German medical students are not sufficiently introduced to the ethical principles and pitfalls of scientific work. Therefore, a compulsory course on good scientific practice has been developed and implemented into the curriculum of medical students, with the goal to foster scientific integrity and prevent scientific misconduct. Students’ knowledge and attitudes towards GSP were evaluated by a pre-post-teaching questionnaire survey. Most participants initially had startling knowledge gaps in the field. Moreover, they were not acquainted with core institutions on GSP, (...) the office of ombudsperson and the nationally binding guidelines on GSP. The pre-post-teaching comparison showed statistically significant improvement in all areas tested; moreover, after the course participants confided more trust in GSP institutions. Applying ethical rules into practice can be challenging; therefore, students need to learn to work independently with guidelines on GSP and should be introduced to institutions providing further guidance. As our study has shown, students are very willing to pursue a scientific career based on integrity and honesty, however, they lack the knowledge how to do so. In light of our results, we therefore recommend to integrate courses on GSP already at an early time into the mandatory curriculum of medical students. (shrink)

The paper discusses an ethical analysis of three common cases involving the most popular requests in rhinoplasty. As the nose plays a fundamental role in the aesthetics and physiognomy of the human face, the request for rhinoplasty may be an expression of both subjective discomfort and objective dysfunction. The paper aims, therefore, to fill the gap between qualitative-subjective impressions related to bodily self-perception and its quantitative-objective assessment. Ethical evaluation should start with consideration of the formal object and circumstances of the (...) act, by posing the following question: Is this a real clinical case? Only after an undoubtedly positive answer to this question, should we consider specific case-related aspects; i.e., the best scientific evidence, available nosography and informed consent, before conducting an ethical evaluation of the case. DOI: 10.5294/pebi.2016.20.1.8. (shrink)

BackgroundThe preferable position of Deep Brain Stimulation electrodes is proposed to be located in the dorsolateral subthalamic nucleus to improve general motor performance. The optimal DBS electrode localization for the post-operative improvement of balance and gait is unknown.MethodsIn this single-center, retrospective analyses, 66 Parkinson’s disease patients were assessed pre- and post-operatively by using MDS-UPDRS, freezing of gait score, Giladi’s gait and falls questionnaire and Berg balance scale. The clinical outcome was related to the DBS electrode coordinates (...) in x, y, z plane as revealed by image-based reconstruction. Binomial generalized linear mixed models with fixed-effect variables electrode asymmetry, parkinsonian subtype, medication, age class and clinical DBS induced changes were analyzed.ResultsSubthalamic nucleus-deep brain stimulation improved all motor, balance and FoG scores in MED OFF condition, however there were heterogeneous results in MED ON condition. DBS electrode reconstructed coordinates impacted the responsiveness of axial symptoms. FoG and balance responders showed slightly more medially located STN electrode coordinates and less medio-lateral asymmetry of the electrode reconstructed coordinates across hemispheres compared to non-responders.ConclusionDeep brain stimulation electrode reconstructed coordinates, particularly electrode asymmetry on the medio-lateral axis affected the post-operative responsiveness of balance and FoG symptoms in PD patients. (shrink)

Background: To evaluate the effectiveness of a multifaceted intervention in improving emergency department (ED) patient privacy and satisfaction in the crowded ED setting. Methods: A pre- and post-intervention study was conducted. A multifaceted intervention was implemented in a university-affiliated hospital ED. The intervention developed strategies to improve ED patient privacy and satisfaction, including redesigning the ED environment, process management, access control, and staff education and training, and encouraging ethics consultation. The effectiveness of the intervention was evaluated using patient surveys. (...) Eligibility data were collected after the intervention and compared to data collected before the intervention. Differences in patient satisfaction and patient perception of privacy were adjusted for predefined covariates using multivariable ordinal logistic regression. Results: Structured questionnaires were collected with 313 ED patients before the intervention and 341 ED patients after the intervention. There were no important covariate differences, except for treatment area, between the two groups. Significant improvements were observed in patient perception of "personal information overheard by others", being "seen by irrelevant persons", having "unintentionally heard inappropriate conversations from healthcare providers", and experiencing "providers' respect for my privacy". There was significant improvement in patient overall perception of privacy and satisfaction. There were statistically significant correlations between the intervention and patient overall perception of privacy and satisfaction on multivariable analysis. Conclusions: Significant improvements were achieved with an intervention. Patients perceived significantly more privacy and satisfaction in ED care after the intervention. We believe that these improvements were the result of major philosophical, administrative, and operational changes aimed at respecting both patient privacy and satisfaction. (shrink)

Segmentation of post-operative glioblastoma multiforme (GBM) is essential for the planning of Tumor Treating Fields (TTFields) treatment and other clinical applications. Recent methods developed for pre-operative GBM segmentation perform poorly on post-operative GBM MRI scans. In this paper we present a method for the segmentation of GBM in post-operative patients. Our method incorporates an ensemble of segmentation networks and the Kullback–Leibler divergence agreement score in the objective function to estimate the prediction label uncertainty (...) and cope with noisy labels and inter-observer variability. Moreover, our method integrates the surgery type and computes non-tumorous tissue delineation to automatically segment the tumor. We trained and validated our method on a dataset of 340 enhanced T1 MRI scans of patients that were treated with TTFields (270 scans for train and 70 scans for test). For validation, we developed a tool that uses the uncertainty map along with the segmentation result. Our tool allows visualization and fast editing of the tissues to improve the results dependent on user preference. Three physicians reviewed and graded our segmentation and editing tool on 12 different MRI scans. The validation set average (SD) Dice scores were 0.81 (0.11), 0.71 (0.24), 0.64 (0.25), and 0.68 (0.19) for whole-tumor, resection, necrotic-core, and enhancing-tissue, respectively. The physicians rated 72% of the segmented GBMs acceptable for treatment planning or better. Another 22% can be edited manually in a reasonable time to achieve a clinically acceptable result. According to these results, the proposed method for GBM segmentation can be integrated into TTFields treatment planning software in order to shorten the planning process. To conclude, we have extended a state-of-the-art pre-operative GBM segmentation method with surgery-type, anatomical information, and uncertainty visualization to facilitate a clinically viable segmentation of post-operative GBM for TTFields treatment planning. (shrink)

