_Initiating Psychoanalysis_ presents an international collection of papers brought together by the Working Party on Initiating Psychoanalysis of the European Psychoanalytic Federation and addresses the specific clinical and technical issues involved in launching the processes that are at the core of psychoanalysis and psychoanalytic treatment. Expert contributors provide introductions and commentaries on a selection of psychoanalytic papers, including one by Freud himself, which refer to beginning psychoanalytic treatment in a wide range of settings. Divided into four main sections, areas of (...) discussion include: historical and conceptual developments in the field practical, technical and ethical considerations unconscious transference and counter-transference dynamics of initial interviews internal factors that can help or hinder psychoanalysts in their work to initiate psychoanalysis. This book will be helpful to all psychoanalytical practitioners in thinking about their work in first interviews with prospective patients, as well as psychoanalysts and psychotherapists at all levels of experience, who will be able to use this book to enrich their own practice. (shrink)

The purpose of this cross-sectional investigation was to examine the item characteristics, factor structure, reliability, convergent validity, and construct validity of the Psychobiosocial States in Physical Education (PBS-SPE) scale. In Study 1, a sample of 1,030 students (582 girls and 448 boys, 10 to 19-year-olds), drawn from middle or high schools, rated the intensity of the 20 items version of the PBS-SPE scale thinking about the feelings they had usually experienced in physical education classes. In Study 2, an additional sample (...) of 1,025 students (578 girls, 447 boys, 10 to 19-year-olds), rated the 16 items of the final version of the scale. Two subsamples also completed an affective-related measure (i.e., the Physical Activity Enjoyment Scale) and two motivation scales often used in the physical education domain (i.e., the Teacher-Initiated Motivational Climate in Physical Education Questionnaire and the Situational Motivation Scale). Exploratory structural equation modeling and confirmatory factor analyses of the data showed that a two-factor, 16-item solution (i.e., 8 pleasant/functional items and 8 unpleasant/dysfunctional items) of the PBS-SPE scale reached satisfactory fit indices. Multi-group comparisons provided support for measurement and structural invariance across samples, gender, and age. Convergent and construct validity was also upheld. Overall, the findings offer support for the use of a new instrument in the assessment of psychobiosocial states in physical education settings. (shrink)

BackgroundInvestigator-initiated clinical trials have flourished in China. However, research on stakeholders’ perceptions and management capacity of investigator-initiated clinical trials, which are crucial for optimizing resource utilization, timely identifying barriers affecting high-quality Investigator-initiated clinical trials output, and providing evidence for establishing, improving, and evaluating the quality management system for Investigator-initiated clinical trials, is rare. Our objective is to assess the perception of the standardized quality management of Investigator-initiated clinical trials among stakeholders at different levels of healthcare institutions.MethodsWe conducted a cross-sectional study (...) using an electronic survey designed using REDCap conducted between June and September 2024 in Healthcare institutions of various levels in Beijing, China. Hospital level, education level, years in research, familiarity, distinction ability, medical personnel, research administrators, methodologists, and other personnel were investigated as potential influencing factors. The primary outcomes were the total number of correct answers and weighted correct rates for each domain and all six domains.ResultsA total of 717 individuals participated in the study. The distribution of total correct answers and weighted correct rates across all domains was 20.0 (15.0–23.0) and 0.8 (0.6–0.9), respectively. Participants from higher-level hospitals, those with higher education levels, greater familiarity, and higher distinction ability, and administrators performed significantly better in terms of the total number of correct answers and weighted correct rates across all domains.ConclusionsThe stakeholders performed well overall. However, much room for improvement still exists. Hospital level, education level, familiarity, distinction ability, and the role of research administrators can influence the overall performance of stakeholders. Establishing, improving, and evaluating a quality management system for Investigator-initiated clinical trials in China is crucial.Trial registrationNot applicable. (shrink)

Any problem is a problem until a solution is designed and implemented. This paper reports on a workshop that highlights preliminary work done by the working group on Gamification in the scope of European Network for Academic Integrity, which aims to explore the possibility of developing and testing a gamified learning module on academic integrity values. In this paper, the group aims to look at proposing steps we are currently using to develop storyboards of scenarios for the first phase of (...) the project, which were presented at the 6th International Conference Plagiarism Across Europe and Beyond 2020 held virtually in Dubai as a workshop. The study also presents updated findings and scenarios drawn from the workshop conducted and audience feedback, in the following sections that pave the way for the future stages of the gamification process. This serves as a guide to academics and researchers in academic integrity who may wish to study gamification and apply it to develop their own modules for their learning modules. (shrink)

This elegant and painstakingly detailed portrait of St. Thomas Aquinas, whose distinctive theme is the unity of his life and work, is an elaboration of the first section of the author's substantial article on Aquinas in the Dictionnaire de spiritualité. The present work consists of the following parts: a foreword; sixteen chapters which narrate and reflect upon the relevant events, including the composition of Aquinas' writings, between his birth in 1224/25 and his canonization on July 18, 1323 and its (...) aftermath; a summary chronology; a catalogue of writings and a bibliography, both established by Gilles Emery; and indexes of Aquinas' writings and of proper names. As this bare enumeration of contents suggests, the work resembles and indeed depends upon James A. Weisheipl's monumental Friar Thomas d'Aquino: His Life, Thought, and Works, which was originally published in 1974 and then reprinted "with addenda and corrigenda" in 1983. However, it also goes beyond Weisheipl's work in two important respects. (shrink)

This study investigates interpretations of the Japanese initial mora-based minimizer “X.Y...”-_no_ “X”-_no ji-mo_ ‘lit. even the letter “X” of “X.Y...”.’ Although initial mora-based minimizers have a literal interpretation of _ji_ ‘letter’, they have a non-literal interpretation as well. The non-literal interpretation has several distinctive features that are not present in ordinary minimizers. First, it is highly productive in that various expressions can appear in the form “X.Y...”-_no_ “X”-_no ji_. Second, non-literal minimizers typically co-occur with predicates that relate to (...) knowledge, information, concepts, thought, and habituality, as seen in the corpus data (Balanced Corpus of Contemporary Written Japanese [BCCWJ]). I argue that in the non-literal use, X refers to the minimum on the scale of the main predicate concerning “X.Y...”. I suggest that the non-literal use was developed as a result of the conventionalization of the pragmatic inference derived from the literal reading, and that the co-occurrence with predicates related to knowledge, information, knowledge, concepts, thought, or habituality is due to the interpretation of “X.Y...”, which were originally interpreted as letters as an abstract concept. The theoretical implication of this study is that, in addition to a non-compositional (lexically specified) minimizer whose scale is lexically fixed (e.g., _give a damn_, _lift a finger_), there also exists a compositional (lexically unspecified) minimizer in natural language, whose scale is specified via the predicate with which the minimizer co-occurs. The last section of this paper briefly discusses similar/related phenomena in Bosnian/Croatian/Serbian, Korean, and English from a cross-linguistic perspective. (shrink)

This analysis explores theories of recollective memories and their shortcomings to show how certain recollective memories are to some extent the initial experiencing of past conscious mental states. While dedicated memory theorists over the past century show remembering to be an active and subjective process, they usually make simplistic assumptions regarding the experience that is remembered. Their treatment of experience leaves unexplored the notion that the truth of memory is a dynamic interaction between experience and recollection. The argument's seven (...) sections examine how experience, consciousness, and the self produce memories in odd but actual situations. Examples are presented that are either actual or technologically possible, and they pose a challenge for some theories of memory. Showing that an experience and a memory must be bound by psychological continuity, the sections build upon each other to challenge aprioristic beliefs about the self and consciousness. The later sections examine the lack of available accounts of memory that acknowledge consciousness, dissociation, and "selfhood" to be matters of degree, thus rendering memory theories next to useless when trying to effectively incorporate the notions of experience and reality. (shrink)

