Law Schools are now required to provide education to law students on bias, cross-cultural competency, and racism under ABA Standard 303(c). Law clinics, with their social justice orientation, have long taught about structural causes of bias and oppression and ways to intervene at system levels to prevent problems. Medical legal partnership (MLP) clinics have done so by employing concepts from social work and health science programs on structural competency. This article examines MLP and related curriculum to (...) meet the ABA mandate. (shrink)

This symposium of the Journal of Bioethical Inquiry illustrates structural competency: how clinical practitioners can intervene on social and institutional determinants of health. It will require training clinicians to see and act on structural barriers to health, to adapt imaginative structural approaches from fields outside of medicine, and to collaborate with disciplines and institutions outside of medicine. Case studies of effective work on all of these levels are presented in this volume. The contributors exemplify structural (...) competency from many angles, from the implications of epigenetics for environmental intervention in personalized medicine to the ways clinicians can act on fundamental causes of disease, address abuses of power in clinical training, racially desegregate cities to reduce health disparities, address the systemic causes of torture by police, and implement harm-reduction programs for addiction in the face of punitive drug laws. Together, these contributors demonstrate the unique roles that clinicians can play in breaking systemic barriers to health and the benefit to the U.S. healthcare system of adopting innovations from outside of the United States and outside of clinical medicine. (shrink)

Adverse developmental exposures and pathologies of the social environment make vastly greater contributions to the leading health burdens in society than currently known genotypic information. Yet, while patients now commonly bring information on single alleles to the attention of their healthcare team, the former conditions are only rarely considered with respect to future health outcomes. This manuscript aims to integrate social environmental influences in genetic predictive models of disease risk. Healthcare providers must be educated to better understand genetic risks for (...) complex diseases and the specific health consequences of societal adversities, to facilitate patient education, disease prevention, and the optimal care in order to achieve positive health outcomes for those with early trauma or other social disadvantage. (shrink)

Contractualists characterize morality as fundamentally concerning how people relate to one another. Insofar as someone treats others in a way that they can accept, her actions are permissible. If someone’s actions cannot be justified to others, she acts wrongly. By relying on this idea of justifiability to others, contractualists can account for the wrongness of acts by appealing to a wide variety of reasons. For instance, contractualists can explain why murder is wrong by appealing to the death of innocents and (...) explain the wrongness of plagiarism in terms of the importance of authenticity and originality. Someone can reasonably reject letting people act on principles that allow murder or plagiarism, at least in part, for those reasons. While this flexibility is a strength of contractualism, it also complicates explaining how the fact that an act is wrong itself provides a reason against doing it. Put differently, if the death of innocents explains the wrongness of murder, why take the .. (shrink)

In the target article, “Revive and Refuse: Capacity, Autonomy, and Refusal of Care After Opioid Overdose,” Kenneth D. Marshall and collaborators (2024) highlight important complexities in the care...

The inclusion of structural competency training in pre-health undergraduate programs may offer significant benefits to future healthcare professionals. This paper presents the results of a comparative study of an interdisciplinary pre-health curriculum based in structural competency with a traditional premedical curriculum. The authors describe a new evaluation tool, the Structural Foundations of Health Survey ©, developed to evaluate structural skills and sensibilities. The authors use the survey to evaluate two groups of graduating seniors at (...) Vanderbilt University—majors in an interdisciplinary pre-health curriculum titled Medicine, Health, and Society, and premed science majors—with particular attention to understanding how political, cultural, economic, and social factors shape health. Results suggest that MHS majors identified and analyzed relationships between structural factors and health outcomes at higher rates and in deeper ways than did premed science majors. MHS students also demonstrated higher understanding of structural and cultural competency in their approaches to race, intersectionality, and racial health disparities. The skills that MHS students exhibited represent proficiencies increasingly emphasized by the MCAT, the AAMC, and other educational bodies that, in an era of epigenetics and social determinants, emphasize how contextual factors shape expressions of health and illness. (shrink)

Every year millions of people suffer minor brain injuries, many of which occur in collision sports. While there has been substantial commentary and debate about the nature of this public health crisis, it is clear that the scientific and clinical arguments reflect values preferences and judgments that are often invisible in documents which combine artful language with undue focus paid to sources of uncertainty at the cost of clarity and transparency. This essay gives a brief history of these patterns and (...) proposes a remedy. (shrink)

