This article examines the involvement of neonatal nurses in ethical issues, achieved through a survey of Australian neonatal nurses. The aim was to discover if nurses were involved in ethical decisions, to examine various categories of neonates and the concerns that nurses felt about them, and to determine the extent to which nurses saw themselves as advocates. A response rate of 65% was achieved from nurses in two states who worked in intensive care and special care nurseries. The findings show (...) that nurses were more likely to be involved in clinical decision making than in ethical decision making, showed the greatest concern for infants who had an uncertain prognosis, and saw themselves as advocates for their patients. The issues surrounding these findings are examined. (shrink)

One barrier to optimal pain management in the neonatal intensive care unit (NICU) is how the healthcare community perceives, and therefore manages, neonatal pain. In this paper, we emphasise that healthcare professionals not only have a professional obligation to care for neonates in the NICU, but that these patients are intrinsically worthy of care. We discuss the conditions that make neonates worthy recipients of pain management by highlighting how neonates are (1) vulnerable to pain and harm, and (2) completely dependent (...) on others for pain management. We argue for a relational account of ethical decision-making in the NICU by demonstrating how an increase in vulnerability and dependence may be experienced by the healthcare community and the neonate’s family. Finally, an ethical framework for decisions around neonatal pain management is proposed, focussing on surrogate decision-making and the importance of compassionate action through both a reflective and an affective empathy. As empathy can be highly motivating against pain, we propose that, in addition to educational programs that raise awareness and knowledge of neonatal pain and pain management, healthcare professionals must cultivate empathy in a collective manner, where all members of the NICU team, including parents, are compassionate decision-makers. (shrink)

_BMC Medical Ethics_ is an open access journal publishing original peer-reviewed research articles in relation to the ethical aspects of biomedical research and clinical practice, including professional choices and conduct, medical technologies, healthcare systems and health policies. _BMC __Medical Ethics _is part of the _BMC_ series which publishes subject-specific journals focused on the needs of individual research communities across all areas of biology and medicine. We do not make editorial decisions on the basis of the interest of a study or (...) its likely impact. Studies must be scientifically valid; for research articles this includes a scientifically sound research question, the use of suitable methods and analysis, and following community-agreed standards relevant to the research field. Specific criteria for other article types can be found in the submission guidelines. _BMC series - open, inclusive and trusted_. (shrink)

We consider the quantifier hierarchy of Takahashi [1972] and show how it gives rise to reflection theorems for some large cardinals in ZF, a new natural subtheory of Zermelo's set theory, a potentially useful new reduction of the consistency problem for Quine's NF, and a sharpening of another reduction of this problem due to Boffa.

A theory of two-sided containers, denoted ZF2, is introduced. This theory is then shown to be synonymous to ZF in the sense of Visser (2006), via an interpretation involving Quine pairs. Several subtheories of ZF2, and their relationships with ZF, are also examined. We include a short discussion of permutation models (in the sense of Rieger–Bernays) over ZF2. We close with highlighting some areas for future research, mostly motivated by the need to understand non-wellfounded games.

Despite its focus on consent the new Human Tissue Act 2004 allows for testing without consent where a relative could benefitIn recognition of the fact that genetic test results in people can have implications for close relatives, the new Human Tissue Act 2004 allows for a direction to access a person’s tissue so that testing can be carried out for the benefit of a relative, without the consent of that person. Clinical practice governed by common law and statute, before this (...) act, acknowledged that the disclosure, without consent, of the results of a genetic test, is ethically permissible in extreme situations for the benefit of a relative. New testing for the benefit of a relative without donor consent challenges the principle that informed or adequate consent should be obtained before a genetic test with considerable predictive powers is carried out. The debate surrounding the analogous situation of HIV testing concluded that in very rare cases, disclosure of an HIV result without consent may be justified, but testing without consent is a professional misconduct. This part of the legislation is controversial and deserves further debate. The Human Tissue Authority should take measures to limit the potential harm that can be caused by this provision.IntroductionAfter much debate, the new Human Tissue Act 2004 was passed by parliament in November 2004. Implementation of this act may be staggered, but it will be fully operational in May 2006. This act has several provisions that have implications in clinical practice for the use of stored tissue or samples containing cells. These provisions allow the Human Tissue Authority to permit access to human tissue for the purpose of obtaining scientific or medical information about a person for the benefit of another family member, without the consent of the donor . …. (shrink)

