IntroductionThe objectives of this study are to assess and compare differences in the intensity, frequency, and overall severity of moral distress among a diverse group of healthcare professionals.MethodsParticipants from within Baylor Health Care System completed an online seven-point Likert scale (range, 0 to 6) moral distress survey containing nine core clinical scenarios and additional scenarios specific to each participant’s discipline. Higher scores reflected greater intensity and/or frequency of moral distress.ResultsMore than 2,700 healthcare professionals responded to the survey (response rate 18.14 (...) percent); survey respondents represented multiple healthcare disciplines across a variety of settings in a single healthcare system. Intensity of moral distress was high in all disciplines, although the causes of highest intensity varied by discipline. Mean moral distress intensity for the nine core scenarios was higher among physicians than nurses, but the mean moral distress frequency was higher among nurses. Taking into account both intensity and frequency, the difference in mean moral distress score was statistically significant among the various disciplines. Using post hoc analysis, differences were greatest between nurses and therapists.ConclusionsMoral distress has previously been described as a phenomenon predominantly among nursing professionals. This first-of-its-kind multidisciplinary study of moral distress suggests the phenomenon is significant across multiple professional healthcare disciplines. Healthcare professionals should be sensitive to situations that create moral distress for colleagues from other disciplines. Policy makers and administrators should explore options to lessen moral distress and professional burnout that frequently accompanies it. (shrink)

Machine learning algorithms may radically improve our ability to diagnose and treat disease. For moral, legal, and scientific reasons, it is essential that doctors and patients be able to understand and explain the predictions of these models. Scalable, customisable, and ethical solutions can be achieved by working together with relevant stakeholders, including patients, data scientists, and policy makers.

This article considers the theme of discernment in the tradition of Ignatian spirituality emanating from the Spiritual Exercises of St Ignatius of Loyola, the founder of the Society of Jesus. After a brief introduction which addresses the central problematic of bad influences that manifest themselves as good, the article turns to the life and work of two Jesuits, the 16th C English missionary to India, Thomas Stephens and the 20th C French historian and cultural critic, Michel de Certeau. Both kept (...) up a constant dialogue with local culture in which they sought authenticity in their response to ‘events’, whether a hideous massacre which shaped the pastoral commitment and writing of Stephens in the south of the Portuguese enclave of Goa or the 1968 student-led protests in Paris that so much affected the thinking of de Certeau. Very different in terms of personal background and contemporary experience, they both share in a tradition of discernment as a virtuous response to what both would understand as the ‘wisdom of the Spirit’ revealed in their personal interactions with ‘the other’. (shrink)

Biographical essays explore the careers of two major early photographers, Joseph-Philibert Girault de Prangey and William James Stillman. in addition, portfolios with works by Maxime Du Camp, John Beasley Greene, Francis Frith, Robert Macpherson, Adolphe Braun and others testify to the strength and consistency of other early photographers who captured the antique worlds around the Mediterranean."--BOOK JACKET.

This essay takes a transhistorical leap to connect the philosophy of Thomas Reid to the dramatic presentation of ethical choices in Shakespeare's Macbeth. Juxtaposing the two figures reveals an underlying moral ontology common to both. This shared ontology is remarkably nuanced, ultimately affirming moral liberty whilst decisively registering the fallibility of the ‘moral faculty.’ The final section asks whether the degree of comparability warrants any further speculation, revisiting the question of a ‘common humanity.’.

A prefrontal control system that is less mature than the limbic reward system in adolescence is thought to impede self-regulatory abilities, which could contribute to poor dietary choices and obesity. We, therefore, aimed to examine whether structural morphology of the prefrontal cortex and the amygdala are associated with dietary decisions and obesity in children and adolescents. Seventy-one individuals between the ages of 8–22 years participated in this study; each participant completed a computer-based food choice task and a T1- and T2-weighted (...) structural brain scans. Two indices of obesity were assessed, including age- and sex-specific body mass index and waist-to-height ratio. The behavioral task included rating 60 food stimuli for tastiness, healthiness, and liking. Based on each participant’s self-ratings, 100 binary food choices were then made utilizing a computer mouse. Dietary “self-control” was calculated as the proportion of trials where the individual chose the healthier food item over the total number of trials. Cortical thickness and amygdala subnuclei volumes were quantified using FreeSurfer 6.0 and CIT168 atlas, respectively. We found that WHtR was negatively associated with the thickness of bilateral superior frontal, left superior temporal, right insula, and right inferior temporal regions. We also found WHtR to be positively associated with the volume of the central nucleus region of the amygdala, after adjusting for the hemisphere, age, sex, and intracranial volumes. A similar data pattern was observed when BMIz was used. Moreover, we found that across all participants, thinner right superior frontal cortex and larger left CEN volumes predicted lower dietary self-control. These results suggest that differential development of the PFC and amygdala relate to obesity and dietary self-control. Further longitudinal studies are merited to determine causal relationships among altered PFC to amygdala neural circuitry, dietary self-control, and obesity. (shrink)

