Two experiments were conducted for the derivation of psychophysical scales of the following audio descriptors: spectral centroid, spectral spread, spectral skewness, odd-to-even harmonic ratio, spectral deviation, and spectral slope. The stimulus sets of each audio descriptor were synthesized and independently controlled through appropriate synthesis techniques. Partition scaling methods were used in both experiments, and the scales were constructed by fitting well-behaving functions to the listeners' ratings. In the first experiment, the listeners' task was the estimation of the relative differences (...) between successive levels of a particular audio descriptor. The median values of listeners' ratings increased with increasing feature values, which confirmed listeners' abilities to estimate intervals. However, there was a large variability in the reliability of the derived interval scales depending on the stimulus spacing in each trial. In the second experiment, listeners had control over the stimulus values and were asked to divide the presented range of values into perceptually equal intervals, which provides a ratio scale. For every descriptor, the reliability of the derived ratio scales was excellent. The unit of a particular ratio scale was assigned empirically so as to facilitate qualitative comparisons between the scales of all audio descriptors. The construction of psychophysical scales based on univariate stimuli allowed for the establishment of cause-and-effect relations between audio descriptors and perceptual dimensions, contrary to past research that has relied on multivariate stimuli and has only examined the correlations between the two. Most importantly, this study provides an understanding of the ways in which the sensation magnitudes of several audio descriptors are apprehended. (shrink)

Person reidentification aims to recognize a specific pedestrian from uncrossed surveillance camera views. Most re-id methods perform the retrieval task by comparing the similarity of pedestrian features extracted from deep learning models. Therefore, learning a discriminative feature is critical for person reidentification. Many works supervise the model learning with one or more loss functions to obtain the discriminability of features. Softmax loss is one of the widely used loss functions in re-id. However, traditional softmax loss inherently focuses on the feature (...) separability and fails to consider the compactness of within-class features. To further improve the accuracy of re-id, many efforts are conducted to shrink within-class discrepancy as well as between-class similarity. In this paper, we propose a circle-based ratio loss for person re-identification. Concretely, we normalize the learned features and classification weights to map these vectors in the hypersphere. Then we take the ratio of the maximal intraclass distance and the minimal interclass distance as an objective loss, so the between-class separability and within-class compactness can be optimized simultaneously during the training stage. Finally, with the joint training of an improved softmax loss and the ratio loss, the deep model could mine discriminative pedestrian information and learn robust features for the re-id task. Comprehensive experiments on three re-id benchmark datasets are carried out to illustrate the effectiveness of the proposed method. Specially, 83.12% mAP on Market-1501, 71.66% mAP on DukeMTMC-reID, and 66.26%/63.24% mAP on CUHK03 labeled/detected are achieved, respectively. (shrink)

In the age of big data, machine learning models are globally used to execute default risk prediction. Imbalanced datasets and redundant features are two main problems that can reduce the performance of machine learning models. To address these issues, this study conducts an analysis from the viewpoint of different balance ratios as well as the selection order of feature selection. Accordingly, we first use data rebalancing and feature selection to obtain 32 derived datasets with varying ratios of balance and feature (...) combinations for each dataset. Second, we propose a comprehensive metric model based on multimachine learning algorithms to select the best-derived dataset with the optimal balance ratio and feature combination. Finally, the convolutional neural network is trained on the selected derived dataset to evaluate the performance of our approach in terms of type-II error, accuracy, G-mean, and AUC. There are two contributions in this study. First, the optimal balance ratio is found through the classification accuracy, which changes the deficiency of the existing research that samples are imbalanced or the balance ratio is 1 : 1 and ensures the accuracy of the classification model. Second, a comprehensive metric model based on the machine learning algorithm is proposed, which can simultaneously find the best balance ratio and the optimal feature selection. The experimental results show that our method can noticeably improve the performance of CNN, and CNN outperforms the other four commonly used machine learning models in the task of default risk prediction on four benchmark datasets. (shrink)

Decision-making by a Data and Safety Monitoring Board (DSMB) regarding clinical trial conduct and termination is intricate and largely limited by cases and rules. Decision-making by legal jury is also intricate and largely constrained by cases and rules. In this paper, I argue by analogy that legal decision-making, which strives for a balance between competing demands of conservatism and innovation, supplies a good basis to the logic behind DSMB decision-making. Using the doctrine of precedents in legal reasoning as my central (...) analog will lead us to a decision-theoretic analogy for much more systematic documentation of decisions in clinical trials. My conclusion is twofold: every DSMB decision should articulate a clear general principle (a ratio decidendi) that gives reason for the decision; and all such decisions should be made public. I use Bartha’s (2010) theory of analogical arguments to both frame and assess my argument by analogy. (shrink)

The extant clinical literature indicates profound problems in the assessment, monitoring, and documentation of care in long-term care facilities. The lack of adequate resources to accommodate higher staff-to-resident ratios adds additional urgency to the goal of identifying more costeffective mechanisms to provide care oversight. The ever expanding array of electronic monitoring technologies in the clinical research arena demands a conceptual and pragmatic framework for the resolution of ethical tensions inherent in the use of such innovative tools. CareMedia is a project (...) that explores the utility of video, audio and sensor technologies as a continuous real-time assessment and outcomes measurement tool. In this paper, the authors describe the seminal ethical challenges encountered during the implementation phase of this project, namely privacy and confidentiality protection, and the strategies employed to resolve the ethical tensions by applying principles of the interest theory of rights. (shrink)

Ratio, Volume 34, Issue 1, Page 56-67, March 2021.

This paper examines the role of body fat distribution as measured by waist-to-hip ratio (WHR) on the judgment of women’s physical attractiveness. It presents evidence that WHR is correlated with a woman’s reproductive endocrinological status and long-term health risk. Three studies were conducted to investigate whether humans have perceptual and cognitive mechanisms to utilize the WHR to infer attributes of women’s health, youthfulness, attractiveness, and reproductive capacity. College-age as well as older subjects of both sexes rank female figures with (...) normal weight and low WHR as attractive and assign to them higher reproductive capability. The study concludes that WHR is a reliable and honest signal of a woman’s reproductive potential. The adaptive significance of body fat distribution and its role in mate selection is also discussed. (shrink)

Objectives To conduct an independent evaluation of the first phase of the Health Foundation’s Safer Patients Initiative (SPI), and to identify the net additional effect of SPI and any differences in changes in participating and non-participating NHS hospitals. Design Mixed method evaluation involving five substudies, before and after design. Setting NHS hospitals in the United Kingdom. Participants Four hospitals (one in each country in the UK) participating in the first phase of the SPI (SPI1); 18 control hospitals. Intervention The SPI1 (...) was a compound (multi-component) organisational intervention delivered over 18 months that focused on improving the reliability of specific frontline care processes in designated clinical specialties and promoting organisational and cultural change. Results Senior staff members were knowledgeable and enthusiastic about SPI1. There was a small (0.08 points on a 5 point scale) but significant (P<0.01) effect in favour of the SPI1 hospitals in one of 11 dimensions of the staff questionnaire (organisational climate). Qualitative evidence showed only modest penetration of SPI1 at medical ward level. Although SPI1 was designed to engage staff from the bottom up, it did not usually feel like this to those working on the wards, and questions about legitimacy of some aspects of SPI1 were raised. Of the five components to identify patients at risk of deterioration—monitoring of vital signs (14 items); routine tests (three items); evidence based standards specific to certain diseases (three items); prescribing errors (multiple items from the British National Formulary); and medical history taking (11 items)—there was little net difference between control and SPI1 hospitals, except in relation to quality of monitoring of acute medical patients, which improved on average over time across all hospitals. Recording of respiratory rate increased to a greater degree in SPI1 than in control hospitals; in the second six hours after admission recording increased from 40% (93) to 69% (165) in control hospitals and from 37% (141) to 78% (296) in SPI1 hospitals (odds ratio for “difference in difference” 2.1, 99% confidence interval 1.0 to 4.3; P=0.008). Use of a formal scoring system for patients with pneumonia also increased over time (from 2% (102) to 23% (111) in control hospitals and from 2% (170) to 9% (189) in SPI1 hospitals), which favoured controls and was not significant (0.3, 0.02 to 3.4; P=0.173). There were no improvements in the proportion of prescription errors and no effects that could be attributed to SPI1 in non-targeted generic areas (such as enhanced safety culture). On some measures, the lack of effect could be because compliance was already high at baseline (such as use of steroids in over 85% of cases where indicated), but even when there was more room for improvement (such as in quality of medical history taking), there was no significant additional net effect of SPI1. There were no changes over time or between control and SPI1 hospitals in errors or rates of adverse events in patients in medical wards. Mortality increased from 11% (27) to 16% (39) among controls and decreased from 17% (63) to 13% (49) among SPI1 hospitals, but the risk adjusted difference was not significant (0.5, 0.2 to 1.4; P=0.085). Poor care was a contributing factor in four of the 178 deaths identified by review of case notes. The survey of patients showed no significant differences apart from an increase in perception of cleanliness in favour of SPI1 hospitals. Conclusions The introduction of SPI1 was associated with improvements in one of the types of clinical process studied (monitoring of vital signs) and one measure of staff perceptions of organisational climate. There was no additional effect of SPI1 on other targeted issues nor on other measures of generic organisational strengthening. (shrink)

