall short of promises to provide them. We have written this Field Report to share our methods for cultivating a vibrant intellectual community within the Science and Technology Studies Food and Agriculture Network (STSFAN). This is paired with insights from 21 network members on aspects that have allowed STSFAN to (...) thrive, even amid a global pandemic. Our hope is that these insights will encourage others to cultivate their own intellectual communities, where they too can receive the support they need to deepen their scholarship and strengthen their intellectual relationships. (shrink)

BackgroundThe need for an ethical debate about the use of coercion in intensive care units (ICU) may not be as obvious as in other areas of medicine, such as psychiatry. Coercive measures are often necessary to treat critically ill patients in the ICU. It is nevertheless important to keep these measures to a minimum in order to respect the dignity of patients and the cohesion of the clinical team. A deeper understanding of what patients and their relatives perceive during their (...) ICU stay will shed different light on intensive care management. Patients' experiences of loss of control, dependency and abandonment may lead to a new approach towards a broader approach to the concept of coercion in intensive care. The aim of our research is to explore the experiences of patients and relatives in the ICU and to determine when it might be possible to reduce feelings and memories of coercion.MethodsWe conducted and analysed 29 semi-structured interviews with patients and relatives who had been in the ICU a few months previously. Following a coding and categorisation process in MAXQDA™, a rigorous qualitative methodology was used to identify themes relevant to our research.ResultsFive main themes emerged: memory issues; interviewees’ experiences of restricting measures and coercive treatment; patients’ negative perception of situational and relational dependency with the risk of informal coercion; patients’ perceptions of good care in a context of perceived dependency; progression from perception of coercion and dependency to respect for the person. All patients were grateful to have survived. However, coercion in the form of restraint, restriction of movement, and coercive treatment in the ICU was also acknowledged by patients and relatives. These included elements of informal coercion beyond restraints, such as a perceived negative sense of dependence, surrender, and asymmetrical interaction between the patient and health providers.ConclusionsTo capture the full range of patients' experiences of coercion, it is necessary to expand the concept of coercion to include less obvious forms of informal coercion that may occur in dependency situations. This will help identify solutions to avoid or reduce negative recollections that may persist long after discharge and negatively affect the patients' quality of life. (shrink)

Interdisciplinary research needs innovation. As an action-oriented intervention, this Manifesto begins from the authors’ experiences as social scientists working within interdisciplinary science and technology collaborations in agriculture and food. We draw from these experiences to: 1) explain what social scientists contribute to interdisciplinary agri-food tech collaborations; (2) describe barriers to substantive and meaningful collaboration; and (3) propose ways to overcome these barriers. We encourage funding bodies to develop mechanisms that ensure funded projects respect the integrity of social science expertise and (...) incorporate its insights. We also call for the integration of social scientific questions and methods in interdisciplinary projects from the outset, and for a genuine curiosity on the part of STEM and social science researchers alike about the knowledge and skills each of us has to offer. We contend that cultivating such integration and curiosity within interdisciplinary collaborations will make them more enriching for all researchers involved, and more likely to generate socially beneficial outcomes. (shrink)

Orientation towards application, transdisciplinarity and social distribution are prominent ideas when policy prescribes how to conduct research on complex, real-world issues. Issues dealt with in a...

This article comprises a short case exemplifying ethical challenges arising for a participatory researcher working with Afghan women refugees during the Covid-19 pandemic in Germany. The researcher is an Iranian-German woman, qualified as a midwife, undertaking doctoral research on refugees’ access to reproductive health care. Disclosures about some women’s experience of domestic violence are made, which raise ethical issues for the researcher relating to personal-professional boundaries, roles and responsibilities. Two commentaries are given on this case from participatory researchers based in (...) Germany, UK and Austria. Both commentaries highlight the relevance of the ethics of care for participatory research and for this research in particular, which entails very close relationships between the doctoral researcher and the refugee women with whom she is researching. The first commentary analyses the research process in terms of Tronto’s five phases of care, while the second illustrates the importance of caring institutions in supporting researchers working on sensitive topics. (shrink)

