Moral judgment is a complex cognitive process that partly depends upon social and individual cultural values. There have been various efforts to categorize different aspects of moral judgment, but most studies depend upon rare dilemmas. We recruited 25 subjects from Tehran, Iran, to rate 150 everyday moral scenarios developed by Knutson et al. Using exploratory factor analysis (EFA), we observed that the same moral dimensions (except socialness dimension) were driven by the same moral cognitive factors (norm violation, intention, and social (...) affect) in Iranian vs. American studies. However, there were minor differences in the factor loadings between the two cultures. Furthermore, based on the EFA results, we developed a short form of the questionnaire by removing eleven of the fifteen scenarios from each of the ten categories. These results could be used in further studies to better understand the similarities and differences in moral judgment in everyday interactions across different cultures. (shrink)

BackgroundEthical decision-making of nurses could affect patients’ recovery and also decrease medical costs. To make ethical decisions, ICU nurses experience complicated ethical conflicts. Considering the multi-dimensional process of ethical decision-making, the present study was conducted to describe the experiences of ICU nurses regarding ethical decision making.MethodThe present research is a qualitative study with conventional content analysis approach that was done in 2020. Fourteen ICU nurses were interviewed using a semi-structured in-depth interview method. The interviews were recorded, transcribed verbatim, and analyzed (...) using Granheim and Landman approach.ResultsBeing torn by inevitable moral dilemma was defined as the main category which contained the categories of conflict with professional self, feeling squeezed between self-authority and demands of others, and Surrounded by organizational limitations.ConclusionsResults of the present study showed that moral dilemma is a situation in which the nurses are forced to choose between two options based on their equipment and facilities. In these situations, the nurses would hesitate between their internal conflicts and confusion between choosing their own benefits and patients’ benefits. To prevent ethical challenges in decision making, it is necessary to educate healthcare team about ethical dilemmas and empower the personnel for encountering ethical challenges. (shrink)

Background: Nurses require empowerment if they are to make ethical decisions. Ethical empowerment has always been one of the main concerns in nurse training programs. Research aim: The present study was conducted to determine the effect of an ethical empowerment program on critical care nurses’ ethical decision-making. Research design: This is a clinical trial study with two groups and pre and post design. Participants and research context: In this study, 60 nurses working in Intensive Care Unit were selected through random (...) sampling and then divided into a control and an experimental group after filling out the Moral Sensitivity Questionnaire. Both groups completed the questionnaire again immediately and 2 months after the ethical empowerment workshop had been held for the experimental group. The collected data were analyzed in SPSS-16 using descriptive and inferential statistics. Ethical considerations: The goals of the study were explained to the participants and then a written informed consent was received from them. Findings: The results showed no significant differences between the two groups in terms of their ethical sensitivity scores at the beginning of the study; however, immediately and 2 months after the intervention, the mean score increased significantly in the experimental group. Moreover, the scores obtained 2 months after the workshop increased compared to the pre-intervention scores but showed a drop compared to the scores reported immediately after the workshop. Discussion: The ethical empowerment program, given to the critical care nurses in this study, improved their ethical sensitivity in making decisions significantly over time. Despite the extensive methods, available for teaching nursing ethics, the ethical empowerment program, adopted in this study, had long-lasting effects in terms of ameliorating the process of ethical decision-making in clinical situations. Conclusion: The ethical empowerment of nurses requires the adoption and application of proper methods and patterns of complying with nursing ethics. (shrink)

Respecting privacy and patients’ satisfaction are amongst the main indicators of quality of care and one of the basic goals of health services. This study, carried out in 2007, aimed to investigate the extent to which patient privacy is observed and its correlation with patient satisfaction in three emergency departments of Tehran University of Medical Science, Iran. Questionnaire data were collected from a convenience sample of 360 patients admitted to emergency departments and analysed using SPSS software. The results indicated that, (...) according to 50.6% of the patients, the extent to which their privacy was respected was described as either ‘weak’ or ‘average’. Spearman’s coefficient indicated a significant correlation between respecting privacy and the patients’ satisfaction about the various aspects of privacy studied. Considering the levels of privacy observed together with the patients’ degree of satisfaction, it is imperative that clinical professionals address both aspects from conceptual and practical viewpoints. (shrink)

Moral distress has emerged as a significant concern for critical care nurses, particularly due to the complex and demanding care provided to critically ill patients in critical care units. The ongoing COVID-19 pandemic has introduced new ethical challenges and changes in clinical practice, further exacerbating the experience of moral distress among these nurses. This systematic review compares the factors influencing moral distress among critical care nurses before and during the COVID-19 pandemic to gain a comprehensive understanding of the impact of (...) the pandemic on moral distress. For this systematic review, PubMed, Scopus, ProQuest, Web of Science, medRxiv, bioRxiv, Embase, and Google Scholar were all utilized in the search. The search covered articles published from 2012 to December 2022, encompassing a 10-year timeframe to capture relevant research on moral distress among critical care nurses. In total, 52 articles were included in this systematic review. The findings indicate that personal, caring-related, and organizational factors can influence nurses' moral distress. Before the pandemic, factors including futile and end-of-life care, conflicts with physicians, nurse performance and authority, poor teamwork, decision-making regarding treatment processes and patient care, limited human resources and equipment, medical errors, patient restraints, and nurses' age and work experience affect critical care nurses' moral distress. Similarly, during the COVID-19 pandemic, factors contributing to moral distress include futile and end-of-life care, fear of contracting and spreading COVID-19, decision-making about treatment processes, poor teamwork, and being female. This study revealed that the factors contributing to moral distress were approximately similar in both periods. Futile care and end-of-life issues were critical care nurses' primary causes of moral distress. Implementing prevention strategies and reducing these underlying factors could decrease this major issue and improve the quality of care. (shrink)