This paper conducts a cost–benefit analysis of Australia’s Covid-19 lockdown strategy relative to pursuit of a mitigation strategy in March 2020. The estimated additional deaths from a mitigation strategy are 11,500 to 40,000, implying a Cost per Quality Adjusted Life Year saved by locking down of at least 11 times the generally employed figure of $100,000 for health interventions in Australia. The lockdowns do not then seem to have been justified by reference to the standard benchmark. Consideration of the information (...) available to the Australian government in March 2020 yields a similar ratio and therefore the same conclusion that lockdown was not warranted. If Australia experiences a new outbreak, and cannot contain it without resort to a nationwide lockdown, the death toll from adopting a mitigation strategy at this point would be even less than had it done so in March 2020, due to the vaccination campaign, lessons learned since March 2020, and because the period over which the virus would then inflict casualties would now be much less than the period from March 2020. This would favour a mitigation policy even more strongly than in March 2020. This approach of assessing the savings in quality adjusted life years and comparing them to a standard benchmark figure ensures that all quality adjusted life years saved by various health interventions are treated equally, which accords with the ethical principle of equity across people. (shrink)

BackgroundType-Token Ratio, given its relatively simple hand computation, is one of the few LSA measures calculated by clinicians in everyday practice. However, it has significant well-documented shortcomings; these include instability as a function of sample size, and absence of clear developmental profiles over early childhood. A variety of alternative measures of lexical diversity have been proposed; some, such as Number of Different Words/100 can also be computed by hand. However, others, such as Vocabulary Diversity and the Moving Average Type (...) Token Ratio rely on complex resampling algorithms that cannot be conducted by hand. To date, no large-scale study of all four measures has evaluated how well any capture typical developmental trends over early childhood, or whether any reliably distinguish typical from atypical profiles of expressive child language ability.Materials and MethodsWe conducted linear and non-linear regression analyses for TTR, NDW, VocD, and MATTR scores for samples taken from 946 corpora from typically developing preschool children, engaged in adult-child toy play, from the Child Language Data Exchange System. These were contrasted with 504 samples from children known to have delayed expressive language skills. We also conducted a separate sub-analysis which examined possible contextual effects of sampling environment on lexical diversity.ResultsOnly VocD showed significantly different mean scores between the typically -developing children and delayed developing children group. Using TTR would actually misdiagnose typical children and miss children with known language impairment. However, computation of VocD as a function of toy interactions was significant and emerges as a further caution in use of lexical diversity as a valid proxy index of children’s expressive vocabulary skill.DiscussionThis large scale statistical comparison of computer-implemented algorithms for expressive lexical profiles in young children with traditional, hand-calculated measures showed that only VocD met criteria for evidence-based use in LSA. However, VocD was impacted by sample elicitation context, suggesting that non-linguistic factors, such as engagement with elicitation props, contaminate estimates of spoken lexical skill in young children. Implications and suggested directions are discussed. (shrink)

This study was conducted from May to June 2005 to describe the demographic characteristics and factors that affect the VCT acceptance as well as the HIV prevalence among youth VCT acceptors in Addis Ababa. Both quantitative and qualitative methods of data collection were employed. The quantitative data was generated from a two years (October 2002 to December 2004) VCT service utilization data obtained from four youth centers located in Addis Ababa. The data was analysed using univariate and multivariate analysis and (...) results were presented in the form of text, table and figures. The significance and level of associations between independent and dependant variables was computed using X2 tests and odds ratios with 95% confidence interval. The qualitative data was presented in a form of narrations using excerpts. During the period a total of 3220, youth age 15 - 24 years have sought VCT service from the four youth centres VCT service outlets. Higher proportions of females (60.2%) and youth in the age category of 20 – 24 years (58.0%) have accessed the service. The major reasons given for seeking VCT were found to be similar for male and female acceptors. About 71.2% said that they sought for VCT service because they wanted to know their HIV status, 9.5% reported because they were suspicious of being infected with HIV and 5.0% tested because they wanted to go aboard. The HIV prevalence rate is found to be significantly higher, (p = 0.00), among females 9.2 % than in males 1.7 %. Gender segregated multivariate analysis of risk factors indicated significant association of HIV infection with lack of formal education for both males and female: for males P= 0.045, OR = 18.3, 95% CI: 1.1 – 317.7 and for females P=0.00, OR=19.4, 95 % CI: 5.1 – 73.8. Additionally for females HIV infection is markedly associated with being widowed and commercial sex worker. The most common barrier for youth in Addis from accessing VCT were found to be: fear of being emotionally affected if found out HIV positive, stigma and discrimination, lack of money to pay for VCT service, absence of care and support services for people who are already infected. The challenges encountered by youth VCT counsellors were stress, absence of medical care for PLWHA, inadequacy of budget, lack of counsellors and supportive supervision. This study showed high burden of HIV infection among female youth and the risk factors associated with it. Formal education for both females and males is strongly recommended. Female focused HIV prevention interventions are indicated. Additional recommendations are also made in relation to barriers to access youth VCT and for the challenges encountered by youth VCT service providers. (shrink)

Based on the concept of the third paradigm of the «first philosophy», the article analyzes the theo- retical and practical philosophy of Karl-Otto Apel. The role of discursive practices as a paradig- matic basis of the philosophy of communication and meta-institutions of all the rest institutions of society is revealed. The author considers the achievements of Ukrainian philosophers in the study of Apel’s heritage, as well as the possibilities of applying Apel’s philosophical theorizing in the study of Ukrainian realities, development (...) of the Ukrainian ethos, and possibility of theo- retical substantiation and practical legitimization of institutions and values. In addition to this, it is also about the relationship between universalist morality and the particular ethos of local worlds, as well as the relationship between the concepts of universalist ethics and global ethos. Using Apel’s methodology, the author of the article argues that the revival of the conventional ethos and the institutional stage of development of moral consciousness does not end the problem of moral development of the Ukrainian nation. The next, no less important, task is the transition to a potentially democratic postconventional morality, which is achieved by communicative ratio- nalization of the world, the creation of institutions of deliberative democracy. The great role and influence of Apel’s philosophy in the world, which is manifested in the fact that there is a kind of communicative international, which unites many supporters of the Apel paradigm in such well known organization as the “Karl-Otto Apel Centro Filosofico Internazionale”, and in such journals as “Topologik”, “Ethik+Diskurs”, etc., which conduct researches based on the Apel paradigm. (shrink)

Background In the course of the COVID-19 pandemic, the biomedical research community’s attempt to focus the attention on fighting COVID-19, led to several challenges within the field of research ethics. However, we know little about the practical relevance of these challenges for Research Ethics Committees. Methods We conducted a qualitative survey across all 52 German RECs on the challenges and potential solutions with reviewing proposals for COVID-19 studies. We de-identified the answers and applied thematic text analysis for the extraction and (...) synthesis of challenges and potential solutions that we grouped under established principles for clinical research ethics. Results We received an overall response rate of 42%. The 22 responding RECs reported that they had assessed a total of 441 study proposals on COVID-19 until 21 April 2020. For the review of these proposals the RECs indicated a broad spectrum of challenges regarding social value, scientific validity, favourable risk–benefit ratio, informed consent, independent review, fair selection of trial participants, and respect for study participants. Mentioned solutions ranged from improved local/national coordination, over guidance on modified consent procedures, to priority setting across clinical studies. Conclusions RECs are facing a broad spectrum of pressing challenges in reviewing COVID-19 studies. Some challenges for consent procedures are well known from research in intensive care settings but are further aggravated by infection measures. Other challenges such as reviewing several clinical studies at the same time that potentially compete for the recruitment of in-house COVID-19 patients are unique to the current situation. For some of the challenges the proposed solutions in our survey could relatively easy be translated into practice. Others need further conceptual and empirical research. Our findings together with the increasing body of literature on COVID-19 research ethics, and further stakeholder engagement should inform the development of hands-on guidance for researchers, funders, RECs, and further oversight bodies. (shrink)

A growing body of ethics research investigates gender diversity and governance on corporate boards, at individual and firm levels, in single country studies. In this study, we explore the environmental context of female representation on corporate boards of directors, using data from 43 countries. We suggest that women's representation on corporate boards may be shaped by the larger environment, including the social, political and economic structures of individual countries. We use logit regression to conduct our analysis. Our results indicate that (...) countries with higher representation of women on boards are more likely to have women in senior management and more equal ratios of male to female pay. However, we find that countries with a longer tradition of women's political representation are less likely to have high levels of female board representation. (shrink)