As clinical ethics consultants move toward professionalization, the process of certifying individual consultants or accrediting programs will be discussed and debated. With certification, some entity must be established or ordained to oversee the standards and procedures. If the process evolves like other professions, it seems plausible that it will eventually include a written examination to evaluate the core knowledge competencies that individual practitioners should possess to meet peer practice standards. The American Society for Bioethics and Humanities has published core knowledge (...) competencies for many years that are accepted by experts as the prevailing standard. Probably any written examination will be based upon the ASBH core knowledge competencies. However, much remains to be done before any examination may be offered. In particular, it seems likely that a recognized examining board must create and validate examination questions and structure the examination so as to establish meaningful, defensible parameters after dealing with such challenging questions as: Should the certifying examination be multiple choice or short-answer essay? How should the test be graded? What should the pass rate be? How may the examination be best administered? To advance the field of health care ethics consultation, thought leaders should start to focus on the written examination possibilities, to date unaddressed carefully in the literature. Examination models—both objective and written—must be explored as a viable strategy about how the field of health care ethics consultations can grow toward professionalization. (shrink)

Confronting the uncertain environment, this article adopts a case research approach to resonate with the studies of hybridity. It aims to explain how the perception of uncertainty in the institutional environment affects the adaptation of organizational structure in pursuing legitimacy for hybrid organizations. Based on the empirical data collected from a two-staged fieldwork and in-depth interviews, the case analysis concentrates on the correlation between the evolution of institutional logics and organizational structure change from a diachronic perspective. The findings indicate that (...) in the face of competing and changing institutional logics, Chinese mass media organizations have gradually shifted from a dominated blending strategy in the exploration stage to a deeply compartmentalizing strategy in the stable stage. The hybrids can deal with the uncertainty of the institutional environment by enhancing the uncertainty of the organizational structure. Consequently, the case evolves an organizational integration through internal legitimacy. It manifests a possibility for hybrids of combining the two major response mechanisms in one process. (shrink)

Decision-making competence refers to the ability to make better decisions, as defined by decision-making principles posited by models of rational choice. The adult decision-making competence (A-DMC) scale is a relatively mature evaluation tool used for decision-making competence. However, the A-DMC is yet far from other mature psychological evaluation tools, and especially the structure of A-DMC remains unclear. In the current study, we estimated a regularized partial correlation network of decision-making competence in a Chinese sample consisting of 339 adults who were (...) evaluated by the A-DMC, and then the centrality indicators were calculated. The results revealed that all nodes of the decision-making competence networks are positively associated, except for the association of resistance to framing (RF) and resistance to sunk costs (SC). The strongest edge was between RF and applying decision rules (DR; regularized partial correlation = 0.37). The centrality indicators of RF and applying DR were highest, revealing that these two variables may play important roles in the decision-making competence network. Our study conceptualizes the decision-making competence from network perspectives, so as to provide some insights for future researches. (shrink)

Recent findings suggest that medical students’ moral competence decreases throughout medical school. This pilot study gives preliminary insights into the effects of two educational interventions in ethics classes on moral competence among medical students in Munich, Germany. Between 2012 and 2013, medical students were tested using Lind’s Moral Competence Test prior to and after completing different ethics classes. The experimental group participated in principle-based structured case discussions and was compared with a control group with theory-based case discussions. The pre/post C-scores (...) were compared using a Wilcoxon Test, ANOVA and effect-size calculation. The C-score improved by around 3.2 C-points in the EG, and by 0.2 C-points in the CG. The mean C-score difference was not statistically significant for the EG or between the two groups. There was no statistical significance for the teachers’ influence on C-score. In both groups, students with below-average C-scores improved and students with above-average C-scores regressed. The increase of the C-Index was greater in the EG than in the CG. The absolute effect-size of the EG compared with the CG was 3.0 C-points, indicating a relevant effect. Teaching ethics with PBSCDs did not provide a statistically significant influence on students’ moral competence, compared with TBCDs. Yet, the effect size suggests that PBSCDs may improve moral competence among medical students more effectively. Further research with larger and completely randomized samples is needed to gain definite explanations for the results. (shrink)