Let M be a countable recursively saturated model of Th(), and let GAut(M), considered as a topological group. We examine connections between initial segments of M and subgroups of G. In particular, for each of the following classes of subgroups HG, we give characterizations of the class of terms of the topological group structure of H as a subgroup of G. (a) for some (b) for some (c) for some (d) for some (Here, M(a) denotes the smallest M containing a, (...) , , and .). (shrink)

Dynamic Consent is both a model and a specific web-based tool that enables clear, granular communication and recording of participant consent choices over time. The DC model enables individuals to know and to decide how personal research information is being used and provides a way in which to exercise legal rights provided in privacy and data protection law. The DC tool is flexible and responsive, enabling legal and ethical requirements in research data sharing to be met and for online health (...) information to be maintained. DC has been used in rare diseases and genomics, to enable people to control and express their preferences regarding their own data. However, DC has never been explored in relationship to historical collections of bioscientific and genetic heritage or to contexts involving Aboriginal and Torres Strait Islander people.In response to the growing interest by First Peoples throughout Australia in genetic and genomic research, and the increasing number of invitations from researchers to participate in community health and wellbeing projects, this article examines the legal and ethical attributes and challenges of DC in these contexts. It also explores opportunities for including First Peoples' cultural perspectives, governance, and leadership as a method for defining DC on cultural terms that engage best practice research and data analysis as well as respect for meaningful and longitudinal individual and family participation. (shrink)

Objective Futile treatment, which by definition cannot benefit a patient, is undesirable. This research investigated why doctors believe that treatment that they consider to be futile is sometimes provided at the end of a patient9s life. Design Semistructured in-depth interviews. Setting Three large tertiary public hospitals in Brisbane, Australia. Participants 96 doctors from emergency, intensive care, palliative care, oncology, renal medicine, internal medicine, respiratory medicine, surgery, cardiology, geriatric medicine and medical administration departments. Participants were recruited using purposive maximum variation sampling. (...) Results Doctors attributed the provision of futile treatment to a wide range of inter-related factors. One was the characteristics of treating doctors, including their orientation towards curative treatment, discomfort or inexperience with death and dying, concerns about legal risk and poor communication skills. Second, the attributes of the patient and family, including their requests or demands for further treatment, prognostic uncertainty and lack of information about patient wishes. Third, there were hospital factors including a high degree of specialisation, the availability of routine tests and interventions, and organisational barriers to diverting a patient from a curative to a palliative pathway. Doctors nominated family or patient request and doctors being locked into a curative role as the _main_ reasons for futile care. Conclusions Doctors believe that a range of factors contribute to the provision of futile treatment. A combination of strategies is necessary to reduce futile treatment, including better training for doctors who treat patients at the end of life, educating the community about the limits of medicine and the need to plan for death and dying, and structural reform at the hospital level. (shrink)

Indigenous people (IP) have faced multiple difficulties in education. Indigenous students often do worse academically than non-indigenous student peers. These stated the low enrollment rates showed a dropout rate, absenteeism, repetition rates, literacy rate, and thus the educational outcomes, with retention and completion being two significant issues. Further, this study explores the lived experiences and challenges faced by indigenous high school students amidst the new normal education. Employing the Interpretative Phenomenological Analysis, the findings of this study were: (1) The reason (...) why IP learners were not satisfied with their performance is that they cannot understand some of the lessons due to the language barrier. (2) IP learners are committed to finishing their studies, however, some of the students lack resources for studying, like gadgets for researching, and they do not have cell phones. And the other students may have gadgets or cellphones, but their internet connection is low or not accessible in some places at their location. (shrink)

Expanded and up-to-date-the ultimate guide that explores meaning and philosophy of all six seasons of Lost Lost is more than just a popular television show; it's a complex examination of meaningful philosophical questions. What does good versus evil mean on the island? Is it a coincidence that characters John Locke and Desmond David Hume are named after actual philosophers? What is the ethics of responsibility for Jack? An action-adventure story with more than a touch of the metaphysical, Lost forces viewers (...) to ask difficult questions of themselves just as the story asks difficult questions of its characters. Ultimate Lost and Philosophy helps you explore the deeper meaning and philosophical questions hidden within every complex twist and turn in the historic show's entire six-season run. Includes every season of Lost, including 2010's final, highly anticipated season Connects events on the show to core philosophical issues such as truth, identity, and morality Explores a host of intriguing topics such as time travel, freedom, love, and loss For fans of Lost who are interested in what the show reveals about ourselves and the human condition, Ultimate Lost and Philosophy is an entertaining, informative, and enlightening resource. (shrink)

