Hasil untuk "Ethics"

Volkan Korkmaz, Ozlem Guc Suvak, Cenk Aypak

Aim: This study aims to investigate the changes in topics and methodologies of family medicine specialization theses before and during the pandemic. Method: This observational, descriptive, and retrospective study evaluated the family medicine speciality theses published between 2018 and 2022. 2021 and 2022 were considered as during the pandemic and 2018-2020 as before the pandemic; thesis topics were classified according to the International Classification of Primary Care, 2nd edition, by the 32-variable Thesis Information Form. The data were analyzed using IBM SPSS Statistics for Windows, v21.0. Armonk, NY: IBM Corp. A value of p<0.05 was considered statistically significant. Results: Five hundred sixty-four theses were written before the pandemic and 448 were written during the pandemic. A statistically significant difference was observed between before the pandemic and during the pandemic regarding several variables: gender, relation to COVID-19, supervisor title, research location, research type, funding, using questionnaires, and provision of medicine therapy. Among the topics, International Classification of Primary Care, 2nd edition A (General and nonspecific topics) was the most frequently examined during the pandemic (n=114, 25.4%), compared to before the pandemic. The questionnaires became more common during the pandemic, particularly online via email and social media platforms. There was a notable rise in the number of theses focusing on respiratory tract infectionsand the novel coronavirus. All these studies were approved by the ethics committee. Conclusion: This study indicated that family medicine specialty theses and training were affected by the pandemic. The observational and descriptive studies were the most common, accompanied by changes in supervisor titles and a reduction in financial support during the pandemic.

Fanrong Wei, Rui Yan, Yaozhong Zhang et al.

Abstract Objective This study aimed to investigate the relationship between preoperative disability and postoperative outcomes in elderly patients undergoing major abdominal surgery. Methods This retrospective study included elderly patients aged 65 years and older who underwent elective major abdominal surgery in our hospital from September 2023 to November 2024, aiming to explore the predictive value of preoperative disability levels for the main postoperative outcomes in this population. Patients were divided into a non-disability group and a disability group according to WHODAS 2.0 scores under an ethics-approved waiver of consent. Results A total of 436 elderly patients were included, with 87 cases (19.9%) in the non-disability group and 349 cases (80.1%) in the disability group. Baseline characteristics showed significant differences between the two groups in Clavien-Dindo Grade (complications: 2.3% vs. 10.9%, P = 0.013) and age (68.0 vs. 71.0, P = 0.004). Univariable analysis showed that disability (OR = 5.19, 95% CI = 1.23–21.96, P = 0.025), history of radiotherapy (OR = 4.51, 95% CI = 1.12–18.16, P = 0.034), coronary heart disease (OR = 2.21, 95% CI = 1.02–4.78, P = 0.045), preoperative anemia (OR = 3.32, 95% CI = 1.57–6.76, P = 0.002), ASA III + IV grade (OR = 2.14, 95% CI = 1.02–4.50, P = 0.044), and prolonged surgery time (per 30 min: OR = 1.15, 95% CI = 1.04–1.27, P = 0.005) were factors associated with adverse outcomes. Multivariable analysis through three models with stepwise variable adjustment (Model 1: gender, age, BMI, history of radiotherapy, coronary heart disease, preoperative anemia; Model 2: additionally adjusted for surgery time; Model 3: adjusted for ASA classification) consistently showed that preoperative disability was an independent risk factor for adverse outcomes, with adjusted ORs of 4.65 (95% CI = 1.09–19.98, P = 0.038), 4.57 (95% CI = 1.02–19.62, P = 0.041), and 4.54 (95% CI = 1.06–19.52, P = 0.042), respectively. Conclusion Preoperative disability is independently associated with an increased risk of postoperative complications in elderly patients undergoing major abdominal surgery, emphasizing the need to develop personalized perioperative management plans for disabled elderly patients.

Miriam López Santos, Alba Lozano, Carolina Blanco Fontao

In the current landscape, the rapid evolution of educational technology, particularly AI tools like ChatGPT, necessitates understanding how educators perceive their integration into the education system. This study uses a quantitative, non-experimental, descriptive-comparative, and cross-sectional study was conducted with 379 active teachers in Castilla y León, Spain. The research instrument, a validated questionnaire, sought to assess prior knowledge, usage, and perceptions of ChatGPT's application in educational settings. Findings reveal high awareness and exploratory use of ChatGPT among teachers, though practical implementation and specific training remain limited. Teachers acknowledge ChatGPT's potential to enhance educational processes, particularly in generating educational materials and planning tasks. However, significant concerns about plagiarism, critical thinking, and ethical use persist. Differences in perceptions are mainly influenced by specialty, age, and gender, highlighting the need for tailored training and policies to support effective and ethical AI integration in education. These insights underscore the importance of continuous professional development to harness AI's benefits while mitigating associated risks.