Respect for human dignity is a basic and crucial component of nursing care. Illness with restricted physical ability and being confined to bed can compromise the dignity of patients. The views of adolescents regarding dignity in care have not previously been researched. This article details a descriptive-analytic study in which survey data was collected from all nurses and compared with a convenience sample of 180 hospitalized adolescents in two hospitals in Iran. The data was analyzed with SPSS software. A significant (...) difference between nurses and hospitalized ill adolescents’ perceptions was identified in relation to: understanding the importance of privacy (p < 0.001); observance of privacy (p < 0.001); importance of interaction between nurses and patients (p = 0.019); and the observance of interaction between nurses and patients (p < 0.001). Attention to adolescents’ views about dignity can help nurses to improve quality of care for this group. (shrink)

Introduction: Maintaining dignity is one of patients is one of the main ethical responsibilities of caregivers. However, in many cases, the dignity of patients, especially autistic teenagers is not maintained. The extent to which dignity needs are met for this group within the Iranian care system is difficult to determine as dignity is an abstract concept, and there are few related research studies reported. Objectives: The objective of this study is to find out caregivers perspectives on dignity in teenagers with (...) autistic spectrum disorder. Research design: This study uses a qualitative research design. The data were collected through individual, semi-structured interviews and field notes developed during the interviews. In order to analyze the data, qualitative conventional content analysis was used. Participants and research context: In all, 16 professional caregivers for autistic teenagers working in public hospitals were recruited based on a targeted sampling method to reach data saturation from February 2016 to July 2017. Findings: The findings of this study were presented in three main themes, “privacy,” “respecting individual identity,” and “comprehensive support,” and 11 categories. Ethical consideration: This study’s protocol was approved by the Research Ethics Committee of medical universities located in Southeast of Iran and the required ethical principles were followed throughout. Discussion and conclusion: Based on the findings of this study from the perspective of caregivers, autistic teenagers need to be cared for and educated in a respectful environment where their privacy is maintained, their individual identities are respected, and they receive comprehensive familial, social, and financial support. These conditions would maintain the dignity of such teenagers and would result in appropriate behavioral outcomes. Therefore, it is suggested that a cultural, professional and institutional background in which all components of the autistic teenager’s dignity are protected and emphasized be provided. (shrink)

Farah Nayeri addresses the difficult questions plaguing the art world, from the bad habits of Old Masters, to the current grappling with identity politics. For centuries, art censorship has been a top-down phenomenon--kings, popes, and one-party states decided what was considered obscene, blasphemous, or politically deviant in art. Today, censorship can also happen from the bottom-up, thanks to calls to action from organizers and social media campaigns. Artists and artworks are routinely taken to task for their insensitivity. In this (...) new world order, artists, critics, philanthropists, galleries and museums alike are recalibrating their efforts to increase the visibility of marginalized voices and respond to the people's demands for better ethics in art. But what should we, the people, do with this newfound power? With exclusive interviews with Nan Goldin, Sam Durant, Faith Ringgold, and others, Nayeri tackles wide-ranging issues including sex, religion, gender, ethics, animal rights, and race. By asking and answering questions such as: Who gets to make art and who owns it? How do we correct the inequities of the past? What does authenticity, exploitation, and appropriation mean in art?, Takedown provides the necessary tools to navigate the art world"--Publisher's description. (shrink)

Background: Discrimination and injustice are big obstacles in nurses’ way to socialization and are among the major clinical challenges faced by nurses. Workplace discrimination is associated with such negative consequences as stress, fatigue, demoralization, loss of professional commitment, tension and conflicts at work, and resignation. A review of literature shows that not much research has been dedicated to workplace discrimination in nursing. Objective: This study aims to investigate nurses’ perception of workplace discrimination. Method: This cross-sectional study was conducted in the (...) hospitals affiliated with a university of medical sciences in the largest city in the south of Iran in 2019. The participants consisted of 597 nurses who were selected through stratified random sampling. Data were collected using a researcher-made workplace discrimination questionnaire and analyzed in SPSS v. 21. Findings: The mean of the nurses’ workplace discrimination scores was found to be 102.57 ± 14.5, which is considered as moderate. The nurses’ mean scores for the dimensions of vertical and horizontal discrimination (44.53 ± 6.8), consequences of discrimination (20.52 ± 5.55), and unfair promotion (12.38 ± 2.44) were moderate. As for the two other dimensions of workplace discrimination, namely, gender discrimination (14.41 ± 3.28) and cultural-organizational discrimination (11.88 ± 2.99), the participants’ mean scores were low. There was a significant relationship between the nurses’ workplace discrimination mean score on the one hand and their employment status (p = 0.016) and work experience (p = 0.002) on the other. However, the nurses’ workplace discrimination mean score was not found to correlate with their level of education (p = 0.65), marital status (p = 0.274), and gender (p = 0.479). Ethical consideration: This study has been approved by the ethics committee of the university. All the participants had signed the written informed consent form before participation. Conclusion: Hospital managers should take measures to reduce discrimination and establish organizational justice to raise nurses’ morale and improve the quality of their performance as caregivers. (shrink)

Who Gets Believed? is a groundbreaking book about persuasion and performance that asks unsettling questions about lies, truths, and the difference between being believed and being dismissed in situations spanning asylum interviews, emergency rooms, consulting jobs, and family life.