The first observations of dislocations by TEM were published in 1956. Since then the technique has been developed into an indispensable tool for the materials scientist, not only for the characterization of the extended defect structure of materials, but also for the elucidation of the mechanisms controlling their properties. To mark the 50th anniversary of the original work, this Special Issue consists of reprints of the three original papers and some 22 current state-of-the-art articles, which provide a snapshot of the (...) tremendous power and versatility of the technique at the present time. It is also hoped that this collection of papers from different areas of application and including different techniques might stimulate some cross-fertilization. In this introduction, we comment briefly on the context in which the original work was performed, trace some of the important developments that have taken place in the intervening period and identify some of the outstanding problems. (shrink)

The language of “participant-driven research,” “crowdsourcing” and “citizen science” is increasingly being used to encourage the public to become involved in research ventures as both subjects and scientists....

The participants in the present study had to make speeded elevation discrimination responses to visual targets presented to the left or right of central fixation following the presentation of a task-irrelevant auditory cue on either the same or opposite side. In Experiment 1, the cues were presented from in front of the participants (from the same azimuthal positions as the visual targets). A standard crossmodal exogenous spatial cuing effect was observed, with participants responding significantly faster in the elevation discrimination task (...) to visual targets when both the auditory cues and the visual targets were presented on the same side. Experiment 2 replicated the exogenous spatial cuing effect for frontal visual targets following both front and rear auditory cues. The results of Experiment 3 demonstrated that the participants had little difficulty in correctly discriminating the location from which the sounds were presented. Thus, taken together, the results of the three experiments reported here demonstrate that the exact co-location of auditory cues and visual targets is not necessary to attract spatial attention. Implications of these results for the design of real-world warning signals are discussed. (shrink)

The sounds that result from our movement and that mark the outcome of our actions typically convey useful information concerning the state of our body and its movement, as well as providing pertinent information about the stimuli with which we are interacting. Here we review the rapidly growing literature investigating the influence of non-veridical auditory cues (i.e., inaccurate in terms of their context, timing, and/or spectral distribution) on multisensory body and action perception, and on motor behavior. Inaccurate auditory cues provide (...) a unique opportunity to study cross-modal processes: the ability to detect the impact of each sense when they provide a slightly different message is greater. Additionally, given that similar cross-modal processes likely occur regardless of the accuracy or inaccuracy of sensory input, studying incongruent interactions are likely to also help us predict interactions between congruent inputs. The available research convincingly demonstrates that perceptions of the body, of movement, and of surface contact features (e.g., roughness) are influenced by the addition of non-veridical auditory cues. Moreover, auditory cues impact both motor behavior and emotional valence, the latter showing that sounds that are highly incongruent with the performed movement induce feelings of unpleasantness (perhaps associated with lower processing fluency). Such findings are relevant to the design of auditory cues associated with product interaction, and the use of auditory cues in sport performance and therapeutic situations given the impact on motor behavior. (shrink)

The covert administration of medication occurs with incapacitated patients without their knowledge, involving some form of deliberate deception in disguising or hiding the medication. Covert medication in food is a relatively common practice globally, including in institutional and homecare contexts. Until recently, it has received little attention in the bioethics literature, and there are few laws or rules governing the practice. In this paper, we discuss significant, but often overlooked, ethical issues related to covert medication in food. We emphasise the (...) variety of ways in which eating has ethical importance, highlighting what is at risk if covert administration of medication in food is discovered. For example, losing trust in feeders and food due to covert medication may risk important opportunities for identity maintenance in contexts where identity is already unstable. Since therapeutic relationships may be jeopardised by a patient’s discovery that caregivers had secretly put medications in their food, this practice can result in an ongoing deception loop. While there may be circumstances in which covert medication is ethically justified, given a lack of suitable alternatives, we argue that in any particular case this practice should be continually re-evaluated in light of the building moral costs to the relational agent over time. (shrink)

It is one thing to read about the methodology and methods of Heideggerian hermeneutic phenomenological research, the ontic description. It is quite another thing to be faced with an interview transcript. This article draws on a study that asked doctoral students about their experience of doing such research. How did they become “phenomenological/hermeneutic” in their thinking and writing? What helped them to find their way? We offer this article as a means of letting others learn from our own experiences. We (...) support our insights with the writings of Heidegger and Gadamer to show the methodological congruence that is essential to Heideggerian phenomenological hermeneutic research. (shrink)