Robust technology infrastructure is needed to enable learning health care systems to improve quality, access, and cost. Such infrastructure relies on the trust and confidence of individuals to share their health data for healthcare and research. Few studies have addressed consumers’ views on electronic data sharing and fewer still have explored the dual purposes of healthcare and research together. The objective of the study is to explore factors that affect consumers’ willingness to share electronic health information for healthcare and research. (...) This study involved a random-digit dial telephone survey of 800 adult Californians conducted in English and Spanish. Logistic regression was performed using backward selection to test for significant associations of each explanatory variable with the outcome variable. The odds of consent for electronic data sharing for healthcare decreased as Likert scale ratings for EHR impact on privacy worsened, odds ratio = 0.74, 95% CI [0.60, 0.90]; security, OR = 0.80, 95% CI [0.66, 0.98]; and quality, OR = 0.59, 95% CI [0.46–0.75]. The odds of consent for sharing for research was greater for those who think EHR will improve research quality, OR = 11.26, 95% CI [4.13, 30.73]; those who value research benefit over privacy OR = 2.72, 95% CI [1.55, 4.78]; and those who value control over research benefit OR = 0.49, 95% CI [0.26, 0.94]. Consumers’ choices about electronically sharing health information are affected by their attitudes toward EHRs as well as beliefs about research benefit and individual control. Design of person-centered interventions utilizing electronically collected health information, and policies regarding data sharing should address these values of importance to people. Understanding of these perspectives is critical for leveraging health data to support learning health care systems. (shrink)

The essence of the financial stability of public and communal higher educational establishments in the context of current socioeconomic situation in Ukraine has been determined as a state of the financial resources which enables educational establishments to organize the qualitative educational and scientific activity and form the occupational competitiveness of graduates on the base of complete and timely financing of submitted expenditures. The basis of efficient economical activity (including fulfillment of special-purpose programmes) and qualitative educational services is the reception of (...) plan special-purpose financial recourses. The author has explored that current practice of the assessment of the financial stability of state higher educational establishments doesn’t take into account the main aspects of this process in their interconnection and interdependence. The intellectual model of estimating the financial stability of state higher educational establishments has been developed on the base of fuzzy logic which enables to assess the level of the financial stability of educational establishments via simultaneous application of quantitative (maneuverability equity ratio, autonomy coefficient, funding coefficient, the ratio of correlation conducted expenditures and income received, the ratio of payables and receivables, the ratio of the approved cost estimate of special and general funds, the ratio of cash and actual expenditures) and qualitative (assessment of scientific and educational potential quality, assessment of education quality, evaluation of international recognition, the graduates satisfaction of received education and the opportunity to use it in work, employers perception of quality of education in Ukrainian universities, experts perceptions of the quality of education in Ukrainian universities, cooperation between universities and companies-employers) indexes. (shrink)

This paper conducts an evaluative study on the rehabilitation of limb motor function by using a microsensor information flow gain algorithm and investigates the surface electromyography signals of the upper limb during rehabilitation training. The surface EMG signals contain a large amount of limb movement information. By analysing and processing the surface EMG signals, we can grasp the human muscle movement state and identify the human upper limb movement intention. The EMG signals were processed by the trap and filter combination (...) denoising method and wavelet denoising method, respectively, the signal-to-noise ratio was used to evaluate the noise reduction effect, and finally, the wavelet denoising method with a better noise reduction effect was selected to process all the EMG signals. After the noise is removed, the signal is extracted in the time domain and frequency domain, and the root mean square, absolute mean, median frequency in the time domain, and average power frequency in the frequency domain are selected and input to the classifier for pattern recognition. The support vector machine is used to classify the myoelectric signals and optimize the parameters in the support vector machine using the grid search method and particle swarm optimization algorithm and classify the test samples using the trained support vector machine. Compared with the classification results of the grid search optimized support vector machine, the optimized vector machine has a 7% higher recognition rate, reaching 85%. The action recognition classification method of myoelectric signals is combined with an upper limb rehabilitation training platform to verify the feasibility of using myoelectric signals for rehabilitation training. After the classifier recognizes the upper limb movements, the upper computer sends movement commands to the controller to make the rehabilitation platform move according to the recognition results, and finally, the movement execution accuracy of the rehabilitation platform reaches 80% on average. (shrink)

Background In this study, we examined the ethical implications of Egypt’s new clinical trial law, employing the ethical framework proposed by Emanuel et al. and comparing it to various national and supranational laws. This analysis is crucial as Egypt, considered a high-growth pharmaceutical market, has become an attractive location for clinical trials, offering insights into the ethical implementation of bioethical regulations in a large population country with a robust healthcare infrastructure and predominantly treatment-naïve patients. Methods We conducted a comparative analysis (...) of Egyptian law with regulations from Sweden and France, including the EU Clinical Trials Regulation, considering ethical human subject research criteria, and used a directed approach to qualitative content analysis to examine the laws and regulations. This study involved extensive peer scrutiny, frequent debriefing sessions, and collaboration with legal experts with relevant international legal expertise to ensure rigorous analysis and interpretation of the laws. Results On the rating of the seven different principles (social and scientific values, scientific validity, fair selection of participants, risk-benefit ratio, independent review, informed consent and respect for participants) Egypt, France, and EU regulations had comparable scores. Specific principles (Social Value, Scientific Value, and Fair selection of participants) were challenging to directly identify due to certain regulations embodying 'implicit' principles more than explicitly stated ones. Conclusion The analysis underscores Egypt's alignment with internationally recognized ethical principles, as outlined by Emanuel et al., through its comparison with French, Swedish, and EU regulations, emphasizing the critical need for Egypt to continuously refine its ethical regulations to safeguard participant protection and research integrity. Key issues identified include the necessity to clarify and standardize the concept of social value in research, alongside concerns regarding the expertise and impartiality of ethical review boards, pointing towards a broader agenda for enhancing research ethics in Egypt and beyond. (shrink)

Objective The establishment of patient-centered measures capable of empirically determining meaningful cognitive change after surgery can significantly improve the medical care of epilepsy patients. Thus, this study aimed to develop reliable change indices (RCIs) and standardized regression-based (SRB) change norms for a comprehensive neuropsychological test battery in the German language. Methods Forty-seven consecutive patients with temporal lobe epilepsy underwent neuropsychological assessments, both before and 12 months after surgery. Practice-effect-adjusted RCIs and SRB change norms for each test score were computed. To (...) assess their usefulness, the presented methods were applied to a clinical sample, and binary logistic regression analyses were conducted to model the odds of achieving improvement in quality of life (QOL) after surgery. Results The determined RCIs at 90% confidence intervals and the SRB equations for each test score included in the test battery are provided. Cohen’s kappa analyses revealed a moderate mean agreement between the two measures, varying from slight to almost perfect agreement across test scores. Using these measures, a negative association between improvement in QOL and decline in verbal memory functions after surgery was detected (adjusted odds ratio = 0.09, p = 0.006). Significance To the best of our knowledge, this study is the first to develop RCIs and SRB change norms necessary for the objective determination of neuropsychological change in a comprehensive test battery in the German language, facilitating the individual monitoring of improvement and decline in each patients’ cognitive functioning and psychosocial situations after epilepsy surgery. The application of the described measures revealed a strong negative association between improvement in QOL and decline in verbal memory functions after surgery. (shrink)

The American system of long‐term care is disorganized and expensive. Obtaining care for a loved one is a confusing and difficult journey. When it comes to paying for that care, a bit over half who receive care are supported at least partially by insurance, and those with no insurance pay entirely out of pocket. The costs are exorbitant. What makes the system function is reliance on unpaid family members, who care for their loved ones often at considerable cost to themselves.As (...) the baby boom generation ages, this creaky system will become increasingly dysfunctional, and a likely shortage of caregivers will be at the heart of the difficulties. The supply of unpaid family caregivers will become limited, as the ratio of people in the category of ages forty‐five to sixty‐four compared to those who are eighty and older shrinks from just above seven to one in 2010 to just above four to one in 2030. Paid caregivers will be needed to take up the slack, yet they are poorly paid, work under very difficult conditions, and receive little respect from the health care system. In this essay, I discuss the circumstances facing these paid home‐care workers and a possible path forward, illustrating the current problems by drawing on interviews I conducted for a book‐length study published in 2017. (shrink)

Reasons for the limited uptake of the clinician–scientist role within nursing are examined, specifically: the lack of consensus about the nature of nursing science; the varying approaches to epistemology; and the influence of post-modern thought on knowledge development in nursing. It is suggested that under-development of this role may be remedied by achieving agreement that science is a necessary, worthy pursuit for nursing, and that rigorous science conducted from a clinical perspective serves nursing well. Straddling practice and research is a (...) powerful strategy for ensuring relevant research while forging strong links with practice. The clinician–scientist role, typically requiring a 75:25 ratio between research and clinical activities, is well established in medicine. Nursing, however, has been slow to institute the role; it is rare within North America, Australia, and western European countries, and almost non-existent outside those areas. Beyond structural obstacles, philosophical issues may explain nursing's reluctance to implement the role. Following a survey of clinician–scientist roles throughout the world, the nature of nursing science and epistemology, and the influence of post-modern thought on nursing attitudes to research are examined with respect to their influence on this role. The nurse clinician–scientist role holds promise for making strides in clinically relevant research, and for accelerating the knowledge cycle from clinical problem to research question to change in clinical practice. (shrink)

