Moral distress has been identified as an occupational hazard for clinicians caring for vulnerable populations. The aim of this systematic review was (i) to summarize the literature reporting on prevalence of, and factors related to, moral distress among nurses within acute mental health settings, and (ii) to examine the efficacy of interventions designed to address moral distress among nurses within this clinical setting. A comprehensive literature search was conducted in October 2022 utilizing Nursing & Allied Health, Embase, CINAHL, PsychInfo, and (...) PubMed databases to identify eligible studies published in English from January 2000 to October 2022. Ten studies met inclusion criteria. Four quantitative studies assessed moral distress among nurses in acute mental health settings and examined relationships between moral distress and other psychological and work-related variables. Six qualitative studies explored the phenomenon of moral distress as experienced by nurses working in acute mental health settings. The quantitative studies assessed moral distress using the Moral Distress Scale for Psychiatric Nurses (MDS-P) or the Work-Related Moral Stress Questionnaire. These studies identified relationships between moral distress and emotional exhaustion, depersonalization, cynicism, poorer job satisfaction, less sense of coherence, poorer moral climate, and less experience of moral support. Qualitative studies revealed factors associated with moral distress, including lack of action, poor conduct by colleagues, time pressures, professional, policy and legal implications, aggression, and patient safety. No interventions targeting moral distress among nurses in acute mental health settings were identified. Overall, this review identified that moral distress is prevalent among nurses working in acute mental health settings and is associated with poorer outcomes for nurses, patients, and organizations. Research is urgently needed to develop and test evidence-based interventions to address moral distress among mental health nurses and to evaluate individual and system-level intervention effects on nurses, clinical care, and patient outcomes. (shrink)

ASPECTS OF THE NOVEL is a unique attempt to examine the novel afresh, rejecting the traditional methods of classification by chronology or subject-matter. Forster pares down the novel to its essential elements as he sees them: story, people, plot, fantasy, prophecy, pattern and rhythm. He illustrates each aspect with examples from their greatest exponents, not hesitating as he does so to pass controversial judgement on the works of, among others, Sir Walter Scott, Charles Dickens and Henry James. Full of (...) Forster's renowned wit and perceptiveness, ASPECTS OF THE NOVEL offers a rare insight into the art of fiction from one of our greatest novelists. 'His is a book to encourage dreaming.' Virginia Woolf. (shrink)

While translating the pseudo-Aristotelian Problems for the Oxford translation of Aristotle, I have frequently found it necessary to refer to the Fragments of Theophrastus , which are obviously the source of many of the Problems, in particular in books II., V., XX., XXIV., and XXVI. The condition of the text of both the Problems and the Fragments of Theophrastus leaves much to be desired, but considerable improvements are possible in those passages where the compiler of the Problems is adapting or (...) copying from Theophrastus. (shrink)

Tarski [5] showed that for any set X, its set w(X) of well-orderable subsets has cardinality strictly greater than that of X, even in the absence of the axiom of choice. We construct a Fraenkel-Mostowski model in which there is an infinite strictly descending sequence under the relation |w (X)| = |Y|. This contrasts with the corresponding situation for power sets, where use of Hartogs' ℵ-function easily establishes that there can be no infinite descending sequence under the relation |P(X)| = (...) |Y|. (shrink)

We consider the relation between versions of Ramsey’s Theorem and König’s Infinity Lemma, in the absence of the axiom of choice.

In dit essay keert Forster zich tegen geloof met een grote G: het fundamentalistisch geloof in een religie als de enige bron van waarheid, maar ook het geloof in de macht en het geweld van grote mannen en ideologieën. Hij stelt er zijn eigen geloof met een ‘heel kleine g’ tegenover, een geloof in vrijheid, democratie en individualisme, in de adel van de geest.

The Problems, which occupy pp. 859-967 of the Berlin Aristotle, have probably been less read and studied than any other treatise in the Aristotelian Corpus; they contain, however, a vast quantity of interesting information on a great variety of subjects, and an enquiry into their composition may be not without interest.

Traditional analyses of the curve fitting problem maintain that the data do not indicate what form the fitted curve should take. Rather, this issue is said to be settled by prior probabilities, by simplicity, or by a background theory. In this paper, we describe a result due to Akaike [1973], which shows how the data can underwrite an inference concerning the curve's form based on an estimate of how predictively accurate it will be. We argue that this approach throws light (...) on the theoretical virtues of parsimoniousness, unification, and non ad hocness, on the dispute about Bayesianism, and on empiricism and scientific realism. * Both of us gratefully acknowledge support from the Graduate School at the University of Wisconsin-Madison, and NSF grant DIR-8822278 (M.F.) and NSF grant SBE-9212294 (E.S.). Special thanks go to A. W. F. Edwards.William Harper. Martin Leckey. Brian Skyrms, and especially Peter Turney for helpful comments on an earlier draft. (shrink)

A novel Protocol Ethics Tool Kit (‘Ethics Tool Kit’) has been developed by a multi-stakeholder group of the Multi-Regional Clinical Trials Center of Brigham and Women9s Hospital and Harvard. The purpose of the Ethics Tool Kit is to facilitate effective recognition, consideration and deliberation of critical ethical issues in clinical trial protocols. The Ethics Tool Kit may be used by investigators and sponsors to develop a dedicated Ethics Section within a protocol to improve the consistency and transparency between clinical trial (...) protocols and research ethics committee reviews. It may also streamline ethics review and may facilitate and expedite the review process by anticipating the concerns of ethics committee reviewers. Specific attention was given to issues arising in multinational settings. With the use of this Tool Kit, researchers have the opportunity to address critical research ethics issues proactively, potentially speeding the time and easing the process to final protocol approval. (shrink)

A epistemologia de Charles Sanders Peirce parece paradoxal quando comparada a de Rudolf Carnap e W.V. Quine. Como Carnap, mas diferentemente de Quine, Peirce considera que o conhecimento científico reside em princípios lógicos que devem se sustentar para que o discurso sobre o verdadeiro e o falso tenha sentido. Ele também compartilha a visão de Carnap de que esses princípios são anteriores à, e independentes das constatações nas ciências naturais, uma visão que Quine notoriamente rejeita. Todavia, como Quine, mas diferentemente (...) de Carnap, Peirce insiste que não há conhecimento além daquele que é obtido por meio de testes empíricos, que as verdades da lógica estão epistemologicamente a par das verdades descobertas nas ciências naturais, e que nos revelam algo sobre como as coisas são, em vez de carecerem de conteúdo fatual, como Carnap afirma. Um ar de paradoxo emerge no comprometimento simultâneo de Peirce às visões comumente consideradas próprias das teorias epistemológicas incompatíveis. A análise desse paradoxo pela comparação da concepção de conhecimento de Peirce ao de Quine e Carnap nos ajuda a apreciar melhor sua importância na tradição filosófica e na profundeza e originalidade de suas razões. (shrink)

Type 1: This process occurs for half of the population. For this segment of the population, there is 10% chance of developing the disease. There is a test for the disease such that 90% of the people who have the disease in this case will test positive (event E), while the false positive rate is 10%, which means that there is a 10% chance of testing positive for the disease when they do not have the disease.