Bilinguals have been shown to perform worse than monolinguals in a variety of verbal tasks. This study investigated this bilingual verbal cost in a large-scale picture-naming study conducted in Spanish. We explored how individual characteristics of the participants and the linguistic properties of the words being spoken influence this performance cost. In particular, we focused on the contributions of lexical frequency and phonological similarity across translations. The naming performance of Spanish-Catalan bilinguals speaking in their dominant and non-dominant language was compared (...) to that of Spanish monolinguals. Single trial naming latencies were analyzed by means of linear mixed models accounting for individual effects at the participant and item level. While decreasing lexical frequency was shown to increase naming latencies in all groups, this variable by itself did not account for the bilingual cost. In turn, our results showed that the bilingual cost disappeared when naming words with high phonological similarity across translations. In short, our results show that frequency of use can play a role in the emergence of the bilingual cost, but that phonological similarity across translations should be regarded as one of the most important variables that determine the bilingual cost in speech production. Low phonological similarity across translations yields worse performance in bilinguals and promotes the bilingual cost in naming performance. The implications of our results for the effect of phonological similarity across translations within the bilingual speech production system are discussed. (shrink)

Background: In disaster situations, nurses may face new and unfamiliar ethical and legal challenges not common in their everyday practice. Research question/objectives/hypothesis: The aim of this study was to explore Iranian nurses’ experience of disaster response and their perception of the competencies required by nurses in this environment. Research design: This article discusses the findings of a descriptive study conducted in Iran in 2012. Participants and research context: This research was conducted in Iran in 2012. Participants included 35 nurses who (...) had experience in healthcare delivery following a disaster event in the past 10 years, either in a hospital or out-of-hospital context. Ethical considerations: This research study was approved by the Ethics Committee of the Isfahan University of Medical Sciences. Findings: From this study, five themes emerged as areas that nurses require competence in to work effectively in the disaster setting. This article focusses on one theme, the ethical and legal issues that arise during disaster response. Within the theme of ethical and legal issues, two sub-themes emerged. (1) Professional ethics explores professional responsibility of nurses as well as sense of ethical obligation. (2) Adherence to law refers to nurses’ familiarity with and observation of legal requirements. Discussion: This article adds to a growing pool of literature which explores the role of nurses in disasters. The findings of this study emphasize the need for nurses working in the disaster setting to be aware of professional responsibilities and familiar with legal requirements and the challenges related to observing ethical responsibilities. Conclusion: In highlighting these issues, this article may provide a useful starting point for the development of an educational framework for preparing nurses and other health professionals to work in the disaster setting. (shrink)

Background The ethical climate is an essential component of organizational climate or culture. The ethical climate is necessary for clinical practice in operating rooms. Objective This study aimed to compare the ethical climate from the perspective of operating room nursing students and operating room staff of hospitals affiliated with Mashhad University of Medical Sciences, Iran. Method This analytical study was performed on 95 operating room nursing students and 169 operating room staff of hospitals in Mashhad, Iran. The students were selected (...) through the census method and the staff were selected by using stratified random sampling. The data were collected via Olson’s Hospital Ethical Climate Survey and analyzed by using BMI SPSS version 21. Results The total mean scores of the ethical climate were 3.44 ± 0.45 and 3.32 ± 0.48 from students and staff’s perspectives, and the independent t-test showed no significant difference between them ( p 0.05). Furthermore, the results of the study indicated a significant difference in communication with physicians’ score between operating room staff (2.82 ± 0.49) and students’ views (3.25 ± 0.6) ( p < 0.05). Conclusion Although it is difficult to create a right ethical climate in operating rooms, but hospital managers should implement practical programs to improve the ethical climate of operating rooms and inter-professional teamwork. Besides, deans of faculties can provide ethical-based education for students, who can effectively create an ethical climate. (shrink)

Graphical AbstractBy now it is well known that the SARS-COV-2 virus can affect and harm various organs of the body. However, the exact mechanisms for this phenomenon are still unknown. In article 2000198 Fatemeh Aliabadi et al. hypothesize that the body's secretion of prostaglandin E2 (PGE2), a molecule that is involved in several inflammation and immunity pathways, may lead to a cytokine storm causing a variety of side effects.