Investigator-initiated clinical trials have flourished in China. However, research on stakeholders’ perceptions and management capacity of investigator-initiated clinical trials, which are crucial for optimizing resource utilization, timely identifying barriers affecting high-quality Investigator-initiated clinical trials output, and providing evidence for establishing, improving, and evaluating the quality management system for Investigator-initiated clinical trials, is rare. Our objective is to assess the perception of the standardized quality management of Investigator-initiated clinical trials among stakeholders at different levels of healthcare institutions. We conducted a cross-sectional (...) study using an electronic survey designed using REDCap conducted between June and September 2024 in Healthcare institutions of various levels in Beijing, China. Hospital level, education level, years in research, familiarity, distinction ability, medical personnel, research administrators, methodologists, and other personnel were investigated as potential influencing factors. The primary outcomes were the total number of correct answers and weighted correct rates for each domain and all six domains. A total of 717 individuals participated in the study. The distribution of total correct answers and weighted correct rates across all domains was 20.0 (15.0–23.0) and 0.8 (0.6–0.9), respectively. Participants from higher-level hospitals, those with higher education levels, greater familiarity, and higher distinction ability, and administrators performed significantly better in terms of the total number of correct answers and weighted correct rates across all domains. The stakeholders performed well overall. However, much room for improvement still exists. Hospital level, education level, familiarity, distinction ability, and the role of research administrators can influence the overall performance of stakeholders. Establishing, improving, and evaluating a quality management system for Investigator-initiated clinical trials in China is crucial. Not applicable. (shrink)

We examine the impact of a government-initiated CSR project on corporate misconduct using the unique setting of China’s Targeted Poverty Alleviation (TPA) program. The difference-in-differences estimates show that firms participating in the TPA program engage in fewer misconduct activities than do their counterparts. This finding is robust to the parallel trends test, the placebo test, alternative regression specifications, alternative research designs, the reverse causality analysis, and the bivariate probit model with partial observability. Further analysis shows that TPA participation enhances the (...) ability of external financial professionals to monitor performance by stimulating the dissemination of TPA-related incremental information, thereby contributing to the decline in corporate misconduct. The cross-sectional heterogeneity analysis shows that the impact of TPA participation on corporate misconduct is more pronounced in firms with higher information asymmetry, with weaker political connections, and with weaker internal governance. Furthermore, we find evidence that TPA participation improves corporate financial performance but does not deteriorate information transparency. (shrink)

This section presents bibliographic information on the original versions of Paul Horwich’s 10 essays included in this volume. These include the original titles of the essays, the journals where they were published, and publication dates. Essay 1 for instance, was initially published as the ‘Three forms of Realism’ in Synthese, 5 (1982), while Essay 2 was published as ‘Realism and Truth’ in Philosophical Perspectives, 10: ‘Metaphysics’ (1996). The same information for Essays 5-10 are provided.

The increasing pressures to conserve biodiversity—particularly for industries based on the exploitation of natural resources—have reinforced the need to implement specific measures in this area. Corporate commitment to preserving biodiversity is increasingly scrutinized by stakeholders and now represents an important aspect of business ethics. Although stakeholder involvement is often essential to the management of biodiversity, very few studies in the literature have focused on the details of this involvement. The objective of this paper is to analyze how mining and forestry (...) companies can manage biodiversity issues through stakeholder involvement based on a content analysis of 430 sustainability reports using the Global Reporting Initiative framework. The paper elucidates the reasons for such involvement, the nature of stakeholders involved, and the types of measures employed to manage biodiversity. Stakeholders’ motives for becoming involved revolve around four main issues: complexity and knowledge management; self-regulation and relationships with public authorities; legitimacy and social responsiveness; and commercial and strategic objectives. The stakeholders involved in biodiversity initiatives are essentially non-governmental organizations, experts and universities, public authorities, and coalitions of companies. In the end, the initiatives identified can be grouped into three categories: management practices, socio-political actions, and research and conservation measures. The paper provides various examples of these initiatives and shows how they can be implemented in collaboration with different stakeholders depending on the company’s objectives. The contributions the study makes to the literature on biodiversity management and the managerial implications of the study are analyzed in the discussion section. (shrink)

This study explores the ways in which trust deficit undermines anti-corruption initiatives in a context with systemic corruption. Anti-corruption measures as panacea to systemic corruption are not new, but their effectiveness is debatable. Whilst understanding the causal relationship between corruption and trust remains germane to fighting corruption, a growing number of recent studies advocate better context sensitivity in developing anti-corruption initiatives. Consistent with this, we unpack the perceptions of a significant section of the population in which corruption is rampant (...) to identify factors that could enhance trust in the effectiveness of anti-corruption measures. Using commentaries from Nigerian Netizens on two critical corruption incidents that are significant to corporations, we uncover poignant narratives of perception of incompetence, dishonesty and confusion that undermine the anti-corruption measures in the context. We argue that donors, international organisations and businesses must encourage and support beneficiaries’ governments to secure and sustain trust in the anti-corruption initiatives as a condition for better results. (shrink)

With the widespread use of smartphones, patient-initiated recording in emergency departments (EDs) has become an increasing concern. In the high-pressure EDs environment, physicians frequently perceive such recordings as being motivated less by a desire to enhance understanding and more by a defensive intent to preserve evidence for potential disputes. This study investigates emergency physicians’ exposure to and perceptions of this phenomenon in Southwestern China. A cross-sectional survey was conducted via online snowball sampling among 306 emergency physicians from tertiary hospitals in (...) Southwestern China between September and October 2025. The study assessed the frequency with which physicians encounter patient-initiated recording, associated clinical scenarios, response strategies, and perceptions of ethical and legal implications. A total of 90.20% of respondents reported encountering patient-initiated recording within the past year. Among these physicians, 90.22% reported experiencing covert (undisclosed) recording, identifying the behavior through observation rather than patient disclosure. Commonly reported scenarios by the affected physicians included emergency diagnosis and treatment (77.90%) and dispute mediation (59.06%). Regarding attitudes, physicians rated perceived risks significantly higher than benefits on a 5-point Likert scale (1 = Strongly Disagree, 5 = Strongly Agree); while acknowledging moderate utility for elderly patients (mean score = 3.29), they indicated that recording was perceived to promote defensive medical behavior (mean score = 4.82) and induced psychological pressure (mean score = 4.74). Moreover, 72.55% believed the practice negatively impacted the physician-patient relationship. Furthermore, 90.20% expressed a strong demand for professional training, prioritizing case-based analysis of legal disputes (88.89%) and informed consent protocols (88.24%). The high reported exposure to patient-initiated recording—particularly in covert forms—among the surveyed emergency physicians in Southwestern China highlights physicians’ prevalent concerns about a perceived strain on trust and their self-reported association with defensive medical behaviors. Moving beyond strict prohibitions, healthcare institutions should consider prioritizing transparent governance and standardized communication protocols. Furthermore, targeted medico-legal training is essential to clarify rights and obligations, which could potentially help establish clearer institutional boundaries for managing patient-initiated recording. Not applicable (this study is a cross-sectional survey and does not involve any health care intervention). (shrink)

Higher education institutions are expected to produce quality and competitive graduates for the job market and nation-building. In realizing this role, Bukidnon State University needs to ensure that graduates may land a job-relevant and align with their education and training. With this, a tracer study was conducted to verify whether the three batches of graduates are employed and are employable. It ascertained their employability based on their work experience from graduation to the present job. It employed a cross-sectional method and (...) data mining for the information of 326 graduates. The results revealed that the majority of graduates had jobs relevant to their education and training; yet, there was a significant difference in the employability of graduates across batches, except in terms of gender. Biological Science, Social Studies, and Math graduates were employable within the first six and twelve months compared to graduates from other curricula. It was claimed that the BukSU had prepared BSE graduates for employment. However, these results have implications for strategic options in improving the programs. The study made some recommendations for future tracer initiatives. (shrink)

This chapter contains sections titled: * Notes.