Manuel Joaquín Fernández González, Kleio Akrivou

Moral development is crucial for a meaningful life. Many well-founded approaches and models are present in the moral development literature, which is a very diverse and populated field. The model of a ‘person of moral growth’ presented in this paper is a contribution to moral growth research based on personalist virtue ethics. Personalist virtue ethics puts the person at the centre of the moral reflection, addressing the holistic interplay of the person’s dimensions in the process of moral growth. The model is an operationalization of the person’s dimensions for educational and research purposes in the field of moral development. In this paper, the four components of the model are presented: emotional-cognitive, decisional (free commitment to moral growth), practical (moral growth through personal action), and self-understanding (the moral growth identity), and the process of the elaboration of the model is explained. For enhancing the construct validity of the model, its components and pedagogical implications are discussed in the light of recent moral education literature. This model is a contribution to a more cogent moral education and is helping to design and deliver moral educational experiences which address personal moral development in a clear, convincing, and well-structured way.

Katharina Dieck, Herwig Grimm

Despite the challenges the pandemic presented for university teaching, it opened up opportunities to set up and explore digital teaching formats like never before. This paper presents a case study of teaching introductory animal ethics in a digital format with flipped-classroom methods. The Interactive Literature Lecturing Format (ILLF) was designed along the following criteria: 1. Conformity with students’ varying educational needs; 2. Consistent high level of interaction; 3. Maximum transparency in an application-oriented exam; 4. No further contribution to the workload of the teaching staff; 5. Flexibility regarding online or on-site conversions. Rather than provide the students with input in lecture sessions, the ILLF presents students with selected literature and a list of structured questions. This literature questionnaire serves as the main didactic element that guides the knowledge transfer, the structure of the sessions and the exam. This paper reviews the outcome of the redesigning process and the steps we took to implement it. To discuss the overall quality of the format from a student’s perspective, the data from the systematically conducted students’ evaluation (<i>n</i> = 65) are interpreted using quantitative and qualitative methods. Bringing these results together with the perspective of the teaching staff, the following question is discussed: did the ILLF meet these criteria? This case study explores the potential and limits of flipped-classroom methods for applied ethics teaching in a university setting.

Sanne van der Heijden, Donovan Flumens, Maarten Versteven et al.

Summary: Wilms’ tumor protein 1 (WT1) is a tumor-associated antigen overexpressed in various cancers. As a self-antigen, negative selection reduces the number of WT1-specific T cell receptors (TCRs). Here, we provide a protocol to generate WT137-45-specific TCRs using healthy human peripheral blood mononuclear cells. We describe the expansion of WT1-specific T cell clones by two consecutive in vitro stimulations with autologous WT137-45-pulsed dendritic cells and peripheral blood lymphocytes. We then detail the detection with human leukocyte antigen/WT137-45 tetramers. : Publisher’s note: Undertaking any experimental protocol requires adherence to local institutional guidelines for laboratory safety and ethics.

Gustavo Ortiz Millán

This article enquiries whether normative bioethics can be a science. The article aims to address the conditions of possibility for bioethics to be considered a science, without directly answering the question. The article focuses on two conditions that we typically associate with our common concept of science: truth and knowledge, on the one hand, and naturalization, on the other. Bioethics should be able to provide moral truths and therefore moral knowledge so that we could consider it as a science. On the other hand, the normative character of bioethics raises the question of whether it is possible to naturalize it and make it compatible with a scientific perspective. The article argues that, for normative bioethics to be considered a science, a cognitive and naturalistic stance should be taken on ethics.

Castro Conceição, Moreira Tiago

The agricultural branch of the Portuguese cooperative sector assumes an important role in rural development and in the inter-cooperation with local, regional, national, and international structures. Given the principles and values that guide cooperatives, they have a greater responsibility in respecting the pillars of good governance such as transparency, integrity, and accountability. However, cooperatives may not be exempt from corruption. The objective of this paper is to assess farmers’ perception of corruption in the agricultural cooperative sector and to analyse if that level depends on their personal characteristics, on farm-specific characteristics, and the relations with the cooperative. With data collected through a survey, a logistic model was estimated to analyse the impact of personal characteristics of farmers and of their farms in the odd of score very high the level of corruption in the agriculture cooperative sector. Results suggest that farmers perceive high levels of corruption and that gender, age, turnover, and seniority as members of the cooperative are relevant predictors of the said level of corruption. These results raise awareness for the greater need of social accountability, more attention for management and supervisory bodies for the ethics of governance, as well as the need to implement internal control systems.