BackgroundConsidering ethical issues in midwifery care is essential for improving the quality of health services and the client's satisfaction. This study aimed to develop and validate the code of ethics for Midwives in Iran (ICEM).Materials and methodsThis was a mixed sequential study that was performed in three phases including a qualitative study, a review, and the content validity assessment. The first phase was a qualitative study with a content analysis approach. The data were collected by conducting in-depth semi-structured individual interviews (...) with 14 midwifery and ethics experts. The purposive sampling method was used to recruit the participants and sampling continued until data saturation. The data were analyzed using the conventional content analysis described by Graneheim and Lundman. Lincoln and Guba’s criteria were used to confirm the trustworthiness of the data. Then, a narrative review of the selected national and international codes of ethics for Midwives was performed to complete the items of the ICEM. For validity assessment, the face and content validity of the items of ICEM was assessed by 15 experts to calculate the content validity ratio (CVR) and index (CVI).ResultsFourteen experts were interviewed in the qualitative phase, and 207 codes were extracted from a content analysis which were categorized into 23 sub-categories and 6 main categories. The extracted codes were considered as the items for ICEM that were completed by a review of the selected national and international code of ethics for Midwives. The content validity and ratio assessment of the items demonstrated an average CVI = 0.92 and CVR = 0.85. Then, the final version of ICEM was developed with 92 items in 6 domains about; 1) "professional Commitments" with 30 items; 2) "providing midwifery services to the client and her companions” with 26 items; 3) “relationship with colleagues" with 11 items; 4) “herself” with 6 items; 5) “education and research” with 8 items; and, 6) “management” with 11 items.ConclusionICEM was prepared with 92 items in six sections that facilitate its use for midwives who are working in the different fields of care, counseling, education, research, and management. In this new version of the ICEM, the items related to recent social-, scientific, and technical improvements were considered for providing ethical midwifery care. (shrink)

Task-unrelated thought (TUT) occurs frequently in our daily lives and across a range of tasks, but we know little about how this phenomenon arises during and influences the way we communicate. Conversations also provide a novel opportunity to assess the alignment (or divergence) in TUT during dyadic interactions. We conducted a study to determine: (a) the frequency of TUT during conversation as well as how partners align/diverge in their rates of TUT, (b) the subjective and behavioral correlates of TUT and (...) TUT divergence during conversation, and (c) if perceived social group identity impacts TUT and TUT divergence during conversation. We used a minimal groups induction procedure to assign participants (N = 126) to either an ingroup, outgroup, or control condition. We then asked them to converse with one another via a computer-mediated text chat application for 10 min while self-reporting TUTs. On average, participants reported TUT about once every 2 min; however, this rate was lower for participants in the ingroup condition, compared to the control condition. Conversational pairs in the ingroup condition were also aligned more in their rates of TUT compared to the outgroup condition. Finally, we discuss subjective and behavioral correlates of TUT and TUT divergence in conversations, such as valence, turn-taking ratios, and topic shifts. (shrink)

Kripke has taken the Gödel case as a counterexample for reference descriptivism. Machery et al. question the validity of Kripke’s case and had conducted empirical studies to show its inadequacy. Experimental data suggest intuitions on this matter vary both across and within cultures. However, there is a descriptive ambiguity, we argue, in Kripke’s Gödel case, for people associate different types of descriptions with proper names, such as the description of brute facts and the description of social facts. We argue in (...) this paper with experimental data that the descriptive ambiguity exists and affects the actual ratio of Kripkeans in reference. This result flaws Machery et al.’s interpretation on empirical research, but does not challenge their claim on cross-cultural divergence. In fact, there are more East Asian descriptivists than Machery et al. expected. (shrink)

BackgroundCompetent end-of-life care is an essential component of total health care provision, but evidence suggests that it is often deficient. This study aimed to evaluate the knowledge and attitudes about key end-of-life issues and principles of good death among doctors in clinical settings.MethodsA cross-sectional study was conducted among allopathic medical doctors working in in-ward clinical settings of tertiary care hospitals in Sri Lanka using a self-administered questionnaire with open- and close-ended questions as well as hypothetical clinical scenarios. Univariate and logistic (...) regression analysis were used to identify the independent factors associated with knowledge and attitudes.ResultsOf the responders who had not been a caregiver for a terminally ill relative (n = 390), 57.9% were men with a mean age of 36.5 years (SD = 8.2). Compared to undergraduate (65.6%; n = 256), only 27.4% (n = 107) had received end-of-life care training at postgraduate level. Only 65.9% of doctors favoured disclosing terminal prognosis to patients; 27.7% of doctors were aware of advance directives; 14.6% were aware of the correct time of death when certifying brain death; 70.3% felt more comfortable in withholding than withdrawing life-sustaining treatment; 61.3% were aware of do-not-attempt cardiopulmonary resuscitation (DNACPR) decisions while 26.7% felt reluctant to administer it; 15.1% thought that all life-sustaining therapy should be withdrawn with a DNACPR decision; and only17.9% were able to name the four principles of medical ethics while 57.9% could not name a single. Participants scored a mean of 9.2 (SD = 3.9) of a maximum 14 points when tested on principles of a ‘good death’. Doctors who had pursued postgraduate studies were more likely to be aware of breaking bad news (adjusted-Odds-Ratio:1.99; 95%CI = 1.19–3.32), advance directives (adjusted-OR: 4.15; 95%CI = 2.49–6.94), aware of certifying the correct time of death (adjusted-OR:2.37; 95%CI = 1.33–4.2) and less reluctant to make DNACPR decisions (adjusted-OR:1.74; 95%CI = 1.13–2.68). Doctors who had worked in ICU were more comfortable withholding than withdrawing treatment (adjusted-OR:1.99; 95%CI = 1.2–3.31).ConclusionsKnowledge and attitudes about end-of-life care, good death and principles of medical ethics among doctors in Sri Lanka were suboptimal. Structured training of end-of-life care needs to be integrated within curricula and in-service training. (shrink)

Under the vision of music education philosophy, we construct a practical path that conforms to the philosophy of music education and effectively improves students’ music literacy, and comprehensively assess the actual effect of music education in promoting students’ aesthetic literacy enhancement and comprehensive personality development. When determining the weights of the evaluation indicators of education and cultivation, a judgement matrix is constructed using the hierarchical analysis method, and a nine-quartile relative importance ratio scale standard is used to compare the (...) importance of each indicator. A consistency test was conducted to ensure the reasonableness of the judgement matrix. The evaluation results show that the aesthetic critical thinking score of 91.7 reaches the excellent level, indicating that students are enough to think independently, analyse the advantages and disadvantages of musical works, and form their own aesthetic judgments. Music aesthetic perception, music history and culture understanding, and music performance skills mastery were in the good grade with scores of 85.3, 78.9 and 87.5 respectively. Musical aesthetic creativity 76.2 reflects that students have some room for upward movement in music creation. Moral Values and Sense of Responsibility 89.4, indicating that students have achieved remarkable results in the development of moral values and sense of responsibility. Intercultural Communication and Understanding, 67.5, is near the lower end of the pass mark and requires greater educational efforts in this area. The results of the data and the grades are used to formulate targeted music education strategies, including strengthening the cultivation of aesthetic critical thinking, enhancing the cultivation of emotion and mood management skills, and improving self-awareness and intercultural communication skills, in order to jointly promote the synergistic development of aesthetic education and personality cultivation. (shrink)

Master corporate valuation: the financial art and science of accurately valuing any business. George Chacko's Applied Corporate Finance: Valuation is the first valuation book to combine true academic rigor with the practical skills you need to successfully value companies in the real world. Renowned financial instructor and investment manager George Chacko focuses on concepts, techniques, tools, and methodologies that lead directly to accurate valuations, and explains each key concept with up-to-date examples. One step at a time, Chacko develops a practical, (...) rigorous approach to conducting valuation, addressing the projection of financial statements, calculation of free cash flows, risk-adjusted cost of capital, and leading methodologies including WACC, flow-to-equity, and Adjusted Present Value (APV). By avoiding elementary content that financial managers, analysts, and MBA-level finance students already know, this book can focus more tightly on the realistic techniques and advanced issues practitioners are actually concerned with. Coverage includes: market value and accounting balance sheets, cash cycles, the DuPont formula, financial distress, and capital as a risk buffer; constructing pro-formas, projecting and bridging financing shortfalls, and planning sustainable growth; sources/uses of cash, cash income statements, pro-forma balance sheet changes, working capital, depreciation, and capital expenditures; risk-free cost, investment risks, and diversifiable vs. idiosyncratic risks; NPV, APV, Optimal Debt Ratios, Capital Structure Dynamics, Terminal Value Calculations, and more. For all finance professionals, analysts, and MBA students who need to sharpen their skills in valuation and related areas of corporate finance, accounting, or strategic planning. (shrink)

