The COVID-19 outbreak has placed extraordinary demands upon healthcare systems worldwide. Italy's hospitals have been among the most severely overwhelmed, and as a result, Italian healthcare workers' well-being has been at risk. The aim of this study is to explore the relationships between dimensions of burnout and various psychological features among Italian healthcare workers during the COVID-19 emergency. A group of 267 HCWs from a hospital in the Lazio Region completed self-administered questionnaires online through Google Forms, including the Maslach Burnout (...) Inventory, Resilience Scale, and Intolerance of Uncertainty Scale Short Form. Cluster analysis highlighted two opposite burnout risk profiles: low burnout and high-risk burnout. The high-risk group had lower resilience and greater difficulties in tolerating the uncertainty than the low-burnout group. A set of general linear models confirmed that both IU subscales, prospective and inhibition, moderated the relationship between resilience and burnout. In conclusion, the results showed that individual levels of resilience and one's ability to tolerate uncertainty have been significant factors in determining the impact of the COVID-19 emergency on HCWs. The use of emotional strategies that allow individuals to stay in a critical situation without the need to control it appears to protect against burnout in these circumstances. (shrink)

Aim of the study was to analyze the posttraumatic stress disorder risk nurses, detecting the relationship between distress experience and personality dimensions in Italian COVID-19 outbreak. A cross-sectional study was conducted based on 2 data detection. Mental evaluation was carried out in Laboratory of Clinical Psychology on n.69 nurses in range age 22–64 years old. Measurement was focused on symptoms anxiety, personality traits, peritraumatic dissociation and post-traumatic stress for all participants. No online screening was applied. Comparisons within the various demographic (...) characteristics demonstrated few significant differences between groups on DASS-21, PDEQ, and ISE-R scores. Correlation analysis was performed among PDEQ, DASS-21, BFI-10 and IES-R and confirmed between anxiety and peritraumatic dissociation and post-traumatic stress; then anxiety is positively correlated to agreeableness variable of BFI-10 test. The emotional distress was protracted overtime but in long-term personality traits resulted mediator facing subjective stress. Our finding drew details for protective and predictive risk factors as well as mental health issues of nurses dealing with pandemic: healthcare workers faced the protracted challenge caring COVID-19 patients over and over again: in short time the impact was relevant, and the prolonged exposition to the stressor was tackled by personal resources such as personality traits. (shrink)

Much of the sustained attention on pandemic preparedness has focused on the ethical justification for plans for the “crisis” phase of a surge when, despite augmentation efforts, the demand for life...

In November 2018, the practice of health care ethics consultation crossed a major threshold when 138 candidates took the inaugural Healthcare Ethics Consultant Certification Examination. This accomplishment, long in the making, has had and continues to have both advocates and critics. The Healthcare Ethics Consultant Certification Commission, a functionally autonomous body created and funded by the American Society for Bioethics and Humanities, was charged with overseeing creation of the certification process, developing the exam, and formulating certification standards and policies to (...) assess candidates’ qualifications. In this essay, as members of the commission, we describe the process of developing, administering, and scoring the certification examination as well as the historical context and the outlook for certification. By detailing the decisions and actions of the commission, we aim to provide a transparent account of the commission's efforts to develop a psychometrically sound, reliable, and secure examination through a deliberative, fair, and data‐driven process. (shrink)

In the last decade, reading research has seen a paradigmatic shift. A new wave of computational models of orthographic processing that offer various forms of noisy position or context-sensitive coding have revolutionized the field of visual word recognition. The influx of such models stems mainly from consistent findings, coming mostly from European languages, regarding an apparent insensitivity of skilled readers to letter order. Underlying the current revolution is the theoretical assumption that the insensitivity of readers to letter order reflects the (...) special way in which the human brain encodes the position of letters in printed words. The present article discusses the theoretical shortcomings and misconceptions of this approach to visual word recognition. A systematic review of data obtained from a variety of languages demonstrates that letter-order insensitivity is neither a general property of the cognitive system nor a property of the brain in encoding letters. Rather, it is a variant and idiosyncratic characteristic of some languages, mostly European, reflecting a strategy of optimizing encoding resources, given the specific structure of words. Since the main goal of reading research is to develop theories that describe the fundamental and invariant phenomena of reading across orthographies, an alternative approach to model visual word recognition is offered. The dimensions of a possible universal model of reading, which outlines the common cognitive operations involved in orthographic processing in all writing systems, are discussed. (shrink)

