As thousands of healthy research participants are being included in small and large imaging studies, it is essential that dilemmas raised by the detection of incidental findings are adequately handled. Current ethical guidance indicates that pathways for dealing with incidental findings should be in place, but does not specify what such pathways should look like. Building on an interview study of researchers’ practices and perspectives, we identified key considerations for the set-up of pathways for the detection, management and communication of (...) incidental findings in imaging research. We conducted an interview study with a purposive sample of researchers at research facilities across the Netherlands. Based on a qualitative analysis of these interviews and on existing guidelines found in the literature, we developed a prototype ethical framework, which was critically assessed and fine-tuned during a two-day international expert meeting with bioethicists and representatives from large population-based imaging studies from the United Kingdom, Germany, Sweden and Belgium. Practices and policies for the handling of incidental findings vary strongly across the Netherlands, ranging from no review of research scans and limited feedback to research participants, to routine review of scans and the arrangement of clinical follow-up. Respondents felt that researchers do not have a duty to actively look for incidental findings, but they do have a duty to act on findings, when detected. The principle of reciprocity featured prominently in our interviews and expert meeting. We present an ethical framework that may guide researchers and research ethics committees in the design and/or evaluation of appropriate pathways for the handling of incidental findings in imaging studies. The framework consists of seven steps: anticipation of findings, information provision and informed consent, scan acquisition, review of scans, consultation on detected abnormalities, communication of the finding, and further clinical management and follow-up of the research participant. Each of these steps represents a key decision to be made by researchers, which should be justified not only with reference to costs and/or logistical considerations, but also with reference to researchers’ moral obligations and the principle of reciprocity. (shrink)

This interview study investigates the short- and long-term implications of incidental findings detected through brain imaging on research participants’ lives and their surroundings. For this study, nine participants of the Rotterdam Scan Study with an incidental finding were approached and interviewed. When examining research participants’ narratives on the impact of the disclosure of incidental findings, the authors identified five sets of tensions with regard to motivations for and expectations of research participation, preferences regarding disclosure, short- and long-term impacts and impacts (...) on self and others. The paper shows: that the impact of incidental findings may be greater than participants at first let on; incidental findings can have significant effects on participants’ social environment; and participants may not feel prepared for disclosure even if incidental findings have been discussed during the informed consent process. The authors call for investigators to be aware of research participants’ experiences and these short- and long-term impacts when designing suitable courses of action for the detection and management of incidental findings in research settings. (shrink)

Background One of the objectives of medicine is to relieve patients' suffering. As a consequence, it is important to understand patients' perspectives of suffering and their ability to cope. However, there is poor insight into what determines their suffering and their ability to bear it. Purpose To explore the constituent elements of suffering of patients who explicitly request euthanasia or physician-assisted suicide (EAS) and to better understand unbearable suffering from the patients' perspective. Patients and methods A qualitative study using in-depth (...) face-to-face interviews was conducted with 31 patients who had requested EAS. The grounded theory approach was used to analyse the data. Results Medical, psycho-emotional, socio-environmental and existential themes contributed to suffering. Especially fatigue, pain, decline, negative feelings, loss of self, fear of future suffering, dependency, loss of autonomy, being worn out, being a burden, loneliness, loss of all that makes life worth living, hopelessness, pointlessness and being tired of living were constituent elements of unbearable suffering. Only patients with a psychiatric (co)diagnosis suffered unbearably all the time. Conclusions Unbearable suffering is the outcome of an intensive process that originates in the symptoms of illness and/or ageing. According to patients, hopelessness is an essential element of unbearable suffering. Medical and social elements may cause suffering, but especially when accompanied by psycho-emotional and existential problems suffering will become ‘unbearable’. Personality characteristics and biographical aspects greatly influence the burden of suffering. Unbearable suffering can only be understood in the continuum of the patients' perspectives of the past, the present and expectations of the future. (shrink)

Background: Although genetic research into Alzheimer disease (AD) is increasing, the ethical aspects of this kind of research and the differences between ethical issues related to genetic and non-genetic research into AD have not yet received much attention. Objectives: (1) To identify and compare the five ethical issues considered most important by surveyed expert panellists in non-genetic and genetic AD research and (2) to compare our empirical findings with ethical issues in genetic research in general as described in the literature. (...) Method: A modified Delphi study in two rounds Results: Genetic and non-genetic research into AD generated an approximately equal number of topics with a considerable overlap. Different priorities in the ethics of both types of research were found. Genetic research raised new topics such as “confidentiality of genetic information” and “implications of research for relatives” which changes the impact and application of existing ethical topics such as “informed consent” and is judged to have more impact on both individuals and society. A difference with the results of more theoretical approaches on ethical aspects related to AD research was also found. Conclusions: Different priorities are given to ethical issues in genetic and non-genetic research. These arise partly because genetic research causes unique and new questions, mostly related to the position of family members and the status of and access to genetic information. Differences found between the results of our empirical study and the more theoretical literature, suggest an additional value for empirical research in medical ethics. (shrink)