Background Healthcare workers (HCWs) can face situations that conflict with their moral beliefs, leading to moral injury, an adverse psychological consequence that was more frequent during the COVID-19 pandemic. Self-compassion is a potential coping mechanism for moral injury by encouraging acceptance of human limitations and suffering. Objectives This study aimed to examine the associations between self-compassion components and moral injury prevalence among HCWs in Quebec, Canada, during the COVID-19 pandemic. Research design A cross-sectional study design was employed. Participants : and (...) research context: The sample of this study consisted of HCWs and leaders from the Quebec province. Participants completed validated self-administered questionnaires assessing both positive and negative self-compassion components (self-kindness vs self-judgment; common humanity vs isolation; and mindfulness vs overidentification) and moral injury dimensions (self-oriented and other-oriented). Prevalence ratios (PRs) and 95% confidence intervals (CIs) for the associations between self-compassion components and moral injury dimensions were modeled using Poison robust regressions. The models were adjusted for various covariates, including sex, age, gender, and socio-demographic and lifestyle factors. Ethical considerations Ethical approval for this study was obtained from the ethics committee of the Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale in Quebec, Canada. All participants provided written informed consent prior to participating in the study. Additionally, permission was sought and obtained from the original authors of the tools used in this study, including the self-compassion and moral injury scales. Results The study involved 572 HCWs (60.5% nurses) and leaders. Around half of the participants (50.70%) exhibited moderate levels of self-compassion, while the prevalence of low levels of self-compassion ranged from 21.68% to 48.08% for the positive subscales and from 23.78% to 44.41% for the negative subscales. Regarding moral injury, 10.14% of participants reported moderate to high self-oriented moral injury, 29.19% reported moderate to high other-oriented moral injury, and 13.81% demonstrated moderate to high total moral injury. Higher self-compassion levels were associated with lower moral injury prevalence. HCWs with high self-compassion had a 93% lower likelihood of experiencing moral injury (PR: 0.07, 95% CI: 0.03–0.19). Self-kindness demonstrated the strongest association with reduced moral injury (PR: 0.24, 95% CI: 0.11–0.52), followed by mindfulness (PR: 0.37, 95% CI: 0.18–0.75). However, common humanity did not show a statistically significant association with moral injury prevalence. Conclusion These findings suggest a potential association between self-compassion and reduced prevalence of moral injury among HCWs, highlighting promising interventions to manage moral injury during crises. Such initiatives could promote the mental wellbeing of HCWs and preventing the negative consequences of moral injury, including anxiety, depression, and burnout. (shrink)

ABSTRACT Focused upon Descartes’ writings and letters, this paper considers the exponentially-charged relationship between sadness, melancholy, doubt and philosophical inquiry. The first sections examine the relation between sadness in the Cartesian corpus and melancholy as a traditional pathological classification, with both set against a larger seventeenth century intellectual discourse. The letters exchanged between the Princess Elisabeth of Bohemia and the Palatine and Descartes between 1643 and 1649, that is, just prior to the death of the philosopher in 1650, reveal the (...) central paradigm of this particular relationship between sadness and melancholy. The call to use philosophy as a cure against sadness also enters consideration, with the theatrical, artificial nature of the philosophical cure presented as essential not only to Descartes’ relation to sadness, but also to philosophical method in general. The moral aspect of the establishment of mental habits and their emendation by philosophy hence yields central insights into the larger Cartesian project, here viewed as essentially premised upon a medical vocation. (shrink)

This paper discusses the sense of human fulfillment elaborated in the writings of Wendell Berry. The initial section considers the relationship between freedom and social and geographical rootedness; and the second section considers in greater detail how agriculture and personal fulfillment are intertwined in Berry's work. In the concluding section, consideration is given to the degree to which agriculture may be said to be the proper form of human life.

Kendall's (1956) approach to the general epidemic is generalized by dropping the assumptions of constant infectivity and random recovery or death of ill individuals. A great deal of attention is paid to the biological background and the heuristics of the model formulation. Some new results are: (l) the derivation of Kermack's and McKendrick's integral equation from what seems to be the most general set of assumptions in section 2.2, (2) the use of Kermack's and McKendrick's final value equation to (...) arrive at a finite time version of the threshold theorem for the general case, comparable to that for the case of only one Markovian state of illness in section 2.5, (3) the analysis of the behaviour of the solutions of the integral equation when the starting infection approaches zero in section 2.7, (4) the derivation of the probability structure of a general branching process, after conditioning on extinction in section 3.6, (5) the statement of the generalized versions of Kendall's ideas in the form of precise limit conjectures in section 4, (6) the derivation of a closed expression for the limit epidemic resulting from (3) in appendix 4. (shrink)

This article contains four essays from the Anarres Project, a forum for conversations, ideas, and initiatives that promote a future free of domination, exploitation, oppression, war, and empire. In the spirit of philosophy in the contemporary world, the selection includes recent work on the pandemic and related struggles for justice in the past year. An introduction to the project is included.

Recent studies from Western countries indicate significant levels of questionable research practices, but similar data from low and middle-income countries are limited. Our aims were to assess the prevalence of and attitudes regarding research misconduct among researchers in several universities in the Middle East and to identify factors that might account for our findings. We distributed an anonymous questionnaire to a convenience sample of investigators at several universities in Egypt, Lebanon, and Bahrain. Participants were asked to a) self-report their extent (...) of research misconducts, as well as their knowledge of colleagues engaging in similar research misconducts and b) provide their extent of agreement with certain attitudes about research misconduct. We used descriptive, bivariate, and multivariate logistic regression statistics to analyze the data. Data from 278 participants showed a high prevalence of misconduct, as 59.4% of our respondents self-reported to committing at least one misbehaviors and 74.5% reported having knowledge of any misbehaviors among any of their colleagues. The most common type of self-report misconduct was “circumventing research ethics regulations” followed by “fabrication and falsification”. A significant predictor of misconduct included a lack of “prior ethics training”. Scientific misconduct represents a significant issue in several universities in the Middle East. The demonstration that a lack of “prior ethics training” was a significant predictor of misconduct should lead to educational initiatives in research integrity. Further studies are needed to confirm whether our results can be generalized to other universities in the Middle East. (shrink)

Background: The rapid pace of progress in medical research, the consequent need for the timely transfer of new knowledge into practice, and the increasing need for ethics support, is making the work of Ethics Committees (ECs) ever more complex and demanding. As a response, ECs in many countries exhibit large variation in number, mandate, organization and member competences. This cross-sectional study aims to give an overview of the different types of activities of Italian ECs and favour discussion at a European (...) level.Methods: A questionnaire was emailed to all Italian Ethics Committees contained in the national Registry of the Ministry of Health, enquiring whether the EC was conducting, or planning to conduct, 4 specific activities. A telephone interview was conducted to determine reasons for failure to respond.Results: Response rate was 53% (101 respondents out of 191). 20% of ECs restrict their responsibilities to research protocol review, 25% also offer ethical consultation to institutions, support on individual health care decisions and promotes educational initiatives, while the remaining 50% conduct a few of the examined activities to varying degrees. Large variation was observed across different types of hosting institutions and geographical locations.Conclusions: A common European model should be developed, defining EC functions, member selection modalities, necessary member competences, decision-making criteria and measures for work verification. In the absence of sound empirical evidence, it would be interesting to study the effectiveness and efficiency of the different existing models. (shrink)

