Background: Concerns have been expressed regarding the adequacy of ethics review systems in developing countries. Limited data are available regarding the structural and functional status of Research Ethics Committees (RECs) in the Middle East. The purpose of this study was to survey the existing RECs in Egypt to better understand their functioning status, perceived resource needs, and challenges. Methods: We distributed a self-administered survey tool to Egyptian RECs to collect information on the following domains: general characteristics of the REC, membership (...) composition, ethics training, workload, process of ethics review, perceived challenges to effective functioning, and financial and material resources. We used basic descriptive statistics to evaluate the quantitative data. Results: We obtained responses from 67% (12/18) of the identified RECs. Most RECs (10/12) have standard operating procedures and many (7/12) have established policies to manage conflicts of interests. The average membership was 10.3 with a range from 7-19. The predominant member type was physicians (69.5% of all of the REC members) with little lay representation (13.7%). Most RECs met at least once/month and the average number of protocols reviewed per meeting was 3.8 with a range from 1-10. Almost three-quarters of the members from all of the 12 RECs indicated they received some formal training in ethics. Regarding resources, roughly half of the RECs have dedicated capital equipment (e.g., meeting room, computers, office furniture, etc); none of the RECs have a formal operating budget. Perceived challenges included the absence of national research ethics guidelines and national standards for RECs and lack of ongoing training of its members in research ethics. Conclusion: Our study documents several areas of strengths and areas for improvements in the operations of Egyptian RECs. Regarding strengths, many of the existing RECs meet frequently, have a majority of members with prior training in research ethics, and have written policies. Regarding areas for improvements, many RECs should strive for a more diverse membership and should receive more financial resources and administrative support personnel. We recommend that RECs include more individuals from the community and develop a continuing educational program for its members. Institutional officials should be aware of the resource capacity needs of their RECs. (shrink)

Effective treatment of disorders of agency presents a clinical conundrum. Many of the core symptoms or maintaining factors are actions and omissions that cause harm to self and others. Encouraging service users to take responsibility for this behavior is central to treatment. Blame, in contrast, is detrimental. How is it possible to hold service users responsible for actions and omissions that cause harm without blaming them? A solution to this problem is part conceptual, part practical. This chapter offers a conceptual (...) framework that clearly distinguishes between ideas of responsibility, blameworthiness, and "detached" and "affective" blame. It argues that affective blame is detrimental to effective treatment. And it suggests that affective blame can be avoided by attention to service users' past history, which directly evokes compassion and empathy. Finally, the chapter briefly considers whether the clinical stance of responsibility without blame should be adopted in non-clinical interpersonal and social contexts. (shrink)

The tradition of pragmatism has, especially since Dewey, been characterized by a commitment to nonreductive naturalism. The notion of emergence, popular in the early decades of the twentieth century and currently re-emerging as a central concept in metaphysics and the philosophy of mind, may be useful in explicating that commitment. The present paper discusses the issue of the reality of emergent properties, drawing particular attention to a pragmatic way of approaching this issue. The reality of emergents can be defended as (...) a pragmatically-useful ontological commitment; hence, pragmatism can be employed as a tool in the debate over the structure and reality of emergence. This strategy of justifying ontological commitments is examined through historical and systematic discussions of the pragmatist tradition. It turns out, among other things, that while classical pragmatists did not specify any technical notion of emergence in the contemporary sense, their non-reductively naturalist views are relevant to the more recent emergence discussions -- especially because they rejected the metaphysical realism typical of today’s ontologically-oriented emergence theories. (shrink)

