Bioethics education has remarkably grown across the globe in the last few decades. The data of the UNESCO Global Ethics Observatory proves that bioethics education is a global phenomenon with various bioethics institutions, teaching programs, and academicians. However, this situation does not mean that bioethics education has reached a stable and flawless level. Especially, the effectiveness of bioethics programs or their quality assessment is a major area that should be analyzed through more academic works. For filling that gap, this (...) article aims to formulate a general framework to address the quality standards and indicators in bioethics education. The article adapts Donabedian’s three approaches—structure, process, and outcome— as three levels to measure quality in bioethics education. The proposed model considers the indicators the ultimate quantifiable points by creating a sequential classification as the three levels, main categories, standards, and indicators, which means that it applies an inductive approach following a path from the indicators to the standards, from the standards to the main categories, and from the main categories to the levels in order to reach a conclusion about the effectiveness of each level. (shrink)

The quinoa export boom generated a rapid standardization project that sought to transform a heteroglot local grain into a uniform global commodity that could flow smoothly through global markets. All agricultural commodities come into being through different standardization processes that materialize specific concepts of quality. Yet the sudden rise in export demand for quinoa, massive price surge, and the biodiverse nature and local orientation of existing quinoa production made quinoa’s standardization particularly dramatic. This article traces the enforcement of (...) class='Hi'>quality standards for quinoa export ethnographically, focusing on the interactions between farmers and técnicos, a category of actors tasked with training farmers in “quality” quinoa production and enforcing quality at the moment of sale. I argue that standards moralize agricultural production practices, redefining “good quinoa” and “good farmers.” At the same time, they serve as powerful tools to render technical the reorientation of Andean agricultural systems toward quinoa export. Advocates for more just and ecologically sustainable global commodity chains should pay attention to quality standards as a key site of politics with major ramifications for inclusion/exclusion and resilience. (shrink)

Ellen Fox and collaborators have produced the most detailed description of healthcare ethics practices in the United States available. Some findings are shocking for anyone committed to promoting q...

Universities are specialized units aimed to deliver quality education and shaping future leadership to provide competent professionals to the industry. The establishment of ORIC in universities and significant increase in academia-industry linkage activities is strategic move towards achievement of the mentioned objectives. Bridging up the gap between academia and industry by adopting such strategies defines the successful role of HEIs. In view of increasing number of universities and continuous outflow of graduates it seems imperative to analyze and capitalize their (...) potential towards the growth of economy. However, the unemployment ratio and limited growth in SME sector reflect the insignificant absorption of graduates in corporate sector. The study aims to determine the factors that serve as barriers in achieving goals of HEIs by understanding the problems faced by university students in general and business graduates in particular on the basis of data gathered from 100 students from different universities present in Karachi. It shall also assists the policy makers in devising policy as per market demands, level of quality attained by universities, their involvement with corporate sector and in turn need of the industry to keep both parties at par in the fluctuating and contemporary era. (shrink)

Poor quality medical care is sometimes attributed to physicians’ unwillingness to act on evidence about what works best. Evidence-based performance standards (EBPSs) are one response to this problem, and they are increasingly employed by health care regulators and payers. Evidence in this instance is judged according to the precepts of evidence-based medicine (EBM); it is probabilistic, and the randomized controlled trial (RCT) is the gold standard. This means that EBPSs suffer all the infirmities of EBM generally—well rehearsed problems (...) with the external validity of research findings as well as the inferential leap from study results in the aggregate to individual patient care. These theoretical weaknesses promise to have a practical impact on the care of patients. To avoid this, EBPSs should be understood as guidelines indicative of average effectiveness rather than standards to be applied in every case. (shrink)

Objective The establishment of patient-centered measures capable of empirically determining meaningful cognitive change after surgery can significantly improve the medical care of epilepsy patients. Thus, this study aimed to develop reliable change indices (RCIs) and standardized regression-based (SRB) change norms for a comprehensive neuropsychological test battery in the German language. Methods Forty-seven consecutive patients with temporal lobe epilepsy underwent neuropsychological assessments, both before and 12 months after surgery. Practice-effect-adjusted RCIs and SRB change norms for each test score were computed. To (...) assess their usefulness, the presented methods were applied to a clinical sample, and binary logistic regression analyses were conducted to model the odds of achieving improvement in quality of life (QOL) after surgery. Results The determined RCIs at 90% confidence intervals and the SRB equations for each test score included in the test battery are provided. Cohen’s kappa analyses revealed a moderate mean agreement between the two measures, varying from slight to almost perfect agreement across test scores. Using these measures, a negative association between improvement in QOL and decline in verbal memory functions after surgery was detected (adjusted odds ratio = 0.09, p = 0.006). Significance To the best of our knowledge, this study is the first to develop RCIs and SRB change norms necessary for the objective determination of neuropsychological change in a comprehensive test battery in the German language, facilitating the individual monitoring of improvement and decline in each patients’ cognitive functioning and psychosocial situations after epilepsy surgery. The application of the described measures revealed a strong negative association between improvement in QOL and decline in verbal memory functions after surgery. (shrink)

