BackgroundNurse champions are front-line practitioners who implement innovation and reconstruct policy.PurposeTo understand through a network theory lens the factors that facilitate nurse champions’ engagement with radical projects, representing their actions as street-level bureaucrats.Materials and methodsA personal-network survey was employed. Ninety-one nurse champions from three tertiary medical centers in Israel participated.FindingsGiven high network density, high levels of advice play a bigger role in achieving high radicalness compared with lower levels advice. High network density is also related to higher radicalness when networks (...) have high role diversity.DiscussionUsing an SLB framework, the findings suggest that nurse champions best promote adoption of innovation and offer radical changes in their organizations through professional advice given by colleagues in their field network. Healthcare organizations should establish the structure and promote the development of dense and heterogeneous professional networks to realize organizations’ goals and nurses’ responsibility to their professional employees, patients, and society. (shrink)

When two people move in synchrony, they become more social. Yet it is not clear how this effect scales up to larger numbers of people. Does a group need to move in unison to affiliate, in what we term unitary synchrony; or does affiliation arise from distributed coordination, patterns of coupled movements between individual members of a group? We developed choreographic tasks that manipulated movement synchrony without explicitly instructing groups to move in unison. Wrist accelerometers measured group movement dynamics and (...) we applied cross-recurrence analysis to distinguish the temporal features of emergent unitary synchrony and distributed coordination. Participants’ unitary synchrony did not predict pro-social behavior, but their distributed coordination predicted how much they liked each other, how they felt toward their group, and how much they conformed to each other's opinions. The choreography of affiliation arises from distributed coordination of group movement dynamics. (shrink)

Background: Positioned at the frontlines of the battle against COVID-19 disease, nurses are at increased risk of contraction, yet as they feel obligated to provide care, they also experience ethical pressure. Research question and objectives: The study examined how Israeli nurses respond to ethical dilemmas and tension during the COVID-19 outbreak, and to what extent this is associated with their perceived risk and motivation to provide care? Research design: The study implemented a descriptive correlative study using a 53-section online questionnaire, (...) including 4 open-ended questions. Participants and research context: The questionnaire was complete by 231 registered and intern nurses after being posted on nurses’ Facebook and WhatsApp groups, and through snowball sampling. Ethical considerations: The research was pre-approved by the ethics committee of the Faculty of Social Welfare and Health Sciences at the University of Haifa, Israel. Findings: In all, 68.8% of the respondents had received some form of training about COVID-19. Respondents positioned themselves at perceived high risk levels for contracting the virus. About one-third feared going to work because of potential contraction and due to feeling inadequately protected. While 40.9% were scared to care for COVID-19 patients, 74.7% did not believe they have the right to refuse to treat certain patients. When asked about defining an age limit for providing patients with scarce resources (such as ventilation machines) in cases of insufficient supplies, respondents stated that the maximum age in such scenarios should be 84 (standard deviation (SD = 19) – yet most respondents (81.4%) believed that every patient has the right to receive optimal treatment, regardless of their age and medical background. Discussion: Correlating with their strong commitment to care, nurses did not convey intention to leave the profession despite their stress, perceived risk, and feelings of insufficient support and protection at work. The nurses did not hold a utilitarian approach to resource allocation, thereby acknowledging the value of all people and their entitlement to care, regardless of optimal outcomes. Conclusion: While experiencing significant personal risk and emotional burden, nurses conveyed strong dedication to providing care, and did not regret working in the nursing profession, yet they did seek a supportive climate for their needs and ethical concerns. (shrink)

Daniel Sperling discusses the legal status of posthumous interests and their possible defeat by actions performed following the death of a person. The author first explores the following questions: Do the dead have interests and/or rights, the defeat of which may constitute harm? What does posthumous harm consist of and when does it occur, if at all? This is followed by a more detailed analysis of three categories of posthumous interests arising in the medico-legal context: the proprietary interest in (...) the body of the deceased, the testamentary interest in determining the disposal of one's body after death and the interest in post-mortem medical confidentiality. Sperling concludes that if we acknowledge the interest in one's symbolic existence and legally protect it, not only do some interests survive a person's death but we should also enjoy a peremptory legal power to shape in advance our symbolic existence after death. (shrink)