Widowhood is common in old age, can be accompanied by serious health consequences and is often linked to substantial changes in social network. Little is known about the impact of social isolation on the development of depressive symptoms over time taking widowhood into account. We provide results from the follow-up 5 to follow-up 9 from the longitudinal study AgeCoDe and its follow-up study AgeQualiDe. Depression was measured with GDS-15 and social isolation was assessed using the Lubben Social Network Scale (LSNS-6). (...) The group was aligned of married and widowed people in old age and education through entropy balancing. Linear mixed models were used to examine the frequency of occurrence of depressive symptoms for widowed and married elderly people depending on the risk of social isolation. Our study shows that widowhood alone does not lead to an increased occurrence of depressive symptoms. However, "widowed oldest old", who are also at risk of social isolation, have significantly more depressive symptoms than those without risk. In the group of "married oldest old", women have significantly more depressive symptoms than men, but isolated and non-isolated do not differ. Especially for people who have lost a spouse, the social network changes significantly and increases the risk for social isolation. This represents a risk factor for the occurrence of depressive symptoms. (shrink)

Despite being considered the proverbial backbone of our healthcare systems, nursing still seems to struggle to scientifically demonstrate its contribution to care experiences and patient outcomes. This leads to erosive tendencies that threaten the development of the profession and its progress as an academic discipline. With this paper, we want to contribute to the theoretical discourse concerning the nature of nursing and the research into its effectiveness. We begin by outlining a set of prevailing paradoxes and their consequences relating to (...) nursing and nursing research: the issue of demonstrating its unique contribution despite a clear societal mandate; a discrepancy between subjectively experienced effectiveness and objectively ascertainable effectiveness; and a mismatch between theoretical premises of nursing and task‐oriented cultures in practice environments. Using an example of a seemingly simple nursing intervention, we intend to demonstrate the qualities and complexities of nursing. We further illustrate this by drawing on several of our research projects using theory‐based evaluation methodologies. From these illustrative examples, we distil two insights relating to nursing interventions that we consider fundamental: the nurse, as a person, is central to its unique effectiveness; and there is always an interplay between context, intervention and its intended effect. We summarise our considerations and argue the case for conceiving research designs in alignment with theoretical premises of nursing. (shrink)

The article explores the rich and varied experiences of a collective writing project, unfolding through an anecdote involving Charlie, a young boy who creatively disrupted conventional photography methods. This incident, during an evening promenade by the sea in Ericeira (Portugal), epitomizes the project's embrace of playfulness and exploration of diverse perspectives–materialized through Charlie's playful insistence on experimenting with different angles. The event embodied the group’s approach to writing, leading to a collective inquiry into the interplay of ages, angles, and other (...) themes like waves, threads, shadows, and liminal spaces. The project, driven by the Between Ages Collective, began with informal gatherings in Plymouth, UK, and expanded into a year-long online reading group. Participants, spanning different generations and academic stages, shared various materials, including films, picture books, and scholarly texts, which inspired individual contributions. Influenced by the Collective's collaborative spirit, these contributions explore the concept of 'between ages' – a metaphorical and literal space of transition and fluidity. Contributors were invited to craft pieces that delve into the 'between ages' theme, often exploring serendipitous moments that transform interactions and experiences. The writing tries to capture a sense of openness and curiosity, embracing the uncertainties and ambiguities inherent in the process. The works do not strictly adhere to conventional academic or narrative forms but rather emerge from the collective's shared experiences, including cooking, eating, swimming and walking together. The article suggests that these writings are not meant to be definitive or conclusive but are explorations that invite readers to engage with the mundane and profound textures of everyday life. The stories and themes explored are marked by their diversity in style, rhythm, and imagery, ranging from reflections on the philosophy of shadows to the profound implications of intergenerational and interspecies relationships. The Collective’s work is presented as an ongoing experiment in thinking and writing together, with each piece offering unique insights into the fluid and often blurred boundaries between different states of being. This openness to the in-between spaces brings into question the notion of fixed identities and experiences, inviting a more nuanced understanding of the relational dynamics that shape existence. The article allows the readers to delve into these narratives and engage with the myriad ways they resonate with broader themes of being, storying, and connecting. (shrink)

