Organisational change is one of the most frequently recurring organisational phenomena of our time, yet despite this, organisations are not succeeding in instituting change processes effectively; dismal "change success rates" are recorded. Van Tonder and Van Vuuren (2004) have argued that the adoption of an ethical framework from within which change practices are to be approached and "managed", would significantly reduce the negative consequences of change initiatives. As a first step in this direction, the current study set out to (...) establish the meaning that employees attribute to "ethical" and "unethical" change. Data obtained from a sample of 111 respondents from seven companies were subjected to basic content analysis and key themes extracted. The results indicate a limited understanding of ethics concepts among employees. A clear need for both intensified education and research is indicated. (shrink)

This article focuses on maternal-fetal surgery (MFS) and on the concept of clinical equipoise that is a widely accepted requirement for conducting randomized controlled trials (RCT). There are at least three reasons why equipoise is unsuitable for MFS. First, the concept is based on a misconception about the nature of clinical research and the status of research subjects. Second, given that it is not clear who the research subject/s in MFS is/are, if clinical equipoise is to be used as a (...) criterion to test the ethical appropriateness of RCT, its meaning should be unambiguous. Third, because of the multidisciplinary character of MFS, it is not clear who should be in equipoise. As a result, we lack an adequate criterion for the ethical review of MFS protocols. In our account, which is based on Chervenak and McCullough's seminal work in the field of obstetric ethics, equipoise is abandoned. and RCT involving MFS can be ethically initiated when a multidisciplinary ethics review board (ERB), having an evidence-based assessment of the risks involved, is convinced that the value of answering the research hypothesis, for the sake of the health interests of future pregnant women carrying fetuses with certain congenital birth defects, justifies the actual risks research participants might suffer within a set limit of low/manageable. (shrink)

A hippocampal patient is described who shows preserved item recognition and simple recognition-based recollection but impaired recall and associative recognition. These data and other evidence suggest that contrary to Aggleton & Brown's target article, Papez circuit damage impairs only complex item-item-context recollection. A patient with perirhinal cortex damage and a delayed global memory deficit, apparently inconsistent with A&B's framework, is also described.

La métaphysique de Berkeley présente une synthèse des méthodes analytique et phénoménologique et sa pensée peut être considérée à cet égard, comme le pont entre la philosophie contemporaine du continent et la philosophie anglo-saxonne. C'est pour cela que des penseurs comme Husserl, Wittgenstein, Wisdom, Ryle et d'autres sont mentionnés dans l'article. La métaphysique procure à Berkeley Ja condition transcendentale de telles méthodes. L'analyse du langage élimine les sentences de la métaphysique spéculative. Quand on dit par exemple qu'un dé est dur, (...) carré, etc., cela n'implique pas que ces qualités sont des propriétés d'une substance inconnue, mais elles ne sont que l'explication de ce qu'on entend par l'existence du dé. Berkeley ne veut pas supprimer l'existence, mais rendre le terme explicite. Son analyse découvre que le mot existence est employé lorsqu'on aperçoit quelque chose. L'idée de l'existence d'un paysage non perçu est une image où l'homme se supprime comme observateur. Berkeley ne s'efforce pas de suppléer les intervalles , en supposant Dieu comme observateur permanent. Il part plutôt du langage quotidien où il va de soi que les choses continuent d'exister, même sans être perçues. Cette réalité ne dépend apparemment pas de l'homme individuel et elle renvoie donc vers Dieu, l'existence n'étant rien en soi-même, autrement le mot serait dénué de sens. Les « idées » sont chez Berkeley les choses elles-mêmes et non leur copie dans l'esprit comme chez Locke. Le mot idée indique que leur existence est conçue comme processus de vérification. Berkeley analyse d'une même manière « opérationnelle » les conceptions mathématiques. Le triangle n'est qu'une convention par définition à l'égard de l'utilisation de ce symbole. Les lois de la nature sont une grammaire de la nature qui indique les régularités extérieures et non les forces occultes. Le point de départ de sa méthode que l'on peut appeler phénoménologique est la perception attentive de sa propre conscience. C'est là que les idées se manifestent comme les choses elles-mêmes dans leur présence corporelle. Husserl reconnaît ici son propre effort d'une constitution de la « mondanité » . Berkeley offre une phénoménologie de la perception dans laquelle le monde extérieur manifeste un rapport à la subjectivité. Le temps également trouve sa source dans son rapport à l'esprit. C'est ainsi que Berkeley combat l'objectivisme des sciences naturelles. L'esprit et ses « notions » ne sont comme principe actif, pas à comparer avec les choses .Berkeley, par opposition à la conception des facultés de l'âme, dit que la volonté, la haine, l'amour etc., sont des orientations de l'esprit qui se manifestent aux objets et aux situations. L'objectivité corporelle est un modèle de la subjectivité de l'esprit. métaphysique de Berkeley ne donne pas une compréhension des faits nouveaux, mais une nouvelle compréhension des faits ; elle ne crée pas un arrière-monde, mais elle dévoile l'horizon de sens de ce monde-ci. C'est pour cela qu'elle n'est pas réductrice. La matière n'est pas réduite à l'esprit, mais elle est plus riche que la conception objectiviste de la matière, n'existant que dans une cohésion de signification avec l'esprit. Le monde devient langage dont le sens est de renvoyer vers Dieu ; Dieu est l'auteur, non la cause première. Il est inconnaissable comme objet étant le sujet à partir duquel le dessein du langage et la grammaire de la nature deviennent lisibles. Ici, il ne s'agit plus d'un langage purement théorique mais pratique, qui dévoile le sens du monde en le rendant tendancieux. (shrink)

