The analysis of critical incidents in the pre-professional practice of teacher training is essential to promote reflection. Building upon this notion, the urgent need for a reflective practice in the training of science teachers is addressed. In this context, future educators are instructed in the preparation of reports that highlight the critical incidents experienced in their pedagogical work. From these perspectives, reflective practice emerges as a fundamental resource to solidify their identity and pedagogical mastery by incorporating (...) experiences for guidance purposes, emphasizing the significance of reflection. (shrink)

Background: Intensive care unit nurses are providing care to COVID-19 patients in a stressful environment. Understanding intensive care unit nurses’ sources of distress is important when planning interventions to support them. Purpose: To describe Canadian intensive care unit nurse experiences providing care to COVID-19 patients during the second wave of the pandemic. Design: Qualitative descriptive component within a larger mixed-methods study. Participants and research context: Participants were invited to write down their experiences of a critical incident, which distressed them (...) when providing nursing care. Thematic analysis was used to analyze the data. Ethical considerations: The study was approved by the ethics committee at the researchers’ university in eastern Canada. Results: A total of 111 critical incidents were written by 108 nurses. Four themes were found: (1) managing the pandemic, (2) witness to families’ grief, (3) our safety, and (4) futility of care. Many nurses’ stories also focused on the organizational preparedness of their institutions and concerns over their own safety. Discussion: Nurses experienced moral distress in relation to family and patient issues. Situations related to insufficient institutional support, patient, and family traumas, as well as safety issues have left nurses deeply distressed. Conclusion: Identifying situations that distress intensive care unit nurses can lead to targeted interventions mitigating their negative consequences by providing a safe work environment and improving nurses’ well-being. (shrink)

Hispanics are grossly underrepresented in the receipt of STEM Ph.Ds. The National Science Foundation Science and Engineering Indicators suggest that only 7.8% of S and E doctoral recipients are Hispanic while their representation in the population is more than twice that, and that figure goes even higher if restricted to those within the college-age range. To address this gap, the NSF has awarded a grant to the City College of New York and the University of Texas at El Paso to (...) work with Hispanic STEM doctoral students to provide teaching training and preparation for academic positions so they can become role models for Hispanic community college undergraduates. In working to understand the career-decision making of our Fellows, in-depth interviews were conducted to understand what put them on the path to defy the odds and become a STEM doctoral recipient. Interview results suggest that isolated, critical incidents and chance events were responsible for a number of our students entering into doctoral programs. This research suggests that for some Hispanic STEM doctoral students the experience of chance events meant the path to a STEM doctorate was not assured from a young age and further, that the provision of “planned” critical incidents may support an increase in Hispanic STEM doctoral enrollment. (shrink)

In January 2007, media outlets across Australia reported the local court decision _Police v Rose_. Mr Rose pleaded guilty and the presiding magistrate recorded no conviction. This event sparked a ‘butterfly effect’ that culminated in legislative amendments changing the make-up of the body responsible for oversight of judges in New South Wales. Key players failed to observe the doctrine of the separation of powers; while others called for its observation. None of this would have been foreseeable to Mr Rose or (...) the two transit officers on the night he was detained. This paper uses complexity theory and digital media analysis to locate flashpoints around which critical incidents occur; and what the unexpected flow-on effects reveal about the host society. (shrink)

The complexity of registered nurses’ work in the intensive care unit places them at risk of experiencing critical incident stress. Gadamer's philosophical hermeneutics (1960/2013) was used to expand the meanings of work‐related critical incident stress for registered nurses working with adults in the intensive care unit. Nine intensive care unit registered nurses participated in unstructured interviews. The interpretations emphasized that morally distressing experiences may lead to critical incident stress. Critical incident stress was influenced by the perception (...) of judgment from co‐workers and the organizational culture. Nurses in this study attempted to cope with critical incident stress by functioning in ‘autopilot’, temporarily altering their ability to critically think and to conceal emotions. Participants emphasized the importance of timely crisis interventions tailored to support their needs. This study highlighted that critical incident stress was transformative in how intensive care unit nurses practiced, potentially altering their professional self‐identity. Work‐related critical incident stress has implications for nurses, the discipline, and the health care system. (shrink)

This study explores the relationship between moral intensity and the use of different sensemaking strategies in military critical incidents. First, narratives of military personnel were used to select prototypical high/low moral intensity critical incidents. In a follow-up, a scenario study was conducted with active duty military personnel to examine the relationship between moral intensity and the use of sensemaking tactics. This study offers three main conclusions. First, the use of sensemaking tactics is strongly tied to the (...) level of moral intensity in the situation. In high-intense situations, the servicemen draw on previous experiences, prediction of consequences, and help of others to recognize and interpret the situation. Less attention goes out to higher level critical thinking. Thus, it seems that in these critical incidents, the servicemen react without giving room for thorough consideration and deliberation. Second, the number of deployments a serviceman experienced influences the perceived seriousness and harmfulness of the situation negatively in low-intense situations. Finally, and in line with earlier studies, the results indicate that the concept of moral intensity is formed out of three rather than the six dimensions originally proposed by Jones. The implications of these findings are discussed. (shrink)

Von Mitarbeitenden im Gesundheitswesen wird ein professioneller Umgang mit PatientInnen und Zugehörigen verlangt. Die Begleitung in Lebenskrisen, bei Erkrankung, Sterben und Tod stellt hohe Anforderungen. Als besonders belastend kann erlebt werden, wenn Mitarbeitende bei der Entscheidungsfindung in Gewissenskonflikte geraten oder sich in einer Dilemmasituation wiederfinden. Das Spektrum reicht von außergewöhnlichen Triage-Entscheidungen bis hin zu einem – vergleichsweise häufigeren – Beteiligtsein an einem (mutmaßlichen oder Beinahe‑) Behandlungsfehler. Angesichts der teilweise tragischen Auswirkungen auf die Patienten und Zugehörigen, die ihr Vertrauen in die (...) Institution gesetzt haben, wird der Umgang für die Mitarbeitenden vor allem dann zusätzlich belastend, wenn innerhalb der Organisation kein glaubwürdiges Konzept für einen strukturierten Umgang mit derartigen Ereignissen etabliert und unter den Kolleginnen und Kollegen sowie Vorgesetzten wenig Wissen über hilfreiche Unterstützungsmöglichkeiten vorhanden ist. (shrink)