Covid-19 lockdown restrictions constitute a population-wide “life-change event” disrupting normal daily routines. It was proposed that as a result of these lockdown restrictions, physical activity levels would likely decline. However, it could also be argued that lifestyle disruption may result in the formation of increased physical activity habits. Using a longitudinal design, the purpose of this study was to investigate changes in physical activity of different intensities, across individuals who differed in activity levels prior to lockdown restrictions being imposed, and (...) across three time periods: pre-, during- and post-lockdown. This study also examined the extent to which the experience of daily hassles explained any changes in physical activity. A convenience sample recruited through social media, provided data from an online survey administered during weeks 2–3 of a 5-week lockdown and 231 participants provided complete data again 6 weeks post-lockdown. Participants completed the International Physical Activity Questionnaire–Short Form and the Daily Hassles Scale. Results showed that vigorous and moderate intensity PA were significantly lower during- and post-lockdown compared to pre-lockdown in those individuals who had been highly active pre-lockdown. In contrast, for moderately active individuals pre-lockdown, vigorous and moderate intensity PA was significantly higher during-lockdown compared to pre-lockdown, and these increased levels of vigorous PA were maintained post-lockdown. Participants experienced daily hassles due to inner concerns, time pressures, family, and financial concerns to the same extent during- and post-lockdown. Those daily hassles had a small negative predictive effect on post-lockdown PA. It appears that to understand the effect of COVID-19 restrictions on PA, the activity status of individuals pre-lockdown needs to be taken into account. The daily hassles appeared to play a role in post-lockdown PA behavior, but future research should investigate why these results occurred. (shrink)

Transcranial magnetic stimulation can be used to mask visual stimuli, disrupting visual task performance or preventing visual awareness. While TMS masking studies generally fix stimulation intensity, we hypothesized that varying the intensity of TMS pulses in a masking paradigm might inform several ongoing debates concerning TMS disruption of vision as measured subjectively versus objectively, and pre-stimulus versus post-stimulus TMS masking. We here show that both pre-stimulus TMS pulses and post-stimulus TMS pulses could strongly mask visual stimuli. We found (...) no dissociations between TMS effects on the subjective and objective measures of vision for any masking window or intensity, ruling out the option that TMS intensity levels determine whether dissociations between subjective and objective vision are obtained. For the post-stimulus time window particularly, we suggest that these data provide new constraints for models of vision and visual awareness. Finally, our data are in line with the idea that pre-stimulus masking operates differently from conventional post-stimulus masking. (shrink)

Three major aspects of G1 regulation acting at START in fission yeast are discussed in this review. Firstly, progression towards S phase in the mitotic cycle. This is controlled by the activation of transcription complexes at START which cause cell cycle‐dependent activation of genes required for DNA synthesis. The second aspect is the regulation of developmental fate occurring during G1. Passage through START appears to inhibit sexual differentiation because the meiotic and mitotic pathways are mutually exclusive. This is brought about (...) because the meiotic pathway is inhibited by the same gene functions that are required for S phase onset. Thirdly, distinct checkpoint, or dependency, controls operate both pre‐ and post‐START in the mitotic cycle to inhibit mitosis in the absence of replicated DNA, and also to limit rounds of DNA replication to one per cell cycle. (shrink)

In this text Cassin and Narcy begin their reassessment of the mode of thought that is sophistry, which has historically functioned as the (negative) “other” of classical philosophy. To this end, the authors first present a close reading of Book Gamma of Aristotle’s Metaphysics, understood as a concerted “strategy against sophism” that, in establishing a logical basis for metaphysics, seeks to relegate the former to the sidelines once and for all. What proves ineliminable in this operation, however, and which “resurfaces (...) beyond metaphysics,” is discourse itself. Cassin and Narcy then set about exploring the contemporary resurgences of sophistry, first through the discourse of (novelistic) fiction, then, more rigorously, in the work of Jacques Lacan, whose own thought poses radical challenges to the relation of language to meaning. (shrink)

Did the September 11, 2001 terrorist attacks on the U.S. cause the values of teenagers in the U.S. to change? Did their previously important self-esteem and self-actualization values become less important and their survival and safety values become more important? Changes in the values of teenagers are important for practitioners, managers, marketers, and researchers to understand because high school students are our current and future employees, managers, and customers, and research has shown that values impact work and consumer-related attitudes and (...) behaviors. Further, studies that compared higher to lower performing for-profit and not-for-profit companies have found that higher performing organizations had strong values that permeated their organizations [Collins J. C., and J. I. Porras: 1994, Built to Last: Successful Habits of Visionary Companies (New York, Harper Business); O’Reilly, C. A. and J. A. Chatman: 1996, in B. M. Staw and L. L. Cummings (eds.), Research in Organizational Behavior, vol. 18 (JAI Press, Greenwhich, CT), pp. 157–200; O’Reilly, C. A.: 1989, California Management Review 31(4), 9–25; Posner, B. Z., and W. H. Schmidt: 1996, Public Personnel Management, 25(3), 277–298; Rousseau, D.: 1990, Group and Organization Studies 15(4), 448–460; Schein, E. H.: 2004, Organizational Culture and Leadership. San Francisco, Jossey Bass)]. While one study of adults found value changes, no known studies have explored if the values of teenagers also changed post-9/11. This study filled that research gap by exploring the values of a random sample of 1000 U.S. teenagers in grades 9 to 12 pre- and post-9/11, using a demographic questionnaire and the Rokeach Value Survey. The research results indicated that teenage survival, safety, and security values (a world at peace, freedom, national security, and salvation) increased in importance while their self-esteem and self-actualization values (a sense of accomplishment, inner harmony, pleasure, self-respect, and wisdom) decreased in importance, mirroring the changes for adults. The meaning of these findings for practitioners, managers, marketers and researchers was discussed. (shrink)

IntroductionThe stressful pre-operative period exerts a profound impact on psychological, physiological and immunological outcomes. Oncological surgeries, in particular, elicit significantly higher stress responses than most other surgeries. Managing these responses through psychological interventions may improve long-term outcomes. The purpose of the current research was to review studies that have explored pre-operative psychological interventions in cancer patients in order to map the types of current interventions and provide an initial assessment of whether these interventions improved psychological, physiological, and/or immunological (...) indices as well as long-term cancer outcomes.MethodsA systematic literature search for studies that included pre-operative psychological interventions in oncology patients was conducted, using the databases PubMed and Web of Science. Inclusion criteria included studies pertaining to oncological surgery in adults, study designs that included a clearly defined pre-operative psychological intervention and control group.ResultsWe found 44 studies, each using one of the following interventions: psychoeducation, cognitive interventions, relaxation techniques, integrated approaches. All the studies reported improved immediate post-operative psychological, physiological, and/or immunological outcomes. Only a few studies addressed long-term cancer outcomes, and only one reported improved survival.ConclusionsResearch on pre-operative interventions with cancer patients is missing systematic methods. Studies provide varying results, which makes it difficult to compare them and reach reliable conclusions. There is considerable heterogeneity in the literature regarding the specific intervention used, the timing of intervention, the characteristics of the patients studied and the outcome measures. In order to improve research in this field, including the measurement of long-term outcomes, we suggest some steps that should be taken in further research. (shrink)