Hospital ethics committees have become widespread over the last 25 years, stimulated by the Quinlan decision of the New Jersey Supreme Court, the report of a President's Commission, and most recently by the Joint Commission on Accreditation of Health Care Organizations , which now man dates that each hospital seeking accreditation have a functioning process for the consideration of ethical issues in patient care. Laws and regulations in several states require that hospitals establish ethics committees, and some states stipulate that (...) certain types of cases and disputes be taken to such committees. At least one state grants legal immunity to those who implement recommendations of an ethics committee. (shrink)

As the world's leader inavocado production, Mexico produces anestimated 900,000 tons/year, of which the stateof Michoacán produces 83% of nationalproduction and 40% of world avocado productionwithin five regional districts. In 1914 theUnited States imposed a phytosanitary banagainst Mexican avocado exports to the USmarket, a non-tariff barrier that stood despiteNAFTA. This paper examines increasedstandardization of product quality in avocadoas a political process in Michoacán duringthe 1980s and 1990s, during which differentregional groups and firms struggled to imposetheir standards and defend (...) their economicinterests in the market. In the 1990s, alliedwith the Mexican government, elite avocadogrowers mounted a phytosanitary campaign thatconvinced the USDA and US government to liftthe ban and allow Mexican avocado imports intothe US market in 1997. Since 1997 the Mexicangovernment has expanded Michoacán'sphytosanitary campaign, imposing internationalstandards on all avocado growers, even thoseproducing for the national market. By expandingthe campaign and institutionalizing newstandards of quality, industry experts nowconsciously link phytosanitary quality tocommercial quality. They propose atransformation of previously acceptedproduction and post-harvest practices.Theoretically, increased standards of quality,accompanied by systematic methods of evaluationand verification, should benefit all producers.However those growers producing for thenational market adhere to new rules designed toimprove product quality yet receive noimmediate, tangible economic benefits. Thiscase study demonstrates that theinstitutionalization of product standards iscarried out within an existing politicalsystem. Understanding whose standards countrequires careful analysis of how powerfulactors in specific agricultural industriesreshape and define standards of quality interms that benefit themselves. (shrink)

This work fulfills the need for a conceptual and technical framework to improve understanding of Information Quality (IQ) and Information Quality standards. The meaning and practical implementation of IQ are addressed, as it is relevant to any field where there is a need to handle data and issues such as accessibility, accuracy, completeness, currency, integrity, reliability, timeliness, usability, the role of metrics and so forth are all a part of Information Quality. -/- In order to support (...) the cross-fertilization of theory and practice, the latest research is presented in this book. The perspectives of experts from beyond the origins of IQ in computer science are included: library and information science practitioners and academics, philosophers of information, of engineering and technology, and of science are all contributors to this volume. -/- The chapters in this volume are based on the work of a collaborative research project involving the Arts and Humanities Research Council and Google and led by Professor Luciano Floridi, University of Oxford. -/- This work will be of interest to anyone handling data, including those from commercial, public, governmental and academic organizations. The expert editors’ contributions introduce issues of interest to scientists, database curators and philosophers, even though the issues may be disguised in the language and examples common to a different discipline. (shrink)

Decisions to override a parental request to withhold or withdraw treatment in the neonatal intensive care unit are often made based on the harm standard, with death being cast as the ultimate harm. However, often the treatment itself is not without harm, and the suffering engendered is undergone by an infant who is neither able to understand it nor express its presence. We can draw upon anticipated future quality of life to justify the present suffering, but are in a (...) quandary when that future is not guaranteed or is likely to hold little but further suffering. I propose that conflicts over continuing treatment are based both on disagreements about the desirability of possible futures, and on differing perceptions of the infant’s current level of suffering. Those of us who witness the suffering of these tiny, mute infants all bear some responsibility to insure that their suffering is not without purpose. (shrink)