Background End-stage renal disease (ESRD) is the final stage of chronic kidney disease. Yet dialysis is not suitable for all ESRD patients. Moreover, while shared decision-making (SDM) is the preferred model for making medical decisions, little is known about SDM between nephrology nurses and ESRD patients in Israel. Research Objective Assessing the views, attitudes, practices, and ethical dilemmas of nephrology nurses in Israel regarding SDM with ESRD patients. Methods Using the descriptive quantitative approach, questionnaires were completed by 444 nephrology nurses (...) in Israel. In addition to conducting descriptive statistics, t-tests for independent samples, f-tests for analysis of variance, and both tests for independence were also performed. Ethical Considerations The research aims, expected advantages and risks have been explained to respondents before completing the questionnaire to secure informed consent. Anonymity and confidentiality were ensured throughout the study. The study was approved by the Research Ethics Committee at the University of Haifa (Approval # 411/21). Results About one-third (30%–36.5%) of nurses reported discussing quality of life issues with ESRD patients, asking about their advance directives/power of attorney, exploring cultural/religious beliefs in end-of-life care, and ask about their preferred place of death. Nurses who convey high levels of patient-centered care (68.9%, p<0.0001), have high end-of-life training (76.2%, p<0.0001), and report cooperating with interdisciplinary teams (63.8%, p = 0.0415), also reported higher SDM practices than others. Nurses who refer less patients to palliative care (70%, p<0.0001) reported higher involvement in SDM compared to other nurses. Conclusions Nephrology nurses in Israel do not tend to implement the SDM model, despite its potential for improving quality of life for ESRD patients and their families and increasing conservative care options. Policy makers and educators in Israel should develop and implement training programs and support in the workplace, to enhance SDM between nephrology nurses and ESRD patients. (shrink)

Background During disease outbreaks, nurses express concerns regarding the organizational and social support required to manage role conflicts. Objectives The study examined concerns, threats, and attitudes relating to care provision during the COVID-19 outbreak among nurses in Israel. Design A 53-item questionnaire was designed for this research, including four open-ended questions. The article used a qualitative research to analyze the responses to the open-ended questions and their association with responses to the close-ended ones. Participants and research context In all, 231 (...) registered nurses and fourth-year nursing students throughout the whole country. The questionnaire was delivered in nursing Facebook and WhatsApp groups and through snowball sampling. Ethical considerations The research was pre-approved by the Ethics Committee at the researchers’ university. Results Nurses mostly referred to personal risk, followed by dilemmas regarding care provision. On average, 38.6% of quotations stated that during the pandemic, nurses are not asked to perform unfair duties. Nurses discussed activities and requirements that impact their personal and familial safety, their relationship with employer, organization or the state, and their duty to providing care. Other than fear of contraction, respondents’ most frequent themes of concerns were related to work condition and patients’ interests, inter-collegiate relationships, and uncertainty and worries about the future. Respondents’ ethical dilemmas mostly referred to clinical questions, providing care without adequate equipment or managerial support, and in conditions of uncertainty and increased risk. Discussion Nurses raise important issues concerning their relationships with employers and family members, and significant insights regarding the pandemic and their revised responsibilities and definition of work. They raise serious concerns regarding their rights at work and their standing for them. Conclusions Health managers should find ways to enhance the ethical climate and institutional support to enable a better work-life balance in times of pandemic and support nurses’ working needs and labor rights. (shrink)

The autosomal recessive genetic disease, Fanconi anaemia, is perceived as another manifestation of defective cellular DNA repair, just as in the autosomal recessive disease Xeroderma pigmentosum. The biochemistry and cellular biology of Xeroderma pigmentosum have been convincingly elucidated, but the same has not been true for Fanconi anaemia. In this review we consider the pleiotropic nature of Fanconi anaemia, its clinical and cellular variability and its genetic heterogeneity. We take into account the wealth of experimental findings available and offer a (...) novel hypothesis involving feedback control of DNA replication during S phase of the cell cycle to explain the basic defect in the disease. (shrink)

The autosomal recessive genetic disorder, Nijmegen Breakage Syndrome, is characterised by an excessively high risk for the development of lymphatic tumours and an extreme sensitivity towards ionising radiation. The most likely explanation for these characteristics, a deficiency in the repair of DNA lesions, has been greatly substantiated by the recent cloning of the gene mutated in Nijmegen Breakage Syndrome patients and the analysis of its protein product, nibrin. The direct involvement of this protein in the processing of DNA double strand (...) breaks caused by ionising radiation and those also necessary for normal DNA metabolism can be correlated with many of the cellular and clinical aspects of the disease, including the cancer predisposition of patients and their heterozygous relatives. BioEssays 21:649–656, 1999. © 1999 John Wiley & Sons, Inc. (shrink)

A tale of two commissions -- Disciplining disorder -- Transparent fictions -- Conscientious objections -- A failed experiment -- Stem cells, interrupted.

