BackgroundClinical ethics consultations can be complex interventions, involving multiple methods, stakeholders, and competing ethical values. Despite longstanding calls for rigorous evaluation in the field, progress has been limited. The Medical Research Council proposed guidelines for evaluating the effectiveness of complex interventions. The evaluation of CEC may benefit from application of the MRC framework to advance the transparency and methodological rigor of this field. A first step is to understand the outcomes measured in evaluations of CEC in healthcare settings. ObjectiveThe primary (...) objective of this review was to identify and map the outcomes reported in primary studies of CEC. The secondary objective was to provide a comprehensive overview of CEC structures, processes, and roles to enhance understanding and to inform standardization.MethodsWe searched electronic databases to identify primary studies of CEC involving patients, substitute decision-makers and/or family members, clinicians, healthcare staff and leaders. Outcomes were mapped across five conceptual domains as identified a priori based on our clinical ethics experience and preliminary literature searches and revised based on our emerging interpretation of the data. These domains included personal factors, process factors, clinical factors, quality, and resource factors. ResultsForty-eight studies were included in the review. Studies were highly heterogeneous and varied considerably regarding format and process of ethical intervention, credentials of interventionist, population of study, outcomes reported, and measures employed. In addition, few studies used validated measurement tools. The top three outcome domains that studies reported on were quality, process factors, and clinical factors. The majority of studies examined multiple outcome domains. All five outcome domains were multidimensional and included a variety of subthemes.ConclusionsThis scoping review represents the initial phase of mapping the outcomes reported in primary studies of CEC and identifying gaps in the evidence. The confirmed lack of standardization represents a hindrance to the provision of high quality intervention and CEC scientific progress. Insights gained can inform the development of a core outcome set to standardize outcome measures in CEC evaluation research and enable scientifically rigorous efficacy trials of CEC. (shrink)

Detecting contract cheating in written submissions can be difficult beyond direct plagiarism detectable via technology. Successfully identifying potential cases of contract cheating in written work such as essays and reports is largely dependent on the experience of assessors and knowledge of student. It is further dependent on their familiarity with the patterns and clues evident in sections of body text and reference materials to identify irregularities. Consequently, some knowledge of what the patterns and clues look like is required. This paper (...) documents how to identify some of the patterns and clues observed in essay and report submissions. Effective assessment design with specific contextual requirements make irregularities easier to detect and interpret. The irregularities identified were confirmed as instances of contract cheating through conversations held with postgraduate students. An essential element of the conversations was the evidence presented for discussion. Irregularities were noted on a pro-forma specifically developed for this purpose. Patterns identified include misrepresented bibliographic data, inappropriate references, irrelevant material and generalised text that did not address the assessment question or grading criteria. The validated patterns formed the basis of identifying potential instances of contract cheating in later submissions. Timely conversations with students before the end of semester are essential to determining whether the patterns and clues link to poor knowledge of academic writing conventions or classified as contract cheating necessitating the application of appropriate penalties under institutional policies and procedures. (shrink)

The United States National Preparedness System has evolved significantly in the recent past. These changes have affected the system structures and goals for disaster response. At the same time, actors such as private businesses have become increasingly involved in disaster efforts. In this paper, we begin to fill the gap in the cross-sector literature regarding interactions that have systemic impacts by investigating how the simultaneous processes of systemic change and intensifying cross-sector interaction worked and interacted in the context of the (...) preparedness system. We examine these inter-linkages through a qualitative study in the setting of Hurricane Sandy. Drawing from systems theory, we develop a grounded model that provides an explanation for the system change and highlights how cross-sector interaction relates to the changes observed in the system. (shrink)

Research on emotion and psychopathology has blossomed due in part to the translation of affective science theory and methods to the study of diverse disorders. This translational approach has helped the field to hone in more precisely on the nature of emotion deficits to identify antecedent causes and maintaining processes, and to develop promising new interventions. The future of emotion research in psychopathology will benefit from three inter-related areas, including an emphasis on emotion difficulties that cut across traditional diagnostic boundaries (...) (i.e., a transdiagnostic approach), the explicit linking of emotion and cognition in behavioral and neuroimaging studies in psychopathology, and continued translation of the latest conceptualizations of emotion to the study of psychopathology. (shrink)