The notion of quality features prominently in contemporary discourse. Numerous ratings, rankings, metrics, auditing, accreditation, benchmarking, smileys, reviews, and international comparisons are all used regularly to capture quality. This book paves the way in exploring the socio-political implications of evaluative statements, with a specific focus on the contribution of the concept of quality to these processes. Drawing on perspectives from the history of ideas, sociology, political science and public management, Dahler-Larsen asks what is the role of (...) class='Hi'>quality, and more specifically quality inscriptions, such as measurement? What do they accomplish? And finally, as a consequence of all this, does the term quality make it possible to deal with public issues in a way that lives up to democratic standards? This cross-disciplinary book will be of interest to scholars and students across various fields, including sociology, social epistemology, political science, public policy, and evaluation. (shrink)

The present paper proposes a theoretical model of institutional quality of a higher education institution (HEI) which, in addition to the internal dimensions of quality, incorporates also the external dimension, i.e. the outcomes dimension. This dimension has been neglected by the quality standards and models examined in our paper. Furthermore, the standards and models analyzed consider stakeholders as one of the quality factors of a HEI. The stakeholders’ perspective is seen as a lens through (...) which stakeholders define, control and assess the quality of a HEI. The proposed model therefore gives stakeholders greater significance compared to the dimensions of institutional quality of a HEI. The model has been validated from the employers’ perspective. On the basis of 339 completed questionnaires or a 39.74 % response rate we concluded that outcomes constitute the most important dimension of institutional quality of a HEI from the perspective of employers in Slovenia. The outcomes dimension is followed, in descending order, by the non-financial resources and inputs, sustainable development, value chain, and, finally, the financial resources and inputs dimensions. The results of the study have shown that of the 44 quality factors of a HEI the following data are of key importance to employers: information on the participation of students in practical training, achievements of graduates at the workplace, implementation of a HEI’s research achievements in practice, graduate employability, and a HEI’s responsiveness to the demands and changes in the environment. (shrink)

Quality of life is part of many different discourses and has been used in a variety of meanings ranging from purely descriptive (as in some medical contexts) to distinctly evaluative meanings (as in some social science and political contexts). The paper argues that there are good normative reasons to make the concept as descriptive as possible at least in its medical applications and, furthermore, to reconstruct it in a thoroughgoing subjectivist way, making the reflexive self-evaluation of the subject him- (...) or herself the ultimate standard. Attention is drawn to the fact that only few of the measures of quality of life applied in present-day medicine correspond to these requirements. (shrink)

ABSTRACTThe quality of medicines is generally adequately assured by manufacturers and regulatory authorities for well-resourced settings, while the implementation of existing quality standards is challenged in many low- and middle-income countries. This situation of multiple pharmaceutical standards raises the question whether it could ever be ethically justified to compromise on the quality assurance of medicines depending on what individuals, communities, or societies can afford. In this paper, we contend that ethically, any unjustified exceptions to medicines’ (...) quality assurance represents a violation of the principles of beneficence and non-maleficence. Exceptions are only acceptable in exceptional and temporary circumstances, if based on a meaningful quality risk assessment, guided by a rigorous ethical framework built on the principles of independence, technical competence, transparency, and accountability. We also discuss how such exceptional and temporary circumstances should be defined/justified.... (shrink)

There is an increasing need for quality in ethics consultations, though there have been significant achievements in the United States and Europe. However, fundamental concerns that place the profession in jeopardy are discussed from the perspective of the U.S. in a manner that will be helpful for other countries. The descriptive component of the essay (the first two points) explains the achievements in ethics quality (illustrated by the IntegratedEthics program of the Veterans Health Administration) and the progress on (...) standards and competencies for ethics consultations (represented by the Core Competencies of the American Society for Bioethics and Humanities). Based on these achievements, the analytical component of the essay (the final three points) identifies and seeks to resolve three fundamental concerns (with increasing levels of importance) that compromise quality in ethics consultations: standards of quality; professionalism; and credentialing. The analysis argues for clearer standards of quality in ethics consultation and urges further professionalism by explaining the need for the following: interpreting the ASBH core competencies in a normative manner, developing a Code of Ethics, and clarifying the meaning of best practices. However, the most serious concern that threatens quality in ethics consultations is the lack of a credentialing process. This concern can be resolved effectively by developing an independent Ethics Consultation Accreditation Council to accredit and standardize graduate degree programs, fellowship experiences, and qualifying examinations. This credentialing process is indispensable if we are to strategically enhance quality in ethics consultations. (shrink)

I motivate and defend a previously underdeveloped functionalist account of the metaphysics of color, a view that I call ‘quality-space functionalism’ about color. Although other theorists have proposed varieties of color functionalism, this view differs from such accounts insofar as it identifies and individuates colors by their relative locations within a particular kind of so-called ‘quality space’ that reflects creatures’ capacities to discriminate visually among stimuli. My arguments for this view of color are abductive: I propose that (...) class='Hi'>quality-space functionalism best captures our commonsense conception of color, fits with many experimental findings, coheres with the phenomenology of color experience, and avoids many issues for standard theories of color such as color physicalism and color relationalism. (shrink)