Attitudes toward robots influence the tendency to accept or reject robotic devices. Thus it is important to investigate whether and how attitudes toward robots can change. In this pilot study we investigate attitudinal changes in elderly citizens toward a tele-operated robot in relation to three parameters: (i) the information provided about robot functionality, (ii) the number of encounters, (iii) personality type. Fourteen elderly residents at a rehabilitation center participated. Pre-encounter attitudes toward robots, anthropomorphic thinking, and personality were assessed. Thereafter the (...) participants interacted with a tele-operated robot (Telenoid) during their lunch (c. 30 min.) for up to 3 days. Half of the participants were informed that the robot was tele-operated (IC) whilst the other half were naïve to its functioning (UC). Post-encounter assessments of attitudes toward robots and anthropomorphic thinking were undertaken to assess change. Attitudes toward robots were assessed with a new generic 35-items questionnaire (attitudes toward social robots scale: ASOR-5), offering a differentiated conceptualization of the conditions for social interaction. There was no significant difference between the IC and UC groups in attitude change toward robots though trends were observed. Personality was correlated with some tendencies for attitude changes; Extraversion correlated with positive attitude changes to intimate-personal relatedness with the robot (r = 0.619) and to psychological relatedness (r = 0.581) whilst Neuroticism correlated negatively (r = -0.582) with mental relatedness with the robot. The results tentatively suggest that neither information about functionality nor direct repeated encounters are pivotal in changing attitudes toward robots in elderly citizens. This may reflect a cognitive congruence bias where the robot is experienced in congruence with initial attitudes, or it may support action-based explanations of cognitive dissonance reductions, given that robots, unlike computers, are not yet perceived as action targets. Specific personality traits may be indicators of attitude change relating to specific domains of social interaction. Implications and future directions are discussed. (shrink)

BackgroundCarrier screening is generally performed with the aim of identifying healthy couples at risk of having a child affected with a monogenic disorder to provide them with reproductive options. Expanded carrier screening, which provides the opportunity for multiple conditions to be screened in one test, offers a more cost-effective and comprehensive option than screening for single disorders. However, implementation of ECS at a population level would have implications for genetic counseling practice.MethodsWe conducted semi-structured interviews with sixteen European clinical and molecular (...) geneticists with expertise in carrier screening to explore their views on the implementation of ECS in the clinical setting.ResultsUsing inductive content analysis, we identified content categories relevant to the pre- and post-test settings. Participants believed ECS would ideally be targeted at couples before pregnancy. There was some disagreement regarding the acceptability of performing ECS in individuals, with several participants actively opposing individual-based screening. In addition, participants discussed the importance of ensuring informed and voluntary participation in ECS, recommending measures to minimize external pressure on prospective parents to undergo testing. A need for adequate counseling to foster informed, autonomous reproductive decision-making and provide support for couples found to be at risk was emphasized.ConclusionsPractical challenges in optimizing pre-test education and post-test counseling should not be underestimated and they should be carefully addressed before implementing ECS in the clinical setting. (shrink)

Background Ethical decision‑making and behavior of nurses are major factors that can affect the quality of nursing care. Moral development of nurses to making better ethical decision-making is an essential element for managing the care process. The main aim of this study was to examine and comparison the effect of training in ethical decision-making through lectures and group discussions on nurses’ moral reasoning, moral distress and moral sensitivity. Methods In this randomized clinical trial study with a pre- and post-test (...) design, 66 nurses with moral reasoning scores lower than the average of the community were randomly assigned into three equal groups (n = 22) including two experimental groups and one control group. Ethical decision-making training to experimental groups was provided through the lectures and group discussions. While, the control group did not receive any training. Data were collected using sociodemographic questionnaire, the nursing dilemma test (NDT), the moral distress scale (MDS) and the moral sensitivity questionnaire (MSQ). Unadjusted and adjusted binary logistic regression analysis was reported using the odds ratio (OR) and 95% confidence intervals. Results Adjusted regression analysis showed that the probability of increasing the nursing principle thinking (NPT) score through discussion training was significantly higher than lecture (OR: 13.078, 95% CI: 3.238–15.954, P = 0.008), as well as lecture (OR: 14.329, 95% CI: 16.171–2.005, P < 0.001) and discussion groups compared to the control group (OR: 18.01, 95% CI: 22.15–5.834, P < 0.001). The possibility of increasing moral sensitivity score through discussion training was significantly higher than lecture (OR: 10.874, 95%CI: 6.043–12.886, P = 0.005) and control group (OR: 13.077, 95%CI: 8.454–16.774, P = 0.002). Moreover, the moral distress score was significantly reduced only in the trained group compared to the control, and no significant difference was observed between the experimental groups; lecture group vs. control group (OR: 0.105, 95% CI: 0.015–0.717, P = 0.021) and discussion group vs. control group (OR: 0.089, 95% CI: 0.015–0.547, P = 0.009). Conclusions The results of this study indicate that ethical decision-making training is effective on empowerment of ethical reasoning. Whereas the group discussion was also effective on increasing the ethical sensitivity, it is recommended the training plan provided in this study to be held as workshop for all nurses in health and treatment centers and placed in curricular plan of nursing students. Registration This randomized clinical trial was registered in Iranian Registry of Clinical Trials under code (IRCT2015122116163N5) in 02/07/2016. (shrink)

Installation art is one of the most important and provocative developments in the visual arts during the last half century and has become a key focus of artists and of contemporary museums. It is also seen as particularly challenging or even disliked by many viewers, and—due to its unique in situ, immersive setting—is equally regarded as difficult or even beyond the grasp of present methods in empirical aesthetic psychology. In this paper, we introduce an exploratory study with installation art, utilizing (...) a collection of techniques to capture the eclectic, the embodied, and often the emotionally-charged viewing experience. We present results from an investigation of two pieces, both part of Olafur Eliasson’s exhibition “Baroque, Baroque” held at the Belvedere museum in Vienna. These were assessed by pre- and post-viewing questionnaires focusing on emotion, meaning-making, and appraisals, in tandem with mobile eye tracking to consider viewers’ attention to both installed artworks and/or to the museum environment. The data showed differences in participants’ emotional states, appraisals, and visual exploration, which together paint a picture of the aesthetic reactions to the works. These differences also showed how viewers’ appraisal strategies, meaning making, and physical actions facilitated relatively more or less deep engagement with, and enjoyment of, the art. The results are discussed in terms of their implications for museum studies, art education, and theory in empirical aesthetics. (shrink)

