Background: Moral distress is a growing problem for healthcare professionals that may lead to dissatisfaction, resignation, or occupational burnout if left unattended, and nurses experience different levels of this phenomenon. Objectives: This study aims to investigate the factor structure of the Persian version of the Moral Distress Scale–Revised in intensive care and general nurses. Research design: This methodological research was conducted with 771 nurses from eight hospitals in the Mazandaran Province of Iran in 2017. Participants completed the Moral Distress Scale–Revised, (...) data collected, and factor structure assessed using the construct, convergent, and divergent validity methods. The reliability of the scale was assessed using internal consistency (Cronbach’s alpha, Theta, and McDonald’s omega coefficients) and construct reliability. Ethical considerations: This study was approved by the Ethics Committee of Mazandaran University of Medical Sciences. Findings: The exploratory factor analysis ( N = 380) showed that the Moral Distress Scale–Revised has five factors: lack of professional competence at work, ignoring ethical issues and patient conditions, futile care, carrying out the physician’s orders without question and unsafe care, and providing care under personal and organizational pressures, which explained 56.62% of the overall variance. The confirmatory factor analysis ( N = 391) supported the five-factor solution and the second-order latent factor model. The first-order model did not show a favorable convergent and divergent validity. Ultimately, the Moral Distress Scale–Revised was found to have a favorable internal consistency and construct reliability. Discussion and conclusion: The Moral Distress Scale–Revised was found to be a multidimensional construct. The data obtained confirmed the hypothesis of the factor structure model with a latent second-order variable. Since the convergent and divergent validity of the scale were not confirmed in this study, further assessment is necessary in future studies. (shrink)

Physicians try hard to alleviate mental and physical ailments of their patients. Thus, they are heavily burdened by observing ethics and staying well-informed while improving health of their patients. A major ethical concern or dilemma in medication is that some physicians know their behavior is unethical, yet act against their moral compass. This study develops models of theory–practice gap, offering optimal solutions for the gap. These solutions would enhance self-motivation or remove external obstacles to stimulate ethical practices in medicine. The (...) Constructivist Grounded Theory Methodology is applied here where the participants and the main researcher mutually interacted with each other. Data collection was performed through qualitative methods including observation and semi-structured interviews with 21 physicians and medical students. Initial and focused coding was done, from which principal concepts were later extracted. MAXQDA software was used for analyzing data. Analysis of twelve major concepts in the study resulted in two factors and solution groups, from which four general notions influencing the ethical theory and practice gap in medicine were extracted: (1) providing effective education to change attitude and behavior; (2) considering motivational and emotional factors; (3) reconstructing regulations and processes to facilitate ethical practice; (4) conducting comprehensive and systematic studies. The existing medical educational system needs to be reconsidered to add to individual internal motivation, including optimizing persuasion strategies, maximizing participation of students, adhering to virtuous ethical theories, and fostering emotions. Additionally, regulations and processes can be reconstructed to remove practical obstacles and promote ethical practice with insignificant damages to individual self-motivation. (shrink)

We examined the current field identity of Islamic banks and its evolution. We conducted interviews with 44 Sharia (Islamic law) scholars and related professionals in the fields of Islamic and conventional banking, representing nine jurisdictions. We found that Islamic banks are still hybrid organizations belonging to two equally powerful fields of Islamic law (Sharia) and conventional banking. Consequently, Islamic banks abide by two completely different institutional logics. The hybrid identity of Islamic banks resultantly became static due to institutional pressures exerted (...) by both root fields. We discuss how hybrid fields evolve focusing on the conditions that prevent hybrid field identities from becoming independent. We also contribute to the literature on elastic hybrid identity of organizations by theorizing an elastic fatigue model. Finally, we suggest some practical motions to boost the static hybrid identity of Islamic banks and transform it to an elastic one. (shrink)