Building on a functionalist framework for decision-making in legal translation, a holistic approach to quality is presented in order to respond to the specificities of this field and overcome the shortcomings of general models of translation quality evaluation. The proposed approach connects legal, contextual, macrotextual and microtextual variables for the definition of the translation adequacy strategy, which guides problem-solving and the rest of the translation process. The same parameters remain traceable between the translation brief and the translation product (...) both in pre-delivery revision and in post-delivery assessment. They are the yardstick for identifying predictable evaluative criteria and competence requirements for translators and quality controllers. The implications of the approach on quality assessment and quality management practices are also discussed. Overall, the model illustrates the potential benefits of enhancing predictability and reducing subjectivity on the basis of specific legal translation methodologies. It supports the need for legal translation expertise in quality evaluation and the relevance of Legal Translation Studies to raising standards in professional practice. (shrink)

Conscious experiences are characterized by mental qualities, such as those involved in seeing red, feeling pain, or smelling cinnamon. The standard framework for modeling mental qualities represents them via points in geometrical spaces, where distances between points inversely correspond to degrees of phenomenal similarity. This paper argues that the standard framework is structurally inadequate and develops a new framework that is more powerful and flexible. The core problem for the standard framework is that it cannot capture precision structure: for example, (...) consider the phenomenal contrast between seeing an object as crimson in foveal vision versus merely as red in peripheral vision. The solution I favor is to model mental qualities using regions, rather than points. I explain how this seemingly simple formal innovation not only provides a natural way of modeling precision, but also yields a variety of further theoretical fruits: it enables us to formulate novel hypotheses about the space and structures of mental qualities, formally differentiate two dimensions of phenomenal similarity, generate a quantitative model of the phenomenal sorites, and define a measure of discriminatory grain. A noteworthy consequence is that the structure of the mental qualities of conscious experiences is fundamentally different from the structure of the perceptible qualities of external objects. (shrink)

The research aims to assess the extent of Green Business Standard implementation in hotels, determine the efficiency and effectiveness of Green Business Standard implementation in hotels, and define the influencing factors affecting GBSI in hotels. The research was conducted with 132 hotel representatives from six provinces and one municipality, five DoT officials, and 119 people who have experience of staying in hotels. Both quantitative and qualitative approaches were employed. To analyze the data, SPSS statistical tools were employed, including simple regression, (...) multiple regression, and descriptive statistical tools. Content analysis was employed to analyze qualitative data. -/- First, the Green Business Standard was implemented to a high degree in hotels regarding energy consumption with the use of efficient energy equipment, water consumption through efficient water materials and equipment, and air quality management, while the GBSI in hotels is low regarding the promotion of green products and local economic development, environmental protection, and local cultural promotion. Second, the practice of GBSI in hotels reduced water use, energy consumption, costs, and guest and profit margins. Third, the GBSI in hotels was predicted by customers’ support, government regulations, perceived benefits, hotel managers' or owners’ behavior, and staff support. -/- Keywords: green business standards, efficiency, effectiveness, and influencing factors of GBSI in hotels . (shrink)

The Quality Attestation Presidential Task Force's recent proposal for “quality attestation” (QA) of clinical ethics consultants was advanced on the premise that, “[g]iven the importance of clinical ethics consultation, the people doing it should be asked to show that they do it well.” To this end, the task force attempted to develop “a standardized system for proactively assessing the knowledge, skills, and practice of clinical ethicists.” But can this proposed method deliver? If the proposed QA process is flawed, (...) it will label clinical ethicists as qualified to do clinical ethics consultations (CECs) when they are not. The result will be the creation of a new, likely intractable, problem of CEC “false positives:” consultants who have passed QA without actually possessing the requisite knowledge and skills to perform CECs.To avoid the risk of false positives, the QAPTF needs to conduct a rigorous analysis of the skills that the QA process will be positioned to judge and those that are simply beyond the scope of its current metrics. Rather than “attesting” to overall CEC “quality,” QA needs to be precise about the skill inventory it can confirm yet honest about the skills it has no basis to assess. I will argue here that QA has strong prospects for accurately assessing consultants’ competence in ethical analysis but very weak prospects for determining competence in two other skills listed as essential by the QAPTF: value‐neutrality and conflict resolution. (shrink)