This research formed phase 1 of the Economic and Social Research Council project ‘Pupils’ Approaches to Subject Option Choices’ and is a near repeat of a project carried out in the mid-1980s, thus allowing for a comparison of approaches to subject choice a decade apart, comparing the situation pre- and post-National Curriculum implementation. The simple two-part questionnaire, completed by 1600 children in 11 schools, shows the differences across time and between-school differences in subject preference, but little instability in (...) perceptions of subject importance. Some useful additional data, giving student's reasons for liking subjects and finding subjects important, were obtained from interviews in four schools which formed phase 2 of the project. Comparisons are drawn with the data collected in 1984 on a similar basis. Issues of concern are highlighted with respect to particular subjects and to students’ stated reasons for liking subjects or finding them important, with regard to how this might relate to their subsequent subject choices and career development. (shrink)

Background: Serious Illness Conversations aim to discuss patient goals. However, on acute medicine units, seriously ill patients may undergo distressing interventions until death. Objectives: To investigate the feasibility of using the Surprise Question, “Would you be surprised if this patient died within the next year?” to identify patients who would benefit from early Serious Illness Conversations and study any changes in the interdisciplinary team’s beliefs, confidence, and engagement as a result of asking the Surprise Question. Design: A prospective cohort pilot (...) study with two Plan-Do-Study-Act cycles. Participants/context: Fifty-eight healthcare professionals working on Acute Medicine Units participated in pre- and post-intervention questionnaires. The intervention involved asking participants the Surprise Question for each patient. Patient charts were reviewed for Serious Illness Conversation documentation. Ethical considerations: Ethical approval was granted by the institutions involved. Findings: Equivocal overall changes in the beliefs, confidence, and engagement of healthcare professionals were observed. Six out of 23 patients were indicated as needing a Serious Illness Conversation; chart review provided some evidence that these patients had more Serious Illness Conversation documentation compared with the 17 patients not flagged for a Serious Illness Conversation. Issues were identified in equating the Surprise Question to a Serious Illness Conversation. Discussion: Appropriate support for seriously ill patients is both a nursing professional and ethical duty. Flagging patients for conversations may act as a filtering process, allowing healthcare professionals to focus on conversations with patients who need them most. There are ethical and practical issues as to what constitutes a “serious illness” and if answering “no” to the Surprise Question always equates to a conversation. Conclusion: The barriers of time constraints and lack of training call for institutional change in order to prioritise the moral obligation of Serious Illness Conversations. (shrink)

PurposeThe purpose of this study is to describe the implementation and outcomes of an Eye Movement and Desensitization Reprocessing treatment-program for women with posttraumatic stress disorder after childbirth.MethodsA prospective cohort-study with pre- and post-measurements was carried out in the setting of an academic hospital in the Netherland. Included were women who gave birth to a living child at least 4 weeks ago, with a diagnosis of PTSD, or severe symptoms of PTSD combined with another psychiatric diagnosis. All received up (...) to 8 sessions of EMDR-therapy. The posttraumatic stress disorder Checklist for DSM-5 was administered before and after treatment. Trauma history was assessed before treatment with the Life Events Checklist for the DSM-5, the Childhood Trauma Questionnaire and the Childbirth Perception Scale. Descriptive statistics were used.ResultsForty-four women were referred, 26 met the inclusion criteria. After treatment, none of the women met the criteria for diagnosis of PTSD after on average 5 weekly sessions of EMDR- therapy. These outcomes are promising, as they were achieved in women with relatively high levels of psychiatric comorbidity and high rates of previous mental health treatment.ConclusionImplementing an EMDR-treatment program for women with PTSD after childbirth in the setting of an academic hospital is feasible and effective. Key factors for success include a close collaboration between the relevant hospital departments and a thorough case conceptualization addressing the etiology of the PTSD. (shrink)

This article addresses the issue of asking questions as an important element of international business negotiation where there are differences in cultural background. A Dutch-Spanish difference in questioning was related to differences between the two parties in uncertainty reduction and negotiation goals. All 480 questions in 8 simulated Kelley game negotiations were reviewed: both monocultural and intercultural, i.e. 2 cultures and 3 languages. This analysis may also allow an illustration of the Sapir-Whorf Hypothesis which holds, at least in its weak (...) version, that culture frames language and language frames culture. It may also be possible to determine the extent to which intercultural differences between Dutch and Spanish questioning behaviours - assuming they can be ascertained in comparison with monocultural Dutch and Spanish behaviour - are language bound. In other words, do negotiators use a different typology of questions in their native language than in a neutral language? A comparison of the monocultural and intercultural data makes it possible to illustrate the above hypothesis, and to establish how far the L1-culture connection differs from that of the L2-culture. For another similar test on culture-language relations in South African mathematics texts and their readers, see Prins and Ulijn. The uncertainty reduction theory of Berger and the negotiation models developed by Fisher and Ury and Mastenbroek are related to question behaviour, which is analysed with the Verbal Response Mode Taxonomy of Stiles. Pre- and post-negotiation questionnaires were developed and administered to relate the results of the linguistic analysis to the perceptions of the negotiators in order to test the ecological validity of UR. Asking questions appeared to be a critical success factor in both monocultural and intercultural business negotiation on the basis of their relation with UR variables and Kelley game profit levels, but in a different sense to Gudykunst et al., who suggest that questions reduce uncertainty by increasing attributional confidence in a general way, seemingly irrespective of a national cultural background. In this study the Dutch, starting from a higher level of issue-related global confidence, used questions significantly less than the Spanish to attribute confidence to the person, indicating a cultural difference. Most questioning differences appeared to be language - as well as culture-bound. The Spanish asked significantly more for acknowledgement, and the Dutch asked more indirect questions with disclosure, but the two groups did not differ in global uncertainty and attributional confidence after their negotiations. They seemed to reduce uncertainty by adopting a passive, unobtrusive observation strategy. It may be that the type of information needed to become more confident depends on the communicator's personality rather than on his or her cultural background. Dutch and Spanish managers would therefore be advised to balance openness and vagueness to reach their negotiation goals in maximizing profits by using a combination of clear and ambiguous questions and answers and to be aware of the linguistic differences in questioning between Spanish and Dutch, which may even be carried over to English when it is used as a tool of communication. (shrink)

A quantum key distribution scheme whose security depends on the features of pre- and post-selected quantum states is described.