Purpose Algorithms are in the mainstream media news on an almost daily basis. Their context is invariably artificial intelligence and machine learning decision-making. In media articles, algorithms are described as powerful, autonomous actors that have a capability of producing actions that have consequences. Despite a tendency for deification, the prevailing critique of algorithms focuses on ethical concerns raised by decisions resulting from algorithmic processing. However, the purpose of this paper is to propose that the ethical concerns discussed are limited in (...) scope and suggest that it is not clear what concerns dominate the debate. Design/methodology/approach The paper uses a systematic mapping study approach to review articles appearing in leading UK national papers from the perspective of the ethical concerns over a period of one year. The articles are categorised using a widely cited framework detailing a taxonomy of ethical concerns. The UK context is important because of UK public policy initiatives around AI. Findings The research presented in this paper contributes the first systematic mapping study of articles appearing in leading UK national papers from the perspective of widely accepted ethical concerns such as inscrutable evidence, misguided evidence, unfair outcomes and transformative effects. Originality/value The research presented in this paper contributes the first systematic mapping study of articles appearing in leading UK national papers from the perspective of the ethical concerns. The UK context is important because of UK public policy initiatives around AI. To review the media content from the perspective of ethical concerns, this paper uses the synthesised conceptual map of ethical concerns developed by Mittelstad et al. Given the dominance of that framework, this paper’s contribution is also an important instantiation and experimental validation of using that conceptual map. (shrink)

Halin in 1965 proved that if a graph has [Formula: see text] many pairwise disjoint rays for each [Formula: see text] then it has infinitely many pairwise disjoint rays. We analyze the complexity of this and other similar results in terms of computable and proof theoretic complexity. The statement of Halin’s theorem and the construction proving it seem very much like standard versions of compactness arguments such as König’s Lemma. Those results, while not computable, are relatively simple. They only use (...) arithmetic procedures or, equivalently, finitely many iterations of the Turing jump. We show that several Halin-type theorems are much more complicated. They are among the theorems of hyperarithmetic analysis. Such theorems imply the ability to iterate the Turing jump along any computable well ordering. Several important logical principles in this class have been extensively studied beginning with work of Kreisel, H. Friedman, Steel and others in the 1960s and 1970s. Until now, only one purely mathematical example was known. Our work provides many more and so answers Question 30 of Montalbán’s Open Questions in Reverse Mathematics in 2011. Some of these theorems including ones in Halin in 1965 are also shown to have unusual proof theoretic strength as well. (shrink)

The sudden emergence of the COVID-19 pandemic brought global disruption to every aspect of society including healthcare, supply chain, the economy, and social interaction. Among the many emergent considerations were the safety and public health of the public, patients, essential workers, and healthcare professionals. In certain locations, clinical research was halted—or terminated—in deference to the immediate needs of patient care, and clinical trials focusing on the treatment and prevention of coronavirus infection were prioritized over studies focusing on other diseases. Difficult (...) decisions were made rapidly; flexibility and reconsideration were necessary not only because the intensity and severity of infection varied over time and by locale but also because knowledge of the disease and understanding of its treatment grew. Here we discuss the ethical challenges in decision-making and competing ethical tensions during the pandemic in an effort to advance future preparedness. (shrink)

Anhedonia is a risk factor for suicide and poor treatment response in depressed individuals. Most evidence-based psychological therapies target symptoms of heightened negative affect instead of deficits in positive affect and typically show little benefit for anhedonia. Viewing positive scenes through virtual reality has been shown to increase positive affect and holds great promise for addressing anhedonic symptoms. In this pilot study, six participants with clinically significant depression completed 13 sessions of exposure to positive scenes in a controlled VR environment. (...) Significant decreases were found in self-reported anhedonia, depression, anxiety, and impairments in functioning from baseline to 1-month follow-up. Negative affect decreased over all 13 sessions, and positive affect increased over sessions 8–13. Results suggest that positive experiences in VR may be a novel avenue for the treatment of anhedonia in depressed individuals. (shrink)