Background The perception of organ donation and brain death among Syrian population has not been previously explored. The goal of this study is to evaluate the attitude and knowledge of organ donation among Syrians and the willingness of this population to donate their organs. Methods We conducted a survey-based cross-sectional study in four hospitals in Aleppo, Syria in November 2019. Patient demographic, awareness of brain death; and attitude toward organ donation were collected and analyzed. Results A total of 350 individuals (...) were invited to participate in the survey among whom 303 agreed to participate in the study. The majority of our participants heard about organ donation with television, social media, and the internet being the most common sources of information. When assessing knowledge about brain death, only 40% answered 3 or more questions correctly. Fifty-eight percent of respondents agreed with the idea of organ donation and 183 would like to donate their organs one day. The leading motivation to organ donation was the desire to help, while the most common reason to refuse donation was the refusal to disfigure a dead body by removing an organ. Religious reasons were cited as motivation for organ donation by 43% of participants, and a reason for refusing to donate organs by 24%. Most respondents were unaware of the laws and legislations related to organ donation in Syria. When asked if religion and law were encouraging organ donation, 76% of respondents would donate their organs. Although more positive attitude was found in those with better brain death knowledge, this did not translate into more willingness to donate organs in this group of participants. Conclusions The promotion of organ donations from deceased donors is a necessity given the rising shortage of organs. The information provided by this study could help policy makers build future strategies to promote deceased organ donation programs and overcome current obstacles preventing such initiatives from achieving their goals. (shrink)

Shared decision making (SDM) is a cornerstone of patient-centered care in oncology, yet its implementation remains inconsistent across clinical contexts. Particularly in gynecologic oncology, where treatment choices often carry profound implications for identity, fertility and quality of life, understanding how patients engage in SDM is crucial. Patient autonomy, understood as the capacity and right to participate meaningfully in medical decisions, is central to this process, yet remains complex and context-dependent. This study explores how women with gynecologic cancers experience decision making (...) processes throughout the course of their treatment, with a focus on how their preferences, needs, and autonomy evolve over time. We conducted a qualitative, single-center, cross-sectional observational study using grounded theory methodology. Semi-structured interviews were held once with 20 female patients undergoing treatment for various gynecologic malignancies at a university medical center. Interviews explored experiences across treatment phases initiation, maintenance, pending/abstention and anticipated decisions. Participants expressed a wide range of attitudes toward decision making, shaped by emotional readiness, trust in clinicians, and interpersonal support. Early in treatment, many preferred clinician-led guidance due to emotional overload. Over time, some sought greater involvement, while others continued to delegate decisions. A minority of participants addressed treatment refusal or end-of-life decisions during interviews, often with ambivalence. Structural issues such as fragmented communication and lack of care continuity were cited as barriers to meaningful participation. Patients’ preferences for involvement in decision making are dynamic and context dependent. Our findings support models of relational and temporal autonomy and highlight the importance of responsive communication, trust, and systemic support in fostering ethical and effective SDM.These insights call for enhanced clinician training and organizational strategies to integrate SDM meaningfully into routine cancer care. (shrink)

Preliminary Note on Terminology: In Jesuit-related documents, the Latin term Nostri [“Ours”] is used to refer to Jesuits, to avoid unnecessarily using a word derived from the name of Jesus. The translations that follow retain the use of “Ours” in English following the Latin. The reader should remember that this term refers to members of the Society of Jesus. Also in the documents of Clavius (Historical Documents, Part II), the term scholastics is used, which refers to young Jesuit seminarians who (...) have pronounced their initial vows as Jesuits but have not yet completed their studies and have not yet been ordained as Catholic priests. Similarly, the term philosophers refers to Jesuit seminarians who have finished studying humanities, are currently studying philosophy, and have not yet started their study of theology. (shrink)

In this thought-provoking study, Jonathan M. Atkins provides a fresh look at the partisan ideological battles that marked the political culture of antebellum Tennessee. He argues that the legacy of party politics was a key factor in shaping Tennessee's hesitant course during the crisis of Union in 1860–61. Between the Jacksonian era and the outbreak of the Civil War, Atkins demonstrates, the competition between Democrats and Whigs in Tennessee was as heated as any in the country. The conflict centered largely (...) on differing conceptions of republican liberty and each party's contention that the other posed a serious threat to that liberty. As the slavery question pushed to the forefront of national politics, Tennessee's parties absorbed the issue into the partisan tumult that already existed. Both parties pledged to defend southern interests while preserving the integrity of the Union. Appeals for the defense of liberty and Union interests proved effective with voters and profoundly influenced the state's actions during the secession crisis. The belief that a new national Union party could preserve the Union while checking the Lincoln administration encouraged voters initially to reject secession. With the outbreak of war, however, West and Middle Tennesseans chose to accept disunion to avoid what they saw as coercion and military despotism by the North. East Tennesseans, meanwhile, preferred loyalty to the Union over membership in a Southern confederacy dominated by a slaveholding aristocracy. No previous book has so clearly detailed the role of party politics and ideology in Tennessee's early history. As Atkins shows, the ideological debate helps to explain not only the character and survival of Tennessee's party system but also the peristent strength of unionism in a state that ultimately joined the Southern cause. The Author: Jonathan M. Atkins is assistant professor of history at Berry College in Mt. Berry, Georgia. (shrink)

In 1974 specialized chambers were introduced in Belgium as an attempt to improve the functioning of the Parliament.Only the Senate endeavoured to put info full practice the experiment of these chambers during the 1974/75 session. The attempt, though proved ephemeral : during the following session a deep cleavage was felt even among those who were initially its fervent advocates. Today, this experiment has been completely nipped in the bud. These chambers have proved inefficient; the goal proving neither attainable nor conclusive.It (...) would appear, therefore, that the specialized chamber is merely a void concept which does not provide for a concrete application. This, at least, is the lesson to be drawn from the «sections» of the Belgian Senate.However, in the context of a reallocation of tasks between the Senate and the House of Representatives, such specialized chambers might prove useful. (shrink)

Objective Moral distress is a complex phenomenon experienced by healthcare professionals. This study examined the relationships between key dimensions of Organizational Culture in Healthcare (OCHC)—perceived psychological safety, ethical climate, patient safety—and healthcare professionals’ perception of moral distress.Design Cross-sectional surveySetting Pediatric and adult critical care medicine, and adult hospital medicine healthcare professionals in the United States.Participants Physicians (n = 260), nurses (n = 256), and advanced practice providers (n = 110) participated in the study.Main outcome measures Three dimensions of OCHC were (...) measured using validated questionnaires: Olson’s Hospital Ethical Climate Survey, Agency for Healthcare Research and Quality’s Patient Safety Culture Survey, and Edmondson’s Team Psychological Safety Survey. The perception of moral distress was measured using the Moral Distress Amidst a Pandemic Survey. The hypothesized relationships between various dimensions were tested with structural equation modeling (SEM).Results Adequate model fit was achieved in the SEM: a root-mean-square error of approximation =0.072 (90% CI 0.069 to 0.075), standardized root mean square residual = 0.056, and comparative fit index =0.926. Perceived psychological safety (β= −0.357, p <.001) and patient safety culture (β = −0.428, p<.001) were negatively related to moral distress experience. There was no significant association between ethical climate and moral distress (β = 0.106, p = 0.319). Ethical Climate, however, was highly correlated with Patient Safety Culture (factor correlation= 0.82).Conclusions We used structural equation model to test a theoretical model of multi-dimensional organizational culture and healthcare climate (OCHC) and moral distress.Significant associations were found, supporting mitigating strategies to optimize psychological safety and patient safety culture to address moral distress among healthcare professionals. Future initiatives and studies should account for key dimensions of OCHC with multi-pronged targets to preserve the moral well-being of individuals, teams, and organizations. (shrink)