ABSTRACT Current attempts to understand unusually high rates of psychiatric illness in complex, chronic illnesses can be guilty of operating within an explanatory framework whereby there are two options. Either (a) that the psychiatric predicaments are secondary to the bodily condition, and (b) that they are primary. In this paper, I draw upon philosophical work on affect, contemporary empirical work, and qualitative first-person patient data to illustrate a much messier reality. I argue that affective experience is generally more complex in (...) such conditions, and that a variety of pre- and post-morbid causal factors dynamically interact such that the resultant psychiatric predicaments do not permit to classification as strictly primary or secondary to the bodily condition. Affective scaffolding, in my view, provides an apt theoretical framework for capturing this nuance. (shrink)

Background: Clinical ethics support instruments aim to support healthcare professionals in dealing with moral challenges in clinical practice. CURA is a relatively new instrument tailored to the wishes and needs of healthcare professionals in palliative care, especially nurses. It aims to foster their moral resilience and moral competences. Aim: To investigate the effects of using CURA on healthcare professionals regarding their Moral Resilience and Moral Competences. Design: Single group pre-/post-test design with two questionnaires. Methods: Questionnaires used were the Rushton (...) Moral Resilience Scale measuring Moral Resilience and the Euro-MCD, measuring Moral Competences. Respondents mainly consisted of nurses and nurse assistants who used CURA in daily practice. Forty-seven respondents contributed to both pre- and post-test with 18 months between both tests. Analysis was done using descriptive statistics and Wilcoxon signed rank tests. This study followed the SQUIRE checklist. Ethical considerations: This study was approved by the Institutional Review Board of Amsterdam UMC. Informed consent was obtained from all respondents. Results: The total Moral Resilience score and the scores of two subscales of the RMRS, that is, Responses to Moral Adversity and Relational Integrity, increased significantly. All subscales of the Euro-MCD increased significantly at posttest. Using CURA more often did not lead to significant higher scores on most (sub) scales. Conclusion: This study indicates that CURA can be used to foster moral resilience and moral competences of healthcare professionals. CURA therefore is a promising instrument to support healthcare professionals in dealing with moral challenges in everyday practice. (shrink)

This paper offers novel insight into the Islamic banking business model by considering the effect of investments in human capital and corporate governance features on the market performance of Islamic banks. Based on a sample of 47 banks operating in different regions during the 2005–2010 period, and controlling for firm-specific characteristics, this paper finds investments in human capital to have a significant positive impact on the market value in the pre- and post-financial crisis period. Based on a market measure, (...) this paper finds board size and CEO power to have a significant positive impact, while the size of Shariah Supervisory Board has the opposite effect on market performance. The results further reveal that the Islamic banking sector is not a homogeneous group, with full-fledged Islamic banks having lax corporate governance mechanisms and large size, while their counterparts, Islamic Shariah-windows, having strong corporate governance mechanisms tend to invest more in human capital to yield positive market value. Overall, the analysis suggests that the financial crisis may have further spurred the impact of investments in human capital on the market performance. (shrink)

Flipped learning could improve the learning effectiveness of students. However, some studies have pointed out the limitations related to flipped classrooms because the content of the flipped course does not vary according to the needs of the students. On the other hand, adaptive teaching, which customizes the learning mode according to the individual needs of students, can make up for some of the shortcomings of flipped teaching. This study combines adaptive teaching with flipped teaching and applies it to face-to-face classroom (...) activities. The purpose of this research is to explore whether the implementation of flipping and adaptive learning in a computer programming course can improve the learning effectiveness of students. The experimental subjects of this study are the sophomore students in the Department of Information Management. The flipped classroom with adaptive instruction has been realized in the limited course time. This study uses questionnaires to collect pre- and post-test data on the “learning motivation” of students. The learning effectiveness was evaluated based on the students' previous programming course and the semester scores of this course. Research results show that the post-test “learning motivation” has improved overall compared with the pre-test, and the learning effect is significant. The results of this research not only prove the effectiveness of modern teaching theories in programming courses but also lay the foundation for future teaching design. (shrink)

ObjectiveSelf-esteem and self-acceptance are not only basic features but also influential factors of mental health. The present study aimed at assessing the effects of psychoeducational lecture and group intervention on self-esteem and self-acceptance in Chinese college students.MethodsA total of 149 Chinese college students who participated in a mental health course were randomly class-based assigned into the psychoeducational lecture group and the self-focused intervention group. The lecture group received 6-session psychoeducational lectures on overview of mental health, campus adaptation, stress adjustment, self-understanding, (...) emotion management, and interpersonal relationships. The self-focused intervention group was treated with self-related group activities involving aspects of self-knowledge, self-feeling, and self-regulation for six sessions. Pre- and post-intervention measurements were taken with Rosenberg Self-Esteem Scale and Self-Acceptance Questionnaire for both groups.ResultsSelf-esteem significantly increased in both groups after six sessions. However, the enhancement of self-acceptance was more robust for the self-focused intervention group than the psychoeducational lecture group.ConclusionThe psychoeducational lecture and self-focused intervention were effective approaches to improve self-esteem for Chinese college students. With respect to self-acceptance, self-focused group intervention might have a more prominent effect. (shrink)

This commentary suggests that there is more continuity in pre- and post-demographic transition populations with respect to grandparental investments than is assumed by Coall & Hertwig (C&H). Recent research employing high-quality data supports the claim that sex-biased grandparental investments are likely to exist in industrialized societies, and that the economic status of grandparents is related to their long-term fitness.

This study examined whether the Flipped Classroom (FC) approach is the most effective approach for teachers to create a stimulating and interactive environment that helps students overcome speaking challenges and enhance their English-speaking performance in the context of EFL learners. The study employed quantitative research with a quasi-experimental design. An oral speaking test and a Likert-scale questionnaire were used in this study. The oral speaking test was used to investigate students' improvement in speaking performance before and after the implementation (...) of the FC approach in speaking class. A Likert scale was distributed to determine the students' perspectives on using the FC approach in speaking class. A paired t-test was used to compare the pre and post-test results of the EFL students. Percentage analysis was used to interpret the questionnaire results. The results show that there is a statistically significant difference between the total score of the learners on the post-test (M = 24.53, SD = 5.518) and the total score on the pre-test (M = 21.25, SD = 4.711). This indicates that the participants' performance on the post-test was superior to their performance on the pre-test. In other words, the learners' English-speaking performance has significantly improved in the post-test results. Furthermore, based on the analysis of the questionnaire, the data revealed that most students have positive perspectives or views on the use of FC in speaking class based on the indicator of (1) students' perspectives; (2) students' feedback; and (3) the role of the video materials. (shrink)