There are a lot of university in Indonesia. This condition make them become more competitive, to gets much students. There are several ways to win the competition, one is promotion. To promote university we have to pay attention for the referrence groups used in our advertising. With the appropriate referrence groups we used, the message from our advertising can be well delivered to our customer (students, their parents, and high school students).

Meike Wagner and Wolf-Dieter Ernst Performing the Matrix. Mediating Cultural Performances Neo: The matrix? Morpheus: Do you want to know what it is? ...

Organizations differ tremendously in the extent to which they engage in socially responsible behavior and the extent to which this behavior is evaluated by stakeholders. This research examines the complex role of organization size as a driver of perceptions of an organization’s socially responsible behavior and its social performance. Using a unique data set of 302 organizations in the higher education industry, we find that the strength of the organization size–organizational social performance relationship is contingent on whether the organization is (...) autonomous from community stakeholders and resource pressures. Our results show that the organization size–OSP relationship is stronger when stakeholders in the organization’s community are more involved in the organization itself and decision-making processes, and that this relationship is weaker when greater financial and human resources are available to the organization. (shrink)

Teens are extremely important targets for marketers because: they influence their parents’ spending, spend a lot of money in the future, and they are trendsetters. Some reason that make a brand popular among teens’ are: “quality”, “it’s for people my age”, “advertising”, “if cool friends or peers use it”, and “if a cool celebrity uses it”. Thus, it appears that advertising, peers, and celebrity or reference group have the potential to contribute to brand choice among teens. The objective of this (...) research was to know how reference group influence teenagers’ purchase intention and purchase behavior, especially in food supplement product. Sample was collected as a purposive random sampling method. This study used a questionnaire survey to investigate the influence of reference group in teenagers’ purchase intention and purchase behavior. The questionnaire was adopted from Martin and Bush (2000). Data was analyzed by simple regression analysis. By analyzing the standardized beta coefficients and the significance levels of each reference group, the predictive ability of potential reference group influence on teenagers’ purchase intention and purchase behavior can be examined. The findings suggest that reference group have a significant influence toward food supplement purchase intention and purchase behavior in Teenagers. All reference groups have a significant influence toward food supplement purchase intention, but only experts and celebrity have a significant influence toward purchase behavior in teenagers’. The findings also suggest that reference groups doesn’t plays an important role to influence purchase intention and purchase behavior in Teenagers”. (shrink)

Political decision-makers in the European Union are currently discussing the introduction of a mandatory uniform labelling scheme for meat and milk that provides information on husbandry systems similar to the already existent labelling scheme in the EU egg market. The objective of this paper was to assess whether such information is relevant to consumers when buying meat and milk. The paper was based on a systematic synthesis of 53 scientific journal articles on empirical consumer studies. The review revealed that consumers (...) perceived the aspects of outdoor access, stocking density and floor type as important factors influencing animal welfare. On average, consumers not only had a positive attitude towards more animal welfare-friendly husbandry systems with outdoor access and space allowance but were also willing to pay a price premium for products from such systems. All studies on consumer segmentation identified at least one consumer segment that placed great importance on animal welfare-friendly husbandry systems. Interestingly, many studies identified one or more other segments who still had a significant preference for animal welfare-friendly products even though other product attributes were more important to them. Based on the findings, the paper presents conclusions regarding the labelling of husbandry systems for meat and milk. (shrink)

ABSTRACT Upon encountering Deleuze’s Nietzschean reiteration that it is the task of modern philosophy to overturn Platonism, as put forth in Difference and Repetition (1968), this article worms its way in, seeking to unearth not merely what Deleuze’s differential repetition signifies, but also what such gestures generate in (re)turn. By considering Deleuze’s intervention as a manifold performance of (re)purposeful gestures that put the notion of reversal itself into question, and after providing a brief, Deleuzian, exposition of Platonism, this article not (...) only homes in on Deleuze’s demiurgic detection of an overturning gesture paradoxically already present in, if not itself initiated by, Plato’s writing, but additionally calls attention to other curiosities turn up when reading besides, instead of against, the grain. In introducing Michel Serres as a critical companion, this experimental article ultimately ponders over and entertains the productive possibility of framing Plato’s poignant predicament as a (problem of the) parasite. Composed as fruitful conceptual personae, parasites emerge throughout this article in unforeseen manners, time and time again bringing new food for thought to the table. (shrink)