Despite their status as high-income food producing nations, children and their caregivers, both in the United States (U.S.) and Australia can experience food insecurity. Nutrition researchers formed a joint U.S.-Australia collaboration to help advance food security for households with young children aged 0–5 years. This study investigated food insecurity from the perspective of caregivers, especially their perceptions of the impact of food insecurity on their own childhood, their current life, and for the children in their care. Semi-structured interviews were conducted (...) from July to September 2020 during the COVID-19 pandemic. Participants were recruited in Omaha, Nebraska, U.S. (_n_ = 19) and Melbourne, Victoria, Australia (_n_ = 22), during periods of stay-at-home public health orders. These two case study sites enabled an exploration of some universal, and some context-specific, social, economic, and health conditions that buffer, or exacerbate, food insecurity for families in these neo-liberal political settings. An inductive thematic analysis was conducted and established six themes:_growing up poor_, _lessons learned_,_ feeding a family amidst a pandemic_,_ caregiver coping strategies_, _food security in the early years_ and _protecting (young) children_. Perspectives on local anti-hunger strategies were organized to outline participant’s preferred solutions. Household food insecurity is conceptualized in public policy in the U.S. and Australia as a short-term crisis for people, justifying austere, time-limited and patchwork solutions. A narrative of caregivers’ lived experience of food insecurity suggests that it is inter-generational, and exacerbated by a food system shock (i.e., COVID-19). These findings from two varying cities and nations offer a different conceptualization of the timespan and nature of the phenomenon of food insecurity, challenging a dominant policy narrative and highlighting the inadequacy of current so-called solutions. (shrink)

The suggestion of seeking specificity in a higher-order array is attractive, but Stoffregen & Bardy fail to provide a compelling empirical basis to their claim that specificity exists solely in the global array. Using the example of relative motion, the alternate hypotheses that must be considered are presented.

This article provides ethical guidance on using race in health research as a variable or in defining the study population. To this end, a plain, non-exhaustive checklist is provided for researchers and research ethics committees, preceded by a brief introduction on the need for justification when using race as a variable or in defining a study population, the problem of exoticism, that distinctions pertain between race, ethnicity and ancestry, the problematic naming of races, and that race does not serve well (...) as a presumed biological construct in genetic research. (shrink)