In both academic literature and the media, financial conflicts of interest in human subjects research have come center-stage. The cover of a recent edition of Time magazine features a research subject in a cage with the caption human guinea pigs, signifying perhaps that human research subjects are no more protected from research abuses than are laboratory animals. That magazine issue highlights three well-publicized cases of human subjects research violations that occurred at the University of Oklahoma, the University of Pennsylvania, and (...) Johns Hopkins University.At St. John Medical Center in Tulsa, Oklahoma, a study that was co-sponsored by the University of Oklahoma Health Sciences Center investigated an experimental vaccine for malignant melanoma. In that case, the chair of the university's institutional review board — the committee within each medical institution charged with ethics review of human research projects undertaken at that institution — and the dean of the University's College of Medicine allegedly concealed from both the IRB and the United States Food and Drug Administration a report by an outside consulting firm that had found severe deficiencies with the melanoma vaccine study being conducted at the medical center. (shrink)

In both academic literature and the media, financial conflicts of interest in human subjects research have come center-stage. The cover of a recent edition of Time magazine features a research subject in a cage with the caption human guinea pigs, signifying perhaps that human research subjects are no more protected from research abuses than are laboratory animals. That magazine issue highlights three well-publicized cases of human subjects research violations that occurred at the University of Oklahoma, the University of Pennsylvania, and (...) Johns Hopkins University.At St. John Medical Center in Tulsa, Oklahoma, a study that was co-sponsored by the University of Oklahoma Health Sciences Center investigated an experimental vaccine for malignant melanoma. In that case, the chair of the university's institutional review board — the committee within each medical institution charged with ethics review of human research projects undertaken at that institution — and the dean of the University's College of Medicine allegedly concealed from both the IRB and the United States Food and Drug Administration a report by an outside consulting firm that had found severe deficiencies with the melanoma vaccine study being conducted at the medical center. (shrink)

Edmund Husserl was one of the very first to experience the direct impact of challenging problems in set theory and his phenomenology first began to take shape while he was struggling to solve such problems. Here I study three difficulties associated with Frege's use of sets that Husserl explicitly addressed: reference to non-existent, impossible, imaginary objects; the introduction of extensions; and 'Russell's paradox'.I do so within the context of Husserl's struggle to overcome the shortcomings of set theory and to develop (...) his own theory of manifolds. I define certain issues involved and discuss how Husserl's theory of manifolds might confront them. In so doing I hope to help bring Husserl's theories about sets and manifolds out of the realm of abstract theorizing and prompt further exploration of uncharted philosophical territory rich in philosophical implications. (shrink)

Belgian data from the PIDOP project show that boys are more involved than girls in illegal political actions, namely the production of graffiti and other acts of “incivility”. These activities must be considered in both groups as complementary to conventional political and social participation and not as their opposite. The main explanatory factor is the level of the perceived efficaciousness of such actions. The lack of trust in institutions and the level of awareness of societal discrimination play no significant explanatory (...) role. In males, the involvement level in these activities depends on feelings of personal discrimination and on the lack of freedom concerning individual choice, confirming the theory of societal vulnerability and Honneth’s theory of recognition. This level also increases along with increasing opportunities to make acquaintances and have fun in the neighbourhood. In females, this involvement is explained by the distance with regard to pro-sociality level. (shrink)

Abstract: Groundwork is lain for answering questions as to how to situate Husserl’s theory of functions in relation to Frege’s. I examine Husserl’s ideas about analyticity and mathematics, logic and mathematics, formalization, calculating with concepts and propositions, the foundations of arithmetic, extensions to show that, although he knew, studied and lauded Frege’s ideas about functions and concepts, each man approached the issues from different angles. Seduced by the siren of transcendental phenomenology Husserl did not pursue the issues, implications, and consequences (...) of his ideas about functions. I ask whether so doing could provide new insight into, or even solutions to, the problems involving functions that beset Frege, Russell and have beset their successors. (shrink)