Few qualitative studies explore the phenomenon of positive ethical climate and what actions are perceived as promoting it. Therefore, the aim of this study was to explore and describe actions that acute care ward nurses perceive as promoting a positive ethical climate. The critical incident technique was used. Interviews were conducted with 20 nurses at wards where the ethical climate was considered positive, according to a previous study. Meeting the needs of patients and next of kin in a considerate (...) way, as well as receiving and giving support and information within the work group, promoted a positive ethical climate. Likewise, working as a team with a standard for behaviour within the work group promoted a positive ethical climate. Future research should investigate other conditions that might also promote a positive ethical climate. (shrink)

Background: The COVID-19 pandemic severely strained the already unprepared Italian healthcare system. This had repercussions on healthcare workers, stemming, in particular, from a lack of clear guidelines, adequate protective equipment, and professional preparedness. Such conditions were especially prevalent in Northern Italy.Objectives: This study aimed to examine COVID-19-related professional and psychoemotional stress among nurses and doctors in two hospitals in Northern Italy, along with the worst critical incidents affecting healthcare personnel. A parallel objective was to elicit healthcare professionals' opinions (...) about what changes are needed in the healthcare system's operations, as well as about the relational/emotional skills that are needed to better manage relationships with patients in emergency situations.Participants: Snowball sampling was used to recruit participants and yielded 17 hospital professionals: six nurses and 11 doctors. Three of these professionals worked in intensive care and the others in different wards. All had close contact with COVID-19 patients.Methods: The study employed a qualitative research design, using in-depth interviews of ~60 min each that were conducted via Skype video calls. The interviews were recorded and transcribed, then analysed. The qualitative analysis employed mixed methods to identify the most relevant and recursive themes from the interviews.Results: Four fundamental themes emerged from our analysis of the interview texts: disorganisation and psychoemotional stress; urgency and critical incidents; everything surreal; and disruptions in empathetic relationships with patients.Conclusions: Through our analysis of the interview narratives, we found that systematic and in-depth psychological training is needed to prepare professionals for altered relationships with patients in emergencies; use of exceptional medical equipment; elaboration of new bioethical models suitable for disasters and pandemics; and engagement with the themes of death and dying. (shrink)

Background Intensive care nurses frequently encounter ethical issues with potentially severe consequences for nurses, patients, and next of kin. Therefore, ethical issues in intensive care units (ICU) should be recognized and managed. Research objectives To analyze ethical issues reported by intensive care nurses and how reported issues were managed within the organization using register data from the HaiPro critical incident reporting system (CIRS), and to explore the suitability of this system for reporting and managing ethical issues. Research design This (...) was a retrospective descriptive register study. CIRS reports on ethical issues in adult ICUs ( n = 12) in one hospital district in Finland over 25 months (2019–2021) were analyzed through inductive content analysis and descriptive quantification. The CIRS’s suitability for reporting and managing ethical issues was evaluated through a strengths, weaknesses, opportunities, and threats (SWOT) analysis. Ethical considerations The study was approved by the University Ethics Committee, and permission to conduct the research was granted before data collection within the organization. Results CIRS reports on ethical issues ( n = 35) made by nurses were found in seven of the 12 ICUs. The CIRS managers of these units managed these reports. The ethical issues described by the nurses were divided into four main categories: nature, situational information, consequences, and contributing factors. Management of reported ethical issues was divided into three main categories: preventive actions proposed by nurses, proposals for actions by CIRS managers, and actions taken by CIRS managers. Conclusions Systematic register data broadly describe ethical issues and their management, indicating that the CIRS could be suitable for reporting and managing ethical issues, thereby enabling the monitoring and development of ethical quality at the unit and organizational levels. (shrink)

Ethnic minority patients face challenges concerning communication and are at higher risk of experiencing health problems and consuming fewer healthcare services. They are also exposed to disparaging societal discourses about migrants which might undermine healthcare institutions’ ambitions of equitable health care. Therefore, healthcare professionals need to critically reflect on their practices and processes related to ethnic minority patients. The aim of this article is to explore healthcare professionals’ experiences of working with ethnic minority patients by using the critical incident (...) (CI) technique. In two focus group sessions, participants discussed challenging events in their encounters with patients. The critical incidents show that healthcare professionals may experience unfamiliar situations related to their work performance, prejudice toward patients, and labeling by patients the professionals do not identify with. The professionals’ reflections are discussed in relation to social discourses on migration and their work conditions, and the possible influence on the professionals’ preconceptions and the patient–professional relationship in health care. Reflections about work experiences with ethnic minority patients and aligned societal discourses should be included in healthcare workers’ professional development. Critical incident reflections at work may contribute to better‐coping strategies for healthcare professionals and improved patient–professional relationships with ethnic minority patients. (shrink)

This article describes the nature of ethical dilemmas in perioperative nursing practice. Using the Critical Incident Technique, common ethical dilemmas experienced by periop erative nurses are explored. The aim of the study was to elicit the ethical dilemmas that arise in perioperative nurses' practice. The study has a descriptive design and the data are critical incidents described by 48 anaesthetic nurses and 76 operating theatre nurses. An analysis of the critical incidents gave four domains of (...) ethical dilemmas: those arising as value conflicts in the intraoperative phase of surgery; those emanating from the patient's right of self- determination ; those arising in caring for patients; and those resulting from the alloca tion of scarce resources and the demands of increased effectiveness. (shrink)

BackgroundCritical Incident Reporting Systems (CIRS) provide a well-proven method to identify clinical risks in hospitals. All professions can report critical incidents anonymously, low-threshold, and without sanctions. Reported cases are processed to preventive measures that improve patient and staff safety. Clinical ethics consultations offer support for ethical conflicts but are dependent on the interaction with staff and management to be effective. The aim of this study was to investigate the rationale of integrating an ethical focus into CIRS.MethodsA six-step approach (...) combined the analysis of CIRS databases, potential cases, literature on clinical and organizational ethics, cases from ethics consultations, and experts’ experience to construct a framework for CIRS cases with ethical relevance and map the categories with principles of biomedical ethics.ResultsFour main categories of critical incidents with ethical relevance were derived: (1) patient-related communication; (2) consent, autonomy, and patient interest; (3) conflicting economic and medical interests; (4) staff communication and corporate culture. Each category was refined with different subcategories and mapped with case examples and exemplary related ethical principles to demonstrate ethical relevance.ConclusionThe developed framework for CIRS cases with its ethical dimensions demonstrates the relevance of integrating ethics into the concept of risk-, quality-, and organizational management. It may also support clinical ethics consultations’ presence and effectiveness. The proposed enhancement could contribute to hospitals’ ethical infrastructure and may increase ethical behavior, patient safety, and employee satisfaction. (shrink)