ABSTRACT Like no other medium, virtual reality (VR) offers new possibilities to alter the perception of reality. These possibilities are mainly related to the feeling of presence in a virtual environment. With the VR performance ‘The Machine to be Another’ (TMTBA), we find an innovative embodiment system that enables a virtual body swap between two users. Hence, we conceptualise the performance as some kind of breaching experiment in order to alter self- and body perception. With the use of TMTBA and (...) a qualitative research approach, we hope to gain a closer insight into the formation, alteration and persistence of body images. This challenges the phenomenological idea that our sense of bodily presence is essentially anchored in our physical or ‘objective’ body as we know it and seems to potentially expand our notion of what bodily presence can mean. (shrink)

Objectives:Social isolation is increasing in aging societies and several studies have shown a relation with worse cognition in old age. However, less is known about the association in the oldest-old (85+); the group that is at highest risk for both social isolation and dementia. Methods:Analyses were based on follow-up 5 to 9 of the longitudinal German study on aging, cognition, and dementia in primary care patients (AgeCoDe) and the study on needs, health service use, costs, and health-related quality of life (...) in a large sample of oldest-old primary care patients (AgeQualiDe), a multi-center population-based prospective cohort study. Measurements included the Lubben Social Network Scale (LSNS-6), with a score below 12 indicating social isolation, as well as the Mini-Mental Status Examination (MMSE) as an indicator of cognitive function. Results:Dementia-free study participants (n = 942) were M = 86.4 (SD = 3.0) years old at observation onset, 68.2% were women. One third (32.3%) of them were socially isolated. Adjusted linear hybrid mixed effects models revealed significantly lower cognitive function in individuals with smaller social networks (β = 0.5, 95% CI = 0.3-0.7, p <.001). Moreover, changes in an individual's social network size were significantly associated with cognitive changes over time (β = 0.2, 95% CI = 0.1-0.4, p =.003), indicating worse cognitive function with shrinking social networks. Conclusion:Social isolation is highly prevalent among oldest-old individuals, being a risk factor for decreases in cognitive function. Consequently, it is important to maintain a socially active lifestyle into very old age. Likewise, this calls for effective ways to prevent social isolation. (shrink)

The commitment not to engage in tax avoidance – to refrain from using aggressive tax planning techniques – has not become part of the corporate social responsibility agenda in Poland. The purpose of this paper is to examine justificatory and explanatory reasons of that significant absence. The analysis unfolds in the following way. After setting out the necessary terminological background, I present main results of the limited empirical study of selected CSR documents, in order to substantiate the claim that tax (...) avoidance is a theme absent from the CSR programs in Poland. Then I put forward the contention that this commitment should be included in such programs, as prima facie justified, and address a selection of objections that can be raised to defeat this contention. Finally, in the last section of the paper, I briefly comment on possible reasons of this absence and show how they elucidate the nature of CSR. (shrink)

BackgroundPhysician burnout is a growing phenomenon in current health systems worldwide. With the emergence of COVID-19, burnout in healthcare is progressively becoming a serious concern. Increasing emotional exhaustion, depersonalization, and reduced personal accomplishment threaten the effective delivery of healthcare. Compassion fatigue and moral injury are a considerable risk to the doctor-patient relationship. These issues can potentially be mitigated by mindfulness practice, which has shown promising results in reducing burnout, restoring compassion, and preventing moral injury in physicians.MethodologyA scoping review was conducted (...) to investigate the effects of mindfulness practice on physician burnout. High-ranking journals were targeted to analyze high-quality studies and synthesize common themes in the literature. Studies conducted on current practicing physicians were included. Mindfulness practice of varying forms was the main intervention studied. Gray literature and studies conducted only on allied health personnel were excluded from this review.Results31 studies were included in this scoping review. Mindfulness practice decreased emotional exhaustion and depersonalization while improving mood, responses to stress, and vigor. Self-awareness, compassion, and empathy were also increased in study participants. From this review, four themes emerged: innovations in mindfulness practice, mindfulness and positive psychology, the impact of mindfulness on work and patient care, and barriers and facilitators to physician mindfulness practice.ConclusionMindfulness was widely reported to benefit mental health and well-being, but the studies reviewed seemed to adopt a mono focus and omitted key considerations to healthcare leadership, systems-level culture, and practices. Mindfulness practice is a quintessential component of positive psychology and is inherently linked to effective leadership. A mindful and compassionate physician leader will play a crucial role in addressing current practice gaps, prioritizing staff mental health, and providing a supportive platform for innovation. (shrink)