This paper defends the view that the Faculty of Language is compositional, i.e., that it computes the meaning of complex expressions from the meanings of their immediate constituents and their structure. I fargue that compositionality and other competing constraints on the way in which the Faculty of Language computes the meanings of complex expressions should be understood as hypotheses about innate constraints of the Faculty of Language. I then argue that, unlike compositionality, most of the currently available non-compositional constraints predict (...) incorrect patterns of early linguistic development. This supports the view that the Faculty of Language is com- positional. More generally, this paper presents a way of framing the compositionality debate (by focusing on its implications for language acquisition) that can lead to its even- tual resolution, so it will hopefully also interest theorists who disagree with its main conclusion. (shrink)

Background Teaching ethical competencies is an essential component of professional and postgraduate curricula. Developing practical–ethical problem-solving competencies as well as appraising program-specific studies and related research ethics are topics typically addressed. However, assessment of these ethical competencies poses a challenge. Written or oral assessment formats addressing relevant learning objectives is mainly limited to knowledge testing alone, often not capturing relevant skills or attitudes pertinent to those competencies. Aim During the reaccreditation of the masters of science program in Nursing Science at (...) Witten/Herdecke University, this challenge was addressed by implementation of an innovative examination format for postgraduate education. Procedure For the module “Ethics in nursing practice and research” a format based on the Objective Structured Clinical Examination format was developed. This assessment method incorporates evaluation of acquired skills and attitudes of nursing students. Conclusion The article demonstrates development and adaption of the OSCE format for this purpose. (shrink)

Clinical ethical support services (CESS) represent a multifaceted field of aims, consultancy models, and methodologies. Nevertheless, the overall aim of CESS can be summed up as contributing to healthcare of high ethical standards by improving ethically competent decision-making in clinical healthcare. In order to support clinical care adequately, CESS must pay systematic attention to all real-life ethical issues, including those which do not fall within the ‘favourite’ ethical issues of the day. In this paper we attempt to capture a comprehensive (...) overview of categories of ethical tensions in clinical care. We present an analytical exposition of ethical structural features in judgement-based clinical care predicated on the assumption of the moral equality of human beings and the assessment of where healthcare contexts pose a challenge to achieving moral equality. The account and the emerging overview is worked out so that it can be easily contextualized with regards to national healthcare systems and specific branches of healthcare, as well as local healthcare institutions. By considering how the account and the overview can be applied to i) improve the ethical competence of healthcare personnel and consultants by broadening their sensitivity to ethical tensions, ii) identify neglected areas for ethical research, and iii) clarify the ethical responsibility of healthcare institutions' leadership, as well as specifying required institutionalized administration, we conclude that the proposed account should be considered useful for CESS. (shrink)

In the nation of Belize, and in particular the south side of Belize City, the main metropolitan area of the nation, significant economic disparities have led to child and adolescent exposure to high rates of violent crime, gang activity, unsafe neighborhoods, sexual, and physical violence. Problems associated with poor Social-Emotional Character Development are especially prevalent among boys. Consequently, valid culture-relevant measures are required that identify problematic behavior for policy-based intervention and evaluation of educational programs designed to ameliorate this problem. The (...) present study demonstrates the application of Exploratory Structural Equation Modeling to existing measures through the investigation of structural validity and generalizability of the Social-Emotional and Character Development Scale with a large sample of children from schools in Belize. Exploratory structural equation modeling results demonstrate the original factor correlations were reduced, providing less biased estimates than confirmatory factor analysis. Moreover, a multi-group Exploratory Structural Equation Modeling analysis illuminates significant differences between latent factor scores of males and females for most factors. Using this newer factor analytic procedure, original factors are reconceptualized to better situate the Social Emotional Character Development Scales into the larger body of Social-Emotional Learning competencies literature. (shrink)

Diego Marconi; VIII*—On the Structure of Lexical Competence, Proceedings of the Aristotelian Society, Volume 95, Issue 1, 1 June 1995, Pages 131–150, https://do.

Clinical ethical support services (CESS) represent a multifaceted field of aims, consultancy models, and methodologies. Nevertheless, the overall aim of CESS can be summed up as contributing to healthcare of high ethical standards by improving ethically competent decision‐making in clinical healthcare. In order to support clinical care adequately, CESS must pay systematic attention to all real‐life ethical issues, including those which do not fall within the ‘favourite’ ethical issues of the day. In this paper we attempt to capture a comprehensive (...) overview of categories of ethical tensions in clinical care. We present an analytical exposition of ethical structural features in judgement‐based clinical care predicated on the assumption of the moral equality of human beings and the assessment of where healthcare contexts pose a challenge to achieving moral equality. The account and the emerging overview is worked out so that it can be easily contextualized with regards to national healthcare systems and specific branches of healthcare, as well as local healthcare institutions. By considering how the account and the overview can be applied to i) improve the ethical competence of healthcare personnel and consultants by broadening their sensitivity to ethical tensions, ii) identify neglected areas for ethical research, and iii) clarify the ethical responsibility of healthcare institutions' leadership, as well as specifying required institutionalized administration, we conclude that the proposed account should be considered useful for CESS. (shrink)

