Background: Growing evidence suggests that collaborative practice improves healthcare outcomes, but the precursors to collaborative behavior between nurses and physicians have not been fully explored. Research question: The purpose of this descriptive correlational study was to describe the professional values held by nurses and their attitudes toward physician–nurse collaboration and to explore the relationships between nurses’ characteristics (e.g. education, type of work) and professional values and their attitudes toward nurse–physician collaboration. Research design: This descriptive correlational study examines the relationship between (...) nurses’ professional values (Nurses Professional Values Scale–Revised) and their attitudes toward nurse–physician collaboration (Jefferson Scale of Attitudes toward Physician–Nurse Collaboration). Ethical considerations: Permission to conduct the study was received from the hospital, and the Institutional Review Boards of the healthcare system and the participating university. Participants/context: A convenience sample of 231 registered nurses from a tertiary hospital in the United States was surveyed. Findings: A significant positive relationship was found between nurses’ professional values and better attitudes toward collaboration with physicians ( r =.26, p <.01). Attitude toward collaboration with physicians was also positively associated with master’s or higher levels of education ( F(3, 224) = 4.379, p =.005). Discussion: The results of this study can be helpful to nurse administrators who are responsible for developing highly collaborative healthcare teams and for nurse educators who are focused on developing professional values in future nurses. (shrink)

In this article, we explore how deep brain stimulation (DBS) devices designed to “close the loop”—to automatically adjust stimulation levels based on computational algorithms—may risk taking the individual agent “out of the loop” of control in areas where (at least apparent) conscious control is a hallmark of our agency. This is of particular concern in the area of psychiatric disorders, where closed-loop DBS is attracting increasing attention as a therapy. Using a relational model of identity and agency, we consider whether (...) DBS designed for psychiatric regulation may require special attention to agency. To do this, we draw on philosophical work on relational identity and agency, connecting it with reports from people using first-generation DBS devices for depression and obsessive-compulsive disorder. We suggest a way to extend a notion of relational agency to encompass neural devices. (shrink)

Biography of Madhva, 13th cent. Hindu religious leader and founder of Mādhva sect.

Contemporary bioethics education has been developed predominately within Euro-American contexts, and now, other global regions are increasingly joining the field, leading to a richer global understanding. Nevertheless, many standard bioethics curriculum materials retain a narrow geographic focus. The purpose of this article is to use local cases from the Asia-Pacific region as examples for exploring questions such as ‘what makes a case or example truly local, and why?’, ‘what topics have we found to be best explained through local cases or (...) examples?’, and ‘how does one identify a relevant local case?’ Furthermore, we consider the global application of local cases to help extend the possible scope of the discussion, opening new avenues for the development of practical bioethics educational materials. We begin with a background description and discussion of why local cases enhance bioethics education, move to an overview of what is currently available and what is not for the region, and then outline a discussion of what it means to be local using example cases drawn from Hong Kong, Australia, Pakistan, and Malaysia. We are not creating a casebook but rather constructing by example a toolbox for designing active and dynamic learning cases using regional diversity as contextualised cases with generalised principles. (shrink)

The “practice turn” in philosophy of science has strengthened the connections between philosophy and scientific practice. Apart from reinvigorating philosophy of science, this also increases the relevance of philosophical research for science, society, and science education. In this paper, we reflect on our extensive experience with teaching mandatory philosophy of science courses to science students from a range of programs at University of Copenhagen. We highlight some of the lessons we have learned in making philosophy of science “fit for teaching” (...) outside of philosophy circles by taking selected cases from the students’ own field as the starting point. We argue for adapting philosophy of science teaching to particular audiences of science students, and discuss the benefits of drawing on research within science education to inform curriculum and course design. This involves reconsidering teaching resources, assumptions about students, intended learning outcomes, and teaching formats. We also argue that to make philosophy of science relevant and engaging to science students, it is important to consider their potential career trajectories. By anticipating future contexts and situations in which methodological, conceptual, and ethical questions could be relevant, philosophy of science can demonstrate its value in the education of science students. (shrink)