Ziel dieser Untersuchung ist, Ursachen und Faktoren zu ermitteln, die in der Entstehung und Verstärkung von Bildungsungleichheit im iranischen Bildungssystem wirksam sind. Diese Forschung wurde gemäß einem qualitativen Paradigma unter Verwendung der Methode der “Grounded Theory” durchgeführt. Die Daten wurden von einer Fokusgruppe, bestehend aus 20 Teilnehmern, mithilfe der Methode des Tiefeninterviews erhoben. Die Teilnehmer wurden nach dem Prinzip der maximalen Streuung und unter Berücksichtigung des Sättigungspunkts durch eine gezielte Auswahl ausgewählt. Für die Datenanalyse wurde der interpretativ-absorptive Ansatz verwendet. Die (...) Ergebnisse der qualitativen Analyse zeigten, dass einerseits die Bildungsungleichheit im iranischen Bildungssystem von den sozialen und wirtschaftlichen Ungleichheiten in der Gesellschaft beeinflusst wird, und andererseits das Bildungssystem des Landes und die Struktur, die es regiert, Faktore für die Verstärkung und Ausweitung der Ungleichheiten sind. Nach den Forschungsergebnissen kann mit Sicherheit gesagt werden, dass in der gegenwärtigen Struktur des Bildungswesens der Hauptrahmen des Bildungssystems des Landes, einschließlich der Prinzipien, Ziele, Inhalte, Methoden, Erzieher, und Lernenden, jeweils auf eine bestimmte Art und Weise eine spezifische Rolle bei der Bildungsungleichheit und Ungerechtigkeit in der Gesellschaft spielen. (shrink)

This study was administrated to undergraduate students living in the various hostels of Universiti Sains Malaysia. The primary purpose of this study was to identify the most important factors that predict undergraduate students’ level of satisfaction with the student hostels they are living in. This paper also explored the difference in the satisfaction levels of students living in hostels within the campus and those living in hostels outside the campus. Based on literature review, it was hypothesized that there would be (...) a difference in the satisfaction level between these two groups of hostel residents due to the different characteristics that these hostels have. Additionally, this study investigated the most preferred hostels among students and identified the reasons for the preference. A sample population of 288 students (220 females; and 68 males) was involved in this study with 48.3% living in hostels inside the campus and 51.7% living in hostels located outside the main campus area. The result of the study suggests that satisfaction with fees, distance from university facilities, room safety, room size, hostel security, and hostel facilities are the most important factors which predict undergraduate students’ satisfaction with their hostel. There was also a significant difference in the satisfaction level between inside-campus and outside-campus hostels students. The most important factors that influenced that students satisfaction levels were distance from the university facilities, the exterior condition of the hostel, hostel population, satisfaction with transport, hostel security, room size, and room safety. The study also found that the most preferred hostel among the students was Cahaya Gemilang due to its strategic location, close distance to lecture halls and other main facilities in the campus and, good internet network connection. Keywords: satisfaction, hostels, predicting factors, undergraduate students. (shrink)

Approaches to induce tumor differentiation often result in manageable and therapy‐naïve cellular states in cancer cells. This transformation is achieved by activating pathways that drive tumor cells away from plasticity, a state that commonly correlates with enhanced aggression, metastasis and resistance to therapy. Here, we discuss signaling pathways, epigenetics and non‐coding RNAs as three main regulatory levels with the potential to drive tumor differentiation and hence as potential targets in differentiation therapy approaches. The success of an effective therapeutic regimen in (...) one cancer, however, does not necessarily sustain across cancer types; a phenomenon largely resulting from heterogeneity in the genetic and physiological landscapes of tumor types necessitating an approach designed for each cancer's unique genetic and phenotypic build‐up. (shrink)

Background The organizational climate in the operating room is special due to the specific conditions of the patient, and the ethical climate may affect moral distress of the operating room staff. Objective This study determined the relationship between ethical climate and moral distress from staff working in operating rooms of hospitals affiliated to Mashhad University of Medical Sciences. Method This analytical study was performed on 169 operating room staff in Mashhad, Iran. The operating room staff was selected using stratified random (...) sampling. The data were collected via Olson's Hospital Ethical Climate Survey and the Corley Moral Distress Scale and analyzed with IBM Statistical Package for the Social Sciences (SPSS) software version 21. Results The results showed no relationship between the ethical climate, the frequency, and intensity of moral distress of the operating room staff ( p > 0.05). In addition, the mean score of the ethical climate was 3.32 ± 0.48, indicating the average ethical climate in the operating room. The mean frequency and intensity of moral distress were 36.36 ± 11.68 and 48.8 ± 15.92, showing a moderate rate. There was a significant inverse relationship between the dimensions of ethical climate, the relationship with physicians, and the intensity of moral distress ( p <0.05). A significant relationship was found between the intensity of moral distress, the level of education, and field of study ( p <0.05). Conclusion The results of the current study showed that interventional programs should be implemented to reduce moral distress and improve the ethical climate in the operating room. (shrink)

In this paper we present a neighborhood semantics for Intuitionistic Propositional Logic (IPL). We show that for each Kripke model of the logic there is a pointwise equivalent neighborhood model and vice versa. In this way, we establish soundness and completeness of IPL with respect to the neighborhood semantics. The relation between neighborhood and topological semantics are also investigated. Moreover, the notions of bisimulation and n-bisimulation between neighborhood models of IPL are defined naturally and some of their basic properties are (...) proved. We also consider Basic Propositional Logic (BPL), a logic weaker than IPL introduced by Albert Visser, and introduce and study its neighborhood models in the same manner. (shrink)

