Practical Reasons Research Articles

Non-therapeutic hysterectomy in Mexican young females with intellectual disability: a problematized reality

Non-therapeutic hysterectomy in girls and adolescents with intellectual disability (ID) is an acceptable practice, even when there is a lack of prescriptive ethical reason. To determine the magnitude of the practice of hysterectomy in girls and adolescents with ID, and explore the emic factors associated with this procedure. Multicenter, intersectoral study with a mixed methods design. The quantitative results showed that 50 of 234 reported hysterectomies corresponded to females with ID. Average age at the time of surgery was 15 ± 2.9 years. Prophylactic abdominal hysterectomy was the most common procedure, and the justifications for it were "fertility control", "menstrual hygiene management", and "risk of sexual abuse". A qualitative analysis of 15 focus groups revealed that parents' main concern was how to manage their daughters' index disease and reproductive health; they perceived menstruation positively; they expressed their fear of dying and leaving them without support, and emphasized fertility control; none of them approved hysterectomy. The bodies that define health policies need to create a new philosophy that avoids the reductionist approach of current biomedical model, which separates (in the health-disease process) our interdependence with other humans.

Comparing First-Year Engineering Student Conceptions of Ethical Decision-Making to Performance on Standardized Assessments of Ethical Reasoning

The Defining Issues Test 2 (DIT-2) and Engineering Ethical Reasoning Instrument (EERI) are designed to measure ethical reasoning of general (DIT-2) and engineering-student (EERI) populations. These tools—and the DIT-2 especially—have gained wide usage for assessing the ethical reasoning of undergraduate students. This paper reports on a research study in which the ethical reasoning of first-year undergraduate engineering students at multiple universities was assessed with both of these tools. In addition to these two instruments, students were also asked to create personal concept maps of the phrase “ethical decision-making.” It was hypothesized that students whose instrument scores reflected more postconventional levels of moral development and more sophisticated ethical reasoning skills would likewise have richer, more detailed concept maps of ethical decision-making, reflecting their deeper levels of understanding of this topic and the complex of related concepts. In fact, there was no significant correlation between the instrument scores and concept map scoring, suggesting that the way first-year students conceptualize ethical decision making does not predict the way they behave when performing scenario-based ethical reasoning (perhaps more situated). This disparity indicates a need to more precisely quantify engineering ethical reasoning and decision making, if we wish to inform assessment outcomes using the results of such quantitative analyses.

Mathematical and ethical reasoning in preschool – didactic modeling as an intervention

I artikeln undersöks didaktiska val i undervisning där matematik och hållbar utveckling möts. Undervisningens syfte var att uppmuntra förskolebarn att kollektivt resonera kring fördelningsproblem. Det var barnens resonemang om möjliga lösningar som låg i fokus, inte ett rätt svar. Förskollärarens roll var att skapa möjligheter för agens: att barnen kunde göra egna bidrag i kunskapandet, där barnen kunde ställa olika konflikterande perspektiv om hållbara lösningar mot varandra och diskutera lösningarna. Utifrån metoden didaktisk modellering förde forskare och förskolläre diskussioner om undervisningen utifrån olika expertis. Dokumentationen som skapades under dessa möten analyserades, för att pröva om en didaktisk modell som hanterar de didaktisk vad- och hur-frågorna kunde hjälpa förskollärarna att skapa agens i undervisningen. Resultatet visar hur reflektion kring de didaktiska frågorna kan skapa möjligheter för agens i undervisningen. Didaktiska lösningar handlade om organisation av tid och miljö, om svårigheter att para ihop barn för kollektivt arbete samt språkutvecklande arbete. Mathematical and ethical reasoning in preschool – didactic modeling as an intervention The article examines didactic choices in teaching where mathematics and sustainable development meet. The purpose of the teaching was to encourage preschool children to reason collectively about distribution problems. It was the children's reasoning about possible solutions that was in focus, not a correct answer. The preschool teacher's role was to create opportunities for agency: enable childrens own contributions to knowledge, pit different conflicting perspectives on sustainable solutions against each other and discuss the solutions. Based on the didactic modeling method, researchers and preschool teachers discussed the teaching based on different expertise. Documentation created during these meetings was analysed, in order to investigate if the didactic what and how questions could help the preschool teachers create agency in teaching. The result shows how reflection on the didactic issues created opportunities for agency in relation to organization of time and environment, of pairing children for collective work and language development work.

Effectiveness of a Simulation-Based Education Program to Improve Novice Nurses' Clinical Judgment Skills.

We assessed the effectiveness of a simulation-based education program to improve novice nurses' clinical judgment skills. A simulation education program was implemented for 21 novice nurses. Surveys were conducted on program satisfaction, learning, and clinical judgment skills before, immediately after, and two months after the program. Novice nurses were highly satisfied with the simulation education program. The following nine categories were identified as learnings: provide psychological care for patients, conduct sufficient observation, conduct assessment and make judgment based on observational findings, consult and report appropriately to senior nurses, take response action calmly, collect necessary information, acquire knowledge, predict patients' conditions, and make environmental arrangements. The subscale score for theoretical and practical reasoning was significantly higher immediately after and two months after the program than before it. In addition, the subscale for grasping the condition by observation was significantly higher two months after the program than before and immediately after it. The novice nurses learned to sufficiently observe, obtain necessary information, and prospectively assess patients' conditions by taking part in the simulation education program. The subscale score for grasping the condition by observation was significantly higher two months after the program than before and immediately after it. After the simulation program, novicenurses were likely actively practicing nursing; therefore, this program may not be directly responsible for the improvement of these new nurses' clinical judgment. Nevertheless, we found that the completion of the simulation program was correlated with enhanced clinical judgment.