Background Climate change increasingly affects population health and healthcare systems. While normative frameworks emphasize physicians’ societal role in climate protection, empirical evidence on how general practitioners perceive and address climate- and environment-related issues in daily clinical practice remains somewhat limited and not yet fully consistent across studies. Methods We conducted a nationwide cross-sectional online survey among general practitioners (N = 500; 38.2% female) in Germany. The questionnaire assessed attitudes toward climate protection, attribution of responsibility for climate- and environment-related practice in (...) healthcare, and the frequency of addressing climate- and environment-related issues in practice by patients and practitioners. Data were analyzed using descriptive statistics, group comparisons, and correlation analyses. Results A majority of respondents (65.8%) considered climate- and environment-related issues relevant to their professional role and endorsed physicians’ function as societal role models. Agreement regarding individual responsibility within clinical practice was comparatively moderate (22.6%), with responsibility more frequently attributed to institutional (29.1%) and policy levels (49.2%). Attitudes toward environmental responsibility were largely consistent across subgroups defined by federal state, community size, practice type, and professional experience, while female general practitioners reported higher levels of environmental concern (M = 3.94 vs. M = 3.43; p <.001), indicating a small to moderate effect. Climate- and environment-related issues were reported to arise regularly in general practice, initiated by both physicians and patients (monthly or more often in physicians 68.4% versus patients 59.2%; never in physicians 12.4% versus patients 12.6%). Discussion and Conclusions The findings suggest that German general practitioners broadly acknowledge the relevance of climate- and environment-related issues to their professional role and are open to integrating such considerations into clinical context. At the same time, ambivalence regarding individual responsibility highlights the need for clearer normative orientation. Integrating climate- and environment-related considerations into professional standards, clinical guidelines, and medical education may help provide such orientation and support physicians in navigating ethical tensions. (shrink)

There is convincing evidence of the transmission of anxiety and depression from parents to children; however, mechanisms by which this vulnerability is passed on are unclear. Cognitive models and a small body of cross-sectional research suggest that parental attention biases (ABs) may be one mechanism involved in transmission. Longitudinal associations of maternal and offspring ABs with offspring symptoms have been scarcely studied. Forty-three mothers–child dyads were included. All children (7–12 years old) were diagnosis-free while 24 mothers had a lifetime emotional (...) disorder (anxiety or depression) (high risk, HR) and 19 mothers had no psychiatric diagnoses (low risk, LR). This study examined cross-sectional and longitudinal associations of maternal and child AB and child anxiety symptomology at initial and 12-month assessments. ABs were assessed using a visual-probe task with emotional faces. There was a significant cross-sectional but not longitudinal association of increased child anxiety symptoms with increased maternal threat AB for HR but not LR dyads. At the cross-sectional level, increases in HR but not LR offspring anxiety symptomology were associated with maternal threat AB. Larger longitudinal studies are required that examine the interplay between parent–child variables and include multiple time-points of assessment and measures of AB. (shrink)

The link between spirituality and body donation is an important consideration, especially in Nigeria, where there is currently no formal body bequest program for medical education and research purposes. This study delved into students’ spiritual perspectives, gauging their impact on their willingness to donate their bodies for educational or research purposes. This cross-sectional study assessed 1158 Nigerian medical and allied health students who have been exposed to cadaver dissection via an online questionnaire developed from interviews and the Spirituality Orientation Inventory, (...) which included questions on spiritual beliefs, willingness, and reasons for body donation. Descriptive analysis and chi-squared tests were used to decide proportions and relationships between the study variables, with statistical significance set at p < 0.05. About students’ familiarity and attitudes towards body donation, 15.2% were unfamiliar with the concept. In terms of their stance, 35.23% expressed support for body donation, while nearly half, 49.49%, remained neutral on the subject. Most students (63.65%) refused to consider body donation after death. Only a few respondents (17.62%) were open to donating for education or research or if they would benefit from it (10.49%). More than half (56.24%) agreed that they followed their religion’s teachings. 76.37% believed in life after death, 40% were uncertain about reincarnation while 54.28% were unaware of their religion’s stance on body donation. However, belief in reincarnation is significantly associated with students’ willingness to donate their bodies (p = 0.026). Awareness of body donation among Nigerian medical students is low, with many expressing neutral attitudes and limited understanding of their religion’s stance. Willingness to donate is generally poor, and while spirituality plays a role, specific beliefs such as reincarnation appear more influential than overall religiosity. These findings highlight the need for targeted education and culturally sensitive awareness initiatives. (shrink)

I investigate patterns of usage of thanking formulae in the closing section of a corpus of 94 telephone calls made by tenants to a UK housing association. The data suggest that unilateral thanking is the norm when calls are institutionally and interactionally unmarked. In contrast, mutual thanking correlates mainly with the presence of interactional problems of various kinds, or, in a few cases, with features that are not problematic as such, but simply interactionally marked given the nature of the (...) activity. When initiated by agents rather than by callers, thanking is frequently hearable as conveying an apologetic stance. Participants thus seem to orient to different thanking patterns as devices which may be used either to mark the preceding interaction as an instance of ‘business-as-usual’ or, if such is not the case, to restore interpersonal harmony or index awareness that aspects of the preceding interaction have otherwise deviated from situational expectations. (shrink)

Ethical awareness is fundamental to maintaining integrity in medical research. In the current study, we assess the knowledge of Indian Council of Medical Research (ICMR) ethical guidelines among nursing professionals and examine the association between their demographic characteristics and knowledge levels. Participants (N = 150) completed a structured questionnaire comprising demographic items and a knowledge assessment based on ICMR guidelines. The results showed that approximately 45.0% of participants demonstrated good knowledge of ethical guidelines. Although educational attainment initially appeared to be (...) associated with higher knowledge scores (p = 0.044), this effect did not remain significant after Bonferroni correction for multiple testing (adjusted α = 0.006). No other demographic variables were significantly associated with knowledge. These findings suggest that while a portion of nursing professionals possess adequate ethical awareness, broader and more structured educational efforts are needed to strengthen knowledge and ensure consistent adherence to research ethics in clinical practice. (shrink)

Even in countries with a defined legal framework for advance directives (AD), the rates of completion are low. The goal of the present study was to assess whether intervention by means of a lecture by a family physician (FP) is effective for the facilitation of completion of AD by patients. A secondary aim was to assess the knowledge and attitudes of adults on AD. The intervention included an interactive lecture on AD by an FP in two villages in southern Israel. (...) The success of the intervention was measured as completion of AD at primary care clinics over a three-month period after the intervention. Sixty-seven patients 17 years of age and older attended the lecture (1.0% vs. 19.0% for the religious and secular villages, respectively, p <.001). Ten participants (14.9%) completed AD within three months after the intervention (p =.002). Patients from both the secular and religious villages expected that their FP (74%) and/or an outpatient nurse (33%) would initiate the discussion on AD and commented that they would like the topic to be more prominent in the media. Intervention by means of an interactive lecture delivered by an FP in the community is an effective way to motivate patients to complete AD. (shrink)