Purpose: This article aims to highlight key indicators of residents' quality of life in a specific contemporary building in Kruja, Albania. -/- Design/Method/Approach: A questionnaire with 30 questions was prepared for the inhabitance, and the Binary or Tobit probabilistic models were taken into consideration as part of the methodology, to conclude. The study will further analyze the implications of the inhabitants and their behavior in a specific contemporary building in the city of Kruja. It was examined the statistical significance (...) of each variable (questions) in the models elaborated with EViews 8 software. The stable models that are associated with the “Log-likelihood” statistics were statistically significant at a significance level of p < 5%, or with 95% confidence, based on the model tests. -/- Findings: The study concluded that the most statistically significant quality of life indicators part of the questionnaire is related to the typology of the apartments, methods of cooling during summer, present living conditions, apartment improvement, apartment orientation, and time spent in the living room. Furthermore, the study reveals that most of the quality-of-life indicators (part of the questionnaire) are not statistically important, so they will not be considered part of the models created in the article. The study reveals that increasing the living space and improving orientation is crucial to enhance the satisfaction of apartment inhabitants. When apartment sizes increase and orientation is improved, residents are more likely to opt for fans over air conditioners to reduce electricity costs and avoid installing additional cooling facilities during summer. They believe that better living conditions require larger apartments, additional water supply, increased electrical costs, and more time spent in the living room. The inhabitants also emphasize the importance of reducing moisture levels, decreasing window opening frequency, and increasing time spent with family. Interestingly, a one-degree improvement in summer cooling methods (e.g., switching from air blowers to air conditioning) corresponds to a one-degree improvement in winter heating methods (e.g., switching from gas to electricity), leading to a heightened need for clean electric heating. Overall, the study emphasizes the importance of meeting the physical and spatial needs of the residents to enhance their overall satisfaction and quality of life. Urban policies significantly impact housing affordability, quality, transport systems, environmental sustainability, and social equity, affecting overall living standards and economic growth. Cities must create well-designed policies that consider residents' needs and study findings to ensure sustainable development and citizen welfare. -/- Theoretical Implications: Gujarati’s (Basic Economics) theory was developed in the article. -/- Practical Implications: This study will serve as an indicator to analyze the further improvements that might occur in the specific building (not just in the city of Kruja), considering the main quality of life indicators. -/- Originality/Value: The article will serve as a base for further analysis of resident’s behavior and their social impact in the community in order to be aware of their needs for further developments in the construction field. -/- Research Limitations/Future Research: The findings depend profoundly on the type of building the residents are living in. The research stream that can be inspired by the research is strongly related to mathematical regression models, statistics, and probability. -/- Paper Type: Empirical . (shrink)

Strong emergentists about mental properties of conscious experience typically hold that these are ontologically “over and above” and distinct in kind as compared to physical properties. Powers-based account of strong emergence offer a promising framework for elucidating the ontological “over and above”-ness of strongly emergent properties. However, they do not automatically ensure the desired non-physicality. In this paper, I argue that a conception of properties as powerful qualities has in-built resources for capturing both the ontological “over and above”-ness and the (...) kind distinctness in a unified way. I begin by illustrating powers-based accounts of strong emergence. Then I defend the superiority of a powerful qualities-based account of strong emergence over two standard approaches recovering the distinctness in kind of strongly emergent mental properties: the via negativa strategy, and the anti-materialist strategy. I conclude that a conception of powerful qualities is a surprising yet natural ally for the proponent of strongly emergent mental properties. (shrink)

Background Meaningfully evaluating the quality of institutional review boards (IRBs) and human research protection programs (HRPPs) is a long-recognized challenge. To be accredited by the Association for the Accreditation of Human Research Protection Programs (AAHRPP), organizations must demonstrate that they measure and improve HRPP “quality, effectiveness, and efficiency” (QEE). We sought to learn how AAHRPP-accredited organizations interpret and satisfy this standard, in order to assess strengths, weaknesses, and gaps in current approaches and to inform recommendations for improvement.Methods We (...) conducted 3 small-group interviews with a total of 19 participant representatives of accredited organizations at the 2019 AAHRPP annual meeting. Participants were eligible if they had familiarity with their organization’s approach to satisfying the relevant QEE standard.Results Participants reported lacking clear definitions for HRPP quality or effectiveness but described various approaches to assessing QEE, typically focused on turnaround time, compliance, and researcher satisfaction. Evaluation of IRB members was described as relatively superficial and information regarding research subject experience was not reported as central to QEE assessment, although participants described several efforts to improve consideration of patient, subject, and community perspectives in IRB review. Participants also described efforts to educate and build relationships with key stakeholders as important features of a high-quality HRPP. While generally satisfied with their approaches, participants expressed concern about resource and time constraints that pushed them to be reactive and automatic about QEE, rather than proactive and critical.Conclusions The relevant AAHRPP accreditation standard may obscure critical gaps in defining and measuring QEE elements. We recommend that AAHRPP: (1) offer a definition of QEE or require accredited organizations to provide their own, to help clarify the rationale and goals behind assessment and improvement efforts, and (2) require accredited organizations to establish QEE objectives and measures focused on participant outcomes and deliberative quality during protocol review. (shrink)

