Objectives—This study examined the issue of confidentiality in relation to i) undergraduate curriculum content in physiotherapy, and ii) the awareness, experiences and attitudes of clinical physiotherapists.Design—Postal survey of universities and focus group interviews with physiotherapists.Setting—Twenty-five universities in the UK and Ireland and 44 therapists in five hospitals in southern England.Results—The survey of universities indicated that legal and ethical aspects of confidentiality featured in virtually all preregistration courses that responded. However, whereas its inclusion was rated as extremely important, the degree of (...) coverage of confidentiality varied considerably between courses. Within the focus groups, 35 informants recollected coverage of confidentiality in their preregistration education, and 12 in postregistration in-service training; in neither case was this coverage in great detail. Informants identified environmental factors and working practices as barriers to preserving confidentiality. Disclosure to others also gave rise to difficulties. Informants were only aware in general terms of the relevant sections of the Chartered Society of Physiotherapy's Rules of Professional Conduct.Conclusions—Aspects of hospital-based physiotherapy practice were seen to create specific problems in relation to confidentiality. More detailed sources of education and guidance on this issue appear to be required. (shrink)

[IMPORTANT CORRECTION - See end of abstract.] In Syntactical Treatments of Modality, with Corollaries on Reflexion Principles and Finite Axiomatizability, Acta Philosophica Fennica 16 (1963), 153–167, Richard Montague shows that the use of a single syntactic predicate (with a context-independent semantic value) to represent modalities of alethic necessity and idealized knowledge leads to inconsistency. In A Note on Syntactical Treatments of Modality, Synthese 44 (1980), 391–395, Richmond Thomason obtains a similar impossibility result for idealized belief: under a syntactical treatment of (...) belief, the assumption that idealized belief is deductively closed, together with certain other plausible conditions on idealized belief, imply that an ideal believer with consistent beliefs cannot believe the truth of Robinson's Arithmetic. In this essay I assert an impossibility result similar to Thomason's but which does not assume that belief is deductively closed or ideal in any other way. There are technical mistakes in the formulations of Lemmas 1-4 and Theorem 2, however. Corrections can be found in the Erratum section of the author's website. (shrink)

This paper concerns Kierkegaard's notion of a teleological suspension of the ethical, which is presented by his pseudonym Johannes de Silentio in Fear and Trembling in connection with the biblical narrative of Abraham's sacrifice of Isaac. Against prevailing readings, I argue that Abraham's suspension of the ethical does not consist in his violating the ethical in order to satisfy a higher normative requirement. Rather, it consists in his preparedness to violate an overriding ethical norm, even where he does not believe (...) that there is some competing requirement that such a violation will satisfy - indeed, even where he believes that he has no reason to commit the violation and conclusive reason not to. Abraham's faith, as expressed in the teleological suspension, consists not in his willingness to obey God or his recognition that God's authority overrides that of the ethical; it consists in his trustful confidence that what seems certain - that he will have committed a monstrous wrong - will not obtain, a confidence that is best understood as a practical orientation toward the world rather than a propositional attitude such as a belief. I argue that this way of interpreting the teleological suspension makes the sections in which that phenomenon is discussed cohere better with the text's earlier sections than standard readings, and shows Kierkegaard's conception of faith to be more radical and more interesting than is commonly supposed. (shrink)

Schopenhauer is widely recognized as the Western philosopher who has shown the greatest openness to Indian thought and whose own ideas approach most closely to it. This book examines his encounter with important schools of Hindu and Buddhist philosophy and subjects the principal apparent affinities to a careful analysis. Initial chapters describe Schopenhauer’s encounter with Indian thought in the context of the intellectual climate of early nineteenth-century Europe. For the first time, Indian texts and ideas were becoming available and the (...) belief that they could bring about a second Renaissance—an “Oriental Renaissance”—was widespread. Schopenhauer shared in this enthusiasm and for the rest of his life assiduously kept abreast of the new knowledge of India. Principal sections of the book consider the two main pillars of Schopenhauer’s system in relation to broadly comparable ideas found, in the case of Hindu thought, in Advaita Vedānta, and within Buddhism in the Mādhyamika and Yogācāra schools. Schopenhauer’s doctrine of the world as representation, or a flow of impressions appearing in the consciousness of living beings, is first considered. The convergence between this teaching and Indian idealism, especially the doctrine of illusory appearance, has long been recognized. Schopenhauer himself was aware of it, emphasizing that it was the result not of influence but of a remarkable convergence between Eastern and Western thought. This convergence is subjected to a much more detailed examination than has previously been carried out, undertaken in the light of twentieth-century Indology and recent studies of Schopenhauer. The second main pillar of Schopenhauer’s system, the doctrine of the world as will, is then examined and its relationship to Indian thought explored. This section of the work breaks new ground in the study of Schopenhauer, for although the similarity of his ethical and soteriological teaching to that of Indian religions has long been noted the underlying reasons for this have not been grasped. It is demonstrated that they are to be found in hitherto unrecognized affinities, of which Schopenhauer himself was largely unaware, between the metaphysics of the will and Indian ideas relating to karmic impressions, the store-consciousness, the causal body, and śakti as the “force” or “energy” that maintains the existence of the world. Final chapters discuss the controversial and difficult question of the relation of the will to final reality in Schopenhauer’s thought in the light of Indian conceptions, and suggest that the two central pillars of his philosophy may be seen, to a greater extent than previously supposed, as a bridge by which the Eastern and Western traditions of philosophical thought may be brought into a closer and more creative relationship. (shrink)