Most models of corporate social responsibility revolve around the controversy as to whether business is a single dimensional entity of profit maximization or a multi-dimensional entity serving greater societal interests. Furthermore, the models are mostly descriptive in nature and are based on the experiences of western countries. There has been little attempt to develop a model that accounts for corporate social responsibility in diverse environments with differing socio-cultural and market settings. In this paper an attempt has been made to fill (...) this gap by developing a two-dimensional model of corporate social responsibility and empirically testing its validity in the context of two dissimilar cultures – Australia and Bangladesh. The two dimensions are the span of corporate responsibility and the range of outcomes of social commitments of businesses. The test results confirm the validity of the two-dimensional model in the two environments. The Factor analysis revealed two leading dimensions. Cluster analysis pointed to two distinctive clusters of managers in both Australia and Bangladesh, one consisting of managers with a broad contemporary concept of social responsibility, and the other with a limited narrow view. The paper concludes that corporate social responsibility is two-dimensional and universal in nature and that differing cultural and market settings in which managers operate may have little impact on the ethical perceptions of corporate managers. (shrink)

BackgroundFollowing the increased presence of the Right-to-Die Movement, improved end-of-life options, and the political and legal status of aid-in-dying around the globe, suicide tourism has become a promising alternative for individuals who wish to end their lives. Yet, little is known about this from the perspective of those who engage in the phenomenon.MethodsThis study applied the qualitative research approach, following the grounded theory tradition. It includes 11 in-depth semi-structured interviews with Israeli members of the Swiss non-profit Dignitas who contemplated traveling (...) to Switzerland for aid-in-dying.ResultsSeven themes emerged from the data analysis, including health and functioning; feelings regarding survivorship and existence; interacting with the health sector; attitudes regarding death and dying; suicide; choosing death; and choosing suicide tourism. A significant portion of the participants had experienced suicidal thoughts and had even previously attempted suicide, some more than once. Most of them referred to chronic illnesses, functional disability, and social isolation. They understand suffering within the subjective dimension, namely only by the person who is actually subjected to the disease, ailments, and disability. Participants regarded aid-in-dying in Switzerland as positive thanks to its guaranteed outcome: "beautiful death", compared to "disadvantaged dying" which places a burden on the participants' loved ones throughout the prolonged dying. Most of them do not necessarily want to have their loved ones beside them when they die, and they see no significant meaning in dying in a foreign country to which they have no emotional or civil attachment.ConclusionThe desirable approval or tragic refusal by Dignitas to participants' requests for suicide tourism enhances the paradox between the perception of aid-in-dying as a mechanism for fulfilling controlled death and its bureaucratic and materialistic characteristics specifically reflected in a paid, formalized approach to aid-in-dying that cultivate dependency and collaboration. (shrink)