Thus far, the academic focus has been limited to understand how hybrid organizations balance goal plurality. However, the question how hybrids engage (or fail to engage) local communities in this process and the potential challenges involved has remained unaddressed. Relying on an inductive multiple case study of six Canadian community forest enterprises (CFEs), we describe dilemmas that arise between community engagement and CFEs’ other goals that form their social mission, as well as a distinct set of compromise tactics to address (...) them. We further identify a tension that arises from two distinct dimensions inherent to community engagement that are inherently interwoven yet contradicting. We add to research on paradox by showing that tensions not merely arise between outcome-focused goals that stem from organizational hybridity, but demonstrate that individual goal prescriptions in itself entail elements that cause tension, and warrant paradoxical management to ensure hybrids’ success in fulfilling their overall mission. (shrink)

Despite the trend of secularization, pilgrimages to sacred sites flourish. Most of the pilgrims are women and the reasons for their visits often have to do with the dynamics of women's lives. Some of the pilgrims to sites dedicated to St Mary are Muslims. This is interesting in the present political context in which lines are being redrawn between Christians and Muslims and their respective religious identities. Why would Muslims go to Marian shrines and how do they negotiate their relationship (...) to the figure of the Virgin Mary and thereby define their gender and religious position? This article describes the experiences of Muslim pilgrims at Marian sites in Germany, Portugal and Turkey, and analyses these in terms of gender and religious identity. (shrink)

Happiness is an increasingly prominent topic of interest across academia. However, relatively little attention has been paid to how it is created, especially not in a multidimensional sense. By ‘created’ we do not mean its influencing factors, for which there is extensive research, but how it actually forms in the person. The work that has been done in this arena tends to focus on physiological dynamics, which are certainly part of the puzzle. But they are not the whole picture, with (...) psychological, phenomenological, and socio cultural processes also playing their part. As a result, this paper offers a multidimensional overview of scholarship on the ‘architecture’ of happiness, providing a stimulus for further work into this important topic. (shrink)

Humans preferentially remember information processed for their survival relevance, a memorial benefit known as the survival processing effect. Memory is also biased towards information associated with the prospect of reward. Given the adaptiveness of these effects, they may depend on similar mechanisms. We tested whether motivation drives both effects, with reward incentives that are known to boost extrinsic motivation and survival processing perhaps stimulating intrinsic motivation. Accordingly, we manipulated survival processing and reward incentive independently during an incidental-encoding task in which (...) participants chose between pairs of words concerning their relevance for a scenario, and examined the effects on encoding event-related potentials activity and later performance on a surprise recall test. We hypothesized that if survival processing fosters intrinsic motivation, it should reduce the beneficial effects of extrinsic motivation. In contrast to this prediction, we found that reward incentive and survival processing independently improved memory and that the P300, a measure of lower-level cognitive resource allocation, was increased by reward incentive independent of survival processing. Further, survival processing and reward incentive independently increased the frontal slow wave, a measure of higher-level elaboration. These findings suggest that while survival processing and reward incentive may both increase encoding elaboration, the memory-enhancing effect of survival processing does not depend on increased intrinsic motivation. Additionally, we replicated a recent finding whereby the survival processing effect generalizes to a choice-based encoding task and further showed that the beneficial effect of choice on memory likely does not interact with either survival processing or reward. (shrink)

Name der Zeitschrift: Das Mittelalter Jahrgang: 22 Heft: 1 Seiten: 1-8.