In this paper we extend an argument originally developed in Hülsmann to analyze changes to the structure of production that occur when the demand for money changes. In particular, we show that Hülsmann’s argument, which contrasted such changes under commodity and fiat systems, applies as well to the case of 100% reserve systems contrasted with fractional reserve free banking systems . Specifically, we argue that under a 100% reserve system, the structure of production will change in response to a change (...) in demand for money, and that it will not under FR/FB. In fact, such changes are beneficial. Since one of the central arguments in defense of FR/FB is precisely the fact that it avoids such changes to the structure of production , we conclude that this argument amounts to comparing different mechanisms for attaining different equilibrium states, and hence is invalid as a defense of that mechanism as such. (shrink)

Logic, language and information integration is one of areas broadly explored nowadays and at the same time promising. Authors use that approach in their 8 years long research into Structured Semantic Knowledge Base System. The aim of this paper is to present authors idea of system capable of generating synergy effect while storing various type of information. The key assumption, which has been adopted, is the thesis that the attempt to find universal way of the reality description is very inefficient (...) solution. Combination of several solutions into one system must be based on the principle of supporting rather than on redundancy, ambiguity or mutual antagonism areas of logic, language and information. Natural language processing in the context of logics or information processing is ineffective, not to say pointless in the means of certainty. It is simply caused by the fact that natural languages have been formed long time ago as the main communication channel, rather than for automatic information processing. It was one of the reasons that logic has been founded as the universal language of mathematics and formalized communication in more extensive sense. Information processing however brought more sophisticated problems that mathematics could not smoothly solve, what made computer science appear. Studies over artificial intelligence revealed even more complex issues to solve. The unity of those three areas: logics, language and information is a necessity to acquire complementarity and synergy. (shrink)

A competence model describes the abstract structure of a solution to some problem. or class of problems, facing the would-be intelligent system. Competence models can be quite derailed, specifying far more than merely the function to be computed. But for all that, they are pitched at some level of abstraction from the details of any particular algorithm or processing strategy which may be said to realize the competence. Indeed, it is the point and virtue of such models to specify some (...) equivalence class of algorithms/processing strategies so that the common properties highlighted by the chosen class may feature in psychologically interesting accounts. A question arises concerning the type of relation a theorist might expect to hold between such a competence model and a psychologically real processing strategy. Classical work in cognitive science expects the actual processing to depend on explicit or tacit knowledge of the competence theory. Connectionist work, for reasons to be explained, represents a departure from this norm. But the precise way in which a connectionist approach may disturb the satisfying classical symmetry of competence and processing has yet to be properly specified. A standard ?Newtonian? connectionist account, due to Paul Smolensky, is discussed and contrasted with a somewhat different ?rogue? account. A standard connectionist understanding has it that a classical competence theory describes an idealized subset of a network's behaviour. But the network's behaviour is not to be explained by its embodying explicit or tacit knowledge of the information laid out in the competence theory. A rogue model, by contrast, posits either two systems, or two aspects of a single system, such that one system does indeed embody the knowledge laid out in the competence theory. (shrink)

The fourth industrial revolution will be ushered in by future high technology, and as a result, the world will face new difficulties relating to people, the environment, and profitability. Accordingly, the competitive edge and long-term viability of businesses would depend on the knowledge workers who could overcome these excruciatingly difficult obstacles and have the knowledge and competency to influence the overall performance of any type of company. But managing knowledge workers falls under the purview of human resources, and only (...) effective human resources tools, plans, and procedures can ensure the success of this task. One such tool, which has the capacity and capability to change the whole scenario in an organization's favor, is the human resource information system. The purpose of this structured review is to provide insight into a field of HRM that has largely been neglected by other reviews of the literature and has only been briefly discussed by a small number of publications published in reputable, top-tier journals. A customized HRIS framework is the result of this structured literature review for managing knowledge and competence. The study presents the content analysis of 48 articles, systematically and purposefully selected for this literature review, published during the past three decades. The study has several implications for policymakers and HR practitioners. (shrink)