Existing literature indicates that the moral complexities of teachers’ daily routine have not been searched enough. Robust knowledge on the way teachers apply ethics in their classrooms and schools is also limited. The purpose of this paper is to challenge teachers’ honesty and ethical judgment, as it explores teachers’ lying as a response to critical incidents in schools. Mixed methodology has been used to analyze data from 524 Primary and Secondary teachers. The results indicate that only half of (...) the participants choose to use little conventional lies [“white” lies] in critical situations. They choose to do so for “good reasons”, to protect their students or to cover for colleagues. The study contributes to existing research on ethical knowledge and sensitivity and the moral dimensions of teaching and stresses the practical need for continuous training on ethical sensitivity and the attainment of ethical knowledge when coping with critical incidents and arising dilemmas. (shrink)

This study examines ethical transgressions of school psychology graduate students using the critical incidents technique. Program directors of school psychology programs listed in the Directory of School Psychology Graduate Programs were asked to describe ethical violations committed by their students during the past 5 years. Violations dealt primarily with issues involving confidentiality, competence, and professional and academic honesty. Directors believed that the majority of students would not find most ethical issues problematic. Implications for training are discussed.

ObjectiveIn this study, we extend the impact of mindfulness to the concept of least-worst decision-making. Least-worst decisions involve high-uncertainty and require the individual to choose between a number of potentially negative courses of action. Research is increasingly exploring least-worst decisions, and real-world events (such as the COVID-19 pandemic) show the need for individuals to overcome uncertainty and commit to a least-worst course of action. From sports to business, researchers are increasingly showing that “being mindful” has a range of positive performance-related (...) benefits. We hypothesized that mindfulness would improve least-worst decision-making because it would increase self-reflection and value identification. However, we also hypothesized that trait maximization (the tendency to attempt to choose the “best” course of action) would negatively interact with mindfulness.MethodsThree hundred and ninety-eight participants were recruited using Amazon MTurk and exposed to a brief mindfulness intervention or a control intervention (listening to an audiobook). After this intervention, participants completed the Least-Worst Uncertain Choice Inventory for Emergency Responders (LUCIFER).ResultsAs hypothesized, mindfulness increased decision-making speed and approach-tendencies. Conversely, for high-maximizers, increased mindfulness caused a slowing of the decision-making process and led to more avoidant choices.ConclusionsThis study shows the potential positive and negative consequences of mindfulness for least-worst decision-making, emphasizing the critical importance of individual differences when considering both the effect of mindfulness and interventions aimed at improving decision-making. (shrink)

This book explores the major differences between the kinds of risk encountered in different sectors of industry - production and services - and identifies the main features of accidents within different industries. Because of these differences, unique risk-mitigation measures will need to be implemented in one industry that cannot be implemented in another, leading to large managerial differences between these broad economic sectors. Based on the analysis of more than 500 disasters, accidents and incidents - around 230 cases from (...) the production sector and around 280 cases from the service sector - the authors compare the risk response actions appropriate within different sectors, and establish when and how it is possible to generalize the experience of dealing with risks in any given industry to a wider field of economic activity. This book is mainly intended for executives, strategists, senior risk managers of enterprise-wide organizations and risk management experts engaged in academic or consulting work. By setting out clearly the sector differences in risk management, the authors aim to improve the practice of general risk assessment with regard to identifying and prioritizing risks, and of risk control with regard to planning appropriate mitigation measures. (shrink)

In Badges and Incidents, Michael J. Kaufman undertakes an interdisciplinary investigation of American education law and pedagogy. By weaving together the invaluable insights of law, education, history, political science, economics, psychology, and neuroscience, this book illuminates the ways in which the design of the American educational system does not reflect how human beings live and learn. It examines the principles of the nation's Founders and demonstrates how a distorted presentation of the Founders' views curtailed the development of a truly (...) democratic educational system. The influence of this distortion on several critical Supreme Court decisions is exposed, and these decisions have largely failed to facilitate the educational system the Founders envisioned. By placing contemporary challenges in context and endorsing social constructivist pedagogy as the best path forward, Kaufman's study will prove invaluable to advocates of equity in education, helping them navigate a contentious political climate with an eye toward future reform efforts. (shrink)

This article analyzes the impact of public transport system routes, road and pedestrian infrastructure on the accessibility of commune 10 of San Juan de Pasto, Nariño, Colombia. Through a geospatial approach and using quantitative data from the Geographic Information System (GIS), critical areas were identified in terms of accessibility and urban connectivity. The study evaluated the road infrastructure according to its degree of intervention, classified the platforms by their width and analyzed the public transport routes according to their frequency (...) and coverage. The results reveal that more than 75% of the areas evaluated present critical conditions in road infrastructure, while more than 90% of the areas do not have adequate platforms to guarantee pedestrian accessibility. In addition, it was determined that more than 52% of the commune lacks access to public transport routes with sufficient frequencies. These deficiencies show inequalities in mobility that significantly affect the quality of life of the inhabitants. It is concluded that it is urgent to implement public policies aimed at strategic planning, prioritizing investments in road and pedestrian infrastructure, and optimizing the frequency and coverage of public transport. This study provides key tools for decision-making, facilitating the design of strategies that promote equity, sustainability and connectivity in intermediate urban contexts. (shrink)

The late French literary and social critic's intimate journal, first published after his death and translated into English here for the first time, and three other autobiographical texts in which he explores his homosexuality are combined in one volume. Original.