The present study aimed at investigating the relationship between environmental and individual factors and Stress of Conscience among nursing staff in psychiatric in-patient care. A questionnaire involving six different instruments measuring Stress of Conscience, the ward atmosphere, the psychosocial work environment, Perceived Stress, Moral Sensitivity, and Mastery was answered by 93 nursing staff at 12 psychiatric in-patient wards in Sweden. The findings showed that Sense of Moral Burden, Mastery, Control at Work and Angry and Aggressive Behavior were related to Stress (...) of Conscience. We conclude that Mastery and Control at Work seemed to work as protective factors, while Sense of Moral Burden and perceptions of Angry and Aggressive Behavior made the nursing staff more vulnerable to Stress of Conscience. Future research should investigate whether measures to increase the level of perceived control and being part of decision making will decrease the level of Stress of Conscience among the staff. (shrink)

This paper deals with the nature of trust in science. Understanding what appropriate trust in science is and why it can reasonably break down is important for improving scientists’ trustworthiness. There are two different ways in which philosophers of science think about trust in science: as based on objectivity or as based on shared values. Some authors argue that objectivity actually grounds mere reliance, not genuine trust. They draw on a distinction that philosophers of trust following Annette Baier have made (...) with respect to interpersonal trust, where genuine trust has some normative element to it that is missing in cases of mere reliance. However, I will show that there are plural forms of trust in science: Both objectivity and shared values ground trust in science in a normative sense. I will link the trust in science debate to the literature on interpersonal trust. This is significant in that, beyond references to Baier, there is little connection between both areas of philosophy. In a pluralist reading, different trust accounts help to identify the normative elements involved in different kinds of trust in science. (shrink)

I clarify some ambiguities in blame-talk and argue that blame's potential for irrationality and propensity to sting vitiates accounts of blame that identify it with consciously accessible, personal-level judgements or beliefs. Drawing on the cognitive psychology of emotion and appraisal theory, I develop an account of blame that accommodates these features. I suggest that blame consists in a range of hostile, negative first-order emotions, towards which the blamer has a specific, accompanying second-order attitude, namely, a feeling of entitlement—a feeling that (...) these hostile, negative first-order emotions are what the blamed object deserves. (shrink)

ABSTRACTDespite advances in the conceptualisation of facial mimicry, its role in the processing of social information is a matter of debate. In the present study, we investigated the relationship b...

Evaluating the quality of research ethics committees (RECs) is crucial but challenging due to the difficulty of developing meaningful quality measures. Recently, commentators assessed ten quality instruments for RECs, including the Research Ethics Committee Quality Assurance Self‐Assessment Tool developed for RECs in the Arab Middle East. They identified several missing items in this tool regarding safeguarding participants' rights and welfare.To address these gaps, we aimed to redesign the tool. Using the Delphi method, we involved 15 REC chairs to provide feedback (...) and recommendations for a revised tool. This process led to a modified instrument that incorporated the missing items and additional elements regarding the monitoring of research conduct (an essential oversight function of RECs), and the independence of the RECs from institutional and external influences.We conclude that the revised tool effectively addresses the quality of RECs by including elements relevant to participant outcomes, board deliberations, and participant protection. The added focus on ethics oversight enhances its robustness, significantly impacting participants' rights and welfare. (shrink)

В статті розкривається спосіб тлумачення віджняни в ранній йогачарі і пояснюються рівні віджняни та шлях їх очищення – пробудження. Буддисти переосмислили присутнє у філософській культурі Індії поняття віджняна, витлумачивши його дгармічним (миттєвим, унікальним, безсутнісним). Йогачарини ж, в прагненні з’ясувати причини оманливої позапотоковості віджнян, доповнили шість традиційних рівнів усвідомлення, алаєю-віджняною та кліштамано-віджняною. Вони ж впровадили поняття біджі, які накопичує алая-віджняна. Через васані відбувається забруднення усвідомлення, яке породжує дукгу. Очищення віджняни – звільнення від впливу накопичених біджів. Біджі – відбиток попередніх дгарм, який (...) продукує жагу відтворення миттєвої, а отже, неминуче зниклої реальності. (shrink)