New Zealand’s curriculum, in terms of its approach to technological literacy, attempts to deliver a sound, philosophy-­based understanding of the nature of technology. The curriculum’s main authors claim that it conforms well to Mitcham’s (2014) categorization of different aspects of technology’s nature. Nevertheless, taking advantage of the existing literature of the philosophy of technology, this paper will reveal that the intended urriculum, though an admirable approach, still has a number of points needing improvement, and there are also certain gaps to (...) be bridged in the claimed conformity. This analysis primarily makes use of the method initiated by Nia and De Vries (2016a), based upon Mitcham’s suggested framework and other philosophers’ opinions as to the nature and various features of technology. (shrink)

This paper is motivated by the observation that Southern governments start to take responsibility for a more sustainable production of agricultural commodities as a response to earlier private initiatives by businesses and non-governmental organizations. Indonesia is one of the leading countries in this respect, with new public sustainability regulations on coffee, cocoa and palm oil. Based on the concept of governance capacity, the paper develops an evaluation tool to answer the question whether the new public regulation on sustainable palm oil (...) may become a viable alternative to private regulation. ISPO embraces a tremendous governance challenge as thousands of companies and millions of smallholder farmers are expected to participate. It is concluded that, although ISPO has initiated a process of change, it has not yet developed its full potential. The main reason regards ISPO’s rather loose problem definition, weak authority of the implementing organization, and the fact that the reliability of ISPO is still too low to convince of the global market. ISPO may therefore face difficulties in meeting its own targets and solving palm-oil related problems, such as deforestation, biodiversity loss, greenhouse gas emissions, and social conflicts between big plantations and local communities. The main governance challenge regards combining a more authoritative implementation mechanism with a convincing balance between sustainability objectives and economic interests of the sector. (shrink)

:Many teaching hospitals in the United States were founded on philanthropic principles and aimed to aid the urban poor and underserved. However, as times have changed, there has been a divide created between the urban poor and teaching hospitals. There is a plethora of reasons why this is the case. This paper will specifically focus on the histories of ten hospitals and medical schools and the effect that white flight, segregation, elitism, and marginalization had on healthcare institutions all over the (...) United States. It will call for a reexamination of the values of Ivy League and Ivy Plus teaching hospitals and medical schools and for them to take an intentional look into their communities. (shrink)

The aim of this research is to examine association between intercultural sensitivity with job motivation in PT. Staedtler Indonesia. Participant in this study (N = 55) were employed as a staff at PT Staedtler Indonesia a years at least. Questionnaire of intercultural sensitivity and job motivation was used to collect the data. Data was analyzed use Pearson product Moment in SPSS 16.00. The result shows that rxy (55) = 0,282 and p = 0,037 < 0,05, means that there are a (...) positive association between intercultural sensitivity and job motivation. If the workers have a high intercultural sensitivity they also have a high job motivation. Reverse. . (shrink)

Engineering, as a complex and multidimensional practice of technology development, has long been a source of ethical concerns. These concerns have been approached from various perspectives. There are ongoing debates in the literature of the philosophy of engineering/technology about how to organize an optimized view of the values entailed in technology development processes. However, these debates deliver little in the way of a concrete rationale or framework that could comprehensively describe different types of engineering values and their multi-aspect interrelations in (...) real engineering practices. Approaching engineering values from a meaning-based perspective, as in this paper, can be a reliable method of tackling such a controversial problem. This paper therefore proposes that technology development be considered a systemic normative practice and attempts to provide a comprehensive view of various built-in values, their different origins and features, and a way of prioritizing them in real engineering processes. Studying two cases of the Zayandeh Rood Dam and the Abbasi Dam will lead to practical insights into how to understand norms in technology development and incorporate them into engineering practice. (shrink)