Background: Forgiveness has the potential to resolve painful feelings arising from nurse–patient conflicts. It would be useful to evaluate direct and indirect important factors which are related to forgiveness in order to design interventions that try to facilitate forgiveness. Aim/objective: The purpose of this study was to evaluate the intermediating role of empathy in the cultural competence–forgiveness association among nurses using structural equation modeling. Research design: The research applied a cross-sectional correlational design. Participants and research context: The study included (...) 380 nurses eight hospitals in southern Iran. Ethical considerations: The Ethics and Research Committee of Birjand University of Medical Sciences approved the study protocol. The voluntary nature of participation was explained consent was obtained from participants, and anonymity was guaranteed. Findings: Most of the participants were married and female and fell in the 20- to 30-year-old category. Most of them (89.5%) had a working experience of 1–10 years. The proposed model showed that nurses’ empathy intermediated the association between nurses’ cultural competence and forgiveness which has fitted the data acceptably (root mean square error approximation = 0.070; comparative fit index = 0.993; goodness-of-fit index = 0.983; and χ2/df = 2.85). Conclusion: Empathy skills and cultural competence training were essential for interventions aimed at increasing the tendency to forgive patients. In such interventions, planners should aim at increasing nurses’ cultural competence in order to enhance their empathy toward patients, which can, in turn, lead to a greater wish to forgive patients. (shrink)

There is a long tradition of drawing metaphysical conclusions from investigations into language. This paper concerns one contemporary variation on this theme: the alleged ontological significance of cognitivist truth-theoretic accounts of semantic competence. According to such accounts, human speakers’ linguistic behavior is in part empirically explained by their cognizing a truth-theory. Such a theory consists of a finite number of axioms assigning semantic values to lexical items, a finite number of axioms assigning semantic values to complex expressions on the basis (...) of their structure and the semantic values of their constituents, and a finite number of production schemata. The theory enables the derivation of truth-conditions for each sentence of the language: something of roughly the form ‘S is true iff P’.1 The claim that speakers stand in a cognitive relation to such theories is advanced, not as a conceptual analysis of semantic competence or understanding, but rather as an empirical hypothesis about human speakers in particular, one part of a broader empirical account of our linguistic competence and cognition generally. It therefore must mesh with the rest of our theorizing in these areas and whatever relevant data from neighboring inquiries there may be. The precise nature of the cognitive relation a speaker is supposed to bear to a truththeory is a matter of some dispute. I speak of ‘‘cognizing’’ (following. (shrink)

Meaningful work is a key element of positive functioning of employees, but what makes work meaningful? Based on research on self-determination theory, basic psychological needs, and prosocial impact, we suggest that there are four psychological satisfactions that substantially influence work meaningfulness across cultures: autonomy (sense of volition), competence (sense of efficacy), relatedness (sense of caring relationships), and beneficence (sense of making a positive contribution). We test the relationships between these satisfactions and perceived meaningful work in Finland (n = 594, employees (...) of several organizations), India (n = 342, collected through Mturk), and the USA (n = 373, collected through Mturk). Regression analyses show that – except for competence in USA – all four satisfactions are significantly and independently associated with meaningful work. Moreover, structural equation modeling shows that they fully mediated the relationship between occupational position and work meaningfulness in India and in the USA. In sum, the results support the importance of these four satisfactions in explaining the psychological underpinnings of meaningful work. (shrink)

Feminists have argued that oppressive socialization undermines the liberal model of autonomy. We contend that this argument can also be employed effectively as a challenge to the standard bioethical model of informed consent. We claim that the standard model is inadequate because it relies on presumptions of procedural autonomy and rational choice that overlook the problem of how agents are often socialized so that they adopt and internalize oppressive norms as part of their motivational structure. The argument that oppressive socialization (...) undermines liberalism’s view of autonomy is most relevant to what Beauchamp and Childress call the threshold elements of informed consent—competence and voluntariness. We show how these elements fail to account for morally relevant factors such as oppressive socialization. (shrink)