Heidegger’s philosophy is a significant contribution to understanding the meaning of lived experience. Recognizing this, nurses and other health professionals have taken on the research approach of Heideggerian hermeneutic phenomenology. This requires reading the writing of Heidegger. Philosophers themselves acknowledge this writing is dense, difficult to grasp, uses language for which there is no easy translation, and leaves the reader with more questions than answers. Drawing on commentary from philosophers who seek to read Heidegger and from a research study which (...) interviewed doctoral students who were “reading Heidegger,” we seek to show the nature of the experience of pursuing such a challenging quest. (shrink)

The precarious rights of senior citizens, especially those who are highly educated and who are expected to counsel and guide the younger generations, has stimulated the creation internationally of advocacy associations and opinion leader groups. The strength of these groups, however, varies from country to country. In some countries, they are supported and are the focus of intense interest; in others, they are practically ignored. For this is reason we believe that the creation of a network of all these associations (...) is essential. The proposed network would act as a support for the already-existing policies of the United Nations’ High Commission for Human Rights, of independent experts, and of the Global Alliance for the Rights of Older People. All three have long ago recommended the creation of a recognized instrument for uniting presently scattered efforts. The proposed network, therefore, will seek to promote the international exchange of relevant expertise, and it will reinforce the commitments and actions that single countries are currently taking to meet these objectives. For example, informative public events can be organised to promote particular support initiatives and to provide an opportunity for new members of the network to be presented. The network will promote health for senior citizens, disease prevention, senior mobility, safe free time for seniors, alimentary education, protection against new risks and dangers, as well as equity in the services necessary for seniors to adopt new information and communication technologies. In the case of retired academic members, the network will promote equality with respect to continuing use of digital technologies (particularly email), continuing access to research libraries, and the guaranteed ability for seniors to fund their own research programs and to deliver free seminars. (shrink)

Nos últimos anos verifica-se uma divergência gradual no discurso sobre a sociedade da informação adotado pelos Estados Unidos e por outros países. Essa divergência está presente, por exemplo, nos diferentes resultados dos discursos no Brasil e nos Estados Unidos. Os Estados Unidos implementaram discurso, formas de financiamento e programas voltados para o acesso e atrelados às políticas de treinamento focadas na competência profissional. O Brasil desenvolveu um discurso mais complexo sobre o lugar da inclusão digital no contexto da inclusão social, (...) com debates relativos a competências profissionais, cidadania e necessidade de investimento na educação básica. No Brasil e nos Estados Unidos, os discursos e a respostas são diferentes em vários aspectos centrais, o que inclui o foco sobre raça e saúde. (shrink)

This study articulates the relationship between conceptualisations of time and the accounts of good care in an acute setting. Neoliberal healthcare services, with their focus on efficiencies, predominantly calculate quality care based on time‐on‐the‐clock workforce management planning systems. However, the ways staff conceptualise and then relate to diverse meanings of time have implications for good care and for staff morale. This phenomenological study was undertaken in acute medical–surgical wards, investigating the contextual, temporal nature of care embedded in human relations. The (...) study interviews involved 17 participants: 11 staff, 3 previous patients and 3 family members. Data were analysed iteratively to surface the phenomenality of temporality and good care. The following constituents of the data set are explored that together illustrate the relationship between the conceptualisations of time and the accounts of good care in an acute setting: patient time as a relational journey; patient time, sovereign time and time ethics and time, teamwork and flow. The findings are clinically significant because they offer a contrasting narrative about the relationship between time and care quality. The experiences of giving and receiving good care are indivisible from how temporality is experienced and the social relations within which care is embedded. Healthcare staff experience temporality differently from patients and families, a point that healthcare participants in this study appeared to comprehend and accommodate. For all parties involved in providing care or being the recipient of care, however, the capacity to be present was valued as a humanising ethic of care. Our study reinforces the importance of not creating presumptive binaries about which temporal structures are more or less humanising—there is a place for a fast‐paced tempo, which can be experienced as being in the flow of human relations with one's team and on behalf of patients. (shrink)

_Introduction:_ Clinically relevant information can go uncaptured in the conventional scoring of a verbal fluency test. We hypothesize that characterizing the temporal aspects of the response through a set of time related measures will be useful in distinguishing those with MCI from cognitively intact controls. _Methods:_ Audio recordings of an animal fluency test administered to 70 demographically matched older adults (mean age 90.4 years), 28 with mild cognitive impairment (MCI) and 42 cognitively intact (CI) were professionally transcribed and fed into (...) an automatic speech recognition (ASR) system to estimate the start time of each recalled word in the response. Next, we semantically cluster participant generated animal names and through a novel set of time-based measures, we characterize the semantic search strategy of subjects in retrieving words from animal name clusters. This set of time-based features along with standard count-based features (e.g., number of correctly retrieved animal names) were then used in a machine learning algorithm trained for distinguishing those with MCI from CI controls. _Results:_ The combination of both count-based and time-based features, automatically derived from the test response, achieved 77% on AUC-ROC of the support vector machine (SVM) classifier, outperforming the model trained only on the raw test score (AUC, 65%), and well above the chance model (AUC, 50%). _Conclusion:_ This approach supports the value of introducing time-based measures to the assessment of verbal fluency in the context of this generative task differentiating subjects with MCI from those with intact cognition. (shrink)