Future automated vehicles of different sizes will share the same space with other road users, e. g., pedestrians. For a safe interaction, successful communication needs to be ensured, in particular, with vulnerable road users, such as pedestrians. Two possible communication means exist for AVs: vehicle kinematics for implicit communication and external human-machine interfaces for explicit communication. However, the exact interplay is not sufficiently studied yet for pedestrians' interactions with AVs. Additionally, very few other studies focused on the interplay of vehicle (...) kinematics and eHMI for pedestrians' interaction with differently sized AVs, although the precise coordination is decisive to support the communication with pedestrians. Therefore, this study focused on how the interplay of vehicle kinematics and eHMI affects pedestrians' willingness to cross, trust and perceived safety for the interaction with two differently sized AVs. In this experimental online study, the participants interacted with the AVs in a shared space. Both AVs were equipped with a 360° LED light-band eHMI attached to the outer vehicle body. Three eHMI statuses were displayed. The vehicle kinematics were varied at two levels. Moreover, “non-matching” conditions were included for both AVs in which the dynamic eHMI falsely communicated a yielding intent although the vehicle did not yield. Overall, results showed that pedestrians' willingness to cross was significantly higher for the smaller AV compared to the larger AV. Regarding the interplay of vehicle kinematics and eHMI, results indicated that a dynamic eHMI increased pedestrians' perceived safety when the vehicle yielded. When the vehicle did not yield, pedestrians' perceived safety still increased for the dynamic eHMI compared to the static eHMI and no eHMI. The findings of this study demonstrated possible negative effects of eHMIs when they did not match the vehicle kinematics. Further implications for a holistic communication strategy for differently sized AVs will be discussed. (shrink)

When companies engage in corporate philanthropy, they can donate to a number of causes supporting a variety of issues, thus establishing cause portfolios. This research examines how the focus of a cause portfolio affects company evaluations. Results from an experiment show that when a company donates a small amount of money, consumers have lower evaluations of a company when the cause portfolio is focused (i.e., supports one issue) versus diverse (i.e., supports many issues). This is because the focused (vs. diverse) (...) portfolio is perceived to have a weaker impact to society. We provide additional evidence of this effect using a data set of Fortune 500 companies’ foundations, showing that cause portfolios are more likely to result in lower stakeholder evaluations when focused (vs. diverse). Again, we find that donation amount alleviates the difference between focused and diverse portfolios. The findings hold important implications for the company’s management of cause portfolios. (shrink)

Name der Zeitschrift: Das Mittelalter Jahrgang: 22 Heft: 1 Seiten: 197-204.

Name der Zeitschrift: Das Mittelalter Jahrgang: 22 Heft: 1 Seiten: 75-92.

Organic agriculture promotes the transformation toward sustainability because of positive effects for the environment. The organic label on food products enables consumers to make more sustainable purchasing decisions. Although the global market for organic food has grown rapidly in recent years, only a part of the organic product range benefits from this positive trend. To develop the organic market further, it is important to understand the food-related values and attitudes that drive the purchase of organic food. Previous research on this (...) topic has suffered from two main weaknesses. Firstly, most studies have been based on surveys and rely on stated behavior instead of actual purchase behavior. Secondly, the focus of most extant studies is predominantly on organic food in general or on food products with a relatively high organic market share, such as milk and eggs. To address this knowledge gap, the present study analyzes the value-attitude-behavior relationship by means of structural equation modeling using household purchase panel data from GfK. The paper provides evidence for the existence of an attitude-behavior gap in the organic market, with this gap found to be much stronger in the case of meat, frozen food, cheese, and sweets than for organic purchases in total. Analysis in different product categories reveals that while purchase behavior is driven by the same food-related values, their relative importance differs. (shrink)

Engaging communities in community-based health research is increasingly being adopted in low- and middle-income countries. The use of community advisory boards is one method of practicing community involvement in health research. To date, few studies provide in-depth accounts of the strategies that CAB members use to practice community engagement. We assessed the perspectives, experiences and practices of the first local CAB in Eswatini, which was implemented as part of the MaxART Early Access to ART for All study. Trained Swazi research (...) assistants conducted two focus group discussions and 13 semi-structured interviews with CAB members who had been part of the MaxART study for at least 2.5 years. Interviews explored CAB composition and recruitment, the activities of CAB members, the mechanisms used to engage with communities and the challenges they faced in their role. The MaxART CAB played an active role in the implementation of the Early Access to Art for All study, and activities mainly focused on: promoting ethical conduct, in particular privacy, consent and confidentiality; communication and education, communicating about the study and educating the community on the benefits of HIV testing and early access to HIV treatment; and liaising between the community and the research team. Strategies for interacting with communities were varied and included attending general community meetings, visiting health facilities and visiting public places such as cattle dipping tanks, buses, bars and churches. Differences in the approach to community engagement between CAB members living in the study areas and those residing outside were identified. The experiences of the first CAB in Eswatini demonstrate that community engagement using CABs is a valuable mechanism for engaging communities in implementation studies. Considerations that could impact CAB functioning include clearly defining the scope of the CAB, addressing issues of CAB independence, the CAB budget, providing emotional support for CAB members, and providing continuous training and capacity building. These issues should be addressed during the early stages of CAB formation in order to optimize functioning. (shrink)