Schopenhauer is widely recognized as the Western philosopher who has shown the greatest openness to Indian thought and whose own ideas approach most closely to it. This book examines his encounter with important schools of Hindu and Buddhist philosophy and subjects the principal apparent affinities to a careful analysis. Initial chapters describe Schopenhauer’s encounter with Indian thought in the context of the intellectual climate of early nineteenth-century Europe. For the first time, Indian texts and ideas were becoming available and the (...) belief that they could bring about a second Renaissance—an “Oriental Renaissance”—was widespread. Schopenhauer shared in this enthusiasm and for the rest of his life assiduously kept abreast of the new knowledge of India. Principal sections of the book consider the two main pillars of Schopenhauer’s system in relation to broadly comparable ideas found, in the case of Hindu thought, in Advaita Vedānta, and within Buddhism in the Mādhyamika and Yogācāra schools. Schopenhauer’s doctrine of the world as representation, or a flow of impressions appearing in the consciousness of living beings, is first considered. The convergence between this teaching and Indian idealism, especially the doctrine of illusory appearance, has long been recognized. Schopenhauer himself was aware of it, emphasizing that it was the result not of influence but of a remarkable convergence between Eastern and Western thought. This convergence is subjected to a much more detailed examination than has previously been carried out, undertaken in the light of twentieth-century Indology and recent studies of Schopenhauer. The second main pillar of Schopenhauer’s system, the doctrine of the world as will, is then examined and its relationship to Indian thought explored. This section of the work breaks new ground in the study of Schopenhauer, for although the similarity of his ethical and soteriological teaching to that of Indian religions has long been noted the underlying reasons for this have not been grasped. It is demonstrated that they are to be found in hitherto unrecognized affinities, of which Schopenhauer himself was largely unaware, between the metaphysics of the will and Indian ideas relating to karmic impressions, the store-consciousness, the causal body, and śakti as the “force” or “energy” that maintains the existence of the world. Final chapters discuss the controversial and difficult question of the relation of the will to final reality in Schopenhauer’s thought in the light of Indian conceptions, and suggest that the two central pillars of his philosophy may be seen, to a greater extent than previously supposed, as a bridge by which the Eastern and Western traditions of philosophical thought may be brought into a closer and more creative relationship. (shrink)

This chapter contains sections titled: Metaphysics and epistemology.

This chapter highlights a well-known problem for defenders of transubstantiation: namely, the apparent impossibility of supposing that accidents can be separated from their substance. It begins by arguing that Aquinas’s account of accidents, in which the truth-making function of accidents relative to their substances is understood in terms of the existence of such accidents, is highly susceptible to this kind of objection. The next section considers Giles of Rome’s attempts to overcome this worry, most specifically by distinguishing the existence (...) of an accident from its truth-making function, both of which are described. Giles maintains that the existence of an accident is to be identified with the existence of its substance. According to Scotus, this means that Giles is scarcely better off than Aquinas in defending himself against the worry about separated accidents, since a separated accident needs its own existence and, Scotus avers, there is no way for an accident to gain existence when separated. Scotus agrees with Giles that the truth-making function of accidents is to be distinguished from their existence, and holds that accidents, even when united to their substances, have their own proper existence. Overall, the tale is one of the increasing hypostatization of accidents in the light of pressures from Eucharistic doctrine. (shrink)

