Background The increasing prevalence of moral distress in the stressful environment of the intensive care unit (ICU) provides grounds for nursing error and endangers patients’ health, safety, and even life. One of the most important reasons for this distress is the treatment team’s second victim syndrome (SVS), especially nurses, following errors in the treatment system. Objectives The present study aimed to determine the relationship between moral distress and SVS in ICUs. Research design This cross-sectional study involved a sample size of (...) 96 ICU nurses working in hospitals affiliated with Tehran University of Medical Sciences, Iran, in the 2021–2022 period, who were selected via a simple random sampling method. Data were collected using the Demographic Questionnaire, the second victim experience and support tool (SVEST) and Moral Distress Scale-Revised (MDS-R). Descriptive statistics (percentage, frequency, mean, and SD) and analytical tests (Spearman correlation coefficient test, independent t-test, and ANOVA) were employed for data analysis. Participants and research context This study used a sample size of 96 intensive care unit nurses working in hospitals affiliated to Tehran University of Medical Sciences selected by simple random sampling. Ethical considerations The study obtained research ethics approval, and all participants were informed of the voluntary and anonymous nature of their participation. Findings The results showed that 59.4% of nurses suffered a low level of moral distress, and 40.6% suffered from a moderate level of moral distress. The SVS score of 86.5% of the nurses was moderate. There was no significant and direct correlation between moral distress and SVS in nurses; however, there was a significant and inverse correlation between the moral distress intensity and SVS ( p = 0.011). Conclusion Despite no significant correlation between moral distress and SVS, these variables were at moderate levels. Accordingly, it is suggested to provide a proper ground for expressing morally stressful situations, counseling and training strategies to deal with moral distress, creating support resources for those suffering from SVS, and implementing empowerment programs. (shrink)

Since their discovery over two decades ago, the molecular and cellular functions of the NIPSNAP family of proteins (NIPSNAPs) have remained elusive until recently. NIPSNAPs interact with a variety of mitochondrial and cytoplasmic proteins. They have been implicated in multiple cellular processes and associated with different physiologic and pathologic conditions, including pain transmission, Parkinson's disease, and cancer. Recent evidence demonstrated a direct role for NIPSNAP1 and NIPSNAP2 proteins in regulation of mitophagy, a process that is critical for cellular health and (...) maintenance. Importantly, NIPSNAPs contain a 110 amino acid domain that is evolutionary conserved from mammals to bacteria. However, the molecular function of the conserved NIPSNAP domain and its potential role in mitophagy have not been explored. It stands to reason that the highly conserved NIPSNAP domain interacts with a substrate that is ubiquitously present across all species and can perhaps act as a sensor for mitochondrial health. (shrink)

This introduction to the Queer Death Studies special issue explores an emerging transdisciplinary field of research. This field critically, reflexively and affirmatively investigates and challenges conventional normativities, assumptions, expectations, and regimes of truths that are brought to life and made evident by current planetary scale necropolitics and its framing of death, dying and mourning in the contemporary world. It is set against the background of traditional engagements with the question of death, often grounded in Western hegemonic and normative ideas of (...) dying, dead and mourning subjects and bodies, on the one hand; and on the other contemporary discourses on human and nonhuman death and extinction, directly linked to the environmental crisis, capitalist and post/colonial extractivist necropolitics, material and symbolic violence, oppression and inequalities, and socio-economic, political and ecological unsustainabilities. By bringing together conceptual and analytical tools grounded in feminist materialisms and feminist theorising broadly speaking, queer theory and decolonial critique, the contributions in this special issue strive to advance queerfeminist methodologies and ontological, ethical and political understandings that critically and creatively attend to the problem of death, dying and mourning in the current environmental, cultural, and socio-political contexts. (shrink)

Ethical decision making is a complex issue because it strongly depends on the religion, beliefs, traditional laws and moral views of each society. The purpose of this study was to explore the experience of Iranian family caregivers of end stage cancer patients about ethical decision making. This qualitative study is based on van Manen’s method of hermeneutic phenomenology. In-depth interviews were carried out to collect data. Participants were 12 caregiver. Audiotapes were transcribed and analyzed for common themes that represented the (...) participants’ experiences. Trustworthiness of the findings was established using the Lincoln and Guba’s criteria. Three themes reflected the essence of caregivers’ lived experience including; fluctuating between hope and despair, wandering dilemma, and ethical decision making. Each of these themes consisted of several subthemes. The present study revealed that, the caregivers of terminally ill cancer patients need different information about prognosis and end of life decision making process. Our perception of how families negotiate ethical issues in their decision-making is still developing. Opportunities should be created to empowering caregivers to talk about their uncertainties and concerns. (shrink)