The demand for science trainees to have appropriate responsible conduct of research instruction continues to increase the attention shown by federal agencies and graduate school programs to the development of effective ethics curriculums. However, it is important to consider that the main learning environment for science graduate students and post-doctoral research fellows is within a laboratory setting. Here we discuss an internal laboratory program of weekly 15-minute ethics discussions implemented and used over the last 3 years in addition to the (...) graduate school’s program of scientific integrity training. During this time, the environment and culture within our laboratory has changed to place greater emphasis on the ethical implications of our own research and the research we evaluate. We still struggle with how to accurately assess this behavioral change; although, we present preliminary survey results on the evaluation and impact of this style of curriculum for ethics instruction in our laboratory. (shrink)

Background: ICU patients’ family members are in a new, uncertain, and vulnerable situation due to the patient’s critical illness and complete dependence on the ICU nurses and physicians. Family members’ feeling of being cared for is closely linked to clinicians’ attitudes and behavior. Aim: To explore ICU nurses’ and physicians’ bedside interaction with critically ill ICU patients´ families and discuss this in light of the ethics of care. Research design: A qualitative study using participant observation, focus groups, and thematic narrative (...) analysis. Participants and research context: Data were gathered from July 2017 to August 2019, in four ICUs in Norway through 270 h of fieldwork and seven focus groups with ICU nurses and physicians. Ethical considerations: The Regional Committee for Medical and Health Research Ethics and the Norwegian Centre for Research Data approved the study. Findings: Quality of ICU family care depends on nurses’ and physicians’ attitudes, behavior, and personality traits. Three main themes were identified: being attentive, an active approach, and degree of tolerance. Discussion: The findings are discussed in light of the ethics of care and empirical research from the intensive care environment. Conclusions: This study shows that attentive, active, and tolerant clinicians represent a culture of ethical care that gives families greater freedom of action and active participation in patient care. Clinicians must not bear sole responsibility for this culture; it must have a firm basis in the hospital and ICU and be established through training, interprofessional reflection, and support of clinicians. (shrink)

A central feature of our waking mental experience is that our attention naturally toggles back and forth between “external” and “internal” stimuli. In the midst of an externally demanding task, attention can involuntarily shift internally with no clear reason how or why thoughts momentarily shifted inward. In the case of external attention, we are typically exploring and encoding aspects of our external world, whereas internal attention often involves searching for and retrieving potentially relevant information from our memory networks. Cognitive science (...) has traditionally focused on understanding forms of internal and external attention separately, leaving a mystery about what sparks the seemingly automatic shifts between the two. Specifically, what shifts attentional focus from being outward‐directed to being inward‐directed? We present a candidate mechanism: Familiarity‐detection. (shrink)

The distinction between stakeholders and shareholders frequently employed in business ethics can illuminate challenges faced by a bioethics advisory panel. I use the distinction to reflect back on the work of an advisory panel on which I served, a panel on US transplant policy. The panel hearings were akin to a shareholders’ meeting, with many stakeholders absent. In addition to ‘hearing out’ the shareholders who were present, the panel had duties to absent stakeholders to insure their interests were included in (...) public discussion. While panel efforts to include stakeholder perspectives rightfully framed its report, such duties should have framed its operating procedures more robustly. The stakeholder/shareholder distinction also offers a critical prism on the actual evolution of organ allocation policy, which the panel failed to influence. Current policy embodies a compromise among shareholders that obscures major stakeholder interests. This results in under‐attention to likely medical benefit of transplant, compared to other allocation criteria. Recognition of duties to stakeholders amidst pressures of shareholders complicates the notion of ‘consensus’ for an advisory panel. Consensus framed on terms defined only by shareholders, not stakeholders, may be an inadequate measure of public interest. (shrink)

This paper outlines a strategy for teaching an Introduction to Philosophy anthology. The author argues that students in introductory philosophy courses are unable to comprehend primary sources in philosophy anthologies because of the distance and foreignness of the text. A course relying on lectures as the primary mode of engagement with texts results in mere exposition and does not facilitate a critical engagement with primary texts for students. The author suggests that teachers in introductory courses should integrate weekly and monthly (...) writing assignments into the curriculum to help facilitate a critical engagement with primary texts. The writing assignments provide students with constant feedback on their own thoughts and allow educators to assess how well students read and comprehend primary sources before the course lectures. The writing assignments also encourage more classroom discussion because students are able to think through their objections and critiques and to feel more comfortable talking in class. (shrink)

