Macroergonomic compatibility refers to the extent to which macroergonomic factors and elements interact positively with humans. It is one of the most complex constructs to measure in work systems and in ergonomics. The goal of this paper is to determine the levels of MC in a manufacturing system. As methods, we use the macroergonomic compatibility index and the Macroergonomic Compatibility Questionnaire. The MCQ was administered in its three versions to collect data about the macroergonomic practices implemented in the manufacturing company. (...) Regarding results, all the macroergonomic factors and most of the macroergonomic elements showed a low level of MC; that is, MCI < 0.7. Only macroergonomic elements Education, Knowledge, and Skills reached a medium level; namely, MCI = 0.709. The factor with the highest level of MC was the Person factor. Similarly, the whole manufacturing system showed a low level of MC. In conclusion, the studied manufacturing company requires urgent macroergonomic interventions. Also, we found that the MCI can effectively measure the level of MC of MFEs and can guide the implementation of macroergonomic practices and explain the MC construct. (shrink)

Background: The feeding modalities applied in countries with school meal programs are varied because these are shaped not only by the national commitments to alleviate food insecurity among children but also by resource availability from national and international agencies. In terms of financial resources, the USA plays a consistent role in providing donations, grants, loans, and loan guarantee programs to support global school feeding. The U.S. Department of Agriculture (USDA) oversees these funding sources for international school meal programs. Aim: This (...) study aims to examine the moderating effect of USDA funding on the relationship between supply purchasing methods and feeding modalities among countries implementing school meal programs. Methods: The Bayesian Mindsponge Framework, combining the reasoning strengths of Mindsponge Theory and inference advantages of Bayesian analysis, was employed on a dataset of 126 government representatives who manage large-scale school meal programs in 126 different countries. Results: The findings indicated that USDA funding has the potential to positively moderate the relationship between foreign supply purchases and the feeding modalities of school meal programs. However, the direct association between foreign purchases and feeding modalities was unclear. Conversely, while USDA funding was found to have a negative moderation effect on the relationship between domestic supply purchases and feeding modalities, it is these domestic purchases that show potential for positively influencing the feeding modalities. Conclusions: Findings underscore the importance of supporting the World Bank and World Food Programme’s recommendation to rely more on local resources and capacities for developing long-term and sustainable school meal programs. Further exploration of the impact of foreign supply purchases on feeding modalities is needed. Formulating strategic plans to better leverage USDA funding for enhancing domestic supply purchases is highly recommended. (shrink)

ABSTRACTIn answering the circularity charge, Descartes consistently distinguished between truths whose demonstrations we currently perceive clearly and distinctly and truths whose demonstrations we merely remember having perceived clearly and distinctly. Descartes uses C-truths to prove God’s existence, thus validating R-truths. While avoiding one form of circularity, this introduces another circle, for Descartes believes that God’s existence validates R-truths even when itself an R-truth. I consider Newman and Nelson’s grounds enhancement strategy according to which this problem is solved when God’s existence (...) is rendered axiomatic. I argue that since it is still possible to doubt axioms when not directly apprehending them, this strategy cannot work; having to reproduce the argument for God’s existence in face of sceptical doubt is unavoidable. Drawing both on Newman and Nelson’s notion of grounds enhancement and on repr... (shrink)

Objectives: To describe the concerns and priorities of key stakeholders in a developing country regarding ethical obligations held by researchers and perceptions of equity or “what is fair” for study participants in an HIV/AIDS clinical drug trial. Design: Qualitative study with focus groups. Setting: Teaching and referral hospital and rural health centre in western Kenya. Participants: Potential HIV/AIDS clinical trial participants, clinician researchers, and administrators. Results: Eighty nine individuals participated in a total of 11 focus groups over a (...) four month period. The desire for continued drug therapy, most often life long, following an HIV/AIDS clinical trial was the most common priority expressed in all focus groups. Patients with and without HIV/AIDS also thought subsidisation of drug therapies and education were critical forms of compensation for clinical trial participation. Financial incentives were considered important primarily for purchasing drug therapy as well as obtaining food. Patients noted a concern for the potential mismanagement of any money offered. Clinician researchers and administrators felt strongly that researchers have a moral obligation to participants following a trial to provide continued drug therapy, adverse event monitoring, and primary care. Finally, clinician researchers and administrators stressed the need for thorough informed consent to avoid coercion of study participants. Conclusions: Kenyan patients, clinician researchers, and administrators believe that it would be unfair to stop antiretroviral therapy following an HIV/AIDS clinical trial and that researchers have a long term obligation to participants. (shrink)

Involuntary psychiatric commitment for suicide prevention and physician aid-in-dying (PAD) in terminal illness combine to create a moral dilemma. If PAD in terminal illness is permissible, it should also be permissible for some who suffer from nonterminal psychiatric illness: suffering provides much of the justification for PAD, and the suffering in mental illness can be as severe as in physical illness. But involuntary psychiatric commitment to prevent suicide suggests that the suffering of persons with mental illness does not justify ending (...) their own lives, ruling out PAD. Since both practices have compelling underlying justifications, the most reasonable accommodation might seem to be to allow PAD for persons with mental illness whose suffering is severe enough to justify self-killing, but prohibit PAD for persons whose suffering is less severe. This compromise, however, would require the articulation of standards by which persons’ mental as well as physical suffering could be evaluated. Doing so would present a serious philosophical challenge. (shrink)

The journey metaphor used by Nie and colleagues (2016) can be analyzed in terms of the way in which health care professionals can support well-being and attend to the aspects of illness that often...

An Institute of Medical Ethics working party argues that an ethically desirable relationship of mutual empowerment between patient and clinician is more likely to be achieved if patients understand the ground rules of medical confidentiality. It identifies and illustrates ambiguities in the General Medical Council's guidance on AIDS and confidentiality, and relates this to the practice of different doctors and specialties. Matters might be clarified, it suggests, by identifying moral factors which tend to recur in medical decisions about maintaining (...) or breaching confidentiality. The working party argues that two such factors are particularly important: the patient's need to exercise informed choice and the doctor's primary responsibility to his or her own patients. (shrink)

In most Western European countries and North America, strategies to contain the spread of AIDS have emphasized civil liberties. This may be due more to the epidemiology of the disease than to moral progress.

Patient decision aids enable patients to be better informed about the potential benefits and harms of their healthcare options. Certification of patient decision aids at the national level in the United States is a critical step towards responsible governance—primarily as a quality measure that increases patients’ safety, as mandated in the U.S. Patient Protection and Affordable Care Act (PPACA). Certification would provide a verification process to identify conflicts of interest that may otherwise bias the scientific evidence presented in (...) decision aids. Certification also benefits clinicians who may otherwise face malpractice claims based on harm to patients caused by possible reliance on patient decision aids that are inaccurate, incomplete, or presented in a manner that biases the patient’s decision. Existing work by the International Patient Decision Aid Standards Collaboration could guide the establishment of a certification process within the U.S. This article argues for national certification of patient decision aids and discusses how that may be achieved. (shrink)

In a recent edition of the Medical Journal of Australia, Greg Dore and David Cooper called on persons in developed nations like Australia to bridge the divide between resource-rich countries to nations in the developing world, where therapies to ease or halt the ravages of the virus are nonexistent or in short supply.