The prevalence of Clinical ethics support services is increasing. Yet, questions about what quality of CES entails and how to foster the quality of CES remain. This paper describes the development of a national network, which aimed to conceptualize and foster the quality of CES in the Netherlands simultaneously. Our methodology was inspired by a responsive evaluation approach which shares some of our key theoretical presuppositions of CES. A responsive evaluation methodology engages stakeholders in developing quality (...) standards of a certain practice, instead of evaluating a practice by predefined standards. In this paper, we describe the relationship between our theoretical viewpoint on CES and a responsive evaluation methodology. Then we describe the development of the network and focus on three activities that exemplify our approach. In the discussion, we reflect on the similarities and differences between our approach and other international initiatives focusing on the quality of CES. (shrink)

The present work deals with an initiative that aims at creating and promoting rural development through high quality. It is called “Presidia”, it has been started by the Slowfood movement, and it relies on an approach to rural economies different from the standard spreading of industrialization. The phenomenon on focus is based upon the cooperative dynamics of several small producers, and thus some criticalities typical of social dilemmas have emerged in the case-based study on the field: they deal with (...) the role played by cooperation-supporting institutions. Through an empirically grounded agent-based model which allows what-if analysis of some policy suggestions, different mechanisms for promoting cooperation among producers are thus investigated. Simulation results outline how single altruistic actions are not capable of sustaining a positive aggregate while single selfish choices can determine very negative outcomes, and how only the strong commitment of most central actors can protect the system from random fluctuations in cooperation levels. Two main results are finally discussed: informal control mechanisms do not ensure the desired level of cooperation and high quality; interaction structure codetermines the outcome. (shrink)

This paper reports an initiative from the National Research Ethics Service (UK) and research ethics committees in the UK to develop a shared ethical debate between committees and to promote standards of ethical review, exploring the problems and practicalities of such an approach.

Research in the field of management has increasingly focused on strategies and tools related to corporate sustainability. Of the tools examined, codes of ethics have been found to play a primary role. Many studies have investigated the content of such codes, as well as their capacity to condition the behaviour of people within organizations. However, few studies have considered the intrinsic quality of codes of ethics. This study aims to investigate the impact that specific factors—firm size, degree of internationalization (...) and industry effect—can have on the quality of codes of ethics. Based on a sample of 248 listed Italian companies, the results of the empirical analysis show that the quality standard is particularly high in larger companies and in those firms operating in industries in which relationships established with critical stakeholders—and disclosure to those stakeholders—play a crucial role. These results have interesting implications for both researchers and practitioners. (shrink)

Quality improvement (QI) is fundamental to maintaining high standards of health care. Significant debate exists concerning the necessity for an ethical approval system for those QI projects that push the boundaries, appearing more similar to research than QI. The authors discuss this issue identifying the core ethical issues in family medicine (FM), drawing upon the fundamental principles of medical ethics, including principles of autonomy, utility, justice and non-maleficence. Recent debate concerning the application of QI ethics boards is discussed (...) with relevance to primary care and issues such as general practitioner (GP) intentions, the impact of QI on patients and the use of confidential patient data and the impact of dissemination. The authors conclude that a system of QI ethical approval leaves many issues unresolved and potentially creates several barriers to implementing QI. To ensure ethical QI work is generated within FM it is essential for GPs to learn about and engage in more ethical reflection so that they can better judge and resolve these issues. (shrink)

The chief sources of groundwater contamination on farms come from point sources and diffuse sources. Possible point sources are feedlots, poorly-sited manure piles, septic sewage-treatment systems—all of which can release nitrate, phosphates and bacteria— and sites of chemical spills. Diffuse sources are typified by excess fertilizer leaching from a number of arable fields. The basis of quality standards for drinking-water is discussed in relation to common contaminants present on farms. Samples of drinking-water were collected in 1991–1992 from wells (...) on about 1,200 farms in order to study the quality of rural groundwater in Ontario. Analysis showed that approximately one third of wells were contaminated with bacteria, 14% were contaminated with nitrate, two wells were contaminated with pesticide, but 40% were considered unsafe because of the presence of at least one contaminant. These values were similar to those reported for similar regions in the U.S. There was no significant effect of agricultural practice on the proportion of contaminated samples. One response of Ontario's farmers to information on water quality has been to initiate their own program, the Environmental Farm Plan, which has 23 modules by which the risk of environmental contamination can be assessed. Government policies for agriculture can be expected to influence farming practices. However, the literature suggests that the consequences of policies aimed at reducing environmental contamination are poorly understood, not least because the instruments used for implementation can have widely differing impacts. The need for discussions on the ethics surrounding the relationship between food producers and consumers with regard to environmental contamination is identified. (shrink)