ObjectiveTo apply a socioecological approach to identify risk and protective factors across levels of the “sports-ecosystem,” which are associated with mental health outcomes among athletes in para-sports and non-para sports. A further aim is to determine whether para athletes have unique risks and protective factor profiles compared to non-para athletes.MethodsA cross-sectional, anonymous online-survey was provided to all categorized athletes aged 16 years and older, registered with the Australian Institute of Sport. Mental health outcomes included mental health symptoms, general psychological (...) distress, risky alcohol consumption and eating disorder risk. Risk and protective factors across multiple levels of the socioecological model, including individual, microsystem, exosystem and macrosystem level factors were assessed via self-report.ResultsA total of 427 elite athletes participated in the study. No significant differences in the rates of mental health problems were observed between para and non-para athletes. Both differences and similarities in risk and protective factor profiles were found across the multiple levels of the sports-ecosystem. Weak evidence was also found to support the hypothesis that certain risk factors, including experiencing two or more adverse life events in the past year, sports related concussion, high self-stigma, inadequate social support and low psychological safety conferred a greater risk for poorer mental health outcomes for para athletes in particular.ConclusionRisk factors occurring across various levels of the sports ecosystem, including individual, interpersonal and organizational level risk factors were found to be associated with a range of poorer mental health outcomes. The association between mental ill-health and certain risk factors, particularly those at the individual and microsystem level, appear to be greater for para athletes. These findings have important implications for policy and mental health service provision in elite sports settings, highlighting the need for more nuanced approaches to subpopulations, and the delivery of mental health interventions across all levels of the sports ecosystem. (shrink)

"The fixed person for fixed duties, who in older societies was such a godsend, in the future ill be a public danger." Twenty years ago, a single legal metaphor accurately captured the role that American society accorded to physicians. The physician was "c- tain of the ship." Physicians were in charge of the clinic, the Operating room, and the health care team, responsible - and held accountabl- for all that happened within the scope of their supervision. This grant of responsibility (...) carried with it a corresponding grant of authority; like the ship's captain, the physician was answerable to no one regarding the practice of his art. However compelling the metaphor, few would disagree that the mandate accorded to the medical profession by society is changing. As a result of pressures from a number of diverse directions - including technological advances, the development of new health professionals, changes in health care financing and delivery, the recent emphasis on consumer choice and patients' rights - what our society expects phy- cians to do and to be is different now. The purpose of this volume is to examine and evaluate the conceptual foundations and the moral imp- cations of that difference. Each of the twelve essays of this volume assesses the current and future validity of the "captain of the ship" metaphor from a different perspective. The essays are grouped into four sections. In Section I, Russell Maulitz explores the physician's role historically. (shrink)

Recent studies from Western countries indicate significant levels of questionable research practices, but similar data from low and middle-income countries are limited. Our aims were to assess the prevalence of and attitudes regarding research misconduct among researchers in several universities in the Middle East and to identify factors that might account for our findings. We distributed an anonymous questionnaire to a convenience sample of investigators at several universities in Egypt, Lebanon, and Bahrain. Participants were asked to a) self-report their extent (...) of research misconducts, as well as their knowledge of colleagues engaging in similar research misconducts and b) provide their extent of agreement with certain attitudes about research misconduct. We used descriptive, bivariate, and multivariate logistic regression statistics to analyze the data. Data from 278 participants showed a high prevalence of misconduct, as 59.4% of our respondents self-reported to committing at least one misbehaviors and 74.5% reported having knowledge of any misbehaviors among any of their colleagues. The most common type of self-report misconduct was “circumventing research ethics regulations” followed by “fabrication and falsification”. A significant predictor of misconduct included a lack of “prior ethics training”. Scientific misconduct represents a significant issue in several universities in the Middle East. The demonstration that a lack of “prior ethics training” was a significant predictor of misconduct should lead to educational initiatives in research integrity. Further studies are needed to confirm whether our results can be generalized to other universities in the Middle East. (shrink)

Background Institutional Review Boards (IRBs) are federally mandated to include both nonscientific and unaffiliated representatives in their membership. Despite this, there is no guidance or policy on the selection of unaffiliated or non-scientist members and reports indicate a lack of clarity regarding members’ roles. In the present study we sought to explore processes of recruitment, training, and the perceived roles for unaffiliated and non-scientist members of IRBs.Methods We distributed a self-administered REDCap survey of members of the Association for the Accreditation (...) of Human Research Protection Programs familiar with IRB member recruitment. The survey included closed and open-ended questions regarding: the operation of the HRPP/IRB(s), how unaffiliated and non-scientist members are recruited, whether they had faced challenges recruiting for these roles, and training and mentorship offered. The survey also collected information regarding the perceived value and roles of unaffiliated and non-scientist members.Results 76 responses were included in the analysis (38% completion rate). The most common approach for recruitment was referral from current IRB members, with almost half of respondents indicating challenges recruiting unaffiliated members. Over 75% indicated no additional training was provided to unaffiliated or non-scientist members compared to affiliated or scientist members. Most common supports provided were travel/parking expenses and honoraria. Commonly perceived roles were to provide an independent voice from the participant perspective, notably regarding consent processes and materials.Conclusions Respondents indicated challenges in defining unaffiliated and non-scientist members and limited practices toward recruitment and support. Future work should more closely examine the challenges in defining these roles and applying the definitions in practice, as well as strategies that may improve recruitment and retention of unaffiliated and non-scientist members. (shrink)