Background: In recent years, operating theatre nurse students’ education focused on ethics, basic values and protecting and promoting the patients' dignity in perioperative practice. Health professionals are frequently confronted with ethical issues that can impact on patient’s care during surgery. Objective: The objective of this study was to present what operating theatre nursing students perceived and interpreted as undignified caring in perioperative practice. Research design: The study has a descriptive design with a hermeneutic approach. Data were collected using Flanagan’s (...) class='Hi'>critical incident technique. Participants and research context: Operating theatre nurse students from Sweden and Norway participated and collected data in 2011, after education in ethics and dignity. Data consisting of 47 written stories and the text were analysed with hermeneutical text interpretation. Ethical considerations: The study was approved by the Karlstad University's Research Ethics Committee. Findings: The findings show careless behaviour and humiliating actions among health professionals. Health professionals commit careless acts by rendering the patient invisible, ignoring the patient’s worry and pain and treating the patient as an object. They also humiliate the patient when speaking in negative terms about the patient’s body, and certain health professionals blame the patients for the situation they are in. Health professionals lack the willingness and courage to protect the patient’s dignity in perioperative practice. Discussion: In the discussion, we have illuminated how professional ethics may be threatened by more pragmatic and utilitarian arguments contained in regulations and transplant act. Conclusion: The findings reveal that patients were exposed to unnecessary suffering; furthermore, the operating theatre nurse students suffered an inner ethical conflict due to the undignified caring situations they had witnessed. (shrink)

Automatic incident detection plays a vital role among all the safety-critical applications under the parasol of Intelligent Transportation Systems to provide timely information to passengers and other stakeholders in smart cities. Moreover, accurate classification of these incidents with respect to type and severity assists the Traffic Incident Management Systems and stakeholders in devising better plans for incident site management and avoiding secondary incidents. Most of the AID systems presented in the literature are incident type-specific, i.e., either they (...) are designed for the detection of accident or congestion. While traveling along the road, one may come across different types of traffic incidents, such as accidents, congestion, and reckless driving. This necessitates that the AID system detects and classifies not only all the popular traffic incident types, but severity as well that is associated with these incidents. Therefore, this study aims to propose an efficient incident detection and classification framework for smart cities, by incorporating the efficacy of model stacking, to classify the incidents with respect to their types and severity levels. The experimental results showed that the proposed E-IDC framework achieved performance gains of 5%–56% in terms of incident severity classification and 1%–14% in terms of incident type classification when applied with different classifiers. We have also applied the Wilcoxon test to benchmark the performance of our proposed framework that reflects the significance of our approach over existing individual incident predictors in terms of severity and type classification. Moreover, it has been observed that the proposed E-IDC framework outperforms the existing ensemble technique, such as XGBoost used for the classification of incidents. (shrink)

The aim of this article was to obtain an understanding of what is experienced as human dignity by nurses in surgical practice. In order to obtain experiences from practice, the critical incident technique was chosen. A total of 11 nurses from surgical practice wrote 49 stories about positive and negative incidents. The text was analysed using hermeneutical text interpretation. The findings revealed patient dignity in terms of preserved dignity, that is, healthcare professionals paid attention to the patient. Nurses (...) experienced preserved dignity when healthcare professionals allowed the patient to tell their story, allowed themselves to get close to the patient and in turn received the patient’s trust. Violated dignity included circumstances when the nurses were forced to see what they did not want to see. Nurses experienced violated dignity when healthcare professionals behaved rudely towards the patient, acted as if he or she was invisible or humiliated the patient at the end of life. (shrink)

Purpose New media is reshaping mediated communication. This paper aims to examine whether the online community is concerned about ethical issues in citizen journalism. Design/methodology/approach The study uses critical thematic analyses to examine 1,402 comments posted in response to two YouTube videos of teenage girl molestation in India. This method was appropriate, as it will show how public reacts to information disseminated by common citizens and also show whether ethics are related to citizen journalism. Findings Results show that although (...) some viewers questioned the cameraperson’s and the passerby’s morality, several supportive comments praised the cameraperson’s presence of mind and courage. Furthermore, it shows that while some viewers vilified the victim, others advocated a more prudent response. This shows ambiguity regarding ethics in cyberspace. The mixed reactions present strong evidence to challenge the idealistic and exceedingly rational original notion of the public sphere as homogenous or integrated on issues of public concern. Instead, result exhibits an emergence of pluralistic, intersecting and contending publics that are created by new communication technologies like the internet. Research limitations/implications The study was specific to a particular context thereby lacking generalizability. However, it implies further investigation of social agency and the underlying politics in the move from local to global. Originality/value These findings necessitate a reconceptualization of cyberspace ethics to accommodate the new publics that have materialized from new media technologies. (shrink)

Since the solution to many public health problems depends on research, it is critical for the progress and well-being for the patients that we can trust the scientific literature. Misconduct and poor laboratory practice in science threatens the scientific progress, leads to loss of productivity and increased healthcare costs, and endangers lives of patients. Data duplication may represent one of challenges related to these problems. In order to estimate the frequency of data duplication in life science literature, a systematic (...) screen through 120 original scientific articles published in three different cancer related journals [journal impact factor 20] was completed. The study revealed a surprisingly high proportion of articles containing data duplication. For the IF 20 journals, 25 % of the articles were found to contain data duplications. The IF 5–10 journal showed a comparable proportion. The proportion of articles containing duplicated data was comparable between the three journals and no significant correlation to journal IF was found. The editorial offices representing the journals included in this study and the individual authors of the detected articles were contacted to clarify the individual cases. The editorial offices did not reply and only 1 out of 29 cases were apparently clarified by the authors, although no supporting data was supplied. This study questions the reliability of life science literature, it illustrates that data duplications are widespread and independent of journal impact factor and call for a reform of the current peer review and retraction process of scientific publishing. (shrink)

This is a short discussion of Janko Nešić’s [2022. “Towards a Neutral-Structuralist Theory of Consciousness and Selfhood.” International Studies in the Philosophy of Science, 1–17], which conveys a critical review of Beni’s Structural Realist theory of the Self (SRS). Nešić’s critique indicates that there is an incongruity between the structuralist tendency of SRS and its commitment to panpsychism. He argues that Beni can use the notion of internal information to develop a more congenial account of consciousness than panpsychism. In (...) this paper, I defend the panpsychist component of Beni’s theory and explain why I think it’s preferable to Nešić’s proposal. (shrink)