Patient-derived xenografts are currently promoted as new translational models in precision oncology. PDXs are immunodeficient mice with human tumors that are used as surrogate models to represent specific types of cancer. By accounting for the genetic heterogeneity of cancer tumors, PDXs are hoped to provide more clinically relevant results in preclinical research. Further, in the function of so-called “mouse avatars”, PDXs are hoped to allow for patient-specific drug testing in real-time. This paper examines the circulation of knowledge and bodily material (...) across the species boundary of human and personalized mouse model, historically as well as in contemporary practices. PDXs raise interesting questions about the relation between animal model and human patient, and about the capacity of hybrid or interspecies models to close existing translational gaps. We highlight that the translational potential of PDXs not only depends on representational matching of model and target, but also on temporal alignment between model development and practical uses. Aside from the importance of ensuring temporal stability of human tumors in a murine body, the mouse avatar concept rests on the possibility of aligning the temporal horizons of the clinic and the lab. We examine strategies to address temporal challenges, including cryopreservation and biobanking, as well as attempts to speed up translation through modification and use of faster developing organisms. We discuss how featured model virtues change with precision oncology, and contend that temporality is a model feature that deserves more philosophical attention. (shrink)

Background In the coronavirus disease 2019 era, doctors have tried to decrease hospital visits and admissions. To this end, telemedicine was implemented in a non-systematic manner according. The objective of this study was to assess the current knowledge and attitudes of physicians in Alexandria, Egypt, and Punjab, India, toward telemedicine and its ethical and medico-legal issues. Method A cross-sectional study was implemented using an anonymous self-administered questionnaire carried out over two months (July and August 2020). A four-point Likert scale was (...) used to collect data about background knowledge, training in telemedicine and ethical and medico-legal issues in telemedicine practice. Results The questionnaire was completed by 175 Egyptian and 51 Indian physicians from different specialties. A significantly higher percentage of Indian physicians practiced telemedicine than Egyptian physicians during the coronavirus disease 2019 era. Although most physicians had no specific training or licensing to practice telemedicine, most of them practiced telemedicine through their social media accounts. Ethical violations involving waiving patient consent were detected. Significant ethical violations to doctors, for example, blackmail, defamation, hate speech, accusations in a court and violations of privacy, were observed. Indian physicians (39.2%) and Egyptian physicians (24%) thought the penalties should be lower in telemedicine than in traditional practice. Finally, most participants would like to continue using telemedicine after the coronavirus disease 2019 era but with improvements. Conclusions Coronavirus disease 2019 changed the acceptance of telemedicine by physicians. Many ethical and legal issues need to be addressed and clarified using formal training before implementation and standardization of telemedicine services. (shrink)

Genome editing with engineered nucleases (GEENs) introduce site‐specific DNA double‐strand breaks (DSBs) and repairs DSBs via nonhomologous end‐joining (NHEJ) pathways that eventually create indels (insertions/deletions) in a genome. Whether the features of indels resulting from gene editing could be customized is asked. A review of the literature reveals how gene editing technologies via NHEJ pathways impact gene editing. The survey consolidates a body of literature that suggests that the type (insertion, deletion, and complex) and the approximate length of indel edits (...) can be somewhat customized with different GEENs and by manipulating the expression of key NHEJ genes. Structural data suggest that binding of GEENs to DNA may interfere with binding of key components of DNA repair complexes, favoring either classical‐ or alternative‐NHEJ. The hypotheses have some limitations, but if validated, will enable scientists to better control indel makeup, holding promise for basic science and clinical applications of gene editing. Also see the video abstract here https://youtu.be/vTkJtUsLi3w. (shrink)

Biography of Jayatīrtha, fl. 1365-1388, Indian philosopher.