Hoseok Jung, Wookcheol Seo, Taeseong Jeong et al.

Objectives: This study was performed to evaluate the skin irritation toxicity of processed sulfur. Methods: All experiments were conducted at Medvill (Korea), an institution authorized to perform non-clinical studies, under the Good Laboratory Practice (GLP) regulations. In order to investigate skin irritation toxicity of processed sulfur, we divided the back of six rabbits into two control sites and two test sites. One of each of the two control and test sites was then designated abraded sites and intact sites. In test sites, 0.5 g of processed sulfur was applied to the back of the rabbit for 24 hours, and in control sites, 0.5 g of sterile distilled water was applied in the same way. We observed and evaluated mortality, weight, general symptoms, and skin irritation toxicity. This study was conducted with the approval of the Animal Ethics Committee (Approval number: IAC2020-1549). Results: In all experiments, no dead animals were observed. In all cases, skin coloration was observed at 24 hours after processed sulfur administration. This coloration lasted up to 48 hours and is believed to be the effect of the administration of test substances. Weight measurement indicated that weight was lost 72 hours after administration in three cases, but this is considered an accidental weight change. Normal weight gain was observed in the remaining subjects. In all animals, no skin irritation toxicity was observed, and the primary irritation index (P.I.I) was calculated as 0.0 according to Draize's evaluation method. Conclusion: The above findings suggest that it is relatively safe to apply a processed sulfur to the skin. Further research on this topic is needed to provide more specific evidence.

Mirjam Pot, Nathalie Kieusseyan, Barbara Prainsack

Abstract The application of machine learning (ML) technologies in medicine generally but also in radiology more specifically is hoped to improve clinical processes and the provision of healthcare. A central motivation in this regard is to advance patient treatment by reducing human error and increasing the accuracy of prognosis, diagnosis and therapy decisions. There is, however, also increasing awareness about bias in ML technologies and its potentially harmful consequences. Biases refer to systematic distortions of datasets, algorithms, or human decision making. These systematic distortions are understood to have negative effects on the quality of an outcome in terms of accuracy, fairness, or transparency. But biases are not only a technical problem that requires a technical solution. Because they often also have a social dimension, the ‘distorted’ outcomes they yield often have implications for equity. This paper assesses different types of biases that can emerge within applications of ML in radiology, and discusses in what cases such biases are problematic. Drawing upon theories of equity in healthcare, we argue that while some biases are harmful and should be acted upon, others might be unproblematic and even desirable—exactly because they can contribute to overcome inequities.

R. S. Vykhodets

Artificial Intelligence (AI) is one of the central technologies of the fourth industrial revolution. A significant part of the production of surplus value in the XXI century is associated with the mastery and widespread introduction of technologies, which contributes to the consolidation of technological competition as an object of state policy and an important component of international relations. The European Union today occupies a leading position in the field of technology development and Since 2018 the EU is in the process of forming a unified strategy in the field of AI, the directions, principles and approaches of which are the main subject of this article.The study is primarily based on the analysis of official documents included in the EU Strategy on AI: White Paper, Coordination Plan, Proposal for a Regulation establishing harmonized rules for artificial intelligence in the EU, documents of the expert groups of the European Commission, etc. The analysis of the EU policy to promote its own vision and approaches at the international level is based on theoretical models of the concept of “soft power” and the neo-institutional approach.Against the backdrop of fierce global technological competition, the EU was one of the first in the world to form a holistic strategy for the development of AI technologies. This makes it possible not only to strengthen its own position as a world leader in the field of innovative technologies, but also to significantly expand the intra-European and international integration agenda, as well as to supplement the European arsenal of soft power with tools to promote its own norms, standards and ethical principles of AI development at the global level.The key directions of the EU AI Policy are identified and disclosed. These include investments in technologies, creating conditions for their development, promoting development and implementation, creating an educational and regulatory environment, promoting the European vision of AI technology development at the international level. The authors considered key mechanisms of political regulation at the EU level, forms of interaction between stakeholders, approaches to promoting common principles in the field of ethics and security of AI technologies within the EU and at the international level.