For a few decades, patients with Parkinson's disease have been treated with intracerebral transplantations of fetal mesencephalic tissue. The results of open trials have been variable. Double blind, placebo-controlled studies have recently been started in order to further investigate the efficacy of this new medical technique. In this paper we challenge the need for sham surgery in neurotransplantation research on PD patients. Considerations regarding the research subjects' informed consent, therapeutic misconception, the integrity of the human body, and the assessment of (...) risks and benefits argue against sham surgery for patients with PD. Moreover, there is an alternative, less harmful mode of research that can provide the same or comparable scientific evidence. A plea is made for intrapatient research based on quantitative measurements of the patient's pre- and post-operative condition combined with similar research on a reference group of patients who have received the standard treatment. (shrink)

Body expression and dance are activities that contribute to the integral well-being of people. In an educational context, the process of evaluating our students implies variations in their moods. This study tackles the states of mind that students perceive before and after the evaluation of a practice in the subject ofBody expression and dance, developed through choreographies, that were, previously rehearsed, and later presented to the rest of the class in a specific session. Our main interest was the obtention of (...) information on the states of mind of the students prior to the evaluation of their choreographies, and again once they had been performed. The study design consisted of two phases: two different choreographies separated by an interval of 2 months. The students were asked about their moods before and after performing their choreographies, which were evaluated. The participants, 167 in total, 35 women and 132 men, aged 18 to 22 years old, filled out a POMS questionnaire, before and after the evaluation of each occasion. Differences were found in the stress-anxiety, vigor-activity, fatigue-immobility scales and the total mood score. In all of them, except for the fatigue-immobility scale, we found a decrease in scores after the performance, compared to scores before. For the Stress-Anxiety factor, lower values were observed in the post-tests in comparison to the pre-tests, and also lower values in the pre- and post-test scores regarding the second choreography. We conclude that the practical evaluation of the subject through choreography modifies the mood states of the students, favoring their well-being after its execution, which is why evaluation through practice is considered a positive element in the educational process. (shrink)

Research FocusThe promotion of domain-specific knowledge is a central goal of higher education and, in the field of medicine, it is particularly essential to promote global health. Domain-specific knowledge on its own is not exhaustive; confidence regarding the factual truth of this knowledge content is also required. An increase in both knowledge and confidence is considered a necessary prerequisite for making professional decisions in the clinical context. Especially the knowledge of human physiology is fundamental and simultaneously critical to medical decision-making. (...) However, numerous studies have shown difficulties in understanding and misconceptions in this area of knowledge. Therefore, we investigate how preclinical medical students acquire knowledge in physiology over the course of their studies and simultaneously gain confidence in the correctness of this knowledge as well as the interrelations between these variables, and how they affect the development of domain-specific knowledge.MethodIn a pre–post study, 169 medical students’ development of physiology knowledge and their confidence related to this knowledge were assessed via paper-pencil questionnaires before and after attending physiology seminars for one semester. Data from a longitudinal sample of n = 97 students were analyzed using mean comparisons, regression analyses, and latent class analyses. In addition, four types of item responses were formed based on confidence and correctness in the knowledge test.ResultsWe found a significant and large increase in the students’ physiology knowledge, with task-related confidence being the strongest predictor. Moreover, a significantly higher level of confidence at t2 was confirmed, with the level of prior confidence being a strong predictor. Furthermore, based on the students’ development of knowledge and confidence levels between measurement points, three empirically distinct groups were distinguished: knowledge gainers, confidence gainers, and overall gainers. The students whose confidence in incorrect knowledge increased constituted one particularly striking group. Therefore, the training of both knowledge and the ability to critically reflect on one’s knowledge and skills as well as an assessment of their development in education is required, especially in professions such as medicine, where knowledge-based decisions made with confidence are of vital importance. (shrink)

Loneliness was one the most important matters during The Covid Pandemic. This paper claims that this “lonely situation” was a previous cultural condition. Loneliness belongs to a certain style of life of the Western Culture as an effect of the cultural _way of living _during the last decades. For this purpose, we will show the way loneliness has been researched during the last 70 years, which is mostly from a psychological and emotional point of view. On the opposite, we will (...) show 2 reasonings to declare the “emotional loneliness” not enough in order to understand this phenomenon. Finally, we will introduce structural cultural elements – taking Sweden as an example of a very modern western socialdemocracy – to show loneliness as way of life and not only a way of feeling. That conclusion allows us to re-ask the cultural control of an isolated individual in pre-Pandemic times. (shrink)

I approach the idea of empirical turns and transcendental theories indirectly. I do not start “post-“ or “neg-” anything; instead I begin pre-philosophically—that is, before everyone has a position and opposes other positions—with Heidegger’s “preparatory hermeneutical” question: As whom and with what concerns do empirically or transcendentally minded philosophers of technology respond to their experience of technoscientific life? For example, in his second Untimely Meditation, Nietzsche identifies his concern as one of “taking advantage” of historical knowledge “for life,” that (...) is, he understands himself to be motivated by a life-driven, not scientific “need.” But how are “needs” in Nietzsche’s sense to be distinguished? The question leads straight to Heidegger’s idea of a hermeneutics that comes “before philosophy”—a “hermeneutics of facticity” that considers “what goes on in [i.e., motivates] a philosophy before it becomes what it is”? I argue that once Nietzsche’s notion of need is expanded and deepened in Heidegger’s direction, we gain some clarity about how to appropriate any information “for life,” whether it is science-based, culturally operative, or phenomenological. I then consider Ihde, Stiegler, and the future prospects of empirical turns and transcendental theories in light of this idea. (shrink)

This research examines the effect of the project-based learning strategy known as the "gallery walk" on the speaking achievement and self-confidence of English majors at PGRI University in Palembang who possess varying levels of proficiency. Assessing the effect of learning strategies on speaking achievement, this study employed a quasi-experimental design focusing on students with high and low self-confidence. Diversely capable students will be categorized into groups according to their self-assurance in this study. Their confidence in speaking abilities was evaluated using (...) qualitative data gathered through questionnaires and pre- and post-assessments. PjBL enhances students' speaking abilities and self-assurance in various ways, according to the findings of this study. Improvements are influenced by each facet of both speaking proficiency and self-assurance. Fluency, vocabulary, grammar, comprehension, and speaking achievement significantly impact performance. Moreover, cause-and-effect attribution and anxiety regarding language usage are factors that significantly impact self-confidence. In contrast, neither self-efficacy nor perceived L2 competence significantly influenced the students' confidence. (shrink)