Introduction. Healthcare workers (HCWs) should theoretically have the necessary education and environment to adopt a healthy lifestyle, and they supposedly also should have a higher participation rate in WHP programmes. HCWs are, for several reasons, considered to be a key group in health promotion, especially due to the fact that the healthcare system reaches a substantial number of people in need of lifestyle changes such as increased physical activity (PA) [5]. Furthermore, healthcare professionals are considered to be the most credible (...) source of health information [6]. HCWs' lifestyles can play an important role in increasing awareness among patients regarding lifestyle changes, because HCWs' own lifestyle habits and interests in lifestyle behaviour have been shown to positively influence their counselling practices and attitudes [6–7]. The international movement 'Health Promoting Hospitals and Health Services', which was initiated by the World Health Organization (WHO), highlights the importance of also focusing on the health and lifestyle of the employees. Methods. We conducted survey based on a standardized and adapted questionnaire that included socio-demographic data and points related to healthy lifestyle. We adhered to the latest recommendations on designing and reporting survey studies. Before conducting the study, the questionnaire was pretested among 5 experts and revised twice. The survey was conducted in Kazakh / Russian for respondents who speak two languages fluently at the choice of participants. The filling of the questionnaire took on average 45 minutes. We reported absolute numbers and percentages. Chi-square tests were used to compare responses between groups. Results were considered significant at a P value of < 0.05. Statistical analyses were performed using the application SAS OnDemand for academia (version 3.81, Carry, North Carolina, USA). Results. Our data revealed that nurses were more likely to adhere to healthy eating principles and to have a regular diet at home. GPs were more likely to consume fast food and add salt when food is not salted enough. Nurses were more likely to eat greens regularly. GPs had a stronger belief in the impact of diet on health. More nurses rated their diet as healthy. Media promotion significantly influenced GPs for changing diet towards healthier options. Eating patterns vary according to the risk of stress. Research shows that chronic stress influences the amount and types of consumed food, contributing to both overeating and malnutrition, and that stress hormones can lead to the development of obesity. GPs are more likely to have used tobacco products compared to nurses. GPs are more likely to smoke more than 10 cigarettes per day. GPs have a slightly higher belief in the necessity of a healthy lifestyle compared to nurses. GPs and nurses have different testing frequencies for Hepatitis B and C, with nurses testing more frequently. GPs are more likely to have sexual activity after drinking alcohol. Conclusion. It is known that a healthy lifestyle of doctors affects the attitude of patients and their motivation to change their lifestyle. Thus, the lifestyle patterns of health workers, as well as the understanding of the motivation of these patterns, are more likely to affect public health. (shrink)

BackgroundThe 11th revision of the International Classification of Diseases included two distinct trauma-related diagnoses—Posttraumatic Stress Disorder and Complex Posttraumatic Stress Disorder. The initial diagnostic factor for both disorders is exposure to a traumatic event. This study aimed to explore whether exposure to different traumatic experiences distinguish risk for PTSD and CPTSD.MethodsThe study sample comprised 158 trauma-exposed participants, Mage = 33.61. The Life Events Checklist-Revised was used to evaluate trauma exposure, and the International Trauma Questionnaire was used to assess risk (...) for ICD-11 PTSD and CPTSD. Multinomial logistic regression was used to determine traumatic events as predictors of risk for PTSD and CPTSD.ResultsAnalysis revealed that sexual abuse experienced in childhood or adulthood was associated with both PTSD and CPTSD. History of other unwanted sexual experiences and childhood physical abuse predicted CPTSD compared to PTSD, whereas exposure to natural disasters predicted PTSD compared to CPTSD.ConclusionsThe results showed that experiences of certain traumatic events, such as sexual trauma, childhood physical abuse or natural disasters, might help distinguish risk for PTSD and CPTSD. Nevertheless, future studies on specific aspects of trauma exposure are necessary. (shrink)

Trait emotional intelligence (trait EI) covers a wide range of self-perceived skills and personality dispositions such as motivation, confidence, optimism, peer relations and coping with stress. In the last few years, there has been a growing awareness that social and emotional factors play an important part in students? academic success and it has been claimed that those with high scores on a trait EI measure perform better. This research investigated whether scores on a questionnaire measure of trait EI were related (...) to school performance in a sample of British pupils. Results showed that high performing students had higher trait EI scores than low performing students and that some aspects of trait EI (motivation and low impulsivity) as well as total trait EI were significant predictors of academic achievement after controlling for prior attainment at school. Therefore, initiatives to develop the emotional and social abilities of schoolchildren might be worthwhile and more effective than concentrating solely on teaching and curriculum activities. (shrink)

BackgroundAccurate reporting on sex and gender in health research is integral to ensuring that health interventions are safe and effective. In Canada and internationally, governments, research organizations, journal editors, and health agencies have called for more inclusive research, provision of sex-disaggregated data, and the integration of sex and gender analysis throughout the research process. Sex and gender analysis is generally defined as an approach for considering how and why different subpopulations (e.g., of diverse genders, ages, and social locations) may experience (...) health conditions and interventions in different or similar ways.The objective of this study was to assess the extent and nature of reporting about sex and/or gender, including whether sex and gender analysis (SGA) was carried out in a sample of Canadian randomized controlled trials (RCTs) with human participants.MethodsWe searched MEDLINE from 01 January 2013 to 23 July 2014 using a validated filter for identification of RCTs, combined with terms related to Canada. Two reviewers screened the search results to identify the first 100 RCTs that were either identified in the trial publication as funded by a Canadian organization or which had a first or last author based in Canada. Data were independently extracted by two people from 10% of the RCTs during an initial training period; once agreement was reached on this sample, the remainder of the data extraction was completed by one person and verified by a second.ResultsThe search yielded 1433 records. We screened 256 records to identify 100 RCTs which met our eligibility criteria. The median sample size of the RCTs was 107 participants (range 12–6085). While 98% of studies described the demographic composition of their participants by sex, only 6% conducted a subgroup analysis across sex and 4% reported sex-disaggregated data. No article defined “sex” and/or “gender.” No publication carried out a comprehensive sex and gender analysis.ConclusionsFindings highlight poor uptake of sex and gender considerations in the Canadian RCT context and underscore the need for better articulated guidance on sex and gender analysis to improve reporting of evidence, inform policy development, and guide future research. (shrink)

Following an initial section, in which the relation of materialism to positivism and agnosticism is discussed, and the latter views criticized, a formal definition of dialectical materialism is given. Materialism is contrasted to idealism and dualism. Dialectics is contrasted to metaphysics. Some additional assumptions, usually included in dialectics, such as the interpenetrating character of the levels of science, and rationalism, are listed. In a section devoted to the relation between matter and spirit, the foundations of materialist ethics (...) are laid by stating the humanist axiom of purpose. In the last section, historical materialism is defined, and some reasons for the occasional entanglement of scientific, philosophical, and political controversies are discussed. (shrink)

The aim of this paper is threefold. Firstly, §1 and §2 introduce the novel concept logical akrasia by analogy to epistemic akrasia. If successful, the initial sections will draw attention to an interesting akratic phenomenon which has not received much attention in the literature on akrasia (although it has been discussed by logicians in different terms). Secondly, §3 and §4 present a dilemma related to logical akrasia. From a case involving the consistency of Peano Arithmetic and Gödel’s Second Incompleteness (...) Theorem it’s shown that either we must be agnostic about the consistency of Peano Arithmetic or akratic in our arithmetical theorizing. If successful, these sections will underscore the pertinence and persistence of akrasia in arithmetic (by appeal to Gödel’s seminal work). Thirdly, §5 concludes by suggesting a way of translating the dilemma of arithmetical akrasia into a case of regular epistemic akrasia; and further how one might try to escape the dilemma when it’s framed this way. (shrink)