In paediatric oncology, research and treatments are often closely combined, which may compromise voluntary informed consent of parents. We identified two key scenarios in which voluntary informed consent for paediatric oncology studies is potentially compromised due to the intertwinement of research and care. The first scenario is inclusion by the treating paediatric oncologist, the second scenario concerns treatments confined to the research context. In this article we examine whether voluntary informed consent of parents for research is compromised in these two (...) scenarios, and if so whether this is also morally problematic. For this, we employ the account of voluntary consent from Nelson and colleagues, who assert that voluntary consent requires substantial freedom from controlling influences. We argue that, in the absence of persuasion or manipulation, inclusion by the treating physician does not compromise voluntariness. However, it may function as a risk factor for controlling influence as it narrows the scope within which parents make decisions. Furthermore, physician appeal to reciprocity is not controlling as it constitutes persuasion. In addition, framing information is a form of informational manipulation and constitutes a controlling influence. In the second scenario, treatments confined to the research context qualify as controlling if the available options are restricted through manipulation of options. Although none of the influences is morally problematic in itself, a combination of influences may create morally problematic instances of involuntary informed consent. Therefore, safeguards should be implemented to establish an optimal environment for parents to provide voluntary informed consent in an integrated research-care context. (shrink)

Graphical AbstractGene editing with engineered nucleases introduce double-strand breaks that are repaired by error-prone nonhomologous end-joining (NHEJ). In article number 1900126, Sara G. Trimidal et al. propose that the length and type or resulting indels can now be controlled by editing with different engineered nucleases or by manipulating the expression of NHEJ genes.

Over the past decade, the number of clinical trials registered with the Food and Drug Administration has increased dramatically. The business of clinical research has become more diverse, involving academic institutions, clinician-researchers in community settings, pharmaceutical companies, and contract research organizations. This growth has been accompanied by increasing concerns about the ethical conduct of research. Much of this concern has been directed to procedural issues including institutional review board review, data monitoring, and informed consent forms. However, the protection of human (...) subjects cannot be achieved by relying solely on procedural safeguards. There are more nuanced issues related to recruitment and retention of subjects, and to the process of informed consent, that are generated during the interaction between study staff and subjects. It is only through an examination of these relationships that one can more fully define and understand the challenges of protecting subjects in research. (shrink)

Explores the complex nature of truth in Wittgenstein’s philosophy.

In this paper, we review two seemingly unrelated debates. In business ethics, the argument is about values: are they universal or emergent? In entrepreneurship, it is about opportunities – are they discovered or constructed? In reality, these debates are similar as they both overlook contingency. We draw insight from pragmatism to define contingency as possibility without necessity. We analyze real-life narratives and show how entrepreneurship and ethics emerge from our discussion as parallel streams of thought.

"Here is a unique and penetrating postmodernist invitation to reread Pascal's Pensées. With a full control on two centuries of Pascalian hermeneutics, Sara Melzer leads her readers into a passionate quest far beyond the worn-out search for a paleontological reconstruction of the Pensées's hypothetical final form. She rightly and deeply understands Pascal's writing--écriture--as the complex story of the "Fall of Truth into language." Such a perspective gives to Pascal's fragments a rejuvenated life, a newness, a dramatic and powerful voice (...) for our own culture. In brief, a welcome breeze of fresh air in the Pascalian world!" --Edouard Morot-Sir, The University of North Carolina at Chapel Hill "By approaching Pascal's Pensées from the point of view of contemporary critical theory, Melzer sheds new light on this well-known work. Her argument is clear, lucid, and cogent. She has a firm grasp of the major issues at stake in debates among literary critics. I think this is an important work that will be of interest not only to Pascal specialists but also to people who work in the general area of literary theory.... One of the genuine strengths of the book is the author's ability to discern the theological implications of issues that preoccupy literary theorists. This is particularly important at a time when students of theology and religion are becoming more and more interested in literary theory. They will find this analysis of Pascal very suggestive." --Mark Taylor, Williams College. (shrink)