Given its non-invasive nature, there is increasing interest in the use of transcutaneous vagus nerve stimulation across basic, translational and clinical research. Contemporaneously, tVNS can be achieved by stimulating either the auricular branch or the cervical bundle of the vagus nerve, referred to as transcutaneous auricular vagus nerve stimulation and transcutaneous cervical VNS, respectively. In order to advance the field in a systematic manner, studies using these technologies need to adequately report sufficient methodological detail to enable comparison of results between (...) studies, replication of studies, as well as enhancing study participant safety. We systematically reviewed the existing tVNS literature to evaluate current reporting practices. Based on this review, and consensus among participating authors, we propose a set of minimal reporting items to guide future tVNS studies. The suggested items address specific technical aspects of the device and stimulation parameters. We also cover general recommendations including inclusion and exclusion criteria for participants, outcome parameters and the detailed reporting of side effects. Furthermore, we review strategies used to identify the optimal stimulation parameters for a given research setting and summarize ongoing developments in animal research with potential implications for the application of tVNS in humans. Finally, we discuss the potential of tVNS in future research as well as the associated challenges across several disciplines in research and clinical practice. (shrink)

BackgroundAs moral case deliberations (MCDs) have increasingly been implemented in health care institutions as a form of ethics support, it is relevant to know whether and how MCDs actually contribute to positive changes in care. Insight is needed on what actually happens in daily care practice following MCD sessions. This study aimed at investigating the impact of MCD and exploring how ‘impact of MCD’ should be conceptualized for future research.MethodsA multiple-case study was conducted in a care organization for people with (...) intellectual disabilities and/or acquired brain injury, by observing MCD sessions as ‘cases’, followed by interviews with health care professionals concerning the follow-up to these cases, and a focus group with involved MCD facilitators. A conceptual scheme concerning the possible impact formed the basis for analysis: (1) individual moral awareness; (2) the actions of health care professionals; (3) collaboration among health care professionals; (4) the concrete situation of the client; (5) the client’s quality of care and life; (6) the organizational and policy level.ResultsAccording to interviewees, their moral awareness and their collaboration, both among colleagues and with clients’ relatives, improved after MCD. Perceived impact on client situation, quality of care/life and the organizational level varied among interviewees or was difficult to define or link to MCD. Three aspects were added to the conceptual scheme concerning the impact of MCD: (a) preparations and expectations prior to the MCD session; (b) a translational step between the conclusions of the MCD session and practical events in the following period, and (c) collaboration with clients’ relatives. A negative impact of MCD was also found on misunderstandings among participants and disappointment about lack of follow-up.ConclusionsConcretizing and conceptualizing the ‘impact’ of MCD is complicated as many factors play a role either before or during the transition from MCD to practice. It is important to consider ‘impact’ in a broad sense and to relate it to the goals and context of the MCD in question. Future studies in this field should pay additional attention to the preparations, content and process involved in ethics support, including clients’ and relatives’ experiences. (shrink)

BackgroundThe Netherlands is one of the few countries where euthanasia is legal under strict conditions. This study investigates whether Dutch newspaper articles use the term ‘euthanasia’ according to the legal definition and determines what arguments for and against euthanasia they contain.MethodsWe did an electronic search of seven Dutch national newspapers between January 2009 and May 2010 and conducted a content analysis.ResultsOf the 284 articles containing the term ‘euthanasia’, 24% referred to practices outside the scope of the law, mostly relating to (...) the forgoing of life-prolonging treatments and assistance in suicide by others than physicians. Of the articles with euthanasia as the main topic, 36% described euthanasia in the context of a terminally ill patient, 24% for older persons, 16% for persons with dementia, and 9% for persons with a psychiatric disorder. The most frequent arguments for euthanasia included the importance of self-determination and the fact that euthanasia contributes to a good death. The most frequent arguments opposing euthanasia were that suffering should instead be alleviated by better care, that providing euthanasia can be disturbing, and that society should protect the vulnerable.ConclusionsOf the newspaper articles, 24% uses the term ‘euthanasia’ for practices that are outside the scope of the euthanasia law. Typically, the more unusual cases are discussed. This might lead to misunderstandings between citizens and physicians. Despite the Dutch legalisation of euthanasia, the debate about its acceptability and boundaries is ongoing and both sides of the debate are clearly represented. (shrink)