The technological literacy of students has recently become one of the primary goals of education in countries such as the USA, England, New Zealand, Australia, and so forth. However the question here is whether these educations - their long-term policy documents as well as the standards they provide in particular - address sufficient learning about the nature of technology. This seems to be an important concern that through taking advantage of the philosophy of technology (the arena which affords a bountiful (...) ground of various reflections on the nature of technology) is intended to be discussed throughout this study. In the first place, the paper presents a relevant framework based upon Mitcham's (1994) four-aspect account of technology, i.e., technology as objects, knowledge, activities, and volition. Then it categorizes the main relevant concepts and concerns put forward by many other philosophers of technology into this framework; this will yield a concrete model (tool) to analyze any intended standard such as the above mentioned ones. Afterwards, to show how this model works, the well-known case of the USA - Standards for Technological Literacy (ITEA, 2007) - will be used as an example for inspection; the results will disclose the points where the current American case needs to be modified. (shrink)

Hastings Center Report, Volume 52, Issue S1, Page S32-S34, March‐April 2022.

By the slant of their aims, presidential candidates rely on their own rhetorical arsenal to win the acquiescence of the public. Hedges and boosters, two subcategories of metadiscourse markers, are among the rhetorical tropes which assist politicians to increase or decrease commitment, blur or sharpen the boundaries between good and evil, and bolster or emasculate solidarity. Despite the many functions hedges and boosters can play in political discourse, studies that address these devices in relation to their persuasive effect in televised (...) presidential debates cross-linguistically are tremendously scant. To this aim, the current study examined the hedging and boosting strategies used by the winners of American and Iranian presidential elections during one of their latest televised debates. A bottom–up method of analysis was adopted to analyze the debates in terms of hedges and boosters, and a functional model in light of what surfaced in the analysis along with awareness of the existing literature was proposed. The study showed that not only were the frequencies significantly different, but the functions these devices fulfilled were also varied cross-linguistically as the winners of both groups demonstrated diverse tendencies towards using hedges and boosters. (shrink)

ObjectiveCaring for patients with Alzheimer’s disease is a stressful situation and an overwhelming task for family caregivers. Therefore, these caregivers need to have their hardiness empowered to provide proper and appropriate care to these older adults. From the introduction of the concept of hardiness, few studies have been conducted to assess the hardiness of caregivers of patients with AD. Presumably, one reason for this knowledge gap is the lack of a proper scale to evaluate hardiness in this group. This study (...) was conducted to develop a reliable and valid Family Caregivers’ Hardiness Scale to measure this concept accurately among Iranian family caregivers sample.MethodsThis study is a cross-sectional study with a sequential-exploratory mixed-method approach. The concept of family caregivers’ hardiness was clarified using deductive content analysis, and item pools were generated. In the psychometric step, the samples were 435 family caregivers with a mean age of 50.26, and the data were gathered via an online form questionnaire. In this step, the items of the FCHS were evaluated using face and content validity. Then, the factor structure was determined and confirmed using exploratory factor analysis and confirmatory factor analysis followed by convergent and divergent validity, respectively. Finally, scale reliability, including stability, and internal consistency were evaluated.ResultsThe finding revealed that FCHS consists of five factors, namely, “Religious Coping”, “Self-Management”, “Empathic Communication”, “Family Affective Commitment”, and “Purposeful Interaction” that explained 58.72% of the total variance. The results of CFA showed a good model fit. Reliability showed acceptable internal consistency and stability.ConclusionBased on the results of the psychometric evaluation of the FCHS, turned out that the concept of hardiness in Iranian family caregivers is a multidimensional concept that is most focused on individual-cultural values, emotional family relationships, and social relationships. The designed scale also has acceptable validity and reliability features that can be used in future studies to measure this concept in family caregivers. (shrink)

The present study explores the social and economic dimensions affecting the poverty culture existing in the slum areas of Karachi, Pakistan. The significance of the study highlights the major causes of hindrance in community development poverty and lack of social indicators-which are becoming a culture of the people as their value system along with feelings of powerlessness, meaninglessness, isolation, social exclusion, and self-estrangement in their group relations. This is a qualitative as well as an exploratory research that highlights the emergence (...) of poverty culture in Pakistan for which the researchers have developed an idiographic model to identify the major variables of poverty culture. The researchers in the present study provide the positive and constructive counter-narratives and recommendations against myths about the culture of the poor people. In the present study, researchers have used facts and figures from the United Nations and World Bank Report of Poverty Reduction. (shrink)