BackgroundWhile neighborhood safety and stranger danger have been mostly canonized to play a part in parents’ physical activity avoidance, less is known about the impact of parental stress and perceived risk on children’s PA avoidance and consequently on children’s level of PA and wellbeing. Understanding the contributors to children’s wellbeing during pandemic disease is the first critical step in contributing to children’s health during epidemic diseases.MethodsThis study employed 276 healthy children, aged 10–12 years, and their parents. Data were collected in (...) October and November 2020, about 9 months after the local closing of schools due to the coronavirus disease 2019 pandemic. Parents and children answered a separate set of questions. Besides the demographic information, the parents responded to questions on their stress level, perceived risk of COVID-19, and PA avoidance for children. Children responded to questions on their PA and wellbeing in the last week. Data were analyzed using SmartPLS and IBM SPSS 22.ResultsThe result of the study supported the four directional research hypotheses of the sequential study model. As hypothesized, parents’ stress and perceived risk levels of COVID-19 negatively affected children’s PA. The PA level was shown to predict children’s wellbeing and mental health. Housing type, parents’ job security, number of siblings, number of members living together in-home, and history of death or hospitalization of relatives or family members due to COVID-19 were found to be associated with parents’ stress and children’s mental health.ConclusionThis study sheds light on parents’ role in children’s wellbeing and mental health during the COVID-19 pandemic. Parents with higher stress and high restrictive behaviors might put their children at risk of mental disorders in the end. (shrink)

In the contemporary era, thinkers abandoned the issue of the mind in a way that gives rise to the idea that it is essence or material, and addressed the issue of what are mental states, what are their characteristics? On the other hand, Islamic thinkers has always been concerned to the human soul. Fakhr Razi, a famous Muslim theologian, has significant opinions in the discussion of philosophical psychology. He considers the soul to be different from the body, and he has (...) studied a number of soul states and some of their characteristics. The current research deals with the question: what is the relationship between the states and qualities of the soul from Fakhr Razi's point of view and mentality in the contemporary philosophy of mind? In this search, some similarities between Fakhr Razi's opinions and contemporary mentality will be clarified; Emotional states such as pain and pleasure, and perceptual states from the point of view of Fakhr have certain characteristics such as the phenomenality and direct experience of these states for the soul. He has criticized Ibn Sina for not paying attention to these states in the definition of pleasure and pain. He also paid attention to science, which is one of the cognitive states, and it seems that by proposing the addition theory, he intended the consciousness for soul. (shrink)

Publication date: 11 June 2018 Source: Author: Fatemeh Nemati Sogolitappeh, Amjad Hedayat, Mehrdad Rezaee Arjmand, Mohamad Khaledian The purpose of the present study is to investigate the relationship between spiritual intelligence and emotional intelligence with resilience in undergraduate students. The population of the study included all students of Payam Noor University in Ghorveh during 2016-2017 academic years. According to the principles of statistical methodology for correlational studies, 100 students from different disciplines were selected as sample of the study using (...) simple random sampling method. In this research, King's Spiritual Intelligence Questionnaire, Bar-Ann 90-questions Emotional Intelligence Questionnaire, and Conner and Davison resilience questionnaire were used. Descriptive statistics and inferential statistics were used to analyze the data. The results of this study showed that there is a significant positive correlation between spiritual intelligence and emotional intelligence and resilience. Regression coefficients showed that spiritual intelligence and emotional intelligence predict 53.9% of the variation in resiliency. (shrink)

The outbreak of a new, potentially fatal virus, SARS‐COV‐2, which started in December 2019 in Wuhan, China, and since developed into a pandemic has stimulated research for an effective treatment and vaccine. For this research to be successful, it is necessary to understand the pathology of the virus. So far, we know that this virus can harm different organs of the body. Although the exact mechanisms are still unknown, this phenomenon may result from the body's secretion of prostaglandin E2 (PGE2), (...) which is involved in several inflammation and immunity pathways. Noticeably, the expression of this molecule can lead to a cytokine storm causing a variety of side effects. In this paper, we discuss those side effects in SARS‐COV‐2 infection separately to determine whether PGE2 is, indeed, an important causative factor. Lastly, we propose a mechanism by which PGE2 production increases in response to COVID‐19 disease and suggest the possible direct relation between PGE2 levels and the severity of this disease. Also see the video abstract here: https://youtu.be/SnPFAcjxxKw. (shrink)

Background: Despite their negative consequences, evidence shows that futile medical treatments are still being provided, particularly to terminally ill patients. Uncovering the reasons behind providing such treatments in different religious and sociocultural contexts can create a better understanding of medical futility and help manage it effectively. Research objectives: This study was undertaken to explore Iranian nurses’ and physicians’ perceptions of the reasons behind providing futile medical treatments. Research design: This was a qualitative exploratory study. Study data were gathered through conducting (...) in-depth semi-structured personal interviews and analyzed using the conventional content analysis method. Participants and research context: Twenty-one nurses and nine medical specialists were recruited purposively from four teaching hospitals affiliated to Tehran University of Medical Sciences. Ethical considerations: This study was approved by the Nursing and Midwifery Research Center and the Research Ethics Committee of Tehran University of Medical Sciences. All participants gave informed consent for the research and that their anonymity was preserved. Findings: The main theme of the study was “having an obligation to provide medical treatments despite knowing their futility.” This theme consisted of three main categories including patients’ and family members’ request for continuing life-sustaining treatments, healthcare professionals’ personal motives, and organizational atmosphere and structure. Discussion and conclusion: Different personal and organizational factors contribute to providing futile medical treatments. Promoting the structure and the function of hospital ethics committees, establishing and developing home care facilities, increasing the number of palliative care centers and hospices, and educating healthcare professionals, patients, and family members about the services and the benefits of such centers can facilitate making wise decisions about continuing or discontinuing treatments which have been labeled as futile. (shrink)