The article analyzes one of the fundamental rights – the right to maintenance, which proper implementation ensures normal development of the child. This right matches with the duty of parents to maintain their minor children. Paragraph 6 of Article 38 of the Constitution of the Republic of Lithuania states that parents have a duty to educate their children to be honest people and loyal citizens, supporting them until adulthood. The obligation to maintain children is established in the first 3.192 Article (...) paragraph of the Civil Code of the Republic of Lithuania, and the responsibility for avoiding to maintain a child is provided in Article 164 of the Criminal Code. The article discusses the fact that the analysis of criminal law rate is not precise enough. Article 164 of the Criminal Code does not match with the child maintenance methods specified in the CC Article 3.196 paragraph 1. Since criminal liability is only for judgment in default in civil cases, a person shall only be liable for breaking the right to maintain a child, provided in the CC 3.196 paragraph 1. This article deeply analyzes the problematic qualification aspects of the avoidance to maintain a child. Some alternative ways of child maintenance are mentioned, as can be chosen from other law instruments (bailiffs, Guarantee child support fund) and it leads to the ultima ratio principle. On the other hand, it is not required to seek alternative remedies for affected interests, and it is possible to initiate a pre-trial investigation. Therefore, this article seeks to identify specific civil and criminal law rules delimitation. Avoidance of child maintenance is an ongoing crime. The main problem in legal practice is to determine an end of this ongoing criminal conduct. The practice of the Supreme Court of Lithuania is not unanimous. In some cases, the end of this ongoing conduct is considered to be a moment when the past judgment has entered into force, in other cases – the moment of indictment. These positions are criticized by many authors and it is suggested to follow the Supreme Court’s practice, according to which the moment when a judgment of conviction for the criminal act is passed should be considered as an end of an ongoing criminal conduct. (shrink)

BackgroundRespecting patients’ confidentiality is an ethical and legal responsibility for health professionals and the cornerstone of care excellence. This study aims to assess health professionals’ knowledge, attitudes, and associated factors towards patients’ confidentiality in a resource-limited setting.MethodsInstitutional based cross-sectional study was conducted among 423 health professionals. Stratified sampling methods were used to select the participants, and a structured self-administer questionnaire was used for data collection. The data was entered using Epi-data version 4.6 and analyzed using SPSS, version 25. Bi-variable and (...) multivariable binary logistic regression analyses were used to measure the association between the dependent and independent variables. Odds ratio with 95% confidence intervals and P value was calculated to determine the strength of association and to evaluate statistical significance.ResultOut of 410 participants, about 59.8% with [95% CI (54.8–68.8%)] and 49.5% with [95% CI (44.5–54.5%)] had good knowledge and favorable attitude towards patents confidentiality respectively. Being male (AOR = 1.63, 95% CI [1.03–2.59]), taking training on medical ethics (AOR = 1.73, 95% CI = [1.11–2.70]), facing ethical dilemmas (AOR = 3.07, 95% CI [1.07–8.79]) were significantly associated factors for health professional knowledge towards patients’ confidentiality. Likewise, taking training on medical ethics (AOR = 2.30, 95% CI [1.42–3.72]), having direct contact with the patients (AOR = 3.06, 95% CI [1.12–8.34]), visiting more patient (AOR = 4.38, 95% CI [2.46–7.80]), and facing ethical dilemma (AOR = 3.56, 95% CI [1.23–10.26]) were significant factors associated with attitude of health professionals towards patient confidentiality.ConclusionThe findings of this study revealed that health professionals have a limited attitude towards patient confidentiality but have relatively good knowledge. Providing a continuing medical ethics training package for health workers before joining the hospital and in between the working time could be recommended to enhance health professionals’ knowledge and attitude towards patient confidentiality. (shrink)

Cognitive diagnosis models (CDMs) allow classifying respondents into a set of discrete attribute profiles. The internal structure of the test is determined in a Q-matrix, whose correct specification is necessary to achieve an accurate attribute profile classification. Several empirical Q-matrix estimation and validation methods have been proposed with the aim of providing well-specified Q-matrices. However, these methods require the number of attributes to be set in advance. No systematic studies about CDMs dimensionality assessment have been conducted, which contrasts with the (...) vast existing literature for the factor analysis framework. To address this gap, the present study evaluates the performance of several dimensionality assessment methods from the factor analysis literature in determining the number of attributes in the context of CDMs. The explored methods were parallel analysis, minimum average partial, very simple structure, DETECT, empirical Kaiser criterion, exploratory graph analysis, and a machine learning factor forest model. Additionally, a model comparison approach was considered, which consists in comparing the model-fit of empirically estimated Q-matrices. The performance of these methods was assessed by means of a comprehensive simulation study that included different generating number of attributes, item qualities, sample sizes, ratios of the number of items to attribute, correlations among the attributes, attributes thresholds, and generating CDM. Results showed that parallel analysis (with Pearson correlations and mean eigenvalue criterion), factor forest model, and model comparison (with AIC) are suitable alternatives to determine the number of attributes in CDM applications, with an overall percentage of correct estimates above 76% of the conditions. The accuracy increased to 97% when these three methods agreed on the number of attributes. In short, the present study supports the use of three methods in assessing the dimensionality of CDMs. This will allow to test the assumption of correct dimensionality present in the Q-matrix estimation and validation methods, as well as to gather evidence of validity to support the use of the scores obtained with these models. The findings of this study are illustrated using real data from an intelligence test to provide guidelines for assessing the dimensionality of CDM data in applied settings. (shrink)

The current state of the world suggests we have some difficulty in developing effective policy. This paper demonstrates two methods for the objective analysis of logic models within policy documents. By comparing policy models, we will be better able to compare policies and so determine which policy is best. Our ability to develop effective policy is reflected across the social sciences where our ability to create effective theoretical models is being called into question. The broad scope of this issue suggests (...) a source as deep as our unconscious ways of thinking. Specifically, our reliance on modern and postmodern thinking has limited our ability to develop more effective policy, and more particularly, logic models. The move in some quarters toward “integral” thinking may provide insights that support the creation of more useful policy models. However, some versions of that thinking seem to be unwittingly mired in modern and postmodern thinking. This paper identifies how integral thought may be clarified, allowing us to advance beyond postmodern thinking. Usefully, this “neo-integral” form of thinking supports the creation of more mature policy models by encompassing greater complexity and a careful understanding of interrelationships that may be identified within the logic models that are commonly found in policy analyses. Neo-integral thinking is related to more complex forms of systems thinking and both are found in recent conversations within the nascent field of metatheory. And, to some extent, a logic model within a policy operates as a kind of theoretical model because both may be used to inform understanding and decision-making. Therefore, it seems reasonable to apply neo-integral thinking and metatheoretical methodologies to conduct critical comparisons of logic models. In the present paper, these methodologies are applied to critically compare two logic models. The structure of each model is analyzed to objectively determine its complexity and formal robustness. The complexity is determined by quantifying the concepts and connections within each model. The robustness of a model is a measure of its internal integrity, based on the ratio between the total number of aspects and the number of concatenated aspects. In this analysis, one policy model is found to have a robustness of 0.08, while another is found to have a robustness of 0.67. The more robust policy is expected to be much more effective in application. Implications for policy development and policy application are discussed. (shrink)

The purpose of this paper is to investigate the changes in core self-evaluation scores among Chinese employees during 2010–2019. We conducted a cross-temporal meta-analysis including 50 studies to evaluate the relationship between the year of data collection and levels of CSE. We found that correlations between levels of CSE and year of data collection were strong and positive. Regression results showed that the year of data collection could predict the CSE score when the mean sample age and sex ratio (...) were controlled. In addition, CSE scores were positively related to GDP per capita and negatively related to the unemployment rate. (shrink)

Background: Adolescents’ health choices have been widely researched, but the ethical basis of these choices, namely their rights, duties, and responsibilities, have been disregarded and scale is required to measure these. Objective: To describe the development of a scale that measures adolescents’ rights, duties, and responsibilities in relation to health choices and document the preliminary scale testing. Research design: A multi-phase development method was used to construct the Health Rights Duties and Responsibilities ( HealthRDR) scale. The concepts and content were (...) defined through document analysis, a systematic literature review, and focus groups. The content validity and clarity of the items were evaluated by expert panel of 23 adolescents, school nurses, and researchers. We calculated the content validity index and the content validity ratio at on item and scale levels. Preliminary testing was conducted with 200 adolescents aged 15–16 years. Descriptive statistics, Cronbach’s alpha correlation, and statistics for the item-analysis were calculated. Ethical considerations: Ethical approval and permission were obtained according to national legislation and responsible research practice was followed. Informed consent was obtained from the participants and the parents were informed about the study. Findings: The Health Rights Duties and Responsibilities scale comprises of four sub-scales with 148 items: 15 on health choices, 36 on rights, 47 on duties, and 50 on responsibilities. The items had a 0.93 content validity index and a 0.85 content validity ratio. Cronbach’s alpha correlation coefficient was 0.99 for the total scale and the individual sub-scales scores were health choices (0.93), rights (0.97), responsibilities (0.99), and duties (0.98). Discussion: The findings are discussed in light of the ethical concepts and validity and reliability of the developed scale. Conclusion: The Health Rights Duties and Responsibilities scale defines and understands adolescents’ rights, duties, and responsibilities in relation to health choices and has good content validity. Further testing and refinement of the concepts are needed. (shrink)