Higher education institutions are expected to produce quality and competitive graduates for the job market and nation-building. In realizing this role, Bukidnon State University needs to ensure that graduates may land a job-relevant and align with their education and training. With this, a tracer study was conducted to verify whether the three batches of graduates are employed and are employable. It ascertained their employability based on their work experience from graduation to the present job. It employed a cross-sectional method (...) and data mining for the information of 326 graduates. The results revealed that the majority of graduates had jobs relevant to their education and training; yet, there was a significant difference in the employability of graduates across batches, except in terms of gender. Biological Science, Social Studies, and Math graduates were employable within the first six and twelve months compared to graduates from other curricula. It was claimed that the BukSU had prepared BSE graduates for employment. However, these results have implications for strategic options in improving the programs. The study made some recommendations for future tracer initiatives. (shrink)

BackgroundBoosting the individual learning passion of medical students is a novel approach to improve their academic performance. It facilitates the medical education reform, motivating both policymakers and educators to focus on the function of positive psychology in the career development of medical students. Therefore, this study aimed to assess the status of two types of learning passion; to clarify the relationship between self-esteem and two types of learning passion among Chinese medical students; to examine the mediating role of psychological capital (...) in the relationship between self-esteem and two types of learning passion, respectively; and to identify the moderating role of professional identity in the relationship between PsyCap and two types of learning passion, respectively.MethodsA cross-sectional online survey was conducted from April to June 2016 in China. A total of 1,218 valid questionnaires were collected from four medical schools.ResultsSelf-esteem significantly and positively influenced medical students’ PsyCap.ConclusionTwo types of learning passion of medical students are positively influenced by self-esteem and PsyCap. Medical students with high-level self-esteem should possess strong PsyCap, which augments their harmonious as well as obsessive learning passion. Moreover, the positive effect of medical students’ PsyCap on harmonious learning passion is more notable among those with a lower professional identity. Finally, this study argues that strengths-based interventions of self-esteem and PsyCap are a beneficial approach for future enhancing learning passion in the domain of medical education. (shrink)

BackgroundInstances of surrogate decision-making are expected to increase with the rise in hospitalised older adults in Japan. Few large-scale studies have comprehensively examined the entire surrogate decision-making process. This study aimed to gather information to assess the current state of surrogate decision-making in Japan.MethodsA cross-sectional survey was conducted using online questionnaires. A total of 1000 surrogate decision-makers responded to the questionnaire. We examined the characteristics of surrogate decision-makers and patients, content of surrogate decision-making meeting regarding life-sustaining treatment between the (...) doctors and surrogate decision-makers, extent of involvement of the various parties in the surrogate decision-making process, judgement grounds for surrogate decision-making, and frequency of involvement in the surrogate decision-making process.ResultsOf the participants, 70.5% were male and 48.3% were eldest sons. Only 7.6% of the patients had left a written record of their preferences and 48.8% of the surrogates reported no knowledge of the patient having expressed their prior intentions regarding medical care in any form. Respondents indicated that their family meetings with healthcare professionals mostly included the information recommended by guidelines in a surrogate decision-making meeting in Japan. Most participants reported a good understanding of the meeting content. Although many participants based their decisions on multiple grounds, surrogates’ considerations may not adequately reflect respect for patient autonomy in Japan. Specifically, the eldest son considered his own preference more frequently than that of the other surrogate decision-makers. In 26.1% of the cases, either zero or one family meeting with healthcare professionals was held. In these cases, significantly fewer decisions involved the participation of healthcare professionals other than the doctor compared to cases with multiple meetings.ConclusionsSurrogate decisions in Japan are most commonly made by eldest sons and may not frequently consider the perspectives of other surrogates. The finding that patient preferences were rarely known suggests a role for increased advance care planning. (shrink)