The problem of epistemic luck arises when a person has a true belief that is only true by luck. Before Gettier, it was believed that the element of justification would be sufficient for knowledge; but he showed that it is possible to have a justified true belief that is not an example of knowledge because of the intrusion of luck. Duncan Pritchard has examined epistemic luck in an extensive and detailed manner. He offers a modal account of luck based on (...) two elements: a possible-worlds analysis of counterfactual conditions and a significance condition for the factors that make the truth of the belief lucky. Pritchard argues for the superiority of this account to those that focus on whether the truth of the belief is “accidental” and on whether the believer has sufficient control over the belief. Epistemic luck may be “reflective” or “veritic”. Both undermine knowledge claims, although Pritchard gives the central role to veritic luck in his anti-luck epistemology, which is based on two elements: a safety principle and a condition to ensure that the cognitive faculties of the agent are not impaired. In this article, we will describe, analyze, and subsequently, evaluate the viewpoint of Pritchard. In addition to the critiques offered by others, ambiguities in his counterfactual account of luck and other components of his theory detract from his theory. (shrink)

Publication date: 16 April 2018 Source: Author: Amjad Hedayat, Fatemeh Nemati Sogolitappeh, Reza Shakeri, Mohamad Abasifard, Mohamad Khaledian One of the concerns of the organization and management experts is to identify effective factors on organization performance and finding solutions to improve organization performance. The present study was done to analyse the relationship between organizational commitment and job satisfaction in visiting lectures of Payam Nour University. Statistical population of this research includes visiting lectures of Ghorveh town who were teaching in (...) the academic year of 2016-2017. Sample size of 60 participants was selected by simple random sampling. To collect data, Meyer and Allen organizational commitment questionnaire and Field and Rothe job satisfaction questionnaire were used. The research method is correlation which is incorporated in the area of applied studies to analyse data, descriptive statistics, and inferential statistics were utilized. The findings show that there is positive and significant relationship between organizational commitment and job satisfaction. Regression coefficient shows that organizational commitment predicts 42.2 % of the job satisfaction changes. (shrink)

Research objectives Moral distress is a common phenomenon among nurses and can negatively affect their mental health and quality of the care. This study aimed to determine the effect of professional ethics workshop with virtual follow-up on the moral distress of nurses. Methods This experimental study was performed on 50 nurses in Ghaem Hospital, Mashhad, Iran. The intervention group received 8-hour professional ethics workshop and 4 weeks follow-up through social network. The moral distress was evaluated through the Moral Distress Scale-Revised (...) at the beginning of the study, two weeks after the workshop and at the end of follow-up. Data were analyzed using SPSS21 by descriptive and statistical analysis.This study approved by Mashhad university Medical Ethics Committee and publishing ethics were also observed. Results The changes in the mean value of the frequency of moral distress in the intervention group was not significant, while these changes were significant in the control group ( p < 0.001, df = 2, f = 26.41) and had an upward trend. About intensity changes in the intervention group were significant ( p < 0.01, df = 2, f = 8.52) and had a downward trend, while it was not significant in the control group. Changes in the mean value of level of moral distress in the intervention group were not significant, while these changes were significant in the control group ( p < 0.01, df = 1, f = 16.8). The mean value of moral distress level decreased in the intervention and increased in control group. Conclusion The level of moral distress was increased in the control group due to increase in its frequency. This could be due to awareness of nurses regarding the concept of moral distress which caused them to pay more attention to this issue. Professional ethics workshop did not have effect on the frequency of moral distress, while it reduced the intensity and level of moral distress. Moreover, follow-up through social network reduced the frequency, intensity and the level of moral distress among nurses. (shrink)

A model called the “semiotic ladder,” which consists of “consecutive semiotic squares,” is proposed in this paper, through which the meanings of the deep structure of a narrative can be depicted as fluid and dynamic. It shows the stages of producing meanings in the narrative, from beginning to end. To see this, several narratives in the epic and mythological genres are analyzed in order to discover their abstract and deep structural meanings, and to prove the dynamic nature of meaning in (...) the semiotic ladder. According to the analysis, the process of the semiotic ladder depicts the displacement and fluidity of narrative meanings using consecutive semiotic squares, and this pattern can be applied to and implemented in all narratives. Also, the semiotic ladder allows us to clearly observe the pattern of movement of the narrative subject schema in the path of accomplishing the object. (shrink)