The notion of «professional situation,» as we propose to examine it, entails questioning simultaneously the place of contexts and the role of actors in teaching-learning situations. We propose to examine the contextualization of the teaching process in light of the groups welcomed and the conditions in which the teacher’s profession is practiced. Defining contextualization as «an art of doing» in line with a professional competency thus means postulating the legitimacy of the «context(s)» as an explanatory medium or media. The (...) conceptual model here developed follows in the tradition of Anthony Giddens’ (1987) theory of structuration and is complemented by the ecological model of human development advanced by Bronfenbrenner (1986). La notion de « situation professionnelle », telle que nous proposons de la visiter, suppose de questionner, dans un même mouvement, la place des contextes et le rôle des acteurs au sein des situations d’enseignement-apprentissage. Il s’agit pour nous d’interroger la contextualisation de la démarche d’enseignement engagée au regard des publics accueillis et des conditions d’exercice de la profession d’enseignant. Définir la contextualisation comme « un art de faire » qui relève d’une compétence professionnelle suppose alors de poser la légitimité du/des « contexte(s) » comme vecteur(s) explicatif(s). Le modèle conceptuel développé s’inscrit dans la lignée de la théorie de la structuration d’Anthony Giddens (1987). Il est complété par le modèle écologique du développement humain proposé par Bronfenbrenner (1986). (shrink)

When engaging in verbal communication, we do not simply use language to dispense information, but also to perform a plethora of actions, some of which depend on conventionalised, recurrent linguistic structures. Additionally, we must be skilled enough to arrive at the speaker’s intended meaning. However, speakers’ performance may deviate from certain habits and expectations concerning the way of speaking or accomplishing actions, while various factors may hinder comprehension, which may give rise to misappraisals of their respective abilities and capacities as (...) competent language users. This paper discusses whether such misappraisals may be subsumed by any of the already identified types of epistemic injustice and proposes a new label for them. It also describes the consequences of those misappraisals and approaches their origins from a cognitive perspective. (shrink)

Decision Making Competence (DMC) reflects individual differences in rational responding across several classic behavioral decision-making tasks. Although it has been associated with real-world risk behavior, less is known about the degree to which DMC contributes to specific components of risk attitudes. Utilizing a psychological risk-return framework, we examined the associations between risk attitudes and DMC. Italian community residents (n = 804) completed an online DMC measure, using a subset of the original Adult-DMC battery (A-DMC; Bruine de Bruin, Parker, & Fischhoff, (...) 2007). Participants also completed a self-reported risk attitude measure for three components of risk attitudes (risk-taking, risk perceptions, and expected benefits) across six risk domains. Overall, greater performance on the DMC component scales were inversely, albeit modestly, associated with risk-taking tendencies. Structural equation modeling results revealed that DMC was associated with lower perceived expected benefits for all domains. In contrast, its association with perceived risks was more domain-specific. These analyses also revealed stronger indirect effects for the DMC  expected benefits  risk-taking than the DMC  perceived risk  risk-taking path, especially for risk behaviors that may be considered more antisocial in nature. These results suggest that DMC performance differentially impacts specific components of risk attitudes, and may be more strongly related to the evaluation of expected value of the given behavior. (shrink)

What are the semantic representations that underlie language production? We use structural priming to distinguish between two competing theories. Thematic roles define semantic structure in terms of atomic units that specify event participants and are ordered with respect to each other through a hierarchy of roles. Event structures instead instantiate semantic structure as embedded sub‐predicates that impose an order on verbal arguments based on their relative positioning in these embeddings. Across two experiments, we found that priming for datives depended (...) on the degree of overlap in event structures. Specifically, while all dative structures showed priming, due to common syntax, there was a boost for compositional datives priming other compositional datives. Here, the two syntactic forms have distinct event structures. In contrast, there was no boost in priming for dative light verbs, where the two forms map onto a single event representation. On the thematic roles hypothesis, we would have expected a similar degree of priming for the two cases. Thus, our results support event structural approaches to semantic representation and not thematic roles. (shrink)

Background: Ethics play an important role in activating the manpower and achieving the organizational goals. The nurse leaders’ ethical behavior can promote the care quality by affecting the nurses’ performance and bringing up several positive consequences for the organization. Objectives: The aim of this study was to identify and describe the ethical competency of nurse leaders in cultural domains and the working conditions of the Iranian healthcare setting to arrive at a more comprehensive and specific perspective. Methods: This was (...) a qualitative conventional content analysis study conducted with the participation of 14 nurse leaders at various levels. The participants were selected using the purposive sampling method, and the required data were collected using deep interview and also semi-structured interview. A deductive method of content analysis was applied in data analysis. Ethical considerations: This study was conducted in accord with the principles of research ethics and national rules and regulations relating to informed consent and confidentiality. Findings: Data analysis resulted in 17 subcategories that were subsequently grouped into three major categories including empathetic interactions, ethical behavior, and exalted manners. Discussion: Our findings are consistent with previous ones, yet presenting a more complete knowledge about aspects of ethical competency of nurse leaders. The nurse leaders can provide a proper behavioral model for the work environment through the use of new information. Conclusion: The nurse leaders introduced various aspects of ethical competency, so the leaders’ ethical competency could be promoted via planning and managing some ethical development programs. More future research is needed regarding the experiences of the subordinates and other related parties. (shrink)