Introduction: Motor evoked potentials (MEPs) to transcranial magnetic stimulation are known to be susceptible to several sources of variability. However, conflicting evidences on individual characteristics in relatively small sample sizes have been reported. We investigated the effect of age, height, and sex on MEPs of the motor cortex and spinal roots in a large cohort. Methods: A total of 587 subjects clinically and neuroradiologically intact were included. MEPs were recorded during mild tonic contraction through a circular coil applied over the (...) “hot spot” of the first dorsal interosseous and tibialis anterior muscles, bilaterally. Central motor conduction time (CMCT) was estimated as the difference between MEP cortical latency and the peripheral motor conduction time by cervical or lumbar magnetic stimulation. Peak-to-peak MEP amplitude to cortical stimulation and right-to-left difference of each parameter were also measured. Results: After Bonferroni correction, general linear (multiple) regression analysis showed that both MEP cortical latency and peripheral motor conduction time at four limbs positively correlated with age and height. At lower limbs, an independent effect of sex on the same measures was also observed (with females showing smaller values than males). CMCT correlated with both age (negatively) and height (positively) when analyzed by a single regression; however, with a multiple regression analysis this significance disappeared, due to the correction for the multicollinearity within the dataset. Conclusions: Physical individual features need to be considered for a more accurate and meaningful MEPs interpretation. Both in clinical practice and in research setting, patients and controls should be matched for age, height, and sex. (shrink)

The use of evidence in medicine is something we should continuously seek to improve. This book seeks to develop our understanding of evidence of mechanism in evaluating evidence in medicine, public health, and social care; and also offers tools to help implement improved assessment of evidence of mechanism in practice. In this way, the book offers a bridge between more theoretical and conceptual insights and worries about evidence of mechanism and practical means to fit the results into evidence assessment procedures.