Providing high-quality education for students with emergent proficiency in the language of instruction (referred to here as multilingual students) presents a challenge to inclusion for educational systems the world over. In Austria, a new German language support model was implemented in the school year 2018/19 which provides language support in separate classrooms up to 20 h a week. Since its implementation, the model has been strongly criticized for excluding multilingual students from the mainstream classroom, which is argued to reinforce the (...) educational disadvantages that they face. The study presented here provides unprecedented qualitative insight into how schooling for students within the so-called German language support classes (GLSC) was organized during the COVID-19 pandemic. It builds on results of a previous large-scale quantitative study (n= 3,400 teachers), which was conducted during the first lockdown (spring 2020) and indicated a high risk of exclusion for marginalized students, especially for multilingual students in GLSC. To gain deeper insights into the situation of these students during school closures, 37 teachers who work in these classes at both primary and lower-secondary schools in Vienna were interviewed, of which 18 interviews were considered for analysis. The interviews focus on the situation during the first and second school closures in the city of Vienna. A thematic analysis of the interview data reveals teachers’ perceptions of aspects which harmed or promoted inclusion for students in GLSC during these periods of school closure. Teachers’ perceptions of the most harming factors for students included strong language barriers between teachers and students, restricted access to technical equipment and supportive learning spaces, and low parental engagement. A development that promoted inclusion of these students was the option to allow them to come to school during the second school closure. Since existing studies on the schooling of students during school closures have hardly addressed the situation of students in GLSC, this study contributes to closing this research gap. (shrink)

Background: Due to recent legislations on euthanasia and its current practice in the Netherlands and Belgium, issues of end-of-life medicine have become very vital in many European countries. In 2002, the Ethics Working Group of the German Association for Palliative Medicine (DGP) has conducted a survey among its physician members in order to evaluate their attitudes towards different end-of-life medical practices, such as euthanasia (EUT), physician-assisted suicide (PAS), and terminal sedation (TS). Methods: An anonymous questionnaire was sent to the 411 (...) DGP physicians, consisting of 14 multiple choice questions on positions that might be adopted in different hypothetical scenarios on situations of “intolerable suffering” in end-of-life care. For the sake of clarification, several definitions and legal judgements of different terms used in the German debate on premature termination of life were included. For statistical analysis t-tests and Pearson-correlations were used. Results: The response rate was 61% (n=251). The proportions of the respondents who were opposed to legalizing different forms of premature termination of life were: 90% opposed to EUT, 75% to PAS, 94% to PAS for psychiatric patients. Terminal sedation was accepted by 94% of the members. The main decisional bases drawn on for the answers were personal ethical values, professional experience with palliative care, knowledge of alternative approaches, knowledge of ethical guidelines and of the national legal frame. Conclusions: In sharp contrast to similar surveys conducted in other countries, only a minority of 9.6% of the DGP physicians supported the legalization of EUT. The misuse of medical knowledge for inhumane killing in the Nazi period did not play a relevant role for the respondents’ negative attitude towards EUT. Palliative care needs to be stronger established and promoted within the German health care system in order to improve the quality of end-of-life situations which subsequently is expected to lead to decreasing requests for EUT by terminally ill patients. (shrink)

Purpose: To explain physical activity behavior, social-cognitive theories were most commonly used in the past. Besides conscious processes, the approach of dual processes additionally incorporates non-conscious regulatory processes into physical activity behavior theories. Habits are one of various non-conscious variables that can influence behavior and thus play an important role in terms of behavior change. The aim of this review was to examine the relationship between habit strength and physical activity behavior in longitudinal studies.Methods: According to the PRISMA guidelines, a (...) systematic search was conducted in three databases. Only peer-reviewed articles using a longitudinal study design were included. Both, habit and physical activity were measured at least once, and habit was related to physical activity behavior. Study quality was evaluated by assessment tools of the NHLBI.Results: Of 3.382 identified publications between 2016 and 2019, fifteen studies with different study designs were included. Most studies supported that positive correlations between habit and physical activity exist. Some positive direct and indirect effects of habit on physical activity were detected and only a minority of studies showed the influence of physical activity on habit strength. Studies differentiating between instigation and execution habit found positive correlations and revealed instigation habit as a stronger predictor of physical activity. The quality of studies was rated as reasonable using assessment tools of the NHLBI.Conclusion: This review revealed a bidirectional relationship between habit and physical activity. Whether habit predicts physical activity or vice versa is still unclear. The observation of habit influencing physical activity may be most appropriate in studies fostering physical activity maintenance while the influence of physical activity on habit may be reasonable in experimental studies with physical activity as intervention content to form a habit. Future investigations should differentiate between habit formation and physical activity maintenance studies depending on the research objective. Long-term study designs addressing the complexity of habitual behavior would be beneficial for establishing cue-behavior associations for the formation of habits. Furthermore, studies should differentiate between instigation and execution habit in order to investigate the influence of both variables on physical activity behavior independently. (shrink)