Sara Confalonieri presents an overview of Cardano's mathematical treatises and, in particular, discusses the writings that deal with cubic equations. The author gives an insight into the latest of Cardano's algebraic works, the De Regula Aliza (1570), which displays the attempts to overcome the difficulties entailed by the casus irreducibilis. Notably some of Cardano's strategies in this treatise are thoroughly analyzed. Far from offering an ultimate account of De Regula Aliza, by one of the most outstanding scholars of the (...) 16th century, the present work is a first step towards a better understanding. Contents Inter-Dependencies Between the Families of Cubic Equations in the Ars Magna Ars Magna, Chapters XI-XXIII and the Casus Irreducibilis Getting Acquainted with the De Regula Aliza The Method of the Splittings in Aliza, Chapter I Target Groups Academics, researcher and students in the fields of mathematics, the history of mathematics, and epistemology. The Author Sara Confalonieri graduated in Philosophy at the Università degli Studi di Milano, in Mathematics at the Université Paris 6, and in Epistemology at the Université Paris 7, where she also obtained the PhD degree in history of mathematics on cubic equations during the Renaissance. At present, she takes part in a project on history of the didactic of mathematics in the 18th century at the Bergische Universität in Wuppertal as a post-doctoral researcher. (shrink)

This book continues from where the authors' previous book, Structural Proof Theory, ended. It presents an extension of the methods of analysis of proofs in pure logic to elementary axiomatic systems and to what is known as philosophical logic. A self-contained brief introduction to the proof theory of pure logic is included that serves both the mathematically and philosophically oriented reader. The method is built up gradually, with examples drawn from theories of order, lattice theory and elementary geometry. The aim (...) is, in each of the examples, to help the reader grasp the combinatorial behaviour of an axiom system, which typically leads to decidability results. The last part presents, as an application and extension of all that precedes it, a proof-theoretical approach to the Kripke semantics of modal and related logics, with a great number of new results, providing essential reading for mathematical and philosophical logicians. (shrink)

Our objective is to test an optimality model of human fertility that specifies the behavioral requirements for fitness maximization in order (a) to determine whether current behavior does maximize fitness and, if not, (b) to use the specific nature of the behavioral deviations from fitness maximization towards the development of models of evolved proximate mechanisms that may have maximized fitness in the past but lead to deviations under present conditions. To test the model we use data from a representative sample (...) of 7,107 men living in Albuquerque, New Mexico, between 1990 and 1993. The model we test proposes that low fertility in modern settings maximizes number of grandchildren as a result of a trade-off between parental fertility and next generation fertility. Results do not show the optimization, although the data do reveal a trade-off between parental fertility and offspring education and income.We propose that two characteristics of modern economies have led to a period of sustained fertility reduction and to a corresponding lack of association between income and fertility. The first is the direct link between costs of investment and wage rates due to the forces of supply and demand for labor in competitive economies. The second is the increasing emphasis on cumulative knowledge, skills, and technologies in the production of resources. Together they produce historically novel conditions. These two features of modern economies may interact with evolved psychological and physiological mechanisms governing fertility and parental investment to produce behavior that maximizes the economic productivity of lineages at the expense of fitness. If cognitive processes evolved to track diminishing returns to parental investment and if physiological processes evolved to regulate fertility in response to nutritional state and patterns of breast feeding, we might expect non-adaptive responses when returns from parental investment do not diminish until extremely high levels are reached. With high economic payoffs from parental investment, people have begun to exercise cognitive regulation of fertility through contraception and family planning practices. Those cognitive processes maynot have evolved to handle fitness trade-offs between fertility and parental investment. (shrink)

On the Viśiṣṭādvaita philosophy of Rāmānuja, 1017-1137.

This paper problematizes the analogy that Hubert Dreyfus has presented between phenomenology and cognitive science. It argues that Dreyfus presents Merleau-Ponty''s modification of Husserl''s phenomenology in a misleading way. He ignores the idea of philosophy as a radical interrogation and self-responsibility that stems from Husserl''s work and recurs in Merleau-Ponty''s Phenomenology of Perception. The paper focuses on Merleau-Ponty''s understanding of the phenomenological reduction. It shows that his critical idea was not to restrict the scope of Husserl''s reductions but to study (...) the conditions of possibility for the thetic acts. Merleau-Ponty argued, following Husserl''s texts, that the thetic acts rest on the basis of primordial pre-thetic experience. This layer of experience cannot, by its nature, be explicated or clarified, but it can be questioned and unveiled. This is the recurrent task of phenomenological philosophy, as Merleau-Ponty understands it. (shrink)