: The proclamation Banbiantian, which was proposed during the Mao era, is a vivid and straightforward appellation of women in new China that has gained popularity in national and folk discourses over the past seven decades. This article disassembles this term into three elements — quotation marks, Banbian, and tian — to conduct a political phenomenological analysis. By exploring and sorting reports related to Banbiantian in Renmin ribao, this article reflects on changes in relation to status and role of women (...) in the Mao era on the basis of three findings. Firstly, the quotation marks make Banbiantian a symbol of women’s actual experience and ideal image while playing a role in enhancement and guidance. Secondly, Banbian indicates the equal ratio of men and women and symbolizes the dynamic adjustment in determining equal rights, demonstrating equal capabilities, and improving equal status. Thirdly, tian is the scope of women’s liberation. Through women’s participation in public labor and political activities, coupled with balanced national and regional coordination, its scope continues to expand, extending from the family to society and the country. (shrink)

This paper examines some implications of predicted demographic changes in Canadian universities that may make them unable to replace retiring faculty members in numbers permitting academic business as usual. If the predictions prove correct, it will be desirable to reinterpret received verities about the relationship between professor/student ratios and effective education, the dual roles of teaching and research, and democratic governance in communities of higher education. Possibilities for restructuring inquiry and instruction in ways consistent with the responsibilities of educators are (...) all too briefly explored. A revised division of instructional labour is suggested, along with changes in the conduct of research and academic administration that would free professors to focus on the tasks for which they have the greatest expertise. (shrink)

Background Paediatric clinical research faces unique challenges that compromise optimal recruitment of children into clinical trials. A main barrier to enrolment of children is parental misconceptions about the research process. In developing countries, there is a knowledge gap regarding parental perceptions of and attitudes towards their children's participation in clinical trials. Objective To explore such perceptions and attitudes in Lebanese parents. Study design 33 in-depth interviews were conducted with parents with and without previous research experience. Interviews were tape-recorded, transcribed in (...) colloquial Arabic, and later subjected to thematic analysis. Results Benefit/risk ratio assessment was a major determinant of parental consent. Fear of adverse events or painful procedures in research was a recurring theme in most interviews. Whereas perception of direct benefit to the child, trust in the physician or institution, financial gains or having a positive previous experience in research facilitated consent, a complex informed consent form and misunderstanding of the term ‘randomisation’ hindered parental approval of participation. Conclusion Lebanese parents have perceptions of and attitudes towards children's participation in clinical trials that are similar to those reported from the industrialised world. Improving communication with parents and building trust between researchers and parents is important for successful recruitment. Investigators planning to conduct paediatric trials in developing countries need to simplify consent forms and devise new ways to explain randomisation. (shrink)

BackgroundMental illness among Malaysian children is gradually reaching a fundamentally alarming point as it persistently shows increasing trend. The existing literature on the etiologies of children’s mental illness, highlights the most common cause to be ineffective or impaired parenting. Thus, efforts to combat mental illness in children should focus on improving the quality of parenting. Documented interventional studies focusing on this issue, particularly in Malaysia, are scarce and commonly report poor treatment outcomes stemming from inconvenient face-to-face instructions. Consequently, proposing an (...) accessible online and digital-assisted parenting program is expected to reach a larger number of parents, as it can overcome substantial barriers. Hence, this study aims to develop a universal digital-assisted preventive parenting intervention called DaPI, that aims to enhance mental health of children in Malaysia.MethodsA total of 200 parents of children aged 10–14 years will be recruited and randomized into two groups either intervention or waitlist-control based on a 1:1 ratio for a duration of 8 weeks. Those in the intervention group will receive eight sessions of the DaPI program that focus mainly on parenting and children’s mental health. The primary outcome of this study will essentially focus on the changes in parent-reported parenting behavior and parental self-efficacy. The secondary outcome will be changes in children’s mental health. Assessments will be arranged pre- and post-intervention as well as at the 1-month follow-up. Analyses will be conducted using a paired t-test and multivariate analysis of covariance.DiscussionThe expected outcome will be the establishment of DaPI in promoting children’s mental health by targeting changes in parenting behavior and parental self-efficacy in Malaysia. Findings from this study will be beneficial for policymakers to invest in parenting programs that could provide support to parents in enhancing their child’s overall development.Clinical trial registration[www.irct.ir], identifier [IRCT20211129053207N1]. (shrink)

Background: Poor psychosocial work environments are considered critical factors of nurses’ intention to leave their profession. Workplace injustice has been proven to increase the incidence of psychiatric morbidity among workers. However, few studies have directly investigated the effect of workplace justice on nurses’ intention to leave their profession and the population attributable risk among nurses. Objective: This study identified factors associated with workplace justice and nurses’ intention to leave the profession. Method: A cross-sectional survey was conducted using a self-administered structured (...) questionnaire. Approximately 10% of all secondary referral centers in Taiwan were stratified and randomly sampled. Multiple logistic regression and population attributable risks were preformed to assess the effect of workplace justice on nurses’ intention to leave the nursing profession. Ethical considerations: This study was approved by the Research and Ethical Committee of National Taiwan University Hospital. Only nurses who consented to the study participated in the survey. Result: A total of 2268 nurses were recruited, of whom 1417 (62.5%) satisfactorily completed the questionnaire. The participants were classified and 342 (24.1%) of them were placed into the low workplace justice group. Nurses with low workplace justice had a higher intention of leaving the profession (adjusted odds ratio = 1.34, 95% confidence interval = 1.02–1.77). “Employees’ opinions are influential in hospital’s decision making” and “employees’ performance is evaluated fairly” were the most influential factors of the participants’ intention to quit. The adjusted population attributable risk was 3.7% for low workplace justice. Conclusion: This study has identified that workplace justice is a protective factor of nurses’ leaving their current profession. A fair performance appraisal system and increased autonomy at work are warranted to dissuade nurses from leaving the nursing profession. (shrink)

BackgroundWe examine the incidence of medical tribunal decisions and disciplinary actions (DAs) against healthcare professionals (HCPs). In addition, we studied whether an intimate relationship between an HCP and patient as part of the medical tribunal decision is associated with an increased likelihood of disciplinary actions.MethodsWe conducted a nationwide cohort analysis on the downloadable medical tribunal decisions from a medical disciplinary tribunal in the Netherlands from 2010 to 2017.ResultsWe found that 117 (2.8%) of the 4,046 medical tribunal decisions involved an alleged (...) intimate relationship between an HCP and patient. In these medical tribunal decisions the likelihood of a disciplinary action was significantly increased (odds ratio [OR] 12.97, 95% Confidence Interval [95% CI] 7.11–23.64). In addition, we found that nurses and psychiatrists are more frequently accused of and receive disciplinary actions due to intimate relationships than other HCP groups.ConclusionsWe found a limited number of medical tribunal decisions involving an intimate relationship. Especially given the total number of medical tribunal decisions and the number of yearly HCP-patient interactions, the number appears small. Furthermore, an alleged intimate relationship or inappropriate sexual conduct is associated with an increased likelihood of disciplinary action. Future research should obtain statistics on the number of intimate relationships that actually start between HCPs and patients. (shrink)