BackgroundHealthcare professionals are exposed to advertisements for prescription drugs in medical journals. Such advertisements may increase prescriptions of new drugs at the expense of older treatments even when they have no added benefits, are more harmful, and are more expensive. The publication of medical advertisements therefore raises ethical questions related to editorial integrity.MethodsWe conducted a descriptive cross-sectional study of all medical advertisements published in the Journal of the Danish Medical Association in 2015. Drugs advertised 6 times or more were (...) compared with older comparators: comparative evidence of added benefit; Defined Daily Dose cost; regulatory safety announcements; and completed and ongoing post-marketing studies 3 years after advertising.ResultsWe found 158 medical advertisements for 35 prescription drugs published in 24 issues during 2015, with a median of 7 advertisements per issue. Four drug groups and 5 single drugs were advertised 6 times or more, for a total of 10 indications, and we made 14 comparisons with older treatments. We found: ‘no added benefit’ in 4 of 14 comparisons, ‘uncertain benefits’ in 7, and ‘no evidence’ in 3 comparisons. In no comparison did we find evidence of ‘substantial added benefit’ for the new drug; advertised drugs were 2 to 196 times more expensive per Defined Daily Dose; 11 safety announcements for five advertised drugs were issued compared to one announcement for one comparator drug; 20 post-marketing studies were requested for the advertised drugs versus 10 studies for the comparator drugs, and 7 studies assessed both an advertised and a comparator drug at 3 year follow-up.Conclusions and relevanceIn this cross-sectional study of medical advertisements published in the Journal of the Danish Medical Association during 2015, the most advertised drugs did not have documented substantial added benefits over older treatments, whereas they were substantially more expensive. From January 2021, the Journal of the Danish Medical Association no longer publishes medical advertisements. (shrink)

The evaluation of competency in the field of psychology has gained international attention in recent years. Focusing on international competencies can promote high standards of care and identify common values of the profession. However, there is little research regarding international perceptions of competency. Examining ethics codes from different countries can highlight international standards of competent practice, as ethics codes outline professional expectations of the field. The current study compared the ethics standards found in 47 codes of ethics representing 51 countries. (...) Seventeen competency standards emerged after ethics codes were analyzed. Implications for the international practice of psychology are discussed. (shrink)

BackgroundFinancial interactions between pharmaceutical companies and physicians lead to conflicts of interest. This study examines the extent and trends of non-research payments made by pharmaceutical companies to board-certified allergists in Japan between 2016 and 2020.MethodsA retrospective analysis of disclosed payment data from pharmaceutical companies affiliated with the Japanese Pharmaceutical Manufacturers Association was conducted. The study focused on non-research payments for lecturing, consulting, and manuscript drafting made to board-certified allergists from 2016 to 2020. We performed descriptive analyses on payment data. Trends (...) were analyzed using generalized estimating equation models.ResultsOf the 3,943 board-certified allergists, 2,398 (60.8%) received non-research payments totaling $43.4 million over five years. Lecturing fees comprised 85.7% ($37.2 million) of the total payment amounts. For allergists who received at least one payment, the median amount per allergist was $3,106 (interquartile range: $966 – $12,124), in contrast to a mean of $18,092 (standard deviation: $49,233) over the five-year span. The top 1% and 10% of these allergists accounted for 20.8% and 68.8% of all non-research payments, respectively. The annual payment amounts significantly increased by 7.2% annual increase (95% CI: 4.4 – 10.0%, p < 0.001) each year until 2019, but saw a significant decrease in 2020 amid the COVID-19 pandemic.ConclusionThe majority of allergists received non-research payments, with a notable concentration among a small group. Payments increased annually until the pandemic’s onset, which coincided with a substantial decrease. Further research is needed to explore the implications of these financial interactions on clinical practice and patient care in Japan. (shrink)

Based on the nationally representative sample data from the Chinese General Social Survey, this study examines the relationship of education levels and health status with an individual's probability of being employed in China. The findings obtained from the binary logistic regression estimator suggest that people with a higher level of education were more likely to be employed than those who have less or no education. The individual with university or above education was found to be 85% more likely to be (...) employed than college or equal diploma holders. Further, the healthier individual was found to be 11% more likely to be employed than relatively less healthy. Moreover, the resulting coefficients obtained from the moderation effect suggest that all of the two-way interaction effects among health status and education levels with gender are not statistically significant even at the 10% level. The results suggest that there was no multiplicative effect of gender with health status and level of education on an individual's probability of being employed. Further, the study also suggests important policy implications in the light of China's active labor force market and the gender gap in employment. (shrink)