The causes and consequences of revolutionary change have long been the subject of scholarly debate. Through a systematic integration of political economic elements into an analysis of contemporary social transformations, this article joins this conversation by asking how Karl Polanyi’s double movement framework can clarify, and be extended by, the Egyptian Revolution of 2011. By embedding a nuanced account of neoliberalism in Egypt’s modern politics and by bringing those in dialogue with Polanyi’s theoretical apparatus, this article contends that there is (...) a broad alignment between the first movement and the Egyptian neoliberal experience, a partial alignment between the second movement and the Egyptian Revolution, and a multilayered entanglement that implicates and encircles both movements. Not only does this research demonstrate that contemporary Egyptian history can find new currency in and be further illuminated by Polanyi’s political economy, it also critiques, complicates, reconceptualizes and extends Polanyi’s theoretical framework. In so doing, it redresses the underfocus of Polanyian political economy on the theory of revolution in general and the Egyptian Revolution in particular, problematizes extant accounts on neoliberalism and the double movement, and extends analyses between neoliberalism and revolution in political economy literatures. By clarifying our understanding of contemporary social change, this essay underscores how Polanyi’s work remains a pertinent, viable and valuable prism to examine momentous social transformations. (shrink)

O problema da causação descendente é um ponto central na formulação do fisicalismo não-redutivo e na compreensão da emergência de propriedades. Duas interpretações possíveis da causação descendente, nas quais a contribuição do pensamento aristotélico é importante, são examinadas. Os requisitos do programa de matematização da natureza na mecanica clássica, que levaram ao abandono de três dos modos causais aristotélicos, nao parecem igualmente importantes nas ciencias especiais. Isto sugere que a contribuição de Aristóteles pode ser, de certa maneira, retomada. Uma definição (...) de propriedade emergente é apresentada, sendo a causação descendente interprerada de acordo com os modos causais formal e funcional.The problem of downward causation is a key subject in the formulation of nonreductive physicalism as well as in the understanding of property emergence. Two possible interpretations of downward causation, to which Aristotelian thought is relevant, are examined. In the mathematical understanding of nature in classical mechanics, the principle of causality should meet requirements that entailed the rejection of three among the four Aristotelian causal modes. Those requirements do not seem equally important in the special sciences and one may suggest, then, that Aristotle’s contribution may be taken into account. A definition of an emergent property is proposed, in which downward causation is interpreted according to the formal and functional causal modes. (shrink)

Terms loaded with informational connotations are often employed to refer to genes and their dynamics. Indeed, genes are usually perceived by biologists as basically ‘the carriers of hereditary information.’ Nevertheless, a number of researchers consider such talk as inadequate and ‘just metaphorical,’ thus expressing a skepticism about the use of the term ‘information’ and its derivatives in biology as a natural science. First, because the meaning of that term in biology is not as precise as it is, for instance, in (...) the mathematical theory of communication. Second, because it seems to refer to a purported semantic property of genes without theoretically clarifying if any genuinely intrinsic semantics is involved. Biosemiotics, a field that attempts to analyze biological systems as semiotic systems, makes it possible to advance in the understanding of the concept of information in biology. From the perspective of Peircean biosemiotics, we develop here an account of genes as signs, including a detailed analysis of two fundamental processes in the genetic information system (transcription and protein synthesis) that have not been made so far in this field of research. Furthermore, we propose here an account of information based on Peircean semiotics and apply it to our analysis of transcription and protein synthesis. (shrink)