Nowadays, some of the things that are ḥarāmto be consumed, such as lard, its derivatives and alcohol are used as additives or additional nutrients in products, namely food and cosmetics that people use widely in daily life. The provision of these products, which are accepted as najis(impure), stands in front of us as one of the actual fiqh problems. In order to produce an accurate solution in this regard, the reaction condition and the level of dissolution in the product must (...) be determined. In this article, the level of mutanajjis (contamination) of the products that najisthings transforms through istihlāk(physical change) and the provision (hukm) of benefits from such things are examined. The research covers the discussions in the classical period regarding the provision of things, which included najāsah(impurity) and underwent physical change as well as the evaluations of contemporary Islamic jurists. The aim of this study is to contribute to the researches, which will be carried out to determine the provision of products containing ḥarāmelements. As the production is carried out on an industrial scale, such studies are important today in terms of the establishment of “ḥalāl” sensitivity and meeting the needs of people who have this sensitivity to learn the provision of such products.SummaryNowadays, in various sectors, especially food, feed, cosmetics, health and clothing industries, for the purposes of reducing the cost of the product, extending the shelf life, making the product more attractive in terms of color, consistency and aroma, many substances are added to the main material. The fact that some of the substances added are ḥarām(forbidden) such as blood, lard, pest, and ethyl alcohol require the subject to be considered in terms of fiqh. It is important to clarify two issues in order to reach a healthy result in the studies aiming to determine the provision (ḥukm) of the products that are mixed with najis(impure) substance. One of them is the determination of the level of istihlāk(physical change) in the mutanajjis(contamination) things. The second is the determination of the basic principles to be used in determining the provision of the things which najāsahhas undergone the physical change in. In this study conducted within the scope of this purpose and method, the hadīthsrelated to two different issues that are directly related to the subject have been evaluated as the basic textual basis. These are narrations about the cleanliness and pollution status of the contaminated water, and about the availability of fats and oils, which the dead mouse is seen in. It is stated in the narrations about the condition of the water that najāsah involved in, the water will not be najisunless its smell, taste or color changes because of the falling najāsahin it. According to this hadith, which shows the change of description as a measure, the fuqahāʾ(jurists) came to a consensus on the fact that water, which one of its characteristics changed because of najāsahwould be considered mutanajjis. When thishadithis evaluated together with the narrations that indicate the small amount of water is contaminated because of najāsah, in fact, it is seen that while the water is considered to be clean-najis, the situation of the water being affected from najāsahis taken as the basis and aimed to protect human health against the dirty water. At the time when there were not any one of today's microbiological analysis laboratories, the way to understand the pollution status of water was to see if the smell, color and taste of the water changed while taking the amount of the water into account. Since the rate of foreign matter in the water, the level of pollution and the health status of the water can be determined correctly in the laboratory today, operating the modern techniques as well as the measure of qualification change will be appropriate for the purpose of the hadīthsmentioned.In the narrations about the state of the fat, which the dead mouse is found in, it is seen that different operations are requested depending on the fat being solid or liquid. If the fat is liquid, different instructions have been made such as its being poured or used in lighting. Mālikīs, Shāfiʿīs, and Ḥanbalīfaqīhs (jurists) of the first period have ruled that liquids such as vinegar, milk and honey are mutanajjis, whether they are in little quantity or not, and whether their descriptions are changed or not, claiming that the amount of oil and the degree of impact on the dirt is not declared in the hadīths. The Ḥanafīs adopted the provision in the narrations mentioned pointing to a small amount of liquid oil and considered the measure of description change for a large amount of liquid valid. Ẓāhirīs, Ibn Taymiyyah and some of the faqīhsargued that the liquids which one cannot feel the color, taste or smell of the najāsahin are clean, regardless of the amount.These three approaches are open to criticism because the first is limited only to the literal meaning in the narrations and neglects the aims, and the second ignored the non-water fluids’ ability to hide the descriptions of the substance added to them, and the third evaluates the mustahlak substance (that has undergone a physical change) as if it had been istiḥālah(chemically changed). When the narrations related to the subject are examined, it is understood that while the usage of the liquid fat which the dead mouse was seen in as the food was prohibited, in fact, it was based on the foresight that all of the fat is affected by the mouse. It appears to have been ruled out that only the part polluted is the part affected by thenajāsahfor the fact that after the removal of the mouse and the environment from the solid oil exposed to the same contamination, the rest is allowed to be eaten. According to this, it is possible to say that the measure of mutanajjisin the things that affected by najāsahis in the degree of spreading of najāsah.Nowadays it is possible to determine the presence of najisthings in the main material, which is used as additive or addition, by the level of effect of these substances in the product, as well as by the assays. If the najissubstances used for purposes such as brightness, taste, consistency and extending shelf life, perform the expected functions, it means that they protect their presence in the product effectively. In fact, it should be acknowledged that these substances continue to exist effectively in the product, if they perform the targeted function without any chemical change, even the ratio in the product is low or the color, taste and odor are eliminated during the mixture.The faqīhswhile differed in opinion about the mutanajjisof things that the najāsahhad undergone physical changes in, they, in concert, considered the substances, which were not cleaned or could not be cleansed from which that they accept as mutanajjisby their own measurements, khabīs(disgusting), and have accepted the people’s eating of them as ḥarām. Likewise, they did not allow such things to be used in any way touching the body, clothing and containers. They have evaluated the narrations, which requires the spilth the fat that the dead mouse was seen in, as the main basis in this issue. On the other hand, about the use of the mutanajjisthings outside the human consumption area and in such a way that the clothes and body would not be contaminated; the majority of thefaqīhs preferred the mubāḥ provision. They have put forth the narrations as the basis that recommends the usage of the liquid oil in which the mouse was fallen in lighting. These approaches of the fuqahāʾabout the effect of the istihlākon the provision of making use of the things that affected by najāsahare of worth as the basic principles on the subject. It is possible to say that it is not permissible to consume food products containing lard or pork gelatin, and the chicken that has been torn apart while being left in hot water in order to pluck its feathers, and the egg which becomes mutanajjisfor it is boiled up with thenajāsahon, and the using of cosmetic products containing lard when today’s industrial products are evaluated in accordance with these principles. If taken the general opinion that defends that the ethyl alcohol is najis as the basis, the carbonated soft drinks, which are added to alcohol, can also be evaluated in this context. (shrink)

The aim of this study is to develop a valid and reliable measurement tool for determining students' spiritual health and life orientation. For this purpose, the Spiritual Health and Life-Orientation Measure (SHALOM) inventory developed by Fisher (2010) is adapted to Turkish. The adaptation study was carried out on 1591 high school students in three study groups studying in Ankara and Muş. The original English measure consisting of four dimensions and twenty items was translated into Turkish, factor analysis, validity and reliability (...) tests were conducted on the sampling data. As a result of the study, the Turkish-adapted inventory consists of four dimensions (personal, social, environmental and transcendental) which resemble the original inventory. In addition, internal consistency coefficients of the inventory dimensions were in perfect harmony with the original inventory and served the purpose of the scale. In Conclusion The Turkish adaptation of the SHALOM Inventory can be used in different disciplines of psychology, educational sciences, and social sciences. Summary: The concept of religion, which is an important dynamic and carrier of the social field, has gone into a double distinction since the second half of the 18th century; the concept of spirituality has begun to be refined from the concept of religion. The concepts of religion and spirituality are very difficult to define; While the concept of religion focuses ideology and rules of belief, spirituality centers on individual experiences and interrelationships that extend religion. For this reason, different spirituality and religion definitions are made from different perspectives and different spirituality scales were developed within this framework. However, the results of these studies differ significantly from each other; this means that spirituality was defined and conceptualized based on the scale that was used. Early period studies on spirituality mostly focus on religion, health, psychology and work life. In these studies, after defining the concept of spirituality; the relationship between the concept and health, religion, psychology and business life or necessity for human life is discussed. In the West, until the 1950s, the concepts of religion and spirituality were used interrelated. However, today these two concepts are almost completely separated from each other.Literature consists of numerous inventory development studies to measure spirituality. The fact that the inventory works based on different conceptual foundations makes it difficult to draw a general, meaningful and consistent conclusion about spiritual health and life orientation. Furthermore, spirituality measurements reflecting the religion and values ​​of a particular culture cannot be comprehensive or universal. At this point, Fisher criticizes the measurement tools developed for the purpose of measuring spirituality: in terms of "mixing religion and spirituality", "relying on the world of values", "not taking into account cultural differences", "and questioning only the mystical/spiritual experience". As a result, it can be said that no measurement developed in the conceptual structure of the West does not take into account the cultural flexibility and accept its spiritual values as universal or prevalent.The SHALOM inventory developed by Fisher, which adapted to the Turkish culture in present study, is based on four basic (individual, social, environmental and transcendent) areas that constitute the world of interpersonal relationship. In this study, spirituality, as in Fisher's work, emphasizes the interaction with certain concepts of different intensities that are considered as independent from religion and above religions. In this context, the concept of spirituality communicates with one's personal space, social position, nature, and transcendental power. This adaptation study will provide useful information and comments on the students' spiritual health levels. This is the most important motive behind the idea of adapting the SHALOM inventory developed by Fisher to the Turkish culture. In addition, by adapting the SHALOM inventory, which is emphasized to have cultural flexibility and adapted to different languages, a new and different measurement tool will be available to understand the nature of the concept of spirituality.This research was carried out to adapt the inventory of Spiritual Health and Life Orientation scale developed for students to Turkish culture. This inventory adaptation study was performed with the data collected from three working groups in Ankara and Muş provinces and 1591 high school students. The first study group was carried out with 414, the second study group with 788, and the third group with 389 high school students. While the data collected from 414 students were used for Exploratory Factor Analysis (AFA) analysis, data collected from 788 students were used for Confirmatory Factor Analysis (CFA). In addition, 389 students were used to determine the criterion validity of the inventory. The original language of the SHALOM inventory, which is intended to be adapted into Turkish, is English, and translation studies are conducted separately by three linguistic experts who know the grammar and semantic characteristics of both languages. After the translation studies, the scale was applied to the sampling group and AFA was performed on the sample data. The AFA results showed that a factor roof resembling the original inventory was formed. Determining factors are given appropriate names (personal, enviromental, social and transcendental) by taking into consideration the theoretical names and the dimension names in the original form of the SHALOM. The structure was confirmed by DFA, and as a result of the DFA, X2/sd (1.72) ratio and IFI (0.96) fit indicator was found to be the appropiate fit for the model tested. As a result, it is understood that the Spiritual Health and Life Orientation Inventory consists of four dimensions as in the original inventory, the internal consistency coefficients of the inventory dimensions are in harmony with the original inventory and serve the purpose of the scale. In conclusion the Turkish adaptation of the SHALOM Inventory can be used in different disciplines of psychology, educational sciences, and social sciences. Spirituality should not only be defined within the framework of Western theories, but the nature and likelihood of the spirituality predicted by Islam should be discussed. Moreover, the types and dimensions of Islamic spirituality should be determined by taking into account the cultural subjectivity of an Islamic character. In the study of spirituality, the human model which modernity presents universally should not be accepted as the only truth. It should be tried to develop human models that come from Islamic culture and history and which are specific to us and define us. This should be taken into account not only in mental health / religious studies, but also in psychology of religion in general. In addition, culture-specificity should be given importance, and the experience gained from the cultural accumulation developed by the Turkish civilization with the Islamic doctrine should lead to the studies of spirituality. In this respect, this study aims to adapt the value and spiritual orientation of a different culture to Turkish culture, but it is problematic to construct the concept with Western values. Although Western values are similar to Islamic values and principles, it is envisaged that it may be difficult to measure the concept of spirituality in practice. (shrink)