Resumo: O presente artigo tem como objetivo refletir sobre a subjetividade/identidade desejada e propagada no documento da Base Nacional Comum Curricular (BNCC). O documento voltado à formação dos estudantes da educação básica em território brasileiro é tomado, na presente discussão, em sua natureza duplamente política. Para tal, parte-se de uma perspectiva epistemológica pluralista, utilizando-se de conceitos-ferramenta de base foucaultiana e de autores da Sociologia, a saber, Norbert Elias, Zigmunt Bauman, Claude Dubar e Stuart Hall. A partir da discussão de subjetividade, (...) identidade e outros conceitos relevantes às reflexões e problematizações, lança-se um olhar para as 10 competências gerais expressas no documento supracitado. Os excertos selecionados para análise demonstram evocar, validar e propagar subjetividades/identidades ao encontro do que os sociólogos analisam como abertas, móveis, flexíveis, próprias da modernidade tardia ou líquida; além de responsabilizar o sujeito por suas escolhas. Palavras-chave: Identidade; Subjetividade; BNCC The ideal subjectivity in the BNCC: reflections on training in Basic Education Abstract: This article aims to reflect on the subjectivity/identity desired and propagated in the document of the National Common Curricular Base (BNCC). The document aimed at the training of basic education students in Brazilian territory in the present discussion, in its doubly political nature. Therefore, we start from a pluralist epistemological perspective, using Foucaultian-based tool concepts and sociology authors, namely Norbert Elias, Zygmunt Bauman, Claude Dubar, and Stuart Hall. From the discussion of subjectivity, identity, and other concepts relevant to the reflections and problematizations, it launched a look at the 10 general competencies expressed in the aforementioned document. The excerpts selected for analysis show to evoke, validate and propagate subjectivities/identities in line with what sociologists analyze as open, mobile, flexible, typical of late or liquid modernity; in addition to making the subject responsible for their choices. Key-words: Identity; Subjectivity; BNCC La subjetividad ideal en la BNCC: reflexiones sobre la formación en Educación Básica Resumen: Este artículo tiene como objetivo reflexionar sobre la subjetividad/identidad deseada y propagada en el documento de la Base Nacional Común Curricular (BNCC). El documento destinado a la formación de estudiantes de educación básica en territorio brasileño es tomado, en la presente discusión, en su doble naturaleza política. Para ello, partimos de una perspectiva epistemológica pluralista, utilizando conceptos de herramientas basados en Foucault y autores de la sociología, a saber, Norbert Elias, Zigmunt Bauman, Claude Dubar y Stuart Hall. A partir de la discusión sobre la subjetividad, la identidad y otros conceptos relevantes para las reflexiones y problematizaciones, se lanza una mirada a las 10 competencias generales expresadas en el citado documento. Los extractos seleccionados para el análisis demuestran evocar, validar y propagar subjetividades/identidades en línea con lo que los sociólogos analizan como abierto, móvil, flexible, propio de la modernidad tardía o líquida; además de responsabilizar al sujeto de sus elecciones. Palabras clave: Identidad; Subjetividad; BNCC Data de registro: 08/09/2022 Data de aceite: 22/03/2023. (shrink)

As sharing and secondary research use of biospecimens increases, IRBs and researchers face the challenge of protecting and respecting donors without comprehensive regulations addressing the human subject protection issues posed by biobanking. Variation in IRB biobanking policies about these issues has not been well documented.

The principles of the 3Rs—replacement, refinement, and reduction—strongly shape discussion of methods for performing more humane animal research and the regulation of this contested area of technoscience. This special issue looks back to the origins of the 3Rs principles through five papers that explore how it is enacted and challenged in practice and that develop critical considerations about its future. Three themes connect the papers in this special issue. These are the multiplicity of roles enacted by those who use and (...) care for animals in research, the distribution of “feelings that matter” across species and spaces of laboratory animal practice, and the growing importance of “cultures of care” in animal research. (shrink)

Although ethics consultation is offered as a clinical service in most hospitals in the United States, few valid and practical tools are available to evaluate, ensure, and improve ethics consultation quality. The quality of ethics consultation is important because poor quality ethics consultation can result in ethically inappropriate outcomes for patients, other stakeholders, or the health care system. To promote accountability for the quality of ethics consultation, we developed the Ethics Consultation Quality Assessment Tool. ECQAT enables raters to assess the (...) quality of ethics consultations based on the written record. Through rigorous development and preliminary testing, we identified key elements of a quality ethics consultation, established scoring criteria, developed training guidelines, and designed a holistic assessment process. This article describes the development of the ECQAT,.. (shrink)

Although clinical ethics consultation is a high-stakes endeavor with an increasing prominence in health care systems, progress in developing standards for quality is challenging. In this article, we describe the results of a pilot project utilizing portfolios as an evaluation tool. We found that this approach is feasible and resulted in a reasonably wide distribution of scores among the 23 submitted portfolios that we evaluated. We discuss limitations and implications of these results, and suggest that this is a significant step (...) on the pathway to an eventual certification process for clinical ethics consultants. (shrink)

As one of the most important ethicists to emerge since the Second World War, Alan Gewirth continues to influence philosophical debates concerning morality. In this ground-breaking book, Gewirth's neo-Kantianism, and the communitarian problems discussed, form a dialogue on the foundation of moral theory. Themes of agent-centered constraints, the formal structure of theories, and the relationship between freedom and duty are examined along with such new perspectives as feminism, the Stoics, and Sartre. Gewirth offers a picture of the philosopher's theory and (...) its applications, providing a richer, more complete critical assessement than any which has occurred to date. (shrink)