Engineering, as a complex and multidimensional practice of technology development, has long been a source of ethical concerns. These concerns have been approached from various perspectives. There are ongoing debates in the literature of the philosophy of engineering/technology about how to organize an optimized view of the values entailed in technology development processes. However, these debates deliver little in the way of a concrete rationale or framework that could comprehensively describe different types of engineering values and their multi-aspect interrelations in (...) real engineering practices. Approaching engineering values from a meaning-based perspective, as in this paper, can be a reliable method of tackling such a controversial problem. This paper therefore proposes that technology development be considered a systemic normative practice and attempts to provide a comprehensive view of various built-in values, their different origins and features, and a way of prioritizing them in real engineering processes. Studying two cases of the Zayandeh Rood Dam and the Abbasi Dam will lead to practical insights into how to understand norms in technology development and incorporate them into engineering practice. (shrink)

Moral resilience is an emerging concept that has not been fully acknowledged. The aim of this study is to explain lived experiences of moral resilience in intensive care units nurses. This is a qualitative study with a content analysis approach guided by the method of Elo and Kyngäs and based on the theoretical framework of Defilippis et al. Data were collected through 17 in‐depth, individual, and semi‐structured interviews with 17 nurses, who were selected by purposeful sampling. The results of the (...) present study support the theory of Defilippis et al. while adding another category to it. Three categories of self‐awareness, harmonized connection, and moral well‐being, which are consistent with the result of Defilippis et al. were extracted deductively, while the category of moral agency was also extracted inductively from the data. The explanatory theory resulting from Defilippis et al.'s study can be used as a guide to cultivate and improve the moral resilience of nurses working in intensive care units. Moral resilience is fostered in nurses by nurturing and improving their capacities, such as self‐awareness, self‐efficacy, self‐confidence, and self‐reflection. These traits can help maintain and promote moral agency while establishing harmonized connections. Acquiring moral resilience skills can lead to positive outcomes and reduced moral distress. (shrink)

[1] Filosofia viva -- [2] Filosofia e arte -- [3] Vida filosófica.

This study extends the theory of planned behavior framework by introducing three further variables to explain how behavioral intention and actual behavior are induced by situational factors as well as green advertising from the company. Then, this study has four objectives. First, this study will assess the direct effect of personal factors and contextual factors on learning experience and the direct effect of personal factors on subjective norms. Second, this study will assess the direct effect of learning experience on social (...) cognitive factors for a specific green product. Third, this study will assess the direct effect of social cognitive factors on intention purchasing behavior. Finally, this study will assess the role of green marketing as a moderating variable for the relationship between intention and purchasing behavior. Data used in this study were primary data, which were collected through closed questionnaires with a five-point Likert scale. This study succeeded in obtaining 602 valid data from the results of filling out questionnaires by participants. This study uses the partial least square method with SmartPLS 3.0 for data processing. The result of data processing indicated that outcome expectation, self-efficacy, and subjective norms had significant positive effects on purchase intention for green personal care products. This study also found that the learning experience influenced both outcome expectation and self-efficacy. Although weak, the learning experience was influenced by demographic factors and contextual factors. The demographic factors that affect learning experience were gender and level of education. The contextual factor has a more substantial influence on learning experience in developing consumption-related attitudes to green personal care products than the demographic factor. Finally, this study also found the direct effect of intention on actual purchase behavior and the positive role of green marketing as the moderating variable. (shrink)

Since current water governance patterns mandate cooperation and partnership within and between the actors in the hydrosystems, supplementary models are necessary to distinguish the roles and the rules of indoor actions which is why we extend a theory in the frameworks of philosophy of technology. This analysis is empirically grounded on the problematic hydrosystems of a river in central Iran, Zayandehrud. Following a modernist-holistic-based analysis, it illustrates how values in the water apportionment mechanisms are being reshaped. The article by using (...) the theory of normative practice has scrutinised the tasks and the rules of the old and new water-management systems, Mirab. Subsequently according to such philosophical theory, it has argued that the conflicts over the cases are due to interference of structural and directional norms within them. (shrink)