Background: Ethics and dignity in prehospital emergency care are important due to vulnerability and suffering. Patients can lose control of their body and encounter unfamiliar faces in an emergency situation. Objective: To describe what specialist ambulance nurse students experienced as preserved and humiliated dignity in prehospital emergency care. Research design: The study had a qualitative approach. Method: Data were collected by Flanagan’s critical incident technique. The participants were 26 specialist ambulance nurse students who described two critical incidents (...) of preserved and humiliated dignity, from prehospital emergency care. Data consist of 52 critical incidents and were analyzed with interpretive content analysis. Ethical considerations: The study followed the ethical principles in accordance with the Declaration of Helsinki. Findings: The result showed how human dignity in prehospital emergency care can be preserved by the ambulance nurse being there for the patient. The ambulance nurses meet the patient in the patient’s world and make professional decisions. The ambulance nurse respects the patient’s will and protects the patient’s body from the gaze of others. Humiliated dignity was described through the ambulance nurse abandoning the patient and by healthcare professionals failing, disrespecting, and ignoring the patient. Discussion: It is a unique situation when a nurse meets a patient face to face in a critical life or death moment. The discussion describes courage and the ethical vision to see another human. Conclusion: Dignity was preserved when the ambulance nurse showed respect and protected the patient in prehospital emergency care. The ambulance nurse students’ ethical obligation results in the courage to see when a patient’s dignity is in jeopardy of being humiliated. Humiliated dignity occurs when patients are ignored and left unprotected. This ethical dilemma affects the ambulance nurse students badly due to the fact that the morals and attitudes of ambulance nurses are reflected in their actions toward the patient. (shrink)

This essay examines Harriet Jacobs’s Incidents in the Life of a Slave Girl (1861) in light of new archival findings on the medical practices of Dr. James Norcom (Dr. Flint in the narrative). While critics have sharply defined the feminist politics of Jacobs’s sexual victimization and resistance, they have overlooked her medical experience in slavery and her participation in reform after escape. I argue that Jacobs uses the rhetoric of a woman-led health reform movement underway during the 1850s to (...) persuade her readers to end slavery. This essay reconstructs both contexts, revealing that Jacobs links enslaved women’s physical and sexual vulnerability with her female readers’ fears of male doctors’ threats to modesty and of their standard bleed-and-purge treatments. Jacobs illustrates that slavery damages women’s health as much as heroic medicine, and thus merits the political activism of her readers. Specifically, Jacobs dramatizes her conflicts with the rapacious physician-master at moments that are crucial to women’s health: marriage, pregnancy, childbirth, and motherhood. Ultimately, this essay advances a new understanding of the role of health reform in social change: it galvanized other movements such as women’s rights and abolition, particularly around issues of bodily autonomy for women and African Americans. (shrink)

The issue of advocacy has dominated discussion of the ethical dilemmas facing nurses. However, despite this, nurses seem to be no further towards a solution of how they can be effective advocates for patients without compromising their working identity or facing conflicts of loyalty. This article considers some of the problems around advocacy and, by the use of critical incidents written by nurses involved in a diploma module, attempts to highlight where the problem could lie. A communications model (...) is outlined, using a theoretical framework taken from the work of Jürgen Habermas, and applied to nursing practice. Finally, two examples are given from the research, which illustrate how the model could be used, highlighting the problems and pitfalls that still have to be overcome. The conclusion is a positive one, in that it suggests that advocacy is possible if nurses re-examine their practice in the light of the model proposed. (shrink)

Background Ethical principles behind prioritization in healthcare are continuously relevant. However, applying ethical principles during times of increased need, such as during the COVID-19 pandemic, is challenging. Also, little is known about nursing home nurses’ prioritizations in their work to achieve well-being and health for nursing home residents. Aim The aim of this study was to explore nursing home nurses’ priority-setting for older nursing home residents in Sweden during the COVID-19 pandemic. Research design, participants, and research context We conducted a (...) qualitative interview study. Data were collected through in-depth interviews (retrospective self-reports) between February and May 2021 with 21 nursing home nurses. To help respondents to recall their memories, we used the critical incident technique (CIT). We analyzed data within the theoretical framework and the methodological orientation of content analysis. Ethical considerations Written and verbal consent was obtained before the interviews, and information was given to participants informing them that participation was entirely voluntary. The Swedish Ethical Review Agency gave an advisory opinion stating that there were no ethical objections to the research project (Dnr. 2020-05649). Findings We identified an overarching theme—nursing home nurses struggling on multiple fronts, “just do it”—and seven categories: striving for survival and caring about a dignified death; responding sensitively to relatives’ expectations; ranking the urgency of needed care; responding to input from different actors; combating the spread of infection in unconventional ways; taking the lead and doing what is required; and following the ideals of person-centered nursing. Conclusions Nurses’ priority-setting for older nursing homes residents during the COVID-19 pandemic meant strain and struggle. In some cases, nurses had taken responsibility for priorities falling outside their statutory powers. Different demands and interests affected nurses’ priorities. Nursing home nurses need organizational and managerial support to prioritize. (shrink)

Within the research framework of pragma-dialectics, this study analysed and assessed strategic manoeuvring by dissociation in corporate crisis communication, exemplified by the 2017 United Airlines’ Passenger Dragging-off Incident. As shown from the analysis of the public statements issued on its official website and Twitter, United Airlines adopted dissociation using the lexical item “volunteer” in the different stages of argumentation: bringing forward a standpoint, maintaining a standpoint and mitigating a standpoint. In so doing, the corporation strategically manoeuvred the topical potential and (...) the presentational devices to meet the demands of its primary audience, i.e. the international general public. Whereas employing dissociation of the notion “volunteer” seemed to be reasonable and served the corporation’s interests best, its argumentative effectiveness was called into question based upon the general rules for critical discussion and the institutional context. (shrink)

The aim of the present article is to contribute empirically derived knowledge about Swedish researchers’ experience of ethical problems, conflicts and dilemmas in their research practice in relation to the ethical vetting legislation and procedure. The study has been carried out using the critical incident technique, with researchers from various disciplines providing examples from their own research practice of problems relating to research ethics. The analysis of the researchers’ responses indicates three phenomena, partly in line with similar studies in (...) other countries: the law of ethical vetting puts limits on the relevant research ethical questions; it is not possible to anticipate all questions of research ethics; and there are consequences to the fact that the boards for ethical vetting ignore problems that fall outside the law. (shrink)