As of June 2009, Israel’s population was 7,424,400 people, 5,604,900 of which were Jewish, 1,502,400 were Arabs, and approximately 317,200 had no religion or are non-Arab Christians. Established in 1948, Israel is a highly urban and industrialized country. Its gross domestic product per capita is US$23,257, positioning it among the European developed countries. Life expectancy is 79 years for males and 82 years for females, with infant mortality rate of 4 cases per 1,000 live births. Of Israel’s GDP, 7.7% is (...) spent on health. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:On Sharing BreathJody Sperling (bio)My work as choreographer dwells on the inseparability between breath and atmosphere. There are no firm boundaries between the air we breathe in, the air surrounding us, and the air enveloping the planet. This is as true for air as it is for water—there is only one global ocean, although by convention we divide the seas into named regions. When you move through the (...) ocean of air enveloping you, you displace it and create dynamic unseen wakes in your midst.Beginning with my dance, "Turbulence" (2011),1 I sought to visualize such patterns of air disturbance into kinetic sculptural forms. To do so, the six dancers deployed Loie Fuller-style costumes, disquieting the air and materializing its gyrations. An early innovator of performance technology, Fuller danced in robes fashioned from hundreds of yards of silk with embedded wands that extended her body's motion into space. Serendipitously introduced to Fuller's work in 1997, I became seduced by the genre for the way it imbues the doer with an expanded sense of self. Whirling in the Fuller-style garments, I felt, and still feel, integrated into the atmosphere as an eddy or gust.With "Wind Rose" (2019),2 a collaboration with composer Matthew Burtner, I focused on making the connections between breath and wind palpable. Wind is said to be the breath of the planet, a driver of earthly life. A windrose is a meteorological tool that graphically represents wind speed, direction and variability at a particular time and place. I thought, what if I designed choreography with the intention not to create human motion, but in order to create a windrose—an atmospheric snapshot—in the performing space? At the start of "Wind Rose," the five dancers stand shoulder to shoulder and circle the stage so as to forge a human turbine. As the dancers accelerate their cyclonic motion, they push a swelling air wave towards the audience.For another section, I choreographed eight motions, each of which was connected with a sound. The sounds were made either by the dancers whipping their Fuller-style costumes through the air or by the dancers' breathy vocalizations. Matthew took my eight sound-breath-moves and composed a fugue. The dancers perform this music-motion score so that [End Page 155] they stir up a breeze pattern—a fugue that can be felt, as well as seen and heard.Wind has been changing along with climate. Locally, winds are becoming more chaotic. Globally, the high winds are slowing down and the polar jet stream is becoming wonky. But we are not in the habit of listening to the changing winds. One of the root causes of climate inaction has been a deep disconnect between people and their atmosphere. Many among the privileged live out their lives in climate-controlled habitats. Recently, though, even wealthy nations and the elite are starting to feel the heat. These days, no matter how deeply you bury your head in the sand, your butt will still get scorched.As a way of grappling with life in the Anthropocene, I have been formulating an open inquiry called ecokinetics. I conceived ecokinetics as a choreographic corollary to ecoacoustics, an environmental mode of music composition pioneered by Matthew Burtner, my long-time musical collaborator. According to Matthew, "ecoacoustics embeds environmental systems into musical and performance structures using new technologies" (Burtner). Ecokinetics asks, how can we relate human movement to environmental systems? How can choreography (aesthetically patterned human motion) illuminate, echo, expand upon the movement vectors present at a site and help us better understand local ecologies? How can dance entwine with media technologies to embody the processes of natural systems? Ecokinetics is part personal movement practice, part pedagogical tool, and part performance methodology.In its essence, ecokinetics repudiates the separation of humans from nature, a pervasive Colonialist mindset that needs constant undoing. In order to make progress on climate change, we must feel—truly and deeply—that we are part of the planet and not apart from it. This is the opposite of what the billionaires' space club aims to accomplish. Bezos, Branson, and Musk, et al. view distance from Earth as a... (shrink)

This new book explores the interface between political philosophy and politics, looking at the effects of philosophical traditions on the contemporary relationship between women and politics. Analysing key concepts in political philosophy, the author illustrates how common ideas - entrenched in the development of political thought and practice - have become almost intractable 'truths' that continue to differentiate between the sexes in politics. Liz Sperling looks in detail at the works of Plato, Aristotle, Hobbes, Locke, Rousseau, Mill, Marx, Rawls (...) and Nozick, considering general themes to which they have all contributed - such as the state of nature, the state, markets, citizenship and representation. The focus then turns to the specific contributions of the philosophers that continue to influence the association of women to politics. These include an analysis of Greek classicists' establishment of andocracy, Rousseau's treatise on education for citizenship, and nineteenth-century ideas of equality. In conclusion, the themes demonstrated throughout are drawn together to show how they translate into contemporary policy on women in politics. Offering an original insight into the ways in which political thought influences political practice, this will be essential reading in a key area of politics, philosophy and women's studies. (shrink)

Some argue that law is the discipline which has mixed most prominently with bioethics, and that bioethicists can be seduced by the law and by legal procedures. While there is a great consensus that law has influenced bioethics in significant and important ways, certainly much more than it influenced other "law and..." disciplines, scholars dispute as to the exact role which the law plays in bioethics, the goals it purports to achieve and the implications of its relationship with the discipline (...) of bioethics. This Article aims to explore the relationship between law and bioethics and calls for a careful evaluation of the law's contributions to bioethics. Specifically, it will be argued that while the law contributed extensively to the development of bioethics it introduced a language and a way of thinking that are not necessarily appropriate to handle and resolve bioethical issues, and which, in significant portion of cases, was irrelevant and had little impact on decision-making and behavioral patterns of patients. Moreover, law's interference with and shape of bioethical issues resulted in serious threats to some of the major characteristic of such issues and brought about to other societal concerns which the law did not consider seriously. The article will conclude that it is now time to re-evaluate the direction in which bioethics should take in the next years, specifically whether it should continue to integrate with law or other disciplines, or alternatively become a more autonomous and independent discipline. (shrink)