BackgroundHaving moral courage is a crucial characteristic for nurses to handle ethical quandaries, stay true to their professional obligations towards patients, and uphold ethical principles. This concept can be influenced by various factors including personal, professional, organizational, and leadership considerations. The purpose of this study was to explore the predictors of moral courage among nurses working in hospitals.MethodsIn 2018, an observational cross-sectional study was carried out on 267 nurses employed in six hospitals located in the northern region of Iran. The (...) participants were selected through a simple random sampling technique. To collect data, a demographic information form was used along with two questionnaires. The first questionnaire was a standard survey on moral courage, while the second questionnaire was designed to assess the ethical climate. Linear regression was used to assess the predictors of moral courage.ResultsNurses had an average moral courage score of 87.07 ± 15.52 and an average moral climate score of 96.12 ± 17.17. The study showed that 16% of the variation in moral courage scores among nurses was explained by ethical climate and monthly overtime hours.ConclusionThis study underscores the significance of establishing an ethical work environment and minimizing overtime hours in order to enhance moral courage among nurses. These findings carry weight for both nursing practice and organizational policies focused on fostering ethical conduct within healthcare settings. (shrink)

Journal Name: Semiotica Issue: Ahead of print.

The intensive care unit, with its structural complexity and the exposure of critically ill patients to various disparities, presents a significant setting for health disparities. This critical ethnographic study sought to uncover cultural knowledge and ethical practices for reducing health disparities in providing care services within the intensive care unit. The focus was on understanding how ethical considerations and cultural competence can address and mitigate these disparities effectively. This critical ethnographic study was conducted in 2022–2023 at intensive care units in (...) western Iran. Three interrelated phases were used to collect and analyze the data. More than 300 h of observation were done during the first phase. A horizon analysis was carried out in the next phase. To further enhance the dataset, 18 informants participated in semi-structured interviews and informal conversations. Following that, the analysis procedure was conducted to identify a culture of health disparities and factors that reduce it, as it had been in the prior stage. Trustworthiness data collection methods were implemented to ensure the validity and reliability of the study. Two key themes emerged from the study: (A) Improved cultural competence, which encompassed empathy towards patients and their families, effective communication, prioritization of continuous learning, appropriate knowledge and awareness, sensitivity to cultural and religious beliefs, staff attitude and personality, and the delivery of customized care tailored to each patient’s needs. (B) Supporting role and compensating for disparities involved recommendations for upholding ethical standards, compensatory actions, maintaining professional behavior despite external factors, addressing gaps and deficiencies, and actively defending and supporting patients. The findings indicate that staff with high cultural competence can ethically mitigate health disparities through their supportive roles. Managers and health policymakers should create barriers to health disparity by improving staff cultural competence and knowledge about health disparities. (shrink)

Physical activity, and likely the motivation for it, varies throughout the day. The aim of this investigation was to create a short assessment (CRAVE: Cravings for Rest and Volitional Energy Expenditure) to measure motivation states (wants, desires, urges) for physical activity and sedentary behaviors. Five studies were conducted to develop and evaluate the construct validity and reliability of the scale, with 1,035 participants completing the scale a total of 1,697 times. In Study 1, 402 university students completed a questionnaire inquiring (...) about the want or desire to perform behaviors “at the present moment (right now).” Items related to physical activity (e.g., “move my body”) and sedentary behaviors (e.g., “do nothing active”). An exploratory structural equation model (ESEM) revealed that 10 items should be retained, loading onto two factors (5 each for Move and Rest). In Study 2, an independent sample (n= 444) confirmed these results and found that Move and Rest desires were associated with stage-of-change for exercise behavior. In Study 3, 127 community-residing participants completed the CRAVE at 6-month intervals over two years- two times each session. Across-session interclass correlations (ICC) for Move (ICC = 0.72–0.95) and Rest (ICC = 0.69–0.88) were higher than when they were measured across 24-months (Move: ICC = 0.53; Rest: ICC = 0.49), indicating wants/desires have state-like qualities. In Study 4, a maximal treadmill test was completed by 21 university students. The CRAVE was completed immediately pre and post. Move desires decreased 26% and Rest increased 74%. Changes in Move and Rest desires were moderately associated with changes in perceived physical fatigue and energy. In Study 5, 41 university students sat quietly during a 50-min lecture. They completed the CRAVE at 3 time points. Move increased 19.6% and Rest decreased 16.7%. Small correlations were detected between move and both perceived energy and tiredness, but not calmness or tension. In conclusion, the CRAVE scale has good psychometric properties. These data also support tenets of the WANT model of motivation states for movement and rest (Stults-Kolehmainen et al., 2020a). Future studies need to explore how desires to move/rest relate to dynamic changes in physical activity and sedentarism. (shrink)