Analysing time-dependent independent variables requires the use of process-oriented statistical models. Yet social scientists have often had to use data collected at a single point in time, making their task difficult. Making several assumptions about the covariates, the present study uses survival analysis and other statistical techniques to analyse the 1996 South African population census data and examine the effects of selected independent variables on the timing of parenthood in the country. It was found that the onset of parenthood occurs (...) late in South Africa compared with the pattern in most other African societies. While education plays a role in the postponement of parenthood within racial groups, it fails to explain the differences between African and Coloured women on the one hand, and White and Asian women on the other hand, a finding that suggests the existence of two regimes of family formation in South African society. (shrink)

Background In February, 2015, the Supreme Court of Canada struck down the ban on medical assistance in dying. In June, 2016, the federal government passed Bill C-14, permitting MAiD. Current medical students will be the first physician cohort to enter a system permissive of MAiD, and may help to ensure equitable access to care. This study assessed medical student views on MAiD, factors influencing these views, and opportunities for medical education. Methods An exploratory cross-sectional survey was developed and distributed (...) to medical students across all years of a three-year Canadian undergraduate medical program. The investigators administered the survey to participants during academic sessions from November to December, 2015. Analysis of the results included summary descriptive statistics, Pearson’s chi-square test of independence to identify differences between participants by year of study, logistic regression to identify factors that influence students’ stances on MAiD, and Wilcoxon signed rank test to measure changes in student support for MAiD and comfort discussing MAiD. Results There were 405 participants for a response rate of 87%. The majority of students supported the Supreme Court’s decision, 61% would provide the means for a patient to end their life, and 38% would personally administer a lethal medication. Students who were more willing to provide the means for MAiD found medical education/clinical experience and patient autonomy to be important contributors to their stances on MAiD. Those students who were less willing to provide the means for MAiD found religious/spiritual beliefs and teachings, as well as concern about potential negative consequences, to be important contributors to their stances on MAiD. Educational training desired by participants included medicolegal, communication skills, technical skills, and religious. Conclusions Medical students generally supported and would provide the means for MAiD to patients. They also indicated a desire for directed medical education on MAiD. (shrink)

To determine the attitude of general practitioners towards continuing medical education and reasons motivating or hindering them from attending CME procedures, we conducted a cross-sectional survey from November 2013 to April 2014 in Karachi. Three hundred general practitioners who possessed a medical license for practice in Pakistan filled a pre-designed questionnaire consisting of questions pertaining to attitudes towards CME. Data was entered and analyzed using SPSS v16.0. 70.3% of the participants were males. Mean age was 47.75 ± 9.47 years. (...) Only 67.33% knew about CME and only 52% had attended a CME session. Reasons for attending CME procedures reported were: need for updating knowledge, skills and competencies, opportunity to meet colleagues and presenting scientific papers. Mean Likert score was 1.67 for those who thought CME is worthwhile and 1.44 for those who consider their clinical duties as the major hurdle in attending CME procedures. Most common cause for not attending CME was lack of knowledge followed by time constraint. Most physicians were not sufficiently informed about the potential benefits of CME and had never attended a CME session. Most common reason for attending CME procedures reported was need for updating knowledge, skills and competencies while reasons hindering physicians from attending CME were lack of knowledge and time constraint. (shrink)

This study examined individual differences in spatial abilities of architecture students. Students at different educational levels were assessed on spatial ability tests that varied in their domain-specificity to architecture, with the hypothesis that larger differences between beginner and advanced students will emerge on more domain-specific tests. We also investigated gender differences in test performance and controlled for general reasoning ability across analyses. In a cross sectional study, master students (N= 91) outperformed beginners (N= 502) on two novel tests involving (...) perspective taking and object composition, as well as on a standardized visualization of cross-sections test, but not on a standardized mental rotations test. Longitudinally (N= 117), spatial performance improved after the first bachelor year on visualization of cross-sections, object composition and mental rotation. Although both genders showed higher spatial test performance with increased experience, male students outperformed females across tests and levels of education. The results overall confirmed improvements in spatial performance during architecture studies, with partial support for the domain-specificity hypothesis. A gender gap among advanced students calls for further examining architecture-specific spatial thinking. (shrink)