There is a long history, dating back to the 50s, which examines the manner in which team roles contribute to effective team performance. However, much of this work has been built on ad-hoc teams working together for short periods of time under conditions of minimal stress. Additionally, research has been conducted with little attention paid to the importance of temporal factors, despite repeated calls for the importance of considering time in team research (e.g., Mohammed, Hamilton, & Lim, 2009). To begin (...) to understand team roles and how temporal aspects may impact the types of team roles employed when teams are working in extreme mission critical environments, the current manuscript uses a data-driven, bottom-up approach. Specifically, we employ the use of retrospective historical data as our input and a historiometric approach (Simonton, 2003). Source documents consist primarily of autobiographies, memoires, biographies, and first-hand accounts of crew interaction during spaceflight. Critical incidents regarding team interaction were extracted from these source documents and independently coded for team roles by two trained raters. Results of the study speak to the importance of task and social roles within teams that are predominantly intact and operating in extreme environments where mistakes can be life threatening. Evidence for the following task (i.e., coordinator, boundary spanner, team leader, evaluator, critic, information provider, team player, and innovator) and social roles (i.e., team builder, nurturer, harmonizer, entertainer, jokester, and the negative roles of attention seeker and negativist) were found. While it is often task roles that receive the greatest attention, results point to the importance of not neglecting the socioemotional health of the team (and the corresponding roles). Results also indicated that while some roles were consistently enacted independent of temporal considerations (e.g., mission length), the degree to which others were enacted varied across missions of differing lengths. Additionally, based on the current sample we see the following trends: (1) increased enactment of the team builder role as mission duration increases, (2) prominence of the entertainer role, and (3) increased emphasis on the visionary/problem solver role on missions over two years. (shrink)

According to the consencus of Muslim world, al-Aqsā Mosque is located in the land of al-Quds (Jerusalem). In this matter, especially the old Sunnite sources are in agreement with each other. However, there are recently some different views regarding the location of al-Aqsā Mosque. It has been argued that al-Aqsā Mosque most likley was built in a location differnet from Jerusalem. One of the defenders of this opinion is Muhammad Hamīdullah, who is a prominent scholar of Islamic studies and considered (...) to be a reliable authority among contemporary Islāmic historians. He claims that al-Aqsā Mosque, which was also mentioned in the Qur’ān, cannot be the Mosque that is present in Jerusalem. Rather, it must be searched in heavens. If this claim is accepted, then numerous reports informing that the mosque is located in Jerusalem and many interpretations based on these reports, will become problematic and controversial. Therefore, it is necessary to examine those claims and the relevant evidence in detail. Following this pueporse, we aim to examine and evaluate those views with a critical approach in this study. In this regard, we will argue that the comments and approaches that have been argued so far, are not consistent. Rather, relevant claims do not rely on strong evidence but only unsatisfactory interpretations. Summary: Muhammad Hamīdullah who is a prominent researcher and well-known for his studies on History of Islām, has individual opinions on some issues, different from classical scholars of Ahlu’s-Sunnah (branch of Islām that accepts the first four caliphs as rightful successors to Muhammad). One of his distinctive views is the original place of Masjid al-Aqsā (al-Aqsā Mosque). He claims that al-Aqsā Mosque was likely located, not in al-Quds (Jerusalem), but in heavens. In this article, our purpose is to examine this matter by evaluating his arguments regarding the place of al-Aqsā Mosque. Hamīdullah’s argument is based on several reasons which are as follows:Miʻrāc (The Ascension) is a journey from the earth to beyond the heavens. According to Hamīdullah, it is illogical to say that, in relation to such a magnificient occurrence, the Holy Qur’ān only mentions the journey from Mecca to Bayt al-Maqdis/al-Quds.Hamīdullah maintains that the expression “al-Masjid al-Aqsā” in the first verse of Sūrah al-Isrā means “the remotest Mosque.” However, the Palestinian lands are described as “Adna’l-Arḍ/Nearest Country” in the third verse of Sūrah ar-Rūm. Thus, “the remotest Mosque” should not be “the nearest country”; rather it should be a Mosque in heavens.He also argues that in some Hadith texts, the mosque in question is mentioned as “Masjid al-Aqsā”, but there is a grammatical difference between the phrases of “al-Masjid al-Aqsā” and “Masjid al-Aqsā”, which means that the mosque mentioned as “al-Masjid al-Aqsā” in the Qur’ānic verse does not have a connection with al-Quds (Jerusalem). In his opinion, the expression of “Masjid al-Aqsā” which appears in some Hadith texts is in the form of a noun clause, while the quranic expression “al-Masjid al-Aqsā” is in the form of an adjective clause. Accordingly, “Masjid al-Aqsā” and “al-Masjid al-Aqsā” refer to different places. The noun clause -as in the Hadith texts- of “Masjid al-Aqsā” must be in al-Quds, whereas the Qur’ānic expression in the form of an adjective clause of “al-Masjid al-Aqsā” must be a mosque in the heavens.According to his other claim, Abu’l-Yemān, the teacher of the teacher of Bukhārī, when narrating the hadith about mosques, he mentions this mosque, not as “al-Masjid al-Aqsā”, but as Īliyā’. That is, according to him, early sources of hadith do not mention the phrase of “al-Masjid al-Aqsā”, but instead, the phrase of Īliyā’ was used. Hamīdullah also states “... while narrating this hadith, Muslim does not use the phrases “Masjid al-Aqsā” or “al-Masjid al-Aqsā.” Instead, he uses the phrase Īliyā’.”He also states that the term al-masjid (the mosque) which appears in the seventh verse of Sūrah al-Isrā, was used to refer to that Īliyā’, not to refer to “al-Masjid al-Aqsā”. Likewise, the Umayyad Caliph Abdulmelik (26-86 h.c./646-705 g.c.) built the Dome of the Rock (Masjid al-Saḥra) in al-Quds and named it “Masjid al-Aqsā”. This name became so widespread at the times of Imam al-Bukhārī (194-256 h.c./810/870 g.c.) so that the old name Īliyā’ had been totally forgotten. Because of this reason, some hadith narrators were using this more common name “Masjid al-Aqsā” to express and describe this forgotten name.When we critically evaluate the information and approaches explained above, we come to the conclusion that they are not consistent. First of all, the claim that Masjid al-Aqsā is in the heavens, is in disagreement with the Qur’ānic verses implying that “Masjid al-Aqsā” is in al-Quds, and with many authentic hadith texts that indicate its existence on those lands. Also, the sources of Qur’ānic interpretations (exegeses) and historical narrations refute this claim. On the other hand, there is no Qur’ānic verse or tradition (hadith) that state that Masjid al-Aqsā is in the heavens.We argue that Hamīdullah’s claim “...It is illogical to say that, in relation to such a magnificient occurrence, the Holy Qur’ān only mentions the journey from Mecca to al-Aqsā Mosque in al-Quds” is not very appropriate. Because, it is beyond the human judgment to decide which part of this magnificient journey is more important or which part of it should take place in the Holy Qur’ān. Only Allah has the authority to decide for this. Moreover, we should remember that-as mentioned in the conveyed knowledge- the incident mentioned in the first verse of Sūrah al-Isrā is merely the magnificient journey from Mecca to Masjid al-Aqsā, which was clearly stated in the authentic hadith sources. As for the third verse of Sūrah al-Rūm, it is not correct to claim that Masjid al-Aqsā is not in al-Quds but in the heavens, by reading the text of the verse. Because, the phrase al-arḍ (the earth) has several meanings. Moreover, the phrase al-aqsā (the remotest) in the first verse of Sūrah al-Isrā, refers to distance between the two mosques, not between two countries.In some hadith texts, Masjid al-Aqsā was mentioned as “al-Masjid al-Aqsā” in the form of a noun clause, but this does not require that the masjid in question should be in the heavens. Because, many hadith texts mention it in the form of an adjective clause. Besides, some hadith texts mention Masjid al-Harām (Great Mosque of Mecca) in the form of a noun clause (Masjid al-Harām), not in the form of an adjective clause (al-Masjid al-Harām). If we consider Hamīdullah’s claim, we should look for the Masjid al-Harām in the heavens, but not on earth. So far, neither he nor anybody else made such a claim.Hamīdullah argues that Abu’l Yemān mentioned this mosque as Īliyā’, but not as al-Masjid al-Aqsā, and claimed that early religious sources do not use the term al-Masjid al-Aqsā. However, this is not a sound argument. Because, the authorities of hadith and history, who lived both before Abu’l Yemān and also at the same era, used the term “al-Masjid al-Aqsā” in their works and narrated that this term refers to al-Quds or Bayt al-Maqdis (Masjid al-Aqsā). Moreover, Hamīdullah’s claim that Muslim (a senior hadith scholar) did not use the terms “al-Masjid al-Aqsā” or “Masjid al-Aqsā” but instead he used the name “Īliyā’” is incorrect. Because, while narrating this hadith, the hadith scholar (Muslim) used all three names. As for the term “al-Masjid (the Mosque)” mentioned in Q 17.7, it is a groundless comment to claim that it does not refer to “al-Masjid al-Aqsā” in Q 17.1. Because the context of the verses and grammatical rules of Arabic language explicitly prove that the mosque mentioned in the seventh verse refers to “al-Masjid al-Aqsā” which is also mentioned in the first verse.His claim that “the Umayyads named the temple that they built in Jerusalem as “Masjid al-Aqsā” and following the era of Umayyads, in the period of Bukhārī, this naming became widespread” is highly vulnerable and disputable. Because in those times, the temple used to be named as “al-Masjid al-Jami (the Gathering Mosque)”, not as “al-Masjid al-Aqsā”. Nearly three centuries after the Umayyads reign, the naming of the said temple was first introduced to be as “al-Masjid al-Aqsā”. As for the expression of “al-Masjid al-Aqsā” appearing in the early sources of hadith, it was not used for the mosque built by the Umayyads, but was used to mean the entire haram (sacred, respected) region taking place in the south east corner of Jerusalem. In the light of arguments and explanations critically analysed above, we are in a position to argue that Muhammad Hamīdullah’s argument that “Masjid al-Aqsā is in the heavens”, does not rely on sound evidence, but rather, they are only some unsatisfactory interpretations. (shrink)