Health-related quality of life measures aim to assess patients’ subjective experience in order to gauge an increasingly wide variety of health care issues such as patient needs; satisfaction; side effects; quality of care; disease progression and cost effectiveness. Their popularity is undoubtedly due to a larger initiative to provide patient-centered care. The use of patient perspectives to guide health care improvements and spending is rooted in the idea that we must respect patients as self-determining agents. In this paper (...) I look at the two main orientations to quality of life measurement: standardized and individualized measures. I argue that while these measures are attempts to provide for patient self-determination, they both fail to do so. In their place I suggest a new approach which overcomes their respective difficulties: a dialogic approach. (shrink)

Simulated standardized patients (SPs) are trained individuals who pose incognito as people seeking treatment in a health care setting. With the method’s increasing use and popularity, we propose some standards to adapt the method to contextual considerations of feasibility, and we discuss current issues with the SP method and the experience of consent and ethical research in international SP studies. Since a foundational discussion of the research ethics of the method was published in 2012, a growing number of studies (...) have implemented this method to collect data on the quality of care in a variety of settings around the world. We draw from that experience to provide empirical foundations for a popular approach to ethical approval of such studies in the United States and Canada, which has been to obtain a waiver of informed consent from the health care providers who are the subjects of the research. However, the majority of studies to date have evaluated quality of care outside the U.S., requiring additional ethical consideration when partnering with international institutions. We discuss these considerations in the context of a case study from a completed SP study in South Africa, where informed consent is constitutionally protected. (shrink)

Quality in clinical research may be defined as compliance with requirements together with credibility and reliability of the data obtained. Sponsors usually apply Quality Management Systems (QMS) to ensure, control, maintain, and improve quality. These systems encompass several preventive measures, tools, and controls. Standard QMS applied by clinical research sponsors may be based on ISO 9000.

In the last three decades, considerable theoretical and empirical research has been undertaken on the topic of moral distress among health professionals. Understood as a psychological and emotional response to the experience of moral wrongdoing, there is evidence to suggest that—if unaddressed—it contributes to staff demoralization, desensitization and burnout and, ultimately, to lower standards of patient safety and quality of care. However, more recently, the concept of moral distress has been subjected to important criticisms. Specifically, some authors argue (...) that the standard account of moral distress elucidated by Jameton :542–551, 1984) does not refer to a discrete phenomenon and/or that it is not sufficiently broad and that this makes measuring its prevalence among health professionals, and other groups of workers, difficult if not impossible. In this paper, we defend the standard account of moral distress. We understand it as a concept that draws attention to the social, political and contextual determinants of moral agency and brings the emotional landscape of the moral realm to the fore. Given the increasing pressure on health professionals worldwide to meet efficiency, financial and corporate targets and reported adverse effects of these for the quality and safety of patient care, we believe that further empirical research that deploys the standard account moral distress is timely and important. (shrink)

Background: Ontologies and taxonomies are among the most important computational resources for molecular biology and bioinformatics. A series of recent papers has shown that the Gene Ontology (GO), the most prominent taxonomic resource in these fields, is marked by flaws of certain characteristic types, which flow from a failure to address basic ontological principles. As yet, no methods have been proposed which would allow ontology curators to pinpoint flawed terms or definitions in ontologies in a systematic way. Results: We present (...) computational methods that automatically identify terms and definitions which are defined in a circular or unintelligible way. We further demonstrate the potential of these methods by applying them to isolate a subset of 6001 problematic GO terms. By automatically aligning GO with other ontologies and taxonomies we were able to propose alternative synonyms and definitions for some of these problematic terms. This allows us to demonstrate that these other resources do not contain definitions superior to those supplied by GO. Conclusion: Our methods provide reliable indications of the quality of terms and definitions in ontologies and taxonomies. Further, they are well suited to assist ontology curators in drawing their attention to those terms that are ill-defined. We have further shown the limitations of ontology mapping and alignment in assisting ontology curators in rectifying problems, thus pointing to the need for manual curation. (shrink)