Background The increasing incidence of people affected by overweight or obesity is a significant health problem. The knowledge of the factors which influences the inappropriate eating behaviours causing excessive body fat is an essential goal for the research. In fact, overweight and obesity are significant risk factors for many health diseases, such as cardiovascular problems, diabetes, etc. Recently, many studies have focused on the relationship between body weight and cognitive processes. Objectives This systematic review is aimed to investigate the existence (...) and the nature of the relationship between excessive body weight (overweight/obesity) and executive functions, analysing cross-sectional and longitudinal studies in order to verify the evidence of a possible causality between these variables. Methods The review was carried out according to the PRISMA-Statement, through systematic searches in the scientific databases PubMed, Medline, PsychInfo, and PsycArticles. The studies selected examined performance on executive tasks by participants with overweight or obesity, aged between 5 and 70 years. Studies examining eating disorders or obesity resulting from other medical problems were excluded. Furthermore, the results of studies using a cross-sectional design and those using a longitudinal one were separately investigated. Results Sixty-three cross-sectional studies and twenty-eight longitudinal studies that met our inclusion and exclusion criteria were analysed. The results confirmed the presence of a relation between executive functions and overweight/obesity, although the directionality of this relation was not clear; nor did any single executive function emerge as being more involved than others in this relation. Despite this, there was evidence of a reciprocal influence between executive functions and overweight/obesity. Conclusions This systematic review underlines the presence of a relationship between executive functions and overweight/obesity. Moreover, it seems to suggest a bidirectional trend in this relationship that could be the cause of the failure of interventions for weight reduction. The results of this review highlight the importance of a theoretical model able to consider all the main variables of interest, with the aim to structuring integrated approaches to solve the overweight/obesity problems. (shrink)

Der Unterricht in Medizinethik soll Medizinstudierenden die Grundlagen dafür vermitteln, in ihrer zukünftigen ärztlichen Tätigkeit gute Entscheidungen treffen zu können. Im Rahmen einer Panelstudie wird derzeit die Entwicklung moralischer Positionen, medizinethischer Kenntnisse und Motivationen von Medizinstudierenden der Ludwig-Maximilians-Universität München über den Verlauf des Studiums untersucht. Für die Datenerhebung wurde ein Fragebogen entwickelt, der medizinethische Positionen und Kenntnisse sowie Motivationen erfasst. Im Wintersemester 2009/10 wurde die erste Querschnittsuntersuchung mit Studierenden im 1., 3. und 8. Semester sowie im Praktischen Jahr durchgeführt. Die (...) Mehrzahl der Befragten verfügte über einen geringen Kenntnisstand in verschiedenen Themenbereichen des Unterrichtsfachs GTE. Rechtliche Grundlagen und praktische Umsetzung von Therapiebegrenzungsmaßnahmen waren bis ins PJ-Semester vielen Studierenden nicht bekannt. Im Verlauf des Studiums veränderten sich die Motivationen weg von der Motivation, Menschen helfen zu wollen, hin zu Wissenserwerb und dem Ergreifen eines sicheren Berufs. Obwohl viele Befragte ein hohes Interesse an medizinethischen Fragestellungen und Unterricht im Bereich GTE angaben, zeigte sich kein nachhaltiger Zuwachs an medizinethischen Kenntnissen im Laufe des Studiums. In der Zusammenschau werfen die Ergebnisse die Frage auf, inwieweit verschiedene Ausbildungskonzepte Einfluss auf die individuelle ethische Entwicklung Medizinstudierender nehmen können. Eine Untersuchung dieser Fragestellung bleibt Gegenstand weitergehender Forschung. (shrink)

Background: The rapid pace of progress in medical research, the consequent need for the timely transfer of new knowledge into practice, and the increasing need for ethics support, is making the work of Ethics Committees (ECs) ever more complex and demanding. As a response, ECs in many countries exhibit large variation in number, mandate, organization and member competences. This cross-sectional study aims to give an overview of the different types of activities of Italian ECs and favour discussion at a (...) European level.Methods: A questionnaire was emailed to all Italian Ethics Committees contained in the national Registry of the Ministry of Health, enquiring whether the EC was conducting, or planning to conduct, 4 specific activities. A telephone interview was conducted to determine reasons for failure to respond.Results: Response rate was 53% (101 respondents out of 191). 20% of ECs restrict their responsibilities to research protocol review, 25% also offer ethical consultation to institutions, support on individual health care decisions and promotes educational initiatives, while the remaining 50% conduct a few of the examined activities to varying degrees. Large variation was observed across different types of hosting institutions and geographical locations.Conclusions: A common European model should be developed, defining EC functions, member selection modalities, necessary member competences, decision-making criteria and measures for work verification. In the absence of sound empirical evidence, it would be interesting to study the effectiveness and efficiency of the different existing models. (shrink)