Background Disaster scenarios challenge both novice and experienced nurses to navigate complex ethical dilemmas in resource-limited environments. Traditional nursing education often leaves new nurses unprepared for the ethical demands of disaster nursing. Utilitarianism must often guide triage ethics and decision-making. There is a critical need to equip nursing students with these ethical competencies. Research question/Aim This study explores nursing students’ lived experiences using introductory triage ethics in mass casualty incident simulation (MCIS). Research design A qualitative, interpretive phenomenological approach was (...) employed, analyzing reflective journal responses from senior nursing students following MCIS participation. Participants and research context Participants were senior-year nursing students from a private university in the U.S., engaging in MCIS as part of their curriculum, which simulated resource-limited disaster scenarios requiring real-time ethical decisions. Ethical considerations The study received Institutional Review Board (IRB) approval, and participants provided informed consent. Data were anonymized and did not affect academic evaluation. Findings Two major themes emerged: 1. Living in Ethical Dilemmas (subthemes: We Could Have Saved Them If…, Looking Past Obvious Suffering, How Can We Be Prepared?, We Can’t Abandon Them). 2. Development of Ethical Competency (subthemes: Knowing You’ve Done Enough, Finding New Perspectives, There Is No Right Answer). Students grew in moral reasoning and emotional resilience, transitioning from patient-centered care to utilitarian decision-making. Conclusions Participation in the mass casualty incident simulation allowed nursing students to confront and navigate complex ethical challenges in real time, fostering significant growth in moral reasoning and emotional resilience. Through immersion in simulated ethical dilemmas, students grappled with the tension between patient-centered care and the realities of utilitarian decision-making. This experience catalyzed a deeper understanding of ethical ambiguity and the development of moral clarity, equipping them with foundational skills for ethically navigating crises. Nursing curricula should recognize and incorporate opportunities that facilitate this ethical growth through experiential learning. (shrink)

We analyse managerial discourse in corporate communication (‘CEO-speak’) during a 6-month period following a legitimacy-threatening event in the form of an incident in a German nuclear power plant. As discourses express specific stances expressed by a group of people who share particular beliefs and values, they constitute an important means of restoring organisational legitimacy when social rules and norms have been violated. Using an analytical framework based on legitimacy as a process of reciprocal sense-making and consisting of three levels of (...) analysis which capture the relationship between text and context, we investigate the discourse used by CEOs in their initial and subsequent accounts of the incident. We find that CEOs aim to negotiate a resolution between their initial account and organisational audiences’ incongruent interpretations of the event by adopting an ad hoc normative attitude to stakeholders. This manifests itself in the strategic use of the discourse of stakeholder engagement as a means of signalling change, yet maintaining the status quo. It suggests that CEOs strategically use discourse to manufacture organisational audiences’ consent regarding the continued operation of the nuclear power plant affected by the incident. Our findings contribute to the critical corporate communication literature which regards corporate narrative reporting as a means of consolidating the private interests of corporations, rather than increasing transparency and accountability. (shrink)