BackgroundRich in different kind of potent cells, embryos are used in modern regenerative medicine and research. Neurobiologists today are pushing the boundaries for what can be done with embryos existing in the transitory margins of medicine. Therefore, there is a growing need to develop conceptual frameworks for interpreting the transformative cultural, biological and technical processes involving these aborted, donated and marginal embryos. This article is a contribution to this development of frameworks.MethodsThis article examines different emotional, cognitive and discursive strategies used (...) by neurobiologists in a foetal cell transplantation trial in Parkinson’s disease research, using cells harvested from aborted embryos. Two interviews were analysed in the light of former observations in the processing laboratories, using the anthropologist Mary Douglas’s concept of pollution behaviour and the linguist, philosopher, psychoanalyst and feminist Julia Kristeva’s concept of the abjective to explain and make sense of the findings.ResultsThe findings indicate that the labour performed by the researchers in the trial work involves transforming the foetal material practically, as well as culturally, from trash to treasure. The transformation process contains different phases, and in the interview material we observed that the foetal material or cells were considered objects, subjects or rejected as abject by the researchers handling them, depending on what phase of process or practice they referred to or had experience of. As demonstrated in the analysis, it is the human origin of the cell that makes it abjective and activates pollution discourse, when the researchers talk of their practice.ConclusionsThe marginal and ambiguous status of the embryo that emerges in the accounts turns the scientists handling foetal cells into liminal characters in modern medicine. Focusing on how practical as well as emotional and cultural strategies and rationalizations of the researchers emerge in interview accounts, this study adds insights on the rationale of practically procuring, transforming and utilizing the foetal material to the already existing studies focused on the donations. We also discuss why the use and refinement of a tissue, around which there is practical consensus but cultural ambiguity, deserves further investigation. (shrink)

BackgroundThe SARS-COVID-19 pandemic and its associated disease control restrictions have in multiple ways affected families with young children, who may be especially vulnerable to mental health problems. Studies report an increase in perinatal parental distress as well as symptoms of anxiety or depression in children during the pandemic. Currently, little is known about the impact of the pandemic on infants and their development. Infant regulatory problems have been identified as early indicators of child socio-emotional development, strongly associated with maternal mental (...) health and the early parent–infant interaction. Our study investigates whether early parenthood under COVID-19 is associated with more maternal depressive symptoms and with a perception of their infants as having more RPs regarding crying/fussing, sleeping, or eating, compared to mothers assessed before the pandemic.MethodsAs part of a longitudinal study, 65 women who had given birth during the first nationwide disease control restrictions in Northern Germany, were surveyed at 7 months postpartum and compared to 97 women assessed before the pandemic. RPs and on maternal depressive symptoms were assessed by maternal report. Number of previous children, infant negative emotionality, and perceived social support were assessed as control variables.ResultsCompared to the control cohort, infants born during the COVID-19 pandemic and those of mothers with higher depressive symptoms were perceived as having more sleeping and crying, but not more eating problems. Regression-based analyses showed no additional moderating effect of parenthood under COVID-19 on the association of depressive symptoms with RPs. Infant negative emotionality was positively, and number of previous children was negatively associated with RPs.LimitationsDue to the small sample size and cross-sectional assessment, the possibility for more complex multivariate analysis was limited. The use of parent-report questionnaires to assess infant RPs can support but not replace clinical diagnosis.ConclusionsThe pandemic conditions affecting everyday life may have a long-term influence on impaired infant self- and maternal co-regulation and on maternal mental health. This should be addressed in peripartum and pediatric care. Qualitative and longitudinal studies focusing on long-term parental and infant outcomes under ongoing pandemic conditions are encouraged. (shrink)

ZusammenfassungIm Rahmen des Modellvorhabens „Patienten als Partner—Tumorpatienten und ihr Mitwirken bei medizinischen Entscheidungen“ wurden zwischen März 2002 und August 2003 272 palliativ behandelte Tumorpatienten nach ihrer Einstellung zur Patientenverfügung und zur gewünschten Beteiligung an medizinischen Entscheidungen befragt. Von den Befragten kannten 30% Patientenverfügungen nicht, darunter signifikant mehr Befragte mit formal niedrigerem Bildungsabschluss. Es hatten bereits 11% eine Patientenverfügung abgeschlossen, 22% wollten wahrscheinlich eine abschließen, und 30% wollten keine abschließen. Es fand sich ein statistisch signifikanter Zusammenhang zwischen dem Abschluss einer Patientenverfügung (...) und dem Wunsch nach mehr eigener Entscheidungsverantwortung. Die Einstellung zur Patientenverfügung und der Wunsch nach partizipativer Entscheidungsfindung stehen in keinem statistisch signifikanten Zusammenhang. Patienten mit schriftlichen Vorausverfügungen haben einen erhöhten Kommunikations- und Rückkopplungsbedarf, auf den Ärzte sensibel eingehen sollten. Bei der Information über Patientenverfügungen sollten Menschen mit niedrigerem Bildungsstand mehr als bisher berücksichtigt werden. (shrink)