Although transplantation surgeries are relatively successful and save the lives of many, only few are willing to donate organs. In order to better understand the reasons for donation or refusing donation and their implications on and influence by public policy, we conducted a survey examining public views on this issue in Israel. Between January and June 2010, an anonymous questionnaire based on published literature was distributed among random and selected parts of Israeli society and included organ recipients, organ donors, soldiers, (...) university and high school students, and the general population. The analysis of 799 questionnaires revealed that, although 74.7 percent have not signed a donor card, 60.8 percent of participants consider doing so. Additionally, 54.3 percent of respondents objected to giving or receiving compensation for donation, and, if at all, priority in transplantation care is the most desired form of such compensation. The health status of the donor and knowing that donation saves lives or that there exists a shortage of organs for transplantation are the two factors most affecting motivation to donate. Lack of information, relatives’ views on donation, and type of organ involved in donation are factors most inhibiting donation. Willingness to donate is significantly affected by the proximity of the recipient to the donor. With regard to most organs, their contribution to one’s sense of “self” and its symbolic role strongly affects motivation to donate, except for donation to relatives. Compensation for organ donation has little effect on motivation to donate during life and after death. Our findings suggest new ways to construct a more effective public policy on this issue. (shrink)

While painted wooden icons of the Nursing Virgin were relatively common in fifteenth-century Ethiopia, only one miniature of the motif of the time has come to light. This image, bound into a later manuscript of the Miracles of Mary, is painted in a decidedly abstract style, comparable to other representations of the Virgin in fifteenth-century Ethiopian book illustration. Relying on Peirce’s distinction between index and icon, this article considers how such abstract representations might have been meant to evoke the divine (...) presence of Mary as a spiritual trace of the artist’s and the audience’s devotional practices, rather than as a potentially miracle-working depiction of her corporeal presence based on figural likeness, as was the case with painted wooden panels. Incorporating references to Ethiopian and Western theorists of modernity, the essay further proposes to view the multiple and interlocking mirror effects in book art as instances of second-order observation, in which, for example, the Virgin sees herself depicted in a book of her miracles, the compilation of which she commissioned and aided; the scribe and artist is featured in one of the miracles he himself is writing and illustrating; and the donor is depicted gazing at the viewer. Whether enabling skeptical distance or a more fully immersive spiritual experience undisturbed by attempts to capture corporeal likeness, or both, this essay proposes to analyze the politics and theology of abstraction in fifteenth-century Ethiopian book art by centering on a rare depiction of the Nursing Virgin. (shrink)

Dance provides natural conditions for studying relationships between coordination patterns and human experience. von Zimmermann and colleagues investigate whether relatively simple or more complex forms of movement coordination are related to pro‐social experiences during group dance. They find that pro‐social experience depends on the degree to which movement patterns are distributed and diversified, but not the degree to which movement patterns are simply unitary.

Recent professional guidelines published by the General Medical Council instruct physicians in the UK to be honest and open in any financial agreements they have with their patients and third parties. These guidelines are in addition to a European policy addressing disclosure of physician financial interests in the industry. Similarly, In the US, a national open payments program as well as Federal regulations under the Affordable Care Act re-address the issue of disclosure of physician financial interests in America. These new (...) professional and legal changes make us rethink the fiduciary duties of providers working under new organizational and financial schemes, specifically their clinical fidelity and their moral and professional obligations to act in the best interests of patients. The article describes the legal changes providing the background for such proposals and offers a prima facie ethical analysis of these evolving issues. It is argued that although disclosure of conflicting interest may increase trust it may not necessarily be beneficial to patients nor accord with their expectations and needs. Due to the extra burden associated with disclosure as well as its implications on the medical profession and the therapeutic relationship, it should be held that transparency of physician financial interest should not result in mandatory disclosure of such interest by physicians. It could lead, as some initiatives in Europe and the US already demonstrate, to voluntary or mandatory disclosure schemes carried out by the industry itself. Such schemes should be in addition to medical education and the address of the more general phenomenon of physician conflict of interest in ethical codes and ethical training of the parties involved. (shrink)

Miriam Schoenfield argues that moral realism and moral vagueness imply ontic vagueness. In particular, she argues that neither shifty nor rigid semantic accounts of vagueness can provide a satisfactory explanation of moral vagueness for moral realists. This paper constitutes a response. I argue that Schoenfield's argument against the shifty semantic account presupposes that moral indeterminacies can, in fact, be resolved determinately by crunching through linguistic data. I provide different reasons for rejecting this assumption. Furthermore, I argue that Schoenfield's rejection of (...) the rigid semantic account is based on a presupposition that ultimately implies the very same claim that is under dispute: the vagueness of moral predicates in imperfect languages persists in the perfect language, as well. (shrink)