The reality-virtuality continuum encompasses a multitude of objects, events and environments ranging from real-world multisensory inputs to interactive multisensory virtual simulators, in which sensory integration can involve very different combinations of both physical and digital inputs. These different ways of stimulating the senses can affect the consumer’s consciousness, potentially altering their judgements and behaviours. In this perspective paper, we explore how technologies such as Augmented Reality and Virtual Reality can, by generating and modifying the human sensorium, act on consumer consciousness. (...) We discuss the potential impact of this altered consciousness for consumer behaviour while, at the same time, considering how it may pave the way for further research. (shrink)

BackgroundInnovations in technology have contributed to rapid changes in the way that modern biomedical research is carried out. Researchers are increasingly required to endorse adaptive and flexible approaches to accommodate these innovations and comply with ethical, legal and regulatory requirements. This paper explores how Dynamic Consent may provide solutions to address challenges encountered when researchers invite individuals to participate in research and follow them up over time in a continuously changing environment.MethodsAn interdisciplinary workshop jointly organised by the University of Oxford (...) and the COST Action CHIP ME gathered clinicians, researchers, ethicists, lawyers, research participants and patient representatives to discuss experiences of using Dynamic Consent, and how such use may facilitate the conduct of specific research tasks. The data collected during the workshop were analysed using a content analysis approach.ResultsDynamic Consent can provide practical, sustainable and future-proof solutions to challenges related to participant recruitment, the attainment of informed consent, participant retention and consent management, and may bring economic efficiencies.ConclusionsDynamic Consent offers opportunities for ongoing communication between researchers and research participants that can positively impact research. Dynamic Consent supports inter-sector, cross-border approaches and large scale data-sharing. Whilst it is relatively easy to set up and maintain, its implementation will require that researchers re-consider their relationship with research participants and adopt new procedures. (shrink)

The study aimed to investigate the influence of different types of acoustic stimulus (classical vs. rock music) on the growth of bok choy (Brassica rapa) plants. Three separate groups of bok choy plants were exposed to classical music, rock music, or else no music, during growth and development and the influence on yield was observed. The results reveal that those plants exposed to classical music exhibited significant differences in shoot characteristics with the highest total fresh weight, shoot fresh weight, and (...) mean leaf numbers. Meanwhile, those plants exposed to rock music demonstrated values that were the lowest across all plant parameters. Plants treated to classical music had the lowest root length but the highest root volume, indicating that the roots were significantly stouter and more compact as compared to those plants treated to rock music and no music. This study therefore serves as a future reference for the use of music in plant growth. (shrink)

Pediatric biobanking is considered important for generating biomedical knowledge and improving health care. However, the inclusion of children’s samples in biobanks involves specific ethical issues. One of the main concerns is how to appropriately engage children in the consent procedure. We suggest that children should be involved through a personalized assent procedure, which means that both the content and the process of assent are adjusted to the individual child. In this paper we provide guidance on how to put personalized assent (...) into pediatric biobanking practice and consider both the content and process of personalized assent. In the discussion we argue that the assent procedure itself is formative. Investing in the procedure should be a requirement for pediatric biobank research. Although personalized assent will require certain efforts, the pediatric community must be aware of its importance. The investment and trust earned can result in ongoing engagement, important longitudinal information, and stability in/for the research infrastructure, as well as increased knowledge among its participants about research activity. Implementing personalized assent will both respect the child and support biobank research. (shrink)

Biobanks are increasingly being created specifically for research purposes. Concomitantly, we are seeing significant and evolving shifts in research ethics in relation to biobanking. Three discrete shifts are identified in this article. The first extends the ethical focus beyond the protection of human subjects to the promotion of broader community benefits of research utilizing biobanked resources, and an expectation that these benefits will be shared. The second involves the evolution of the traditional consent paradigm for future research uses of biobanks (...) resources that are not in contemplation at the time of donation. The third involves a move away from single project management to more dynamic governance accountability to research participants and the public. These shifts may take different local and institutional forms but share common recognizable elements. (shrink)