Experimental research suggests that people draw a moral distinction between bad outcomes brought about as a means versus a side effect (or byproduct). Such findings have informed multiple psychological and philosophical debates about moral cognition, including its computational structure, its sensitivity to the famous Doctrine of Double Effect, its reliability, and its status as a universal and innate mental module akin to universal grammar. But some studies have failed to replicate the means/byproduct effect especially in the absence of other factors, (...) such as personal contact. So we aimed to determine how robust the means/byproduct effect is by conducting a meta-analysis of both published and unpublished studies (k = 101; 24,058 participants). We found that while there is an overall small difference between moral judgments of means and byproducts (standardized mean difference = 0.87, 95% CI 0.67 – 1.06; standardized mean change = 0.57, 95% CI 0.44 – 0.69; log odds ratio = 1.59, 95% CI 1.15 – 2.02), the mean effect size is primarily moderated by whether the outcome is brought about by personal contact, which typically involves the use of personal force. (shrink)

The Bozeman scale is the most famous scale of statistical stylistics, and is based on the study of the vocabulary used by the author, and the number of verbs and adjectives in the text. Based on this scale, the ratio of dividing the number of verbs by the number of adjectives indicates its literary or sci-entific style and rationality. Therefore, this study aims to answer the follow-ing questions: How accurate is the Bozeman equation in measuring the lit-erary texts and (...) the emotionality of their authors? How does the style of a sermon differ from the style used in other literary arts? Do the subject and content of the sermon play a role in raising the level of the literary style and emotionality of the preacher? What factors affect the value of the Bozeman scale in political speeches and preaching sermons? What factors affect the value of the Bozeman scale in political speeches and preaching sermons? This study aims to apply this objective scale to sermons and compare the value of the scale in them with the percentages in other literary genres on which similar studies were conducted, such as poetry and letters. It also focuses on the impact of the content of the text on the value of the scale by comparing political speeches and preaching speeches. The study chose a sample of political speeches by Ziyâd b. Ebîh and Al-Hajjaj bin Yusuf Al-Thaqafi, and a sample of preaching sermons by `Omar bin Abdul Aziz and Al-Hassan Al-Basri, adopting the descriptive statistical analytical approach. The results revealed that the style of sermons is the most literary and emo-tional one among all other literary genres. Besides, preaching sermons sur-pass political speeches based on the value of the Bozeman scale, thus imply-ing that their style employs emotion, conscience, and literary images. In con-trast, political speeches are characterized by a rational style that relies on arguments and proofs. (shrink)

The study of matching degree between energy equipment manufacturing and market demand is crucial for energy enterprises to adjust business strategies, expand market share, and develop sustainably. Considering that the current electricity market evaluation indicators are rarely selected from a global perspective and a single evaluation method may lead to one-sided results, this article takes the technology and equipment related to electric energy as the research object and selects six indicators, including technical standards, qualification certification, export methods, after-sales service, market (...) concentration, and product concentration. By analyzing the supply and demand characteristics of major global regional markets and the situation of Chinese power enterprises in these markets, we propose matching model cluster including osculating value method, rank-sum ratio method, ideal point method, entropy value method, and efficacy coefficient method to conduct the matching degree study. The results show that the overall market matching degree of Chinese power companies is good, especially in Southeast Asia, Central Asia, and Africa. For markets with a low degree of matching, we analyze the reasons based on the matching indicators values to provide companies with corresponding strategies and recommendations. (shrink)

A survey of consanguineous marriages in Japan was conducted on 1 September 1983, by questionnaires. The total number of couples surveyed was 9225. They were chosen from six widely different areas and the inbreeding coefficients from isonymy and pedigrees were estimated for each area. Random inbreeding remained constant with the marriage year whereas total (F) and non-random (Fn) inbreeding from isonymy and inbreeding from pedigrees ([alpha]) decreased with the marriage year in each area. Estimates of genetic microdifferentiation from surnames were (...) obtained; estimates of the reduced variance indicated low microdifferentiation (0·000014-0·000081) in five areas and a higher value in Fukue City (0·0004). The ratio of FST (the average within-group apriori kinship) to [alpha]-value ranged from 0·42 in Kawanishi City to 3·9 in Minobu-Cho. (shrink)

Japan has one of the highest numbers of high-cost medical devices installed relative to its population. While evaluations of the distribution of these devices traditionally involve simple population-based assessments, an indicator that includes the demand of these devices would more accurately reflect the situation. The purpose of this study was to develop an indicator of the supply–demand balance of such devices, using examples of magnetic resonance imaging scanners (MRI) and extracorporeal shockwave lithotripters (ESWL), and to investigate the relationship between this (...) indicator, personnel distribution statuses and operating statuses at the prefectural level. -/- Using data from nation-wide surveys and claims data from 16 hospitals, we developed an indicator based on the ratio of the supplied number of device units to the number of device units in demand for MRI and ESWL. The latter value was based on patient volume and utilization proportion. Correlation analyses were conducted between the supply–demand balances of these devices, personal distribution and operating statuses. -/- Comparisons between our indicator and conventional population-based indicators revealed that 15% and 30% of prefectures were at risk of underestimating the availability of MRI and ESWL, respectively. The numbers of specialist personnel/device units showed significant, negative correlations with our indicators in both devices. -/- Utilization-based analyses of health care resource placement and utilization status provide a more accurate indication than simple population-based assessments, and can assist decision makers in reviewing gaps between health policy and management. Such an indicator therefore has the potential to be a tool in helping to improve the efficiency of the allocation and placement of such devices. (shrink)

Smartphones with Global Positioning System (GPS) apps offer simple and accurate tools to collect data on human mobility. However, their associated ethical challenges remain to be assessed. We used the Emanuel framework to assess the ethical concerns of using smartphone GPS to record mobility patterns of young adults in rural South Africa for a larger study on mobility and HIV risk (Sesikhona). We conducted four focus groups (FGDs) with individuals eligible for the Sesikhona study. FGD data were coded using the (...) Emanuel framework. Participants perceived use of smartphone GPS to study human mobility and HIV risk as valuable. They raised concerns about invasion of privacy and confidentiality. Also mentioned were risk/benefit ratio, informed consent and ongoing respect. Concerns expressed provided a useful evidence-base for the development of a guide to inform future participants about ethical issues arising in the use of GPS technology to track mobility and health-related issues. (shrink)

The Tri-Council Policy Statement: Ethical Conduct for Research Involving Humans was first developed to establish a standard of practice in research ethics by the three federal agencies responsible for funding institutional research in Canada: Canadian Institutes of Health Research, Natural Sciences and Engineering Research Council, and Social Sciences and Humanities Research Council. In 2010, a second edition of the policy, known as the TCPS 2, was released with updated information and expanded coverage of research ethics issues. According to the TCPS (...) 2, the Agencies’ mandate is “to promote research that is conducted according to the highest ethical standards,” and the TCPS 2 serves as a benchmark for this with respect for human dignity as its underlying value. Research institutions receiving Agency funding are to comply with this policy statement by forming Research Ethics Boards to review all research involving human participants. The intention behind this review requirement is to provide a proportionate assessment of the benefit-to-risk ratio of the research, and in that process, to safeguard “respect for persons”, express a “concern for welfare”, and uphold “justice”. Research may not proceed until ethics approval is granted by an institution’s REB. The current study evaluates REB members’ perspectives on their knowledge of research ethics, and juxtaposes these perceptions with those of researchers. Specifically, we are interested in the extent to which REB members with less experience read the TCPS 2, and whether those with less experience have decreased confidence in their ethics knowledge. (shrink)