The complete title of the Principles is A Treatise Concerning the Principles of Human Knowledge. Wherein the chief causes of error and difficulty in the Sciences, with the grounds of Scepticism, Atheism, and Irreligion, are Inquired into. The complete title of the Dialogues is Three Dialogues between Hylas and Philonous. The design of which is plainly to demonstrate the reality and perfection of human knowledge, the incorporeal nature of the soul, and the immediate providence of a Deity: in opposition to (...) Sceptics and Atheists. Also to open a method for rendering the Sciences more easy, useful, and compendious. The introductions to each work, as well as various remarks in the Philosophical Commentaries, explain at greater length the author's intention of refuting the sceptics and atheists. In the initial section of the introduction to the Principles, Berkeley had said that the attempt to understand the nature of things had led men into all sorts of "uncouth paradoxes, difficulties, and inconsistencies,... till at length, having wander'd through many intricate mazes, we find ourselves just where we were, or, which is worse, sit down in a forlorn scepticism." And a few sections later, Berkeley stated that his intention was to discover the sources of the absurdities and contradictions that have entered philosophy, and to eliminate them. (shrink)

This paper examines the evolution of the doctrine concerning the beginning of philosophy as evidenced in the philosophies of Heinrich Rickert and Werner Flach. The initial section of the paper explores Rickert’s anti-Hegelian approach to the problem of philosophical beginning, while the subsequent section delves into Werner Flach’s adaptation of Rickert’s principles, infusing them with a renewed Hegelian perspective. The concluding segment offers an assessment of the limitations inherent in both doctrines pertaining to the beginning of philosophy.

This essay examines Jacques Derrida’s contribution to recent debates in animal philosophy in order to explore the critical promise of his work for contemporary discourses on animal ethics and vegetarianism. The essay is divided into two sections, both of which have as their focus Derrida’s interview with Jean-Luc Nancy entitled “‘Eating Well’, or the Calculation of the Subject.” My task in the initial section is to assess the claim made by Derrida in this interview that Levinas’s work is (...) dogmatically anthropocentric, and to determine whether Levinas’s conception of ethics leaves a place for animals. In the second half of the essay I turn to an analysis of Derrida’s discussion of vegetarianism and its critical relation to the humanism and anthropocentrism that he is calling into question. The main argument that I seek to advance here is that deconstruction should not be strictly identified with vegetarianism (as certain of Derrida’s readers have suggested), but rather that what is needed is a thorough deconstruction of existing discourses on vegetarianism, a project that remains largely to be developed. (shrink)

Some of the oldest and deepest questions in philosophy fall under the umbrella of consciousness and mind: What is the mind and how is it related to the body? What provides our thoughts with content? How is consciousness related to the natural world? Do we have distinctive causal powers? Analytic philosophers have made significant progress on these and related problems in the last century. Given the high volume of work on such topics, this chapter is necessarily selective. It offers major (...) touchstones but is slanted in favor of work that touches base with the sciences. The chapter starts by describing the progression of thought on the mind-body problem, from dualism and behaviorism to non-reductive materialism. It then describes the problem of intentionality, with a focus on partial solutions from Dretske and Millikan, ending with a brief discussion of 4E theories of mental content. The section on the problem of consciousness starts with the well-known knowledge and modal arguments before describing some attempted initial solutions, such as eliminative materialism and panpsychism. Finally, there is a brief section on agency and free will, which focuses on the link between free will and consciousness. (shrink)

The purpose of the article is to present further information about Avicenna's work on Eastern philosophy, supplementing what was written in the author's Avicenna and the Aristotelian Tradition, pp. 115-30. In view of the prevalent but unfounded notions among some students of Avicenna that the Eastern philosophy is mystical or illuminationist, an initial section traces the history of the development of these tendentious ideas first to Ibn T[dotu]ufayl and then to the followers of his interpretation in the West (...) in the nineteenth and twentieth centuries. Further sections discuss the title of the book, list its contents insofar as they can be reconstructed from Avicenna's statements and the extant portions, and provide additional information about its manuscripts and transmission. The style of the work is then analyzed and compared with that of the šifā' in order to verify Avicenna's claim in the Preface to the latter work that the difference between the two was merely stylistic. A final section gives a table of concordance between the contents of the extant part on physics and the corresponding sections in the šifā', establishing the direct relationship and verbal congruity between the two works. (shrink)

David Fairchild explains that sport is an evocative symbolic system that demonstrates the apparently ‘natural’ division of humans into two separate and dichotomous genders, and also demonstrates the apparently ‘genetically based’ hierarchy between the genders in terms of sporting results. Additionally, this hierarchy of performance translates into a hierarchy of authority, such that men occupy the most powerful positions in coaching, administration and the sports media. The initial section of this paper will follow on from Fairchild to suggest (...) some changes that are necessary before women will gain semantic authority over their participation in sport. The paper will then suggest that the expansion of the discursive space in sport to include alternate standpoints produced by women [and other marginalised groups] can follow tactics employed by feminist standpoint theorists to expand discursive space in other fields. The final section of the paper will look at how a feminist politics in discursive sport will need to challenge what William Morgan has suggested is the recently acquired dominant position of ‘interpretative broad internalism’ in sport philosophy as one of the foundational underpinnings of internalism explains sport as a perfect practice. This underpinning has been used in substantive practice to undermine the knowledges of women athletes and commentators. This final section will look at some examples of translating private authorship into political authority for women in sport. (shrink)

The article explores some of the theoretical and political issues which underpin the current conflict over the accountability of the global economic order. The article develops in five parts, starting with an initial section on the changing nature and form of globalization and ending with an account of how markets and business activities can be reframed. The focus is on the emergence of a number of cosmopolitan social standards which are embedded in human rights regimes and other international (...) legal instruments. These standards are explicated, elaborated and defended. The article argues that these standards need to be clarified further and developed in order to create the basis for global economic accountability and social justice. (shrink)