Over one-third of older adults in many countries have a companion animal, and pets may harbor health-promoting potential. Few studies have considered pet-ownership in relation to economic vulnerability, and pet-ownership has not been often considered within policy efforts to promote ageing-in-place. We conducted a mixed methods case study to understand perspectives of both community agencies that support ageing-in-place and older adults themselves. A shortage of affordable, appropriate pet-friendly housing emerged as a challenge, even when framed as a legitimate choice and (...) preference for many older adults. In this manuscript, we share the trajectories of three economically vulnerable older adults whose affordable housing needs became entangled with commitments to pets. Guided by dialogical narrative methodology, we offer each narrative as a short vignette to illustrate the extent to which older adults will practice ‘more-than-human solidarity’ for a pet, even when their own well-being is compromised as a result; and highlight incongruence between the underlying moral values that shape solidaristic practices of individuals versus solidaristic arrangements that shape affordable housing opportunities. We suggest that housing rules and legislation that disrupt, rather than confirm, more-than-human solidarity may render older adults susceptible to, rather than protected from, deteriorating physical, mental and social well-being. We propose that collective solidaristic practices must reflect and subsume the moral complexity of solidarity practiced by individuals, to enable fair and equitable ageing-in-place. (shrink)

The goal of this book is to help the reader gain knowledge on ethical and legal issues in the field of student affairs and develop competency to follow the profession’s principles and standards of conduct. The significance of the book is due to its focus on the practical value of ethics and legal issues and its aim to address the knowledge, skills, and dispositions required of student affairs educators to develop and maintain integrity in their life and work as described (...) by the ACPA/NASPA. The text offers readers a number of major unique features: It offers multiple ethical decision-making models to guide student affairs educators in their ethical decision-making process. It proposes that ethics is not an individual but an organizational responsibility. It offers that ethical decision making is a professional skill that can be practiced and applied in student affairs educators’ day-to-day practice. It presents the reader with the most current legal issues in student affairs and higher education. Finally, it reflects three themes: integration of ACPA/NASPA competency areas; development of professional identity; and application of knowledge and theory to practice. The book is critical and timely. A book that focuses on ethical and legal issues in student affairs is needed for faculty in preparation programs, new professionals navigating their identity as student affairs educators, and a resource for mid- and senior-level professionals facilitating ongoing professional development. The book begins to address what it means to have a professional identity, which is ground in the shared ethical and legal values espoused within the profession and academia. Each chapter uniquely contributes to the complexity embedded in the study of ethics and how that is applied to practice. Additionally, the volume is a balance of procedural knowledge, case illustrations, and guided practice exercises to facilitate the reader’s ability to translate the theory and research discussed into professional decision making and application. (shrink)

This essay offers a preliminary account of the ways in which alterations to the landscape of fourteenth- and fifteenth-century Sukhothai and Chiang Mai figured within the micro-politics of these city-states. I show how landscape alterations inspired by Lanka and mainland South Asia served the consolidation and projection of royal power within the context of local and regional competition, and how such alterations formed part of strategic royal engagement with Buddhist monastic lineages.

This paper engages with debates around transformations in the production and circulation of images and the changes in modes of perception that these offer. Paul Virilio has argued that technological developments have produced a shift in the site of meaning‐production from the material reference space of the image to the time of visual contact by the viewer. I consider what significance these temporalities have in relation to social difference, and I develop debates around the performative to consider how the viewer (...) is constituted in visual performativity. This focus on time and performativity opens up questions of how vision may constitute the agency, intention and responsibility of the viewer. Drawing on an example of visual irony in advertising, I explore how the temporal suspension of meanings allows for a suspension of the terms of intent and responsibility. This visual performative accesses and reworks the terms of social difference and privilege in what I have called ‘retroactive intentionality’. (shrink)

Euthanasia advocates have recently begun counseling people to create advance directives calling for oral food and water to be withheld if the person reaches a certain stage of dementia. The author shows that these directives are in fact requests for euthanasia, and they leave vulnerable people subject to poor-quality care. Both surrogate decision makers and Catholic institutions have a moral obligation not to implement such directives, and surrogates, rather than withdrawing as proxies, have a moral obligation to advocate for the (...) life and proper care of the incompetent person. Finally, the author argues that society is morally culpable if it does not strongly resist euthanasia in all its forms. National Catholic Bioethics Quarterly 16.3 : 421–434. (shrink)