Moral distress reflects often recurrent problems within a healthcare environment that impact the quality and safety of patient care. Examples include inadequate staffing, lack of necessary resources, and poor interprofessional teamwork. Recognizing and acting on these issues demonstrates a collaborative and organizational commitment to improve. Moral distress consultation is a health system-wide intervention gaining momentum in the United States. Moral distress consultants assist healthcare providers in identifying and strategizing possible solutions to the patient, team, and systemic barriers behind moral distress. (...) Moral distress consultants offer unique perspectives on the goals, successes, areas for improvement, and sustainability of moral distress consultation. Their ideas can help shape this intervention’s continued growth and improvement. This qualitative descriptive study features 10 semi-structured interviews with moral distress consultants at two institutions with longstanding, active moral distress consultation services. Themes from consultant transcripts included consultant training, understanding the purpose of moral distress consultation, interfacing with leadership teams, defining success, and improving visibility and sustainability of the service. These findings describe the beginnings of a framework that organizations can use to either start or strengthen moral distress consultation services, as well as the first steps in developing an evaluation tool to monitor their utility and quality. (shrink)

Distinguished contributors take up eminent scholar Daniel R. Schwarz’s reading of modern fiction and poetry as mediating between human desire and human action. The essayists follow Schwarz’s advice, “always the text, always historicize,” thus making this book relevant to current debates about the relationships between literature, ethics, aesthetics, and historical contexts.

Volume 19, Issue 7, July 2019, Page W1-W3.

Contents: "Analysis of Claude Bernard's Introduction to the Study of Experimental Medicine," "Two Unpublished Chapters from She Came to Stay," "Pyrrhus and Cineas," "A Review of The Phenomenology of Perception by Maurice Merleau-Ponty," "Moral Idealism and Political Realism," "Existentialism and Popular Wisdom," "Jean-Paul Sartre," "An Eye for an Eye," "Literature and Metaphysics," "Introduction to an Ethics of Ambiguity," "An Existentialist Looks at Americans," and "What is Existentialism?".

The rapidly increasing number of cases of Zika virus and limited understanding of its congenital sequelae (e.g., microcephaly) led to stories of fear and uncertainty across social media and other mass communication networks. In this study, we used techniques generic to netnography, a form of ethnography, using Internet‐based computer‐mediated communications as a source of data to understand the experience and perceptions of families with infants diagnosed with Zika‐related microcephaly. We screened 27 YouTube™ videos published online between October 2015 and July (...) 2016, during which the Zika epidemic started, peaked, and declined. We identified three themes: (a) experiencing the news of a diagnosis of Zika‐associated microcephaly; (b) experiencing feelings and expectations of the ‘imperfect’ child; and (c) seeking to understand microcephaly to care for the child. We found that families experienced distressing feelings of shock, sadness, hopelessness, and pain, while dealing with emerging and sometimes conflicting information being transmitted by news outlets, uncertainty about the child's health, and healthcare providers’ lack of clarity to guide the family members. The ‘unknown’ factor of ZIKA was an additional stressful factor in the experience of the families. (shrink)

This paper is intended to stimulate debate amongst stakeholders in the international research community on the topic of returning individual genetic research results to study participants. Pharmacogenetics and disease genetics studies are becoming increasingly prevalent, leading to a growing body of information on genetic associations for drug responsiveness and disease susceptibility with the potential to improve health care. Much of these data are presently characterized as exploratory (non‐validated or hypothesis‐generating). There is, however, a trend for research participants to be permitted (...) access to their personal data if they so choose. Researchers, sponsors, patient advocacy groups, ethics committees and regulatory authorities are consequently confronting the issue of whether, and how, study participants might receive their individual results. Noted international ethico‐legal guidelines and public policy positions in Europe and the United States are reviewed for background. The authors offer ‘Points‐to‐Consider’ regarding returning research results in the context of drug development trials based on their knowledge and experience. These considerations include: the clinical relevance of data, laboratory qualifications, informed consent procedures, confidentiality of medical information and the competency of persons providing results to participants. The discussion is framed as a benefit‐to‐risk assessment to balance the potential positive versus negative consequences to participants, while maintaining the integrity and feasibility of conducting genetic research studies. (shrink)