In this study of English Foreign Language Learners, the author explored the learning preferences of 14 students enrolled in English for Specific Purposes course. All students were provided with the same content, course materials, assignments and time for completing the assignments. They were all given the same pre and post-learning questionnaire, writing tasks and final exam. However, they completed these tasks either in a digital environment or in-class. The study was conducted at South East European University in Macedonia (...) where digital instruction is not well known or practiced. The results indicate that the best way for students to learn is by combining the two learning environments. By completing an assignment both ways, students discovered not only that some tasks are best done in a digital environment and others in class, but also they discovered their preferred way of learning. (shrink)

This article explores Academic Service Learning as a teaching method which bridges the gap between academic requirements for learning and the need of society to have individuals willing to give their time and effort to benefit others in need. Students as part of a course learning requirement engaged in a consulting project whereby a non-profit organization was advised on both short term and long term planning. Students were exposed to the operational needs of the organization as well as the dependency (...) of the needy on their services. A pre- and post- survey was administered which focused on any perceived changes in Emotional Intelligence experienced by the students upon completion of the project. The results indicated that student’s EI was affected by the learning project in terms of how they feel about themselves and their overall effort levels. (shrink)

Self-, collective, and participative efficacy are strong predictors of sustainability action. Yet, few studies have investigated the dynamics and variability of efficacy beliefs. In this transdisciplinary study, we tested such factors in the context of a peer-to-peer coaching program for sustainability volunteers, embedded in a structured-educational context. Over weekends, 2 qualified coaches trained 36 German bottom-up, student-led sustainability initiatives. These coaches instructed students in team building, envisioning, project planning, and on-campus sustainability practice. While 317 participants completed our pre-questionnaire, N (...) = 165 completed both the pre- and post-questionnaire. As hypothesized, after having participated in the coaching weekend, action skills, collaboration skills, group identification, and self-, collective, and participative efficacy all increased. The latter of these increased, to our knowledge, for the first time in environmental psychology research. Group identification and having a vision emerged as important efficacy predictors, and participative efficacy beliefs in turn predicted volunteering. Moreover, we took initial steps in investigating the interaction of psychological and structural factors from a multilevel perspective. Our analyses revealed that efficacy beliefs on the individual level were higher when the university had a green office and when the student initiative was at a small university. We conclude by proposing an empowerment model for sustainability volunteers and by discussing the practical implications of our findings. (shrink)

The idea of ensembles which are both pre- and post-selected was introduced by Aharonov, Bergmann, and Lebowitz and developed by Aharonov and his school. To derive formulae for the probabilities of outcomes of a measurement performed on such an ensemble at a time intermediate between pre-selection and post-selection, the latter group introduces a two-vector formulation of quantum mechanics, one vector propagating in the forward direction in time and one in the backward direction. The formulae which they obtain by (...) this radical generalization are vindicated by a rigorous derivation using Bayes’s theorem together with standard quantum mechanical predictions regarding ensembles that are only pre-selected. Their own two-vector derivation, however, suffers from a serious lacuna. (shrink)

This essay examines several works that contribute to an understanding of the nature of contemporary Chinese capitalism and its historical development. Core issues include the character of the bureaucracy, which has had a distinctive relationship to capital formation, and the character of the working class. The periodisation of Chinese capitalism and the relation between the pre- and post-reform periods are pressing political and analytical concerns. This essay suggests the advantages of a clearer focus on the dynamics of depoliticisation in (...) understanding the transition. The contemporary left-intelligentsia in China has in large part pinned its hopes on achieving some form of ideological hegemony within theccp, maintaining that it still operates within its revolutionary tradition. This represents a questionable strategic gamble. Acknowledging the important contributions made by Au’s book and other recent characterisations of China’s political economy from the left, this essay suggests that there remains much to be done. (shrink)

One of the important issues in mobile robots is finding the position of robots in space. This is normally achieved by using a sensor to locate the position of the robot. However, relying on more than one sensor and then using multisenor data fusion algorithms tends to be more reliable than just using a reading from a single sensor. If these sensors provide inconsistent data, catastrophic fusion may occur, and thus the estimated position of the robot obtained will be less (...) accurate than if an individual sensor is used. This article uses an approach that relies on combining modified Bayesian fusion algorithm with Kalman filtering to estimate the position of a mobile robot. Two case studies are presented to prove the efficiency of the proposed approach in estimating the position of a mobile robot. Both scenarios show that combining fusion with filtering provides an accurate estimate of the location of the robot by handling the problem of uncertainty and inconsistency of the data provided by the sensors. (shrink)

Students experience different levels of autonomy based on the mediation of self-regulated learning, but little is known about the effects of different mediation technologies on students' perceived SRL strategies. This mixed explanatory study compared two technology mediation models, Icourse and Icourse+Pigai, with a control group that did not use technology. A quasi-experimental design was used, which involved a pre and post-intervention academic writing test, an SRL questionnaire, and one-to-one semi-structured student interviews. The aim was to investigate 280 Chinese (...) undergraduate English as a foreign language students' academic writing performance, lexical complexity, and perceptions of self-regulated strategies in academic writing. One-way ANCOVA of writing performance, Kruskal-Wallis test of lexical complexity, ANOVA of the SRL questionnaire, and grounded thematic content analysis revealed that, first, both Icourse and Icourse+Pigai provided significant support for the development of SRL strategies vs. the control group, although there was no significant difference between the two groups. Second, Icourse+Pigai-supported SRL was more helpful for improving students' academic writing performance because it enabled increased writing practice and correction feedback. Third, Icourse+Pigai-supported SRL did not significantly improve students' lexical complexity. In conclusion, we argue that both learning management systems and automated writing evaluation platforms may be used to assist students' SRL learning to enhance their writing performance. More effort should be directed toward developing technological tools that increase both lexical accuracy and lexical complexity. We conclude that the technical tools used in this study were positively connected to the use of SRL techniques. However, when creating technologically mediated SRL activities, students' psychological study preferences should be considered. (shrink)

This study investigates the effectiveness of integrating short stories with task-based learning activities in English as a foreign language (EFL) class to promote vocabulary development and motivation among L2 learners. Six short stories were selected by the participants based on their interests, pre- and post-tests were conducted to evaluate vocabulary acquisition and a questionnaire was used to gather information about the perception of task-based activities after reading short stories among students. The study involved 60 intermediate level English students (...) at the SEEU Language Center, assigned to either the control or experimental group. The experimental group completed post-reading tasks such as keeping vocabulary notebooks, reading circle discussions, sequencing activities, plot structure understanding, and group poster presentations after reading each story. The findings suggest that the incorporating engaging reading activities had a favorable effect on language learning. The experimental group exhibited greater vocabulary acquisition and comprehension than the control group. The follow-up tasks created a sense of achievement, improved communication and interaction among the students. According to the study, including comprehensible input through extensive reading along with constructive output from task-oriented exercises can effectively promote language progress and enhance students’ motivation thus effectively facilitating language development in L2 learners. (shrink)