Elma de Vries, Harsha Kathard, Alex Müller

Abstract Background Every person who seeks health care should be affirmed, respected, understood, and not judged. However, trans and gender diverse people have experienced significant marginalization and discrimination in health care settings. Health professionals are generally not adequately prepared by current curricula to provide appropriate healthcare to trans and gender diverse people. This strongly implies that health care students would benefit from curricula which facilitate learning about gender-affirming health care. Main body Trans and gender diverse people have been pathologized by the medical profession, through classifications of mental illness in the Diagnostic and Statistical Manual of Mental Disorders (DSM) and International Classification of Disease (ICD). Although this is changing in the new ICD-11, tension remains between depathologization discourses and access to gender-affirming health care. Trans and gender diverse people experience significant health disparities and an increased burden of disease, specifically in the areas of mental health, Human Immunodeficiency Virus, violence and victimisation. Many of these health disparities originate from discrimination and systemic biases that decrease access to care, as well as from health professional ignorance. This paper will outline gaps in health science curricula that have been described in different contexts, and specific educational interventions that have attempted to improve awareness, knowledge and skills related to gender-affirming health care. The education of primary care providers is critical, as in much of the world, specialist services for gender-affirming health care are not widely available. The ethics of the gatekeeping model, where service providers decide who can access care, will be discussed and contrasted with the informed-consent model that upholds autonomy by empowering patients to make their own health care decisions. Conclusion There is an ethical imperative for health professionals to reduce health care disparities of trans and gender diverse people and practice within the health care values of social justice and cultural humility. As health science educators, we have an ethical duty to include gender-affirming health in health science curricula in order to prevent harm to the trans and gender diverse patients that our students will provide care for in the future.

Mark Pretorius

Before one can adequately deal with a biblical and neurobiological examination of spiritual experiences, one would need to define what they are. Here, one could offer that a spiritual experience could be an encounter with something or someone that is other than a material experience. It is a supernatural experience that transcends the natural, yet impacts the natural, by affecting our mental and physical senses and how we practise our spirituality. It is an experience that leaves us with a new and perhaps intense sense of otherness. One could further propose that as spiritual experiences are by nature ‘experiences’, they are inherently subjective, and can therefore be classified as personal encounters. In other words, we have unique spiritual experiences in our encounters with God. This article offers several such examples and shows the significance of looking inwardly to answer the important question of why we are (or not) transforming spiritually and mentally. Contribution: The article’s challenge is to not only show that science and theology are not in conflict, but also how the intersection and emerging field of neurobiology (natural science) and theology can help better understand how spiritual experiences manifest, and that naturally we are seemingly wired for these experiences.

Gabriela Schumacher, Lucas Garcia, Márcia Fernandes et al.

O objetivo deste trabalho é verificar a percepção e a compreensão de profissionais de saúde sobre violência e proteção de crianças atendidas em um hospital geral universitário. Foram realizadas entrevistas semiestruturadas com dezoito profissionais de saúde. A abordagem relatada para as situações de violência varia desde o envolvimento até o descaso. Poucos entrevistados tiveram contato com o tema durante a sua formação profissional. A mãe foi identificada como a principal pessoa responsável pelas crianças, mas também como a principal agente de violência. Na perspectiva dos entrevistados, a criança só estará protegida se tiver uma família estruturada. A percepção e a compreensão dos profissionais em relação à violência e proteção de crianças são heterogêneas, modificando-se conforme a sua área de atuação.

Karen-Lis Kristensen

This study addresses teachers' ethical dilemmas in everyday participation in school structures in a Danish Primary School. It focuses in particular on their relations with 'disturbing children'. The author and four first grade teachers work in a research team, documenting and analysing the teachers’ interactions in the classroom. This paper focuses on the interactions between two of the teachers and one of the students. The research team focuses on the teachers’ struggles with stress and burnout symptoms that they impute to students’ misbehaviour. Through their work together, documenting what happens in the classroom, and then working together in collective biography workshops, the research team reveals the contradictory conditions of teachers’ work. They find that following current guidelines for good classroom management, and accepting without question current discourses on ADHD, places the teachers in a double-bind, with teachers and children in opposition to each other, and both teachers and children being judged and found wanting.  The paper seeks new ways of thinking/doing classroom interaction that challenges some of the binds of current management practices.

Alasdair Heron

The article aims to investigate the Calvin’s Genevan Service Order. It focuses on the question how the Psalter Calvin shaped the worship of the Reformed Church in Geneva. The article follows the critical edition of the Genevan prayer in Calvini Opera Selecta and in the German Studienausgabe as the two main published editions of the Genevan order with its related texts. The article shows that Calvin adhered to the general line of the Swiss and Upper German Reformations. It explores the understanding of worship reflected in the Genevan Service Order and the specific significance of its musical aspect. The article illustrates why Calvin gave the psalms the place he did in Genevan Reformed worship.