Research on emotion perception in schizophrenia has focused primarily on the perception of static faces displaying different emotion signals or expressions. However, perception of emotion in daily life relies on much more than just the face. In this article, we review the role of context in emotion perception among people with and without schizophrenia. We argue that not only is context central to the perception of emotion, it in fact helps to construct the perception. Implications for future research on emotion (...) perception are discussed. (shrink)

We propose that IAM and déjà vu may not share a placement on the same gradient, per se, but the mechanism of cue familiarity detection, and a major differentiating factor between the two metacognitive experiences is whether the resulting inward directed search of memory yields retrieved content or not. Déjà vu may manifest when contentless familiarity detection is inexplicable by the experiencer.

A translator and her science consultant, who have worked together on many books, consider the problems of translating primary and secondary texts in science. Various problems encountered in translating an ongoing documentary edition in the history of science are discussed using the collected works of Albert Einstein as a test case. For instance, each language has its own preferred sentence structure; moreover, not every historical term finds a perfect equivalent in modern usage, and historical accuracy is contextually bounded.

This paper explores the notion of practical wisdom asan alternative to current formulations of criticalthinking. The practical realm is that ofill-structured problems that emerge from life aslived; it is a realm of legitimate uncertainty andambiguity that requires an ethical responsiveness orpractical wisdom. The death of a child is a case inpoint. The author identifies and examines threeaspects of practical wisdom – the ethical claims ofpartiality, a yielding responsiveness and the play ofthought – and juxtaposes them with aspects of criticalthinking. The (...) work of Martha Nussbaum and RichardPaul are interwoven throughout the discussion. Theauthor concludes that the discourse of criticalthinking is in danger of lapsing into a form of moralescapism wherein all we are rationally responsible foris thinking correctly. Practical wisdom, on theother hand, recognizes that thinking is not simply anintellectual cognitive act of an individual but adance between the life of a child and the love of anelder, a conversation between what is and what couldbe, an openness to passionate sorrow and surprise, aplay between understanding and perception. As such,practical wisdom provides a more likely account ofliving in good faith with oneself and others. (shrink)

John Haught has awarded the debates between religion (Christianity in particular) and science a central place in his ongoing corpus of work. Seeking to encourage and enhance the conversation, Haught both critiques current positions and offers his own perspective as a potential ground for continuing the discussion in a fruitful manner. This essay considers Haught's primary criticisms of the voices on both sides of the debate which his work connotes as polarizing or conflating the debate. It also extrudes from Haught's (...) work themes that provide alternative visions. The essay concludes with two questions for further consideration. (shrink)

Domain analysis is useful for examination of individual spheres of intellectual activity, both academic and otherwise, and has been used in the knowledge organization (KO) literature to explore specific communities and uses, including web pornography (Beaudoin and Ménard 2015), virtual online worlds (Sköld, Olle 2015), gourmet cooking (Hartel 2010), healthy eating (McTavish 2015), art studies (Ørom 2003), the Knowledge Organization journal (Guimarães et al. 2013), and domain analysis itself (Smiraglia 2015). The results of domain analyses are useful for the development (...) of controlled vocabularies, taxonomies, ontologies, metadata schemas, and other systems for the documentation, description, and discovery of resources, as well as for knowledge discovery in general (Smiraglia 2015; Hjørland 2017). This research describes a methodology for the elucidation of knowledge organization systems (KOS) currently in use on image websites that document graffiti, graffiti art, and street art around the world. (shrink)

This study was designed to compare the natural free form communication that takes place when a person interacts with robotic entities versus live animals. One hundred and eleven participants interacted with one of four entities: an AIBO robotic dog, Legobot, Dog or Cat. It was found that participants tended to rate the Dog as more capable than the other entities, and often spoke to it more than the robotic entities. However, participants were not positively biased toward live entities, as the (...) Cat often was thought of and spoken to similarly to the AIBO robot. Results are consistent with a model in which both appearance and interactivity lead to the development of beliefs about a live or robotic entity in an interaction. Keywords: Human-robot interaction; human-animal interaction; AIBO; free form communication; attributions; human-entity interaction. (shrink)