Drinking water quality has drawn enormous attention from scientific communities, the industrial sector, and the common public in several countries during the last couple of decades. The scholarship in science and technology studies somehow overlooked this crucial domain. This article attempts to contribute to this gray area by exploring how drinking water quality is understood in Indian water policies, laws, and courtrooms. The article argues that water policies and laws in India were significantly shaped by international treaties and (...) global environmental stewardship. In the courtrooms, the Indian judiciary employed minimum science-based evidence in decision making in the context of drinking water–related cases; rather they used a rights-based approach and minimally engaged with the issue of drinking water quality/standards. Whatever little science used as valid science by the judges in the decision making was entirely expert-based. The reliance of the judges on the scientific expertise of the experts representing regulatory organizations and public institutions was another unique characteristic of the relationship between science and law in India. (shrink)

Although organic standards and certification schemes have a crucial role in ensuring quality, safety, and sustainability within food systems, there is a need to critically analyze their implications on human capabilities within alternative food networks (AFNs). Therefore, this paper draws upon the capability approach to analyze the implications of three governance mechanisms (i.e., third-party, social control, and hybrid certification) on human flourishing within AFNs in Ceará, Brazil. The three cases primarily build on 66 interviews with farmers, consumers, AFN (...) owners and employees, certifying officials, governmental and non-governmental representatives, and researchers. Third-party certification has some positive effects in terms of material, political, and environmental capabilities and many negative effects regarding social/cultural capabilities. Social control certification bolsters material, social/cultural, political, and environmental capabilities for the benefit of farmers and consumers. Hybrid certification increases the material control, political power, social legitimacy, and environmental governance of market intermediaries. The findings can help scholars, practitioners, and policymakers rethink the role of organic standardization and certification in fostering fundamental human capabilities and tackling inequalities within AFNs. (shrink)

To improve the accuracy of the multiple channel integration quality evaluation, this paper proposes a comprehensive evaluation method using the nonlinear autoregressive exogenous model and constructs an index system. First, the entropy method is used to determine the objective weight of each indicator. The indicators used in this paper are process consistency, information consistency, emotional value, procedural value, service structure transparency, online result value, business relevance, and online purchase intention. Second, an improved gray relational analysis algorithm is used to (...) obtain the comprehensive gray relational degree between the above eight indicators’ standard samples and the tested samples. Then, this study uses the dataset preprocessed with the GRA algorithm for training the NARX model. Then, this study uses the trained model to evaluate the quality of multiple channel integration comprehensively. Next, this study uses standardized methods to quantify the evaluation results to provide new ideas and theoretical guidance for teaching traditional retailers to use the advantages of multiple channels to expand their online business. This paper uses 50,000 consecutive samples of a product for 3 months as a dataset in the experimental part. Through the GRA method and the NARX model, the comprehensive gray relational degree between the test sample and the ideal sample is obtained, and the results are quantified. Experiments show that, compared with the GRA method, this paper’s method has a higher degree of fit between the output value and the target value. (shrink)

This article presents standards for setting up and educating institutional ethics committees (IECs). These standards are based on experiences in the Netherlands, where IECs have been established in a large number of health care institutions. Though the IEC has become a generally accepted institution within Dutch health care, there are concerns over its effectiveness regarding the improving of the moral quality of clinical decision making. Health care practitioners and members of IECs too, experience a gap between the (...) IEC and the reality of the clinical environment. At this moment, there is interest in developing programmes which educate practitioners in moral issues and how to deal with them, using the method of a structured debate on the ward. The IEC will not be made obsolete by this development, but can play a guiding role in the implementation of such programmes. Current concerns are the lack of patient representation in the Dutch IEC, and the loss of contact with the local community of health care practitioners because of the merger of hospitals into bodies similar to UK National Health Service (NHS) trusts. (shrink)

The chapter outlines an abstract theoretical framework that is currently (re-)emerging in the course of a theoretical convergence of several disciplines. In the first section, the fundamental problem of perception theory is formulated, namely, the generation, by the perceptual system, of meaningful categories from physicogeometric energy patterns. In the second section, it deals with basic intuitions and assumptions underlying what can be regarded as the current Standard Model of Perceptual Psychology and points out why this model is profoundly inadequate for (...) dealing with the fundamental problem of perception theory. In the third section, it discusses a level of analysis that promises to be fruitful for dealing, in conformity with established procedures of the natural sciences, with the problem of perceptual “meaning” and the problem of what constitutes a “perceptual object.” In the fourth section, it outlines a theoretical perspective on basic principles of the perceptual system which centers on the notions of complex data types and conceptual forms, and draws an entirely different theoretical picture of the role of the sensory input than traditional accounts. The final section focusses on the issue of material qualities and discusses, within the general theoretical framework outlined, some observations and results on the perception of certain material properties, namely, lustrous and glassy appearances. (shrink)