Objective To determine the attitudes of Egyptian patients regarding their participation in research and with the collection, storage and future use of blood samples for research purposes. Design Cross-sectional survey. Study population Adult Egyptian patients (n=600) at rural and urban hospitals and clinics. Results Less than half of the study population (44.3%) felt that informed consent forms should provide research participants the option to have their blood samples stored for future research. Of these participants, 39.9% thought that consent forms (...) should include the option that future research be restricted to the illness being studied. A slight majority (66.2%) would donate their samples for future genetic research. Respondents were more favourable towards having their blood samples exported to other Arab countries (62.0%) compared with countries in Europe (41.8%, p<0.001) and to the USA (37.2%, p<0.001). Conclusions This study shows that many individuals do not favour the donation of a blood sample for future research. Of those who do approve of such future research, many favour a consent model that includes an option restricting the future research to the illness being studied. Also, many Egyptians were hesitant to have their blood samples donated for genetic research or exported out of the Arab region to the USA and European countries. Further qualitative research should be performed to determine the underlying reasons for many of our results. (shrink)

BackgroundSelf-prescribing and prescribing to personal contacts is explicitly discouraged by General Medical Council guidelines.AimsThis study examines how widespread the practice of self-prescribing and prescribing to personal contacts is.MethodsA 16-item questionnaire was distributed via an online forum comprising 4445 young medical doctors, which asked respondents about previous prescribing to themselves, their families, friends and colleagues, including the class of medication prescribed. Demographic details were collected including medical grade and specialty.ResultsA total of 729 responses were obtained, the majority of which were from (...) young non-consultant hospital doctors from a range of specialties. Two-thirds of respondents had self-prescribed, over 70% had prescribed to family, and nearly 60% had prescribed to a friend or colleague. Older doctors were more likely to self-prescribe. Interns being less likely to self-prescribe was not unexpected, while general practitioners and paediatricians were more likely to self-prescribe. GPs, paediatricians and hospital medicine specialties were more likely to prescribe to family and surgeons were more likely to prescribe to friends. Some 3% to 7% who had self-prescribed had prescribed an opiate, benzodiazepine or psychotropic medication. Male doctors, anaesthetists and surgeons were more likely to self-prescribe opioids, while those in hospital medicine were more likely to self-prescribe psychotropic medications.ConclusionPrescribing outside the traditional doctor-patient relationship is widespread despite clear professional guidance advising against it. (shrink)

We present a cross-sectional study of ethical decision-making correlated with spirituality and utilizing moral intensity as a moderator for workers in the Southeastern United States. This study presents spirituality as an individual variable and moral intensity as a situational variable along with ethical decision-making to examine the interaction of these factors in moral dilemmas. Utilizing previously validated instruments for ethical decision-making and individual spirituality, we find that workers with relatively high measured spirituality made less ethical decisions compared to workers (...) with relatively lower measures of spirituality. Further, we find that the introduction of high moral intensity as a situational variable does not moderate the observed correlation between spirituality and ethical decision-making. This research supports the conceptual nature of the Interactionist Theory by presenting in a single study both individual and situational variables in ethical decision-making. (shrink)

BackgroundThere has been no in-depth research of public attitudes on withholding or withdrawing life-prolonging treatment, euthanasia, assisted suicide and physician assisted suicide in Croatia. The aim of this study was to examine these attitudes and their correlation with sociodemographic characteristics, religion, political orientation, tolerance of personal choice, trust in physicians, health status, experiences with death and caring for the seriously ill, and attitudes towards death and dying. MethodsA cross-sectional study was conducted on a three-stage random sample of adult citizens (...) of the Republic of Croatia, stratified by regions, counties, and locations within those counties. In addition to descriptive statistics, ANOVA and Chi-square tests were used to determine differences, and factor analysis, correlation analysis and multiple regression analysis for data analysis.Results38.1% of the respondents agree with granting the wishes of dying people experiencing extreme and unbearable suffering, and withholding life-prolonging treatment, and 37.8% agree with respecting the wishes of such people, and withdrawing life-prolonging treatment. 77% of respondents think that withholding and withdrawing procedures should be regulated by law because of the fear of abuse. Opinions about the practice and regulation of euthanasia are divided. Those who are younger and middle-aged, with higher levels of education, living in big cities, and who have a more liberal worldview are more open to euthanasia. Assisted suicide is not considered to be an acceptable practice, with only 18.6% of respondents agreeing with it. However, 40.1% think that physician assisted suicide should be legalised. 51.6% would support the dying person’s autonomous decisions regarding end-of-life procedures.ConclusionsThe study found low levels of acceptance of withholding or withdrawing life-prolonging treatment, euthanasia, assisted suicide and physician assisted suicide in Croatia. In addition, it found evidence that age, level of education, political orientation, and place of residence have an impact on people’s views on euthanasia. There is a need for further research into attitudes on different end-of-life practices in Croatia. (shrink)