We examine the influences of social capital, source credibility, and fairness perceptions on the judgments of experienced compensation committee members who are considering a proposal to reduce management’s performance targets in the middle of a compensation cycle due to difficult circumstances. Eighty-nine U.S. public company CC members participated in a 2 × 2 experiment with social capital and source credibility each manipulated as low or high, and outcome fairness to management, process fairness to shareholders, and outcome fairness to shareholders included (...) as measured variables. While social capital and source credibility are not significant, we find that outcome fairness to the CEO and outcome fairness to shareholders are significantly related to CC members’ support for reducing performance targets during a compensation cycle. In addition, we find that more experienced CC members are less supportive of changing the performance targets. The significant interactions include one between outcome fairness to shareholders and process fairness to shareholders, which suggests that CC member support for the proposal relies on both process and outcome fairness being present. Finally, the participants’ qualitative responses reflect arguments both for and against adjusting performance targets. Overall, the results highlight the important roles of fairness and director experience in boardroom decisions and provide important insights into factors affecting CC judgments. (shrink)

How should nursing knowledge advance? This exploration contextualizes its evolution past and present. In addressing how it evolved in the past, a probable historical evolution of its development draws on the perspectives of Frank & Gills's World System Theory, Kuhn's treatise on Scientific Revolutions, and Foucault's notions of Discontinuities in scientific knowledge development. By describing plausible scenarios of how nursing knowledge evolved, I create a case for why nursing knowledge developers should adopt a post‐structural stance in prioritizing their research agenda(s). (...) Further, by adopting a post‐structural stance, I create a case on how nurses can advance their disciplinary knowledge using an engaging post‐colonial strategy. Given an interrupted history caused by influence(s) constraining nursing's knowledge development by power structures external, and internal, to nursing, knowledge development can evolve in the future by drawing on post‐structural interpretation, and post‐colonial strategy. The post‐structural writings of Deleuze & Guattari's understanding of ‘Nomadology’ as a subtle means to resist being constrained by existing knowledge development structures, might be a useful stance to understanding the urgency of why nursing knowledge should advance addressing the structural influences on its development. Furthermore, Bhabha's post‐colonial elucidation of ‘Hybridity’ as an equally discreet means to change the culture of those constraining structures is an appropriate strategy to enact how nursing knowledge developers can engage with existing power structures, and simultaneously influence that engagement. Taken together, ‘post‐structural stance’ and ‘post‐colonial strategy’ can refocus nursing scholarship to learn from its past, in order to develop relevant disciplinary knowledge in its future. (shrink)

A decade ago, conventional wisdom in the medical establishment was that physicians treating chronic pain with opioid analgesics were at a substantial risk of being sanctioned for overprescribing by state medical regulatory boards. Dozens of articles written since have alluded to this risk as an obstacle to effective pain re1ief. In the early 1990s, a number of high profile cases in which physicians were disciplined by regulatory boards for overprescribing to patients with chronic pain were reported in the press. Although (...) the board actions in many of these cases were eventually overturned by state judiciaries, the publicity heightened practitioners’. sensitivity to the regulatory risks associated with prescribing opioids.A review of the available data on state medical board actions nationwide for the period from 1990 to 1996 reveals that the perception of regulatory risk far exceeds the reality. Indeed, relatively few of the disciplinary actions taken for overprescribing by state medical boards in any given year directly concern the treatment of chronic pain—malignant or nonmalignant—in patients. (shrink)

Physical Review Letters has become the primary forum for the dissemination of innovative work in physics. Physicists' acceptance of this journal, and their adaptation to its requirements, show their ability to present their work in a variety of institutionally sanctioned but evolving frameworks. However, such a forum, because of its constraints on space and its emphasis on innovation, poses special problems to authors in relation to constructing their novel claims and reconstructing the consensus of their fields. In addition, itsprestige has (...) caused the journal to acquire archivalfeatures that have slowed publication and resulted in other unintended consequences. Through an analysis of three letters published in Physical Review Letters and of a follow-up article published in Physical Review, the rhetorical features of this forum are examined as well as the problems its poses for the contextualization of novelty within relevant frameworks of accepted belief. (shrink)