Queer Death Studies (QDS) refers to an emerging transdisciplinary field of research that critically and (self) reflexively investigates and challenges conventional normativities, assumptions, expectations, and regimes of truths that are brought to life and made evident by death, dying, and mourning. Since its establishment as a research field in the 1970s, Death Studies has drawn attention to the questions of death, dying, and mourning as complex and multifaceted phenomena that require inter- or multi-disciplinary approaches and perspectives. Yet, the engagements with (...) death, dying and mourning, constitutive of conventional Death Studies’ investigations, tend to remain insufficient and reductive. They are often governed by the normative notions of: the subject; bonds between humans, as well as between humans and (their) animals; family relations and communities; rituals; and finally, experiences of grief, mourning, and bereavement. Moreover, these engagements are frequently embedded in constraining beliefs in life/death divides, constructed along the lines of conventional religious and/or scientific mind/body dualisms, characteristic of the Western cultural imaginaries. Against this background, QDS offers a site for ‘queering’ traditional ways of approaching death both as a subject of study and philosophical reflection, and as a phenomenon to articulate in artistic work or practices of mourning. Here, the notion of ‘queer’ conveys many meanings. It refers to researching and narrating death, dying, and mourning in the context of queer bonds and communities, where the subjects involved/studied/interviewed and the relations they are involved in are recognised as ‘queer’. Simultaneously, the term ‘queer’ can also function as an adverb and a verb, referring thus to the processes of going beyond and unsettling (subverting, exceeding) binaries and given norms, normativities, and constraining conventions. In other words, ‘queer’ becomes both a process and a methodology that is applicable and exceeds the focus on gender and sexuality as its exclusive concerns. (shrink)

La présente recherche s’intéresse à l’impact du contexte phonétique sur les formants 1, 2 et 3 des voyelles nasales françaises. La chaine parlée en français est constituée de la succession des voyelles orales et nasales influencées par le contexte consonantique. En nous appuyant, dans cette étude, sur le modèle de Stevens et House, dit « production undershoot model »,nous avons abordé plus particulièrement l’effet du contexte phonétique sur les trois voyelles nasales françaises afin de vérifier l’hypothèse suivante : dans le (...) contexte phonétique, la consonne influerait, non seulement, sur le formant 1 et 2 mais aussi sur le formant nasal de la voyelle nasale et elle l’écarte de son propre « hyperespace », bien qu’elle ne bannisse pas l’anti-formant. Pour vérifier notre hypothèse, nous avons analysé les productions phonétiques de 4 étudiants de français de première année de l’université d’Ispahan à l’aide d’un logiciel d’analyse de sons tout en tenant compte des variables acoustiques des formants 1, 2 et 3. Notre corpus est constitué de 2 phrases collectées lors du deuxième semestre de l’année universitaire 2016-2017. Dans les productions phonétiques des apprenants étudiés, l’effet du contexte phonétique donne lieu au phénomène de ratage de cible des voyelles nasales et empêche surtout la constitution du formant nasal ou du murmure nasal, d’où l’apparition d’un écart de prononciation. (shrink)

Studies on end-of-life care reveal different practices regarding withholding and/or withdrawing life-sustaining treatments between countries and regions. Available data about physicians’ practices regarding end-of-life care in ICUs in Egypt is scarce. This study aimed to investigate physicians’ attitudes toward end-of-life care and the reported practice in adult ICUs in Ain Shams University Hospitals, Cairo, Egypt. 100 physicians currently working in several ICU settings in Ain Shams University Hospitals were included. A self-administered questionnaire was used for collection of data. Most of (...) the participants agreed to implementation of “do not resuscitate” (DNR) orders and applying pre-written DNR orders (61% and 65% consecutively), while only 13% almost always/often order DNR for terminally-ill patients. 52% of the participants agreed to usefulness of limiting life-sustaining therapy in some cases, but they expressed fear of legal consequences. 47% found withholding life-sustaining treatment is more ethical than its withdrawal. 16% almost always/often withheld further active treatment but continued current ones while only 6% almost always/often withdrew active therapy for terminally-ill patients. The absence of legislation and guidelines for end-of-life care in ICUs at Ain Shams University Hospitals was the main influential factor for the dissociation between participants’ attitudes and their practices. Therefore, development of a consensus for end-of-life care in ICUs in Egypt is mandatory. Also, training of physicians in ICUs on effective communication with patients’ families and surrogates is important for planning of limitation of life-sustaining treatments. (shrink)