Introduction: Dignified care is one of the moral responsibilities of professional caregivers. However, in many cases the dignity of hospitalized patients, especially women in the delivery room, is not maintained. Dignity is an abstract concept and there has been no previous research exploring the dignity of pregnant women in the delivery room in Iran. Objectives: The objective of this study is to define and explain the concept of dignity for pregnant women in the delivery room from the perspectives of professional (...) caregivers. Research design: This is qualitative research. The data were collected through in-depth semi-structured individual interviews. The conventional content analysis method was used to analyze the data. In qualitative content analysis, participant narrative is examined in-depth and sorted into categories and themes. Participants and research context: Potential participants who met the entrance criteria for this study were approached between July 2016 and February 2017. In all, 20 professional caregivers working in the delivery room setting within Iranian general hospitals were invited to participate in the study. The sampling was done through targeted sampling until saturation was achieved. Ethical considerations: The research ethics committee of the Shiraz University of Medical Sciences has approved the study’s protocol and all commonly recognized ethical principles were followed throughout the study. Findings: The findings of this study were presented in three main themes, including “privacy,” “respecting patients’ preferences,” and “comprehensive attention” and eight categories. Discussions and conclusion: Women in the delivery room need to be taken care of in an environment where healthcare staff promote the preservation of dignity through maintaining privacy, by providing attentive care and through ensuring that patient preferences regarding care and treatment are respected. In such an environment, the dignity of these women would be maintained and desirable outcomes achieved. (shrink)

A significant development for conducting research on patient rights has been made in Iran over the past decade. This study is conducted in order to review and analyze the previous studies that have been made, so far, concerning patient rights in Iran. This is a comprehensive review study conducted by searching the Iranian databases, Scientific Information Database, Iranian Research Institute for Information Science and Technology, Iran Medex and Google using the Persian equivalent of keywords for ‘awareness', ‘attitude’, and ‘patient rights'. (...) For pertinent Iranian papers published in English, scientific databases PubMed, and Google Scholar were searched using the keyword ‘patient rights' and ‘Iran’. A total of 41 Persian and five English articles were found for these keywords, only 26 of which fulfilled the objective of our study. The increasing number of papers published indicates that from 1999 onwards, this subject has begun to draw the attention of Iranian researchers in a progressive fashion and Iranian papers in English have also been compiled and published in international sources. (shrink)

Background Professional misconduct undermines safe and quality care; however, little is known about its nature and influential factors. Aim This study aimed to explain the factors influencing professional misconduct in nurses. Research Design This qualitative study was conducted using the conventional content analysis method. Participants and Research Context Data were collected using semi-structured interviews with 19 nurses working in the hospital selected through a purposeful method and analyzed by Graneheim and Lundman approach. Ethical Considerations The ethics committee of Tehran University (...) of Medical Sciences approved this study with the ethics code IR.TUMS.FNM.REC.1400.187. Informed consent was obtained from all participants. Participants were assured of confidentiality. Findings Factors influencing professional misconduct by nurses were categorized into three main categories: human factors (nurses’ professional characteristics, personal characteristics of nurses and patient/companion, patient’s clinical condition), procedural factors (procedural conditions, possibility of proving misconduct), and organizational factors (recruitment process, conditions of resources, managing misconduct, bureaucracy, and ward characteristics). Conclusion This study assists in explaining the factors influencing professional misconduct by nurses. Therefore this study’s results can help managers and planners develop interventions to prevent and correct factors that contribute to misconduct and strengthen factors that prevent misconduct in order to ensure quality and safe patient care. (shrink)

Publication date: 30 November 2016 Source: Author: Akram Sadat Hosseini, Esmaeil Zohdi Racism is a worldwide matter that is based on the physical characteristics of people's division into different categories on which some people become superior and some inferior. Racism and ethnicity are usually considered as the same concepts while in fact ethnicity is a sub-class of racism. In every nation, there are some ethnic groups with the same origin and similar customs that may or may not be judged (...) equally by the power-handler ethnic groups. An example of such country is Afghanistan which is severely an ethnic country. This study explores the social, cultural, and scientific investigations done on the people's races and ethnical characteristics by using Afghan types as examples. Racism is not the result of scientific observation, but it is due to the human differences that happened between 16th and 19th century when people began differentiating among themselves. This aspect of racism is well expressed by the American sociologist "Feagin". In his view, the natural superiority of some people over others is rejected. The novel The Kite Runner depicts the two major Afghan ethnical populations, Pashtun and Hazara, and their social, cultural, and religious conflicts. Accordingly, this article will try to examine the root of ethnic prejudices and oppression among the Afghan people in the novel and the reasons for their ethnic conducts are explained and analyzed based on the Feagin’s denial of human difference. Moreover, by providing some evidence it is proved that the biological difference is just some excuses for the powerful section to gain their egotistic goals. (shrink)