Book reviewed in this article: Gays/Justice by Richard Mohr. Death:Beyond Whole‐Brain Criteria, edited by Richard M. Zaner. The Contraceptive Ethos:Reproductive Rights and Responsibilities Edited by S.F. Spicker, W.B. Bondeson, H.T. Englehardt, Jr., Dordrecht, Holland:D. Reidel. Made to Order:The Myth of Reproductive and Genetic Progress Edited by Patricial Spallone and Deborah Lynn Steinberg. Reproductive Technologies:Gender, Motherhood and Medicine Edited by Michele Stanworth. For the Patient's Good:The Restoration of Beneficence in Health Care by Edmund D. Pellegrino and David C. Thomasma. ‘The Physician (...) as Captain of the Ship:A Critical Reappraisal’, Philosophy and Medicine, vol. 29. Edited by Nancy M.P. King, Larry R. Churchill, and Alan W. Cross. (shrink)

Managing aggression in mental health hospitals is an important and challenging task for clinical nursing staff. A majority of studies focus on the perspective of clinicians, and research mainly depicts aggression by referring to patient-related factors. This qualitative study investigates how aggression is communicated in forensic mental health nursing records. The aim of the study was to gain insight into the discursive practices used by forensic mental health nursing staff when they record observed aggressive incidents. Textual accounts were extracted (...) from the Staff Observation Aggression Scale-Revised (SOAS-R), and Fairclough’s Critical Discourse Analysis was used to identify short narrative entries depicting patients and staffs in typical ways. The narratives contained descriptions of complex interactions between patient and staff that were linked to specific circumstances surrounding the patient. These antecedents, combined with the aggression incident itself, created stereotyping representations of forensic psychiatric patients as deviant, unpredictable and dangerous. Patient and staff identities were continually (re)produced by an automatic response from the staff that was solely focused on the patient’s behavior. Such response might impede implementation of new strategies for managing aggression. (shrink)

In the last 20 years, much attention has been paid to learners’ demotivation. Researchers have conducted many studies on second/foreign language learning demotivation from the perspectives of social culture, social psychology, and so forth. In China, related studies have mainly focused on college students’ demotivation; scant attention has been paid to senior high school students. Regarding scale development, although much progress has been made, there remains a need for a scale with high reliability and validity that is suitable for students (...) in the basic education stage. Therefore, based on previous studies and choosing Chinese senior high school students as participants, this research study developed a scale with 55 items, and exploratory factor analysis (EFA) was used to develop a 28-item scale with six dimensions. The six-dimensional construct encompasses teacher knowledge, important others, teacher responsibility, learner-related factors, learning contents, and critical incidents, which are the key factors leading to English learners’ demotivation. Among them, the factor of critical incidents is new and has been overlooked by other researchers. Moreover, the descriptive analysis demonstrated the degree to which the demotivators influence learners, and the independent samplest-test found a significant difference in the impact of critical incidents in terms of the students’ language proficiency. Ultimately, four suggestions are put forward to remotivate and sustain learners’ motivation. (shrink)

LIU W, MANIAS E and GERDTZ M. Nursing Inquiry 2011; 18: 290–302 Understanding medication safety in healthcare settings: a critical review of conceptual modelsCommunication can impact on the way in which medications are managed across healthcare settings. Organisational cultures and the environmental context provide an added complexity to how communication occurs in practice. The aims of this paper are: to examine six models relating to medication safety in various hospital and community settings, to consider the strengths and limitations of (...) each model and to explore their applications to medication safety practices. The models examined for their ability to address the complexity of the medication communication process include causal models, such as the Human Error Model and the System Analysis to Clinical Incidents Model, and exploratory models, such as the Shared Decision‐Making Model, the Medication Decision‐Making and Management Model, the Partnership Model and the Medication Communication Model. The Medication Communication Model provides particular insights into possible interactions between aspects that influence medication safety practices. The implications of all six models for healthcare practice and future research are also discussed. (shrink)

Wundt's Völkerpsychologie (VP) is an exceptional case in the history of psychology. Outlined in 1863 in the second volume of Vorlesungen über Menschen- und Thierseele (Lectures on the Human and Animal Soul), VP was finally published 37 years later in 10 volumes during the last 20 years of the author's life. The work was characterized by an ambitious program of multimethod and transdisciplinary research. This article explores the intellectual and contextual reasons for the early successes and failures of VP. We (...) analyzed n = 264 articles published in the German press and n = 220 books, reviews, and articles published in scientific journals that explicitly cited the 10 volumes between 1900 and 1920. VP received considerable criticism from linguists and philologists, who claimed that its results were of little practical use for their research. The first volumes of VP were criticized for their abstract character and psychological indifferentism; on the other hand, positive reviews emphasized their attempt to systematize and give a philosophical order to the individual investigations of philology, linguistics, comparative history, religious studies, and so on. The normative-methodological role that VP tried to play in relation to the other historical sciences was significantly criticized, and this was a determining factor in its diminishing impact over time. Some of Wundt's hypotheses were philosophically at odds with the project of German cultural imperialism that was being developed at the time and with which most of his intellectual enemies agreed. (shrink)

The extent of harm and suffering caused by the coronavirus pandemic has prompted a debate about whether the epidemic could have been contained, had the gravity of the crisis been predicted earlier. In this paper, the philosophical debate on predictive reasoning is framed by Hume’s problem of induction. Hume argued that it is rationally unjustified to move from the finite observations of past incidences to the predictions of future events. Philosophy has offered two major responses to the problem of induction: (...) the pragmatic induction of Peirce and the critical rationalism of Popper. It is argued that of these two, Popper’s critical rationalism provides a more potent tool for preparing for unanticipated events such as the Covid-19 pandemic. Popper’s notion of risky predictions equips strategic foresight with clear hypotheticals regarding potential crisis scenarios. Peirce’s pragmatic induction, instead, leans on probabilities that are slower to be amended as unexpected events start unfolding. The difference between the two approaches is demonstrated through a case study of the patterns of reasoning within the World Health Organization in the early stages of the coronavirus pandemic. (shrink)