This study investigated the effect of stroking vs. simple human presence on later reactions of dairy cows to routine veterinary handling. While in two groups of cows the experimenter stroked the ventral part of the neck or the withers for three consecutive weeks, the third group was exposed to close visual presence. After the treatment period the cows were subjected to rectal palpation. The three groups differed significantly in stepping during rectal palpation, which occurred less often in Neck- and Withers-animals (...) than in control animals. Heart rate increase was significantly higher in the control group than in the two stroking groups. Previous stroking led to fewer stress reactions during the rectal palpation, possibly due to a combined effect of improved relationship towards and thus perception of humans and lasting anti-stress effects of tactile stimulation. Keywords: cattle; tactile stimulation; human–animal relationship; animal welfare. (shrink)

ZusammenfassungIm Rahmen des Modellvorhabens „Patienten als Partner—Tumorpatienten und ihr Mitwirken bei medizinischen Entscheidungen“ wurden zwischen März 2002 und August 2003 272 palliativ behandelte Tumorpatienten nach ihrer Einstellung zur Patientenverfügung und zur gewünschten Beteiligung an medizinischen Entscheidungen befragt. Von den Befragten kannten 30% Patientenverfügungen nicht, darunter signifikant mehr Befragte mit formal niedrigerem Bildungsabschluss. Es hatten bereits 11% eine Patientenverfügung abgeschlossen, 22% wollten wahrscheinlich eine abschließen, und 30% wollten keine abschließen. Es fand sich ein statistisch signifikanter Zusammenhang zwischen dem Abschluss einer Patientenverfügung (...) und dem Wunsch nach mehr eigener Entscheidungsverantwortung. Die Einstellung zur Patientenverfügung und der Wunsch nach partizipativer Entscheidungsfindung stehen in keinem statistisch signifikanten Zusammenhang. Patienten mit schriftlichen Vorausverfügungen haben einen erhöhten Kommunikations- und Rückkopplungsbedarf, auf den Ärzte sensibel eingehen sollten. Bei der Information über Patientenverfügungen sollten Menschen mit niedrigerem Bildungsstand mehr als bisher berücksichtigt werden. (shrink)

The present two-study paper examined the role of communication strategies that athletes use to develop their coach-athlete relationship. Study 1 examined the mediating role of motivation, support and conflict management strategies between the quality of the coach-athlete relationship and athletes’ perceptions of sport satisfaction. Study 2 examined the longitudinal and mediational associations of communication strategies and relationship quality across two time points, over a six-week period. Within both studies, data were collected through multi section questionnaires assessing the studies’ variables. For (...) study 1, structural equation modelling highlighted significant indirect effects for motivation and support strategies between the quality of the coach-athlete relationship and athletes’ experiences of sport satisfaction. For study 2, significant indirect effects were found for the athletes’ perceptions of the quality of the coach-athlete relationship at time 2 between athletes’ use of communication strategies at time point 1 and time point 2. Together these findings provide support for the practical utility of communications strategies in enhancing the quality of the coach-athlete relationship and athlete’s experiences of sport satisfaction. In addition, the findings provide evidence to highlight the potential cyclical relationship between communication and relationship quality across time. (shrink)

Three‐dimensional structured illumination microscopy (3D‐SIM) has opened up new possibilities to study nuclear architecture at the ultrastructural level down to the ∼100 nm range. We present first results and assess the potential using 3D‐SIM in combination with 3D fluorescence in situ hybridization (3D‐FISH) for the topographical analysis of defined nuclear targets. Our study also deals with the concern that artifacts produced by FISH may counteract the gain in resolution. We address the topography of DAPI‐stained DNA in nuclei before and after (...) 3D‐FISH, nuclear pores and the lamina, chromosome territories, chromatin domains, and individual gene loci. We also look at the replication patterns of chromocenters and the topographical relationship ofXist‐RNA within the inactive X‐territory. These examples demonstrate that an appropriately adapted 3D‐FISH/3D‐SIM approach preserves key characteristics of the nuclear ultrastructure and that the gain in information obtained by 3D‐SIM yields new insights into the functional nuclear organization. (shrink)