[English version below] Diese Stellungnahme zielt darauf ab, Empfehlungen für akzeptable Rahmenbedingungen eines Genomischen-Neugeborenen-Screening (gNBS)-Programms in Deutschland zu formulieren, darunter Empfehlungen zu Auswahlkriterien für Zielkrankheiten und zum Management eines gNBS-Programms sowie zur gesetzlichen Neuregulierung. Sie ist Ergebnis eines dreijährigen Forschungsprojektes, das an den Universitäten Heidelberg und Mannheim durchgeführt wurde. An dem interdisziplinären Projekt beteiligt waren Forscher:innen aus den Bereichen Kinder- und Jugendmedizin, Humangenetik, Rechtswissenschaft, Medizinische Psychologie und Medizinethik sowie Vertreter:innen von Patient:innen-Organisationen (Kindernetzwerk e.V. und Deutsche Interessengemeinschaft Phenylketonurie und verwandte angeborene (...) Stoffwechselstörungen e.V.). Das Projekt wurde vom Bundesministerium für Bildung und Forschung (BMBF; seit 2025 Bundesministerium für Forschung, Technologie und Raumfahrt: BMFTR) gefördert und trägt den Titel NEW_LIVES („Genomic NEWborn screening programs – Legal Implications, Value, Ethics and Society” – „Genomische Neugeborenen-Screening-Programme – Rechtliche Implikationen, Werte, Ethik und Gesellschaft“). Die Stellungnahme beginnt mit einführenden Kapiteln zum Hintergrund des gNBS aus Sicht der verschiedenen Fachbereiche und aus Sicht der Gesellschaft, gefolgt von konkreten Empfehlungen für ein zukünftig mögliches gNBS-Pro- gramm in Deutschland. In der Einleitung (1.) werden erste Ergebnisse bisheriger Forschungsprojekte zum gNBS zusammengefasst und die Zielsetzung und Methode, einschließlich der Rolle von Patient:innen-Vertreter:innen bei der Erarbeitung der Stellungnahme werden beschrieben. In Abschnitt 2 („Medizinischer Hintergrund“) werden Entwicklung, Umfang und Ablauf des derzeitigen Neugeborenen-Screening (NBS)-Programms in Deutschland beschrieben und die Besonderheiten eines gNBS-Programms erläutert. Abschnitt 3 („Perspektive von Patient:innen, Eltern und medizinischem Personal“) fasst die Ergebnisse der sozialempirischen Studien zusammen, die im Rahmen des Projektes NEW_LIVES durchgeführt wurden (Fokusgruppen, bevölkerungs-repräsentative Befragung, querschnittliche Online-Befragung) und vergleicht die Ergebnisse mit anderen, internationalen Studien. Abschnitt 3 enthält außerdem eine gemeinsame Stellungnahme der beiden Patient:innen-Organisationen, die am Projekt NEW_LIVES mitgewirkt haben, zum gNBS. Abschnitt 4 („Genomisches Neugeborenen-Screening aus rechtlicher Sicht“) skizziert den rechtlichen Regulierungsrahmen zum gNBS in Deutschland. Abschnitt 5 („Genomisches Neugeborenen-Screening aus ethischer Sicht“) benennt zentrale ethische Herausforderungen des gNBS und formuliert ethische Orientierungsmaßstäbe für ein zukünftiges gNBS-Programm in Deutschland. Da die Neugeborenen diejenigen sind, die an einem gNBS teilnehmen würden und davon profitieren könnten, stellt deren Kindeswohl den zentralen ethischen Orientierungsmaßstab für die Bewertung dar. Die sich in Abschnitt 6 anschließenden Empfehlungen sind aus Sicht aller an der Erarbeitung dieser Stellungnahme beteiligten Fachdisziplinen und der Patient:innen-Organisationen verfasst Darunter sind einerseits transparente Auswahlkriterien für Zielkrankheiten eines gNBS-Programms (Kriterien 1–11). Andererseits werden Empfehlungen für die Einführung, Qualitätssicherung und Nutzenbewertung eines gNBS-Programms formuliert (Kriterien 12–18). Zudem enthält diese Stellungnahme Empfehlungen zur gesetzlichen Neuregulierung. Eine Publikation der Empfehlungen auf Englisch findet sich in Schnabel-Besson et al.: “A multi-dimensional fra- mework for establishing and managing a genomic newborn screening program” (Arbeitstitel; zum Zeitpunkt des Verfassens dieser Stellungnahme in Vorbereitung; DOI der Preprint-Version: 10.1101/2025.06.17.25329 471). - This position paper has the aim of formulating recommendations for what would be an acceptable framework for a genomic newborn screening (gNBS) programme in Germany, including recommendations for selection criteria for target diseases, and for the management of a gNBS programme, as well as for revision of legislation. It is the result of a research project conducted at the Universities of Heidelberg and Mannheim over the course of three years. This interdisciplinary project brought together researchers from the fields of paediatrics and adolescent medicine, human genetics, law, medical psychology, and medical ethics, as well as representatives of patient organisations (Kindernetzwerk e.V., and Deutsche Interessenge- meinschaft Phenylketonurie und verwandte angeborene Stoffwechselstörungen e.V.). The project was funded by the German Federal Ministry of Education and Research (BMBF; since 2025 Federal Ministry of Research, Technology and Space: BMFTR) and is called NEW_LIVES (“Genomic NEWborn screening programs – Legal Implications, Value, Ethics and Society”). The position paper begins with introductory chapters on gNBS from the perspective of the different disciplines, and from a societal viewpoint, followed by concrete recommendations for a possible future gNBS programme in Germany. The Introduction (1.) summarises the initial results of previous research projects on gNBS, and describes the objectives, and methodology, including the role of patient representatives, in the development of the position paper. Section 2 (“Medical Background”) describes the development, scope, and process of the current NBS programme in Germany, and explains the specific features of a gNBS programme. Section 3 (“Perspectives of Patients, Parents, and Medical Staff”) summarizes the results of the social-empirical studies conducted as part of the NEW_LIVES project (focus groups, population-representative survey, cross-sectional online survey), and compares the results with other, international studies. Section 3 also contains a joint statement on gNBS by the two patient organisations that participated in the NEW_LIVES project. Section 4 (“Genomic Newborn Screening from a Legal Perspective”) outlines the legal regulatory framework for gNBS in Germany. Section 5 (“Genomic Newborn Screening from an Ethical Perspective”) identifies key ethical challenges of gNBS, and formulates ethical guidelines for a future gNBS programme in Germany. Since newborns are the ones who would participate in, and benefit from gNBS, their welfare represents the central ethical guideline for the evaluation. The recommendations in Section 6 are written from the perspective of all disciplines, and patient organisations involved in the development of this position paper. These recommendations reflect the consensus of the inter-, and transdisciplinary group of authors, and form the core of the position paper. They comprise 18 criteria for a possible future gNBS programme in Germany. These include, on the one hand, transparent selection criteria for target diseases of a gNBS programme (criteria 1–11). On the other hand, recommendations are formulated for the introduction, quality assurance, and benefit assessment of a gNBS programme (criteria 12–18). This position paper also contains recommendations for new legal regulations. An English version of the recommendations, including the 11 criteria for selecting target diseases and the 7 criteria for programme management can be found in Schnabel-Besson E, Dikow N, Alex K et al.: “A multidimensional framework for establishing and managing a genomic newborn screening program” (working title; in preparation at the time of writing this position paper; doi of preprint version: 10.1101/2025.06.17.25329471). (shrink)

This paper aims to analyse the epistemic regime of the social sciences by recurring to the schemata articulated around the notion of “paradigm” by Thomas S. Kuhn. In order to achieve this objective, the initial section of the article situates the term within the context of Kuhn’s work, with a particular focus on its sociological foundation. Once this groundwork has been completed, the debate on the paradigmatic status of the social sciences themselves will be explored. After summarizing the (...) main positions in this debate (focusing on the multiparadigmatic perspective), we propose that theoretical plurality is not only inherent to the study of the social, but also constitutive of its own form of scientificity—suspended between a hermeneutic task and an experimental task linked to its complex yet undeniable empirical quality. (shrink)

This study critically examines the foundational principles of impartiality and value independence advocated by moral realist epistemologies in the pursuit of objectivity. Central to moral realists is the cognitivist presupposition necessitating a clear distinction between cognitive and emotional components inherent in moral judgments. The investigation focuses on the cognitive-emotional dichotomy underlying the moral realist perspectives of David Enoch and Thomas Nagel. The research findings unveil that the interplay between cognition and emotion, as evidenced by experimental data, poses a formidable challenge (...) to the traditional understanding of impartiality and value independence. The article's initial section delves into the ontological nature of moral judgments, followed by an exploration of the cognitive assumptions shaping Nagel and Enoch's conceptualizations of objectivity. The final section elucidates the cognitive-emotional interdependence that disrupts the conditions of impartiality and value independence, conventionally posited as prerequisites for objectivity. (shrink)