Is time travel just a confusing plot device deployed by science fiction authors and Hollywood filmmakers to amaze and amuse? Or might empirical data prompt a scientific hypothesis of time travel? Structured on a fascinating dialogue involving  ...

This paper presents an experimental study investigating artificial grammar learning (AGL) in monolingual and bilingual children, with and without dyslexia, using an original methodology. We administered a serial reaction time (SRT) task, in the form of a modified Simon task, in which the sequence of the stimuli was manipulated according to the rules of a simple Lindenmayer grammar (more specifically, a Fibonacci grammar). By ensuring that the subjects focused on the correct response execution at the motor stage in presence of (...) congruent or incongruent visual stimuli, we could meet the two fundamental criteria for implicit learning: the absence of an intention to learn and the lack of awareness at the level of resulting knowledge. The participants of our studies were four groups of 10-year-old children: 30 Italian monolingual typically developing children, 30 bilingual typically developing children with Italian L2, 24 Italian monolingual dyslexic children and 24 bilingual dyslexic children with Italian L2. Participants were administered the modified Simon task developed according to the rules of the Fibonacci grammar and tested with respect to the implicit learning of three regularities: (i) a red is followed by a blue; (ii) a sequence of two blues is followed by a red and (iii) a blue can be followed either by a red or by a blue. Results clearly support the hypothesis that implicit learning took place, since participants of all groups became increasingly sensitive to the structure of the input, implicitly learning the sequence of the trials and thus appropriately predicting the occurrence of the relevant items, as manifested by faster reaction times in predictable trials. Moreover, group differences were found, with bilinguals being overall faster than monolinguals and dyslexics less accurate than controls. Finally, an advantage of bilingualism in dyslexia was found, with bilingual dyslexics performing consistently better than monolingual dyslexics and, in some conditions, at the level of the two control groups. These results are taken to suggest that bilingualism should be supported also among linguistically impaired individuals. (shrink)

In 2022, students at North American universities with third-dose COVID-19 vaccine mandates risk disenrolment if unvaccinated. To assess the appropriateness of booster mandates in this age group, we combine empirical risk-benefit assessment and ethical analysis. To prevent one COVID-19 hospitalisation over a 6-month period, we estimate that 31 207–42 836 young adults aged 18–29 years must receive a third mRNA vaccine. Booster mandates in young adults are expected to cause a net harm: per COVID-19 hospitalisation prevented, we anticipate at least (...) 18.5 serious adverse events from mRNA vaccines, including 1.5–4.6 booster-associated myopericarditis cases in males (typically requiring hospitalisation). We also anticipate 1430–4626 cases of grade ≥3 reactogenicity interfering with daily activities (although typically not requiring hospitalisation). University booster mandates are unethical because they: (1) are not based on an updated (Omicron era) stratified risk-benefit assessment for this age group; (2) may result in a net harm to healthy young adults; (3) are not proportionate: expected harms are not outweighed by public health benefits given modest and transient effectiveness of vaccines against transmission; (4) violate the reciprocity principle because serious vaccine-related harms are not reliably compensated due to gaps in vaccine injury schemes; and (5) may result in wider social harms. We consider counterarguments including efforts to increase safety on campus but find these are fraught with limitations and little scientific support. Finally, we discuss the policy relevance of our analysis for primary series COVID-19 vaccine mandates. (shrink)