In Education Sciences, the notion of ‘competence’ is widely used, both as an aim to be reached with students and as performance in teachers’ education. This article advances a type of competence that is highly relevant for teachers’ work, namely the ‘ethical competence.’ Ethical competence enables teachers to responsibly deal with the daily challenges arising from their professional roles. In this study, I put forward a definition of ethical competence and I propose a conceptual structure, both meant to support the (...) illustration, description, and development of ethical competence for teachers. (shrink)

El artículo tiene como objetivo describir las competencias informacionales a desarrollar durante la formación profesional. Se presenta los referentes teóricos a partir del empleo de un enfoque de sistema que supone el análisis y la síntesis, la inducción y la deducción como métodos de investigación, con el propósito de dar conocer los hitos en las universidades y organizaciones internacionales relacionadas. La modelación fue empleada para la construcción de un nuevo proyecto de desarrollo de competencias informacionales desde la perspectiva de la (...) formación profesional universitaria ajustada a las necesidades de la educación superior en Cuba. El nuevo proyecto se configura en tres unidades básicas, con sus respectivos elementos de competencia, saberes esenciales e indicadores para la evaluación del desempeño. El artículo fundamenta la tesis de que el desarrollo de competencias informacionales debe ser sistemáticamente estructurado, planificado y ejecutado como parte integral de la formación curricular en interacción con los contenidos de las disciplinas docentes, bajo la dirección del profesor y la participación protagónica de los profesionales en formación. The article aims at describing the competence to be developed during professional training. It presents the theoretical referents by means of an approach system that includes synthesis and analysis, induction and deduction as research methods in order to reveal the milestones of information skills development in universities and related international organizations. Modeling was used for the construction of a new skills development project from the perspective of university professional training according to the needs of Higher Education in Cuba. The new project is composed of three basic units, with their respective competence elements, essential knowledge and indicators for the evaluation of the performance. The article supports the theory that information development skills must be systematically structured, planned and implemented as an integral part of the curricular training in interaction with the contents of subjects, under the teacher´s guidance and the active participation of profesionals in training. (shrink)

Relying on a powerful collective narrative through which political, legal and social decision-making is guided in the name of science, the authority of scientific experts reaches beyond the boundaries of their certified knowledge base. Therefore, expertise constitutes and is constituted by transgressive competence. The author argues that (1) changes in the decision-making structure of liberal Western democracies and changes in the knowledge production system diminish the authority of scientific expertise while increasing the context-dependency of expertise - thereby altering the nature (...) of its predictive claims; (2) the societal distribution of expertise, while displaying emancipatory features of empowerment of citizens, also raises issues of quality control; and (3) in order to regain a balance between public and private, i.e. individual-based societally distributed expertise, future expert systems will need to adopt a longer time-perspective. The author also reflects on directions in which future expert systems might evolve. (shrink)

A molecular dynamics (MD) approach which determines automatically the complex magnetic structures in itinerant electron systems is applied to Fe-Cr alloys with use of 250 atoms in a MD unit cell (5×5×5 bcc lattice). It is demonstrated that the Fe-Cr alloys show various complex magnetic structures due to competing interactions: the collinear ferromagnetism (F) of matrix Fe with antiparallel Cr moments beyond 80 at.% Fe, the coexistence of non-collinear structure of Cr and collinear F of Fe between 50 and 75 (...) at.% Fe, the coexistence of broken antiferromagnetism (AF) of Cr and the F of Fe between 25 and 45 at.% Fe, the coexistence of F of Fe and antiferromagnetic long-range order of Cr around 20 at.% Fe, the AF of Cr matrix with non-collinear Fe moments (spin-glass like structure) between 5 and 15 at.% Fe, and the AF below 5 at.% Fe. In the concentration region between 5 and 20 at.% Fe, ferromagnetic Fe pairs which are stabilized with different amplitudes of local moments are found. The magnetic phase diagram and calculated magnetic moments are shown to be consistent with the neutron, Mössbauer, and photoemission experiments. (shrink)