Background Equitable care is a fundamental value in the nursing profession. Healthcare workers have both a moral and professional duty to ensure that they do not discriminate. Aim This study aimed to explore how patients perceive equitable nursing care. Research design, participants, and research context This descriptive phenomenological qualitative research study used purposeful sampling to select 17 patients from various departments of a general hospital in southern Iran. The participants were then interviewed using a semi-structured in-depth interview format, which aimed (...) to delve into their experiences with equitable nursing care. The collected data were analyzed using Colaizzi's seven-step method and MAXQDA20 software. Ethical considerations Oral and written information about the study was provided before the participants gave their written consent. The transcribed interviews were de-identified. The study was approved by the Ethics Committee of Jiroft University of Medical Sciences. Findings The data analysis of the study identified three main themes and six subthemes that were related to the experiences of patients with equitable nursing care. The first theme, equitable care, encompassed subthemes such as nurses’ dedicated efforts to facilitate patient recovery and adherence to ethical behavior. The second theme, unconscious causes of inequitable nursing care, included subthemes such as unintentional discrimination stemming from organizational constraints and unconscious biases resulting from a lack of knowledge and skills. The third theme, discriminatory care, comprised subthemes such as deliberate discrimination based on personal traits and selective discrimination. Conclusion The study findings indicate that achieving equitable nursing care requires a multifaceted approach. This includes effective hospital management, organizational reforms, and regulatory enhancements. Additionally, it is crucial to pay close attention to the needs of patients, enhance nurses’ theoretical and practical skills in providing equitable care, fostering a culture of equality within healthcare settings, and consider the personality dimensions and moral characteristics of nurses. (shrink)

The aim of this study is to investigate the necessity of revising the Ethics Code of the Psychology and Counseling Organization of the Islamic Republic of Iran with respect to people’s rights and dignity and to avoid unfair discriminations toward sexual orientation and gender identity. It is said that confused diagnoses; wrong decision making; unethical practice; and the subsequent harm caused to lesbian, gay, bisexual, and transgender clients result from the lack of a clear code and relevant guidelines. In addition, (...) certain conditions in Iran lead professional psychologists and researchers to avoid researching sexual minorities and gender identity, which negatively impacts the Ethics Code of the PCOIRI. Iranian and Western researchers have identified four primary sources to which psychologists and counselors can refer when faced with ethical dilemmas: developmental psychology, professional ethics codes, philosophy of psychology literature, and available researches and compilations on professional ethics. Finally it is suggested that, when dealing with homosexual clients and the related ethical dilemmas, Iranian psychologists and counselors need clear and specific guidelines and a professional ethics code developed from more appropriate reference points than legal and religious sources. (shrink)

Studies have supported the effectiveness of the From Timid to a Tiger and Supportive Parenting for Anxious Childhood Emotions program in reducing childhood anxiety. This study is the first to compare the effectiveness of the two programs in the treatment of childhood anxiety disorder and reducing family accommodations levels. Parents of children aged 6 to 9 were randomly allocated to either FTTT or SPACE groups, and each attended ten online sessions following the manuals of the interventions. Throughout the study, 9 (...) participants dropped out, resulting in a total of 49 participants, and we performed statistical analyses based on data from these 49 participants. The assessment took place pre- and post-treatment and at a ten-week follow-up on parent-rated child anxiety and family accommodation measures. Analyses of variance and gain scores were conducted to examine the data. The results indicated that both treatments approaches produced significant reductions in outcome measures, and the post-treatment gains of both treatments were maintained at a ten-week follow-up, though when considering the mean differences and effect sizes across the assessment scores and between groups, overall, the FTTT was significantly more effective in reducing child anxiety scores and family accommodation levels. Our results demonstrated that FTTT significantly outperformed the SPACE program in reducing childhood anxiety problems and family accommodation levels. (shrink)

Vaccines are responsible for many global public health successes, such as the eradication of smallpox and significant reductions in other serious infections like diphtheria, pertussis, tetanus, polio and measles. However, mass vaccination has also been the subject of various ethical controversies for decades. Several factors need to be considered before any vaccine is deployed at national programme like the potential burden of disease in the country or region, the duration of the protection conferred, herd immunity in addition to individual protection, (...) vaccine-related risks, financing and the logistical feasibility of the large-scale vaccination. Moreover, several ethical dilemmas revolve around authority and mandates for vaccination, informed consent, benefits vs. risks, and disparities in access to vaccination. This review paper aims to elaborate the ethical issues involved in mass vaccination programme and present some additional challenges in the context of a resource-poor settings of public health in Bangladesh. (shrink)

Introduction: Midwives play an important role in maintaining and increasing women’s health and well-being. Training professional midwives is one of the main policies of any healthcare system. Since the number of complaints against midwives has increased recently, this study was conducted to explore the perspectives of midwives regarding patients’ complaint to authorities and their impacts on the profession of midwifery. Methods: Being conducted in 2013, this qualitative study was the first of its type in Iran. Data were collected through in-depth (...) semi-structured interviews with 14 midwives working in different cities across the country. The participants were selected using a purposive sampling method. Interviews were transcribed verbatim and analyzed following a qualitative content analysis approach. Written text was then coded, and themes were extracted from the data. Ethical considerations: The study was conducted with midwives’ free informed consent and was approved by Ethics Committee of Tehran University of Medical Sciences. Findings: By analyzing the data, four main themes regarding the impact of complaint on midwifery profession were developed. These included the following: “dissatisfied of midwifery, professional deviation, obsession with work, and weakening of the professional status.” Conclusion: The experience of patients’ complaint to legal authorities against midwives was described, by participants, as a painful experience. Lack of midwives’ knowledge about professional rules and litigation process created many problems for them and could negatively affect their practice and the society’s attitude toward midwifery. Thus, we suggest that in order to prevent such problems, midwives and midwifery students should be educated regarding factors that have the potential to create such problems and also prevention strategies. (shrink)