Background Interventions targeting healthcare professionals’ confidence in managing ethical issues in dementia care are limited despite documented positive effects of educational programs on staff knowledge and self-efficacy. However, inconsistencies in the literature regarding the impact of educational programs underscore the need for targeted interventions. The CARE intervention, specifically designed to enhance confidence in ethical decision-making, aims to address this gap. This study evaluates the effectiveness of the CARE intervention in enhancing the ethical self-efficacy of healthcare professionals caring for people with (...) dementia, particularly those with initially low levels of self-efficacy. Methods Using a non-experimental pre-post evaluation design, the CARE intervention was administered to healthcare professionals (n = 86), measuring ethical self-efficacy pre-and post-intervention. We hypothesized significant differences in ethical self-efficacy mean scores pre- and post-intervention for all participants, particularly those with low pre-measurement scores, whom we expected to benefit most from the intervention. Statistical analysis included paired t-tests and Wilcoxon tests for the low pre-measurement subgroup analysis. Results While no significant change was observed in the entire sample, participants with low initial self-efficacy showed a statistically significant improvement post-intervention. Conclusions The CARE intervention holds promise in improving ethical self-efficacy among healthcare professionals with initial low confidence levels. Targeted interventions are essential in addressing confidence gaps in managing ethical challenges in dementia care, with implications for professional well-being and quality of care. Further research should explore long-term effects and expand sample size to enhance generalizability and sustainability of findings. (shrink)

BackgroundMoral distress (MD) is an emotional and psychological response to morally challenging dilemmas. Moral distress is experienced frequently by nurses in the intensive care unit (ICU) and can result in emotional anguish, work dissatisfaction, poor patient outcomes, and high levels of nurse turnover. Opportunities to discuss ethically challenging situations may lessen MD and its associated sequela.ObjectiveThe purpose of this project was to develop, implement, and evaluate the impact of nursing ethics huddles on participants’ MD, clinical ethics knowledge, work satisfaction, and (...) patient care among ICU nurses.Sample and SettingThe sample, 32 nurses from three ICU settings in an 800-bed tertiary academic medical center, participated in six nursing ethics huddles over a two-month period.MethodsAlvita K. Nathaniel’s Theory of Moral Reckoning guided development of the nursing ethics huddle process.1 The Moral Distress Thermometer was administered at three data points: baseline level of MD, and pre- and post-huddle to determine changes in the subjects’ level of MD.2 Focused content analysis was used to analyze qualitative responses from questionnaires about the subjects’ perception of the effect of the huddles on work satisfaction and patient care. Knowledge attainment was evaluated via open-ended short-answer questions.ResultsOverall, use of nurse-ethicist-led nursing ethics huddles was associated with improved quality of work life, patient care, and clinical ethics knowledge. The change in pre- and post-nursing ethics huddles MD scores was statistically significant (p < 0.0001). (shrink)

Purpose of the article is to present in two parts the selected aspects of application of monetary policy in the euro area pre and post 2008 as well as insitutional adaptations brought by the EU legislator. Methodology/methods In order to better explain these points, the article relies partially on a comparison with the framework and application of the monetary policy by the Federal Reserve as well as on a historic method when outlining the influence of definition of financial stability (...) from the ECB/eurosystem towards other prominent central banks. Scientific aim The article presents selected aspects of the monetary policy in the part of the EU where single currency was introduced in order to outline state of the art governance structure as well as a certain institutional creativity in application of powers conferred upon the central banks by the Treaty on the Functioning of the European Union and Protocol on the Statute of the European System of Central Banks and of the European Central Bank. The goal is to prove the hypothesis of robustness of the framework and present the limits that can only be pushed further by the legislative power. The conclusions confirm on the one hand that the framework of monetary policy based on strong institutional safeguards such as legislative power and independence is very resilient and can prove efficient and creative enough to stabilise an innovative monetary system, however, on the other hand, validate the hypothesis that certain adaptations can only be performed on the basis of a legislative adaptations. (shrink)

Background: Nursing is a profession that has always been accompanied with common ethical concerns. There are some evidences which indicate that narrative writing on traumatic experiences may improve an individual’s emotional health. Objective: This study aimed to determine the effectiveness of narrative writing on moral distress of nurses working in intensive care unit. Research design: This study was a clinical trial with pre- and post-test design. The frequency and intensity of moral distress was measured by a valid and reliable (...) questionnaire (Corely) at baseline and after 8 weeks. The intervention group was asked to write about their deepest emotions and stressful experiences in the intensive care unit for 8 weeks. Participants and research context: Using consensus sampling, 120 nurses of intensive care unit and neonatal intensive care unit of the teaching hospitals (in Iran) were invited to and were randomly allocated into the intervention and control groups. Ethical considerations: Participation was voluntary, data were anonymized, and the confidentiality of the participating nurses and their institutions maintained. The ethical approval was obtained from an IRB or research ethics committee. Findings: In total, 106 nurses completed the trial consisting of 87.75% females. The mean work experience of nurses in the intervention and control groups was 7.21 ± 4.96 and 8.28 ± 5.45 years, respectively. Independent t-test showed no statistical difference neither in the intensity of moral distress ( P = 0.8), nor in its frequency ( P = 0.5) between the two groups. Discussion: As nurses constantly face ethical tensions, moral distress is a phenomenon that results from the different situations of critical care units. Their concern about receiving negative feedback from the managerial level may have influenced the outcome of the intervention. Conclusion: Narratives writing by the nurses showed no effect on reducing the intensity and frequency of moral distress. It seems that due to the intensity of moral distress in clinical settings, we need to test variety solutions to reduce the problem. (shrink)

Framed by theoretical perspectives on Black Feminist Thought, the life course, and the Generation X/Hip-Hop generation, I present findings from a subset of 10 Black women educators in Birmingham, Alabama who participated in a larger life story project. The participants, who came of age professionally across the pre- and post-civil rights movement (CRM), describe divergent and convergent social and historical contexts that shaped their professionalization, as well as their relationships with and perceptions of Black students and parents. Participants across (...) generation theorize that teaching and leading are activist practices in their own right, which entail clandestine support and silent protest, intergenerational bridge-building, and debunking the myth of Black inferiority. Post-CRM educators, in particular, expressed ambivalence about their urban students? futures. I conclude that multigenerational perspectives should figure more prominently in the scholarship on Black education in the US South. This emphasis could spark new directions and strategies for linking successive generations of Black educators, thereby maximizing opportunities for intergenerational dialogue and collaboration for transformative change in urban education. (shrink)