Background Moral courage is the ability to defend and practice ethical and moral action when faced with a challenge, even if it means rejecting pressure to act otherwise. However, moral courage remains an unexplored concept among middle eastern nurses. Aim This study investigated the mediating role of moral courage in the relationship between burnout, professional competence, and compassion fatigue among Saudi Arabian nurses. Research design Correlational, cross-sectional design following the STROBE guidelines. Participants and research context Convenience sampling was used to (...) recruit nurses ( n = 684) for four government hospitals in Saudi Arabia. Four validated self-report questionnaires (Nurses’ Moral Courage Scale, Nurse Professional Competence Scale-Short Form, Maslach Burnout Inventory, and Nurses Compassion Fatigue Inventory) were used to collect data between May to September 2022. Spearman rho and structural equation modeling analyses were employed to analyze the data. Ethical considerations The ethics review committee of a government university in Ha’il region, Saudi Arabia, approval this study (Protocol no.: H-2021-012; Approved: 08/022,021). Participants were fully explained the study aims, and consent was voluntarily secured. Results The emerging model showed that burnout had a direct and positive influence on compassion fatigue, while professional competence had a direct, negative effect on compassion fatigue. Moral courage had a small and direct but negative influence on compassion fatigue. Mediation analyses also indicated that moral courage significantly mediated the indirect effects of burnout and professional competence on compassion fatigue. Conclusion Moral courage can be a crucial aspect in preserving the psychological and mental health of nurses, particularly under stressful conditions. Therefore, it is advantageous from an organizational and leadership standpoint to implement measures such as programs and interventions to foster moral courage among nurses. (shrink)

The present study aims at analyzing the role of nativeness, the amount of input in L1 acquisition and the multilingual competence in the performance of Italian-German bilingual speakers. We compare novel data from the performance of adult L2 learners (L1: Italian; late L2: German) and that of heritage speakers (heritage language: Italian; majority language: German) to previous data from monolingual speakers of Italian. The comparison deals with the produced word order at the syntax-discourse interface in sentences containing New Information Subjects (...) in answers to questions that prompt the identification of the clausal subject. Overall, adult L2 speakers and heritage speakers perform alike but crucially differently from Italian monolinguals. These data reveal that multilingual proficiency determines an increased variety in the adopted answering strategies; in particular, the German-like strategy is active in Italian. Nativeness alone is thus no guarantee for a homogeneous performance across groups, nor do we find similar patterns of performance in speakers who grew up as monolinguals. Data also show heritage speakers’ sensitivity to verb classes, with answering strategies varying in accordance with the verb argument structure. Participants’ productions reveal an interesting relation in sentences with transitive verbs between subject position (pre-/postverbal) and object form (lexical DP/clitic pronoun). (shrink)

This paper explores the ethical and conceptual implications of the findings from an empirical study (reported elsewhere) of decision-making capacity in anorexia nervosa. In the study, ten female patients aged thirteen to twenty-one years with a diagnosis of anorexia nervosa, and eight sets of parents, took part in semistructured interviews. The purpose of the interviews was to identify aspects of thinking that might be relevant to the issue of competence to refuse treatment. All the patient-participants were also tested using the (...) MacArthur Competence Assessment Tool—Treatment test of competence. This is a formalized, structured, interviewer-administered test of competence, which is a widely accepted clinical tool for determining capacity. The young women also completed five brief, self-administered questionnaires to assess their levels of psychopathology. The issues identified from the interviews are described under two headings: difficulties with thought processing and changes in values. The results suggest that competence to refuse treatment may be compromised in people with anorexia nervosa in ways that are not captured by traditional legal approaches. (shrink)

Moral thinking and communication are critical competencies for confronting social dilemmas in a challenging world. We examined these moral competencies in 70 college students and graduates from Taiwan, the United Kingdom, and the United States. Participants were assessed through semi-structured written interviews, Facebook group discussions, and a questionnaire. In this paper, we describe the similarities and differences across cultural groupings in (1) the social issues of greatest importance to the participants; (2) the factors influencing their approaches to thinking about social (...) issues and communicating with others; and (3) the characteristics of their moral functioning in terms of moral awareness, moral judgment, moral discourse, and moral decision-making. (shrink)