This article illustrates how a collaborative research process can successfully engage an underserved minority community to address health disparities. Pacific Islanders, including the Marshallese, are one of the fastest growing US populations. They face significant health disparities, including extremely high rates of type 2 diabetes. This article describes the engagement process of designing patient‐centered outcomes research with Marshallese stakeholders, highlighting the specific influences of their input on a randomized control trial to address diabetes. Over 18 months, an interdisciplinary research team (...) used community‐based participatory principles to conduct patient‐engaged outcomes research that involved 31 stakeholders in all aspects of research design, from defining the research question to making decisions about budgets and staffing. This required academic researcher flexibility, but yielded a design linking scientific methodology with community wisdom. (shrink)

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: -/- The main aim of this review will be to assess the effects of changing practitioner empathy or patient expectations for all conditions. The main objective is to conduct a systematic review of randomised trials where the intervention involves manipulating either (a) practitioner empathy or (b) patient expectations, or (c) both.

Emotions are multimodal processes that play a crucial role in our everyday lives. Recognizing emotions is becoming more critical in a wide range of application domains such as healthcare, education, human-computer interaction, Virtual Reality, intelligent agents, entertainment, and more. Facial macro-expressions or intense facial expressions are the most common modalities in recognizing emotional states. However, since facial expressions can be voluntarily controlled, they may not accurately represent emotional states. Earlier studies have shown that facial micro-expressions are more reliable than facial (...) macro-expressions for revealing emotions. They are subtle, involuntary movements responding to external stimuli that cannot be controlled. This paper proposes using facial micro-expressions combined with brain and physiological signals to more reliably detect underlying emotions. We describe our models for measuring arousal and valence levels from a combination of facial micro-expressions, Electroencephalography (EEG) signals, galvanic skin responses (GSR), and Photoplethysmography (PPG) signals. We then evaluate our model using the DEAP dataset and our own dataset based on a subject-independent approach. Lastly, we discuss our results, the limitations of our work, and how these limitations could be overcome. We also discuss future directions for using facial micro-expressions and physiological signals in emotion recognition. (shrink)

Background: Organ supply–demand in developing countries worldwide has continued to widen. Hence, using a large survey (n ¼ 10,412), this study seeks to investigate whether human psychology could be used to inculcate philanthropy to raise deceased organ donation rates. Methods: Three models were constructed to examine multidimensional relationships among the variables. Structural equation modeling was applied to estimate the direct and indirect influence of altruism, financial incentives, donation perception, and socioeconomic status simultaneously on willingness to donate deceased organs. Ethical considerations: (...) The study was approved by the University of Malaya ethics committee. Results: The results show that altruism amplifies the impact of socioeconomic status and donation perception on willingness to donate. Also, the results show that financial incentives cannot complement altruism to raise organ donation rates. Hence, investing in education and public awareness enhances altruism in people, which then increases the propensity to donate. Conclusion: Evidence suggests that governments should allocate resources to increase public awareness about organ donation. Awareness programs about the importance of philanthropic donations and the participation of medical consultants at hospitals in the processes form the foundation of such a presumptive approach. (shrink)