This chapter uses Marx’s credit theory in Comments on James Mill and Freire’s theory of the banking model of education from Pedagogy of the Oppressed to argue that the confluence of massive student debt and structures of “banking” pedagogy in contemporary American higher education places many university students in a unique position of dehumanization. The material limitations brought about by the loan are compounded by the social limitations of a resulting push toward productivity in education. Students with loan debt are (...) driven in the direction of business and pre-professional majors and away from the humanities and other fields which would facilitate students’ abilities to critically question the dehumanizing aspects of their situation. (shrink)

Theorems of hyperarithmetic analysis occupy an unusual neighborhood in the realms of reverse mathematics and recursion-theoretic complexity. They lie above all the fixed iterations of the Turing jump but below ATR $_{0}$. There is a long history of proof-theoretic principles which are THAs. Until the papers reported on in this communication, there was only one mathematical example. Barnes, Goh, and Shore [1] analyze an array of ubiquity theorems in graph theory descended from Halin’s [9] work on rays in graphs. (...) They seem to be typical applications of ACA $_{0}$ but are actually THAs. These results answer Question 30 of Montalbán’s Open Questions in Reverse Mathematics [19] and supply several other natural principles of different and unusual levels of complexity.This work led in [25] to a new neighborhood of the reverse mathematical zoo: almost theorems of hyperarithmetic analysis. When combined with ACA $_{0}$ they are THAs but on their own are very weak. Denizens both mathematical and logical are provided. Generalizations of several conservativity classes are defined and these ATHAs as well as many other principles are shown to be conservative over RCA $_{0}$ in all these senses and weak in other recursion-theoretic ways as well. These results answer a question raised by Hirschfeldt and reported in [19] by providing a long list of pairs of principles one of which is very weak over RCA $_{0}$ but over ACA $_{0}$ is equivalent to the other which may be strong or very strong going up a standard hierarchy and at the end being stronger than full second-order arithmetic. (shrink)

We establish the decidability of the${{\rm{\Sigma }}_2}$theory of both the arithmetic and hyperarithmetic degrees in the language of uppersemilattices, i.e., the language with ≤, 0, and$\sqcup$. This is achieved by using Kumabe-Slaman forcing, along with other known results, to show given finite uppersemilattices${\cal M}$and${\cal N}$, where${\cal M}$is a subuppersemilattice of${\cal N}$, that every embedding of${\cal M}$into either degree structure extends to one of${\cal N}$iff${\cal N}$is an end-extension of${\cal M}$.

BL Features of the new edition: The translation has been completely rewritten, and the commentary thoroughly revised in the light of recent scholarship There is an additional glossary, and extended bibliography The Posterior Analytics contains some of Aristotle's most influential thoughts in logic, epistemology, metaphysics, and the philosophy of science. The first book expounds and develops the notions of a demonstrative argument and of a formal, axiomatized science; the second discusses a cluster of problems raised by the axioms or principles (...) of such a science, and investigates in particular the theory of definition. (shrink)

The work of every school of psychotherapy and every therapist is inevitably structured by a value system and requires codes of ethics and practice. This book addresses the conscious and unconscious aspects of the value system in which therapists are situated. Values and Ethics in the Practice of Psychotherapy and Counselling explores the central issues through the experience of the contributors, each of whom is well known in this field. Each chapter will raise questions for the reader which will stimulate (...) individual thinking about practice or can form a basis for discussion and debate for training or graduate groups. The book is firmly rooted in practice. Each chapter deals with a different aspect of the psychotherapist's work beginning with the general underlying principles, continuing through matters of technique and on to contextual issues. Finally the book moves to the outer world, politics and spirituality as ways of connecting inner and outer, social and individual. The arrangement of chapters allows for flexibility and creativity while providing a coherent structure. Values and Ethics in the Practice of Psychotherapy and Counselling is recommended reading for psychotherapists, psychoanalysts and counsellors in training and practice. (shrink)

Automated Influence is the use of Artificial Intelligence to collect, integrate, and analyse people’s data in order to deliver targeted interventions that shape their behaviour. We consider three central objections against Automated Influence, focusing on privacy, exploitation, and manipulation, showing in each case how a structural version of that objection has more purchase than its interactional counterpart. By rejecting the interactional focus of “AI Ethics” in favour of a more structural, political philosophy of AI, we show that the real problem (...) with Automated Influence is the crisis of legitimacy that it precipitates. (shrink)