The controversy over the notion of emergence has recently re-emerged But a rigorous debate concerning how it might be explained or defined is often lacking Emergence is discussed here under two strict conditions (l) emergents can be predictable from the knowledge about a system's parts, (ll) emergents can be regarded as dependent on, and deternuned by, the system's micro-structure O'Connor's definmon of an emergent property is taken as a starting-point for a new definmon, incorporating Emmeche and colleagues' analysis of dounward (...) causation and Baas' treatment of emergence It is not necessary to assume that this defintaon might provide the solution to the problem of emergence Rather, theoretical pluralism regarding different pragmatically-workable notions of emergence is welcome The reality of emergents is discussed here from the standpoint of Dennet's mild realism. (shrink)

The problem of addiction is one of the major challenges and controversies confronting medicine and society. It also poses important and complex philosophical and scientific problems. What is addiction? Why does it occur? And how should we respond to it, as individuals and as a society? The Routledge Handbook of Philosophy and Science of Addiction is an outstanding reference source to the key topics, problems and debates in this exciting subject. It spans several disciplines and is the first collection of (...) its kind. Organised into three clear parts, forty-five chapters by a team of international contributors examine key areas, including: the meaning of addiction to individuals conceptions of addiction varieties and taxonomies of addiction methods and models of addiction evolution and addiction history, sociology and anthropology population distribution and epidemiology developmental processes vulnerabilities and resilience psychological and neural mechanisms prevention, treatment and spontaneous recovery public health and the ethics of care social justice, law and policy. Essential reading for students and researchers in addiction research and in philosophy, particularly philosophy of mind and psychology and ethics, The Routledge Handbook of Philosophy and Science of Addiction will also be of great interest to those in related fields, such as medicine, mental health, social work, and social policy. (shrink)

In this chapter, we will address criticisms to the theory of ecological functions introduced by Nunes-Neto et al. (2014). In doing so, we intend to further develop the theory, as a possible basis for naturalizing the teleological and normative dimensions of ecological functions. We will also take the first steps in the construction of an integrated scientific and ethical approach to sustainability that is intended to avoid an anthropocentric perspective.

Background: Today’s healthcare environment is often characterized by an ethically demanding work situation, and nursing students need to prepare to meet ethical challenges in their future role. Moral sensitivity is an important aspect of the ethical decision-making process, but little is known regarding nursing students’ moral sensitivity and its possible development during nursing education. Objectives: The aims of this study were to investigate moral sensitivity among nursing students, differences in moral sensitivity according to sample sub-group, and the relation between demographic (...) characteristics of nursing students and moral sensitivity. Research design: A convenience sample of 299 nursing students from one university completed a questionnaire comprising questions about demographic information and the revised Moral Sensitivity Questionnaire. With the use of SPSS, non-parametric statistics, including logistic regression models, were used to investigate the relationship between demographic characteristics and moral sensitivity. Ethical considerations: The study followed the regulations according to the Swedish Ethical Review Act and was reviewed by the Ethics Committee of South-East Sweden. Findings: The findings showed that mean scores of nursing students’ moral sensitivity were found in the middle to upper segment of the rating scale. Multivariate analysis showed that gender (odds ratio = 3.32), age (odds ratio = 2.09; 1.73), and parental status (odds ratio = 0.31) were of relevance to nursing students’ moral sensitivity. Academic year was found to be unrelated to moral sensitivity. Discussion and conclusion: These demographic aspects should be considered when designing ethics education for nursing students. Future studies should continue to investigate moral sensitivity in nursing students, such as if and how various pedagogical strategies in ethics may contribute to moral sensitivity in nursing students. (shrink)

The Peircean semiotic approach to information that we developed in previous papers raises several new questions, and shows both similarities and differenceswith regard to other accounts of information. We do not intend to present here any exhaustive discussion about the relationships between our account and otherapproaches to information. Rather, our interest is mainly to address its relationship to ideas about information put forward by Gregory Bateson and Eva Jablonka. We conclude that all these authors offer quite broad concepts of information, (...) but we argue that they are just as broad as they should be, since information is in itself a sweeping concept. Furthermore, all of them suggest a processual approach to information, which departs from the treatment of information as something that is contained in some structure (e.g., in sequences of nucleotides) and moves towards an understanding of information as a process — in terms of our account, a semiotic process, i.e., semiosis. (shrink)