How to act on what you know

That we may rely on our knowledge seems like a platitude. Yet, the view that knowledge is sufficient for permissible reliance faces a major challenge: when much hangs on whether we know, relying on our knowledge seems to license irrational action. Unfortunately, extant proposals to meet this challenge (Hawthorne & Stanley, 2008; Williamson, 2005a; Schulz, 2017, 2021b) either fail to make the correct predictions about high-stakes cases or, as I will argue, face a substantial objection. In this paper, I will offer two novel proposals for defending the sufficiency of knowledge for permissible reliance. My favoured proposal, which I call Flexible Fallibilism, is based on the idea that stakes can affect how we rely on our knowledge and how our knowledge determines what is rational for us to do. Besides making the correct predictions about high-stakes cases, I will argue that Flexible Fallibilism also provides us with a knowledge-based account of when to simplify our practical reasoning. Afterwards, I will present another proposal, which I call Dual Infallibilism, that combines two recent claims by Moss (2013, 2018) and Jackson (2019a) about credal knowledge and the metaphysics of doxastic states. While the offered proposals share various virtues, I will argue that we ultimately should prefer Flexible Fallibilism.

Between Revolution and Reaction: The Political Significance of Kant’s Doctrine of the Idea

Abstract This essay argues that Kant’s conception of regulative ideas of practical reason introduced in the Critique of Pure Reason serves an important twofold function in his political philosophy. First, Kant’s version of the ideal, Platonic republic acts as the a priori paradigm of a rightful state to which existing regimes can and should conform. Second, Kant frames the regulative status of such practical ideas as a resolution of the conflict between the extremes of dogmatism and skepticism. In his principal political writings from the 1790s—i. e., “Theory and Practice,” “Perpetual Peace,” and the Doctrine of Right—Kant draws on his account of practical ideas in the Critique to articulate a counterfactual norm of popular sovereignty that distinguishes his political standpoint from opponents on the left and the right. Radicals repeat the error of the dogmatists by affirming that the norm of collective self-legislation is completely attainable in experience. By contrast, conservatives make the mistake of the skeptics by denying that rational political standards can be applied to reality at all. I show that Kant reconciles these extremes through his model of gradual, non-violent political reform guided by the regulative ideal of a perfectly self-legislating state.

Advancements in surgical education: exploring animal and simulation models in fetal and neonatal surgery training.

Surgical education is undergoing a transformation, moving away from traditional models towards more modern approaches that integrate experiential and didactic methods. This shift is particularly pertinent in the realm of fetal and neonatal surgery, where specialized training is crucial. Historical training methods, such as cadaveric dissection, have been prevalent for centuries, but newer innovations, including animal and non-animal simulation models, are gaining prominence. This manuscript aims to explore the use of both animal and non-animal models in surgical education, with a specific focus on fetal and neonatal surgery. The use of animal models in surgical training has a long history, dating back to Halsted's introduction in 1889. These models, often utilizing large animals like swine and dogs, offer valuable insights into fetal and neonatal surgeries. They allow for the study of long-term outcomes and the simulation of various diseases and anomalies, providing essential training experiences not readily available in human surgeries. However, there are notable limitations, including anatomical and physiological differences from humans, ethical considerations, and substantial infrastructure and maintenance costs. Simulation-based training offers several benefits, including standardized and safe learning environments without risks to real patients. Bench models, using synthetic materials or non-living animal tissue, provide cost-effective options for skills development. Virtual reality and 3-D printing technologies further enhance simulation experiences, allowing for the replication of complex clinical scenarios and patient-specific anatomies. While these models offer significant advantages, they lack the complexity of biological systems found in animal models. In conclusion, both animal and non-animal simulation models play crucial roles in enhancing surgical education, particularly in fetal and neonatal surgery. While advancements in non-animal technologies are important for ethical reasons, the continued necessity of animal models in certain areas should be acknowledged. By responsibly integrating these models into training programs, surgical education can be further enriched while upholding ethical standards and ensuring optimal patient outcomes.

Autonomy and Habit

Abstract An enduring puzzle for theorists of autonomy in the broadly Kantian tradition is how to theorize failures of practical reason. If norms of practical rationality are supposed to be constitutive of agency itself, how can failures to live up them nonetheless be understood as expressions of that agency? Hegelian diagnoses of these difficulties typically emphasize the dichotomies that structure Kantian theories of autonomy, between activity and passivity, reason and nature, norm and desire. They seek to flesh out an alternative that preserves a recognisably post-Kantian notion of autonomy whilst understanding freedom as something that essentially comes in degrees, insisting that self-determination always involves elements of other-determination, and stressing how free subjectivity is inseparable from socio-historically and institutionally bounded character-formation. This article contributes to articulating a Hegelian corrective to Kantian theories of autonomy by beginning to explain the role of habit in Hegel's conception of agency. Building on recent work on Hegel's metaphysics of expression, it shows how he allows us to see conative responses to the world as integral to character development and thus as expressive of free agency, rather than as interruptions to the proper functioning of practical reason. On Hegel's account, the expressive behaviour of mature, reflective agents is grounded in a pre-intentional, affective dimension of subjectivity and presupposes processes of habituation, which he locates at the level of the human ‘soul’. Habit, far from being ‘lifeless, contingent and particular’, is the means by which agents come to make objective contents their own. Understanding the role of habit in Hegel's system is integral to allowing an alternative conceptualization of autonomy to come into view, one on which rational agents express themselves through their affective and emotional responses, rather than merely being a contingent site of those responses.

On the Ethical Priority of Problem Solving in Case‐Based Teacher Ethics: Grounding an Anti‐Oppressive Approach

AbstractA central problem for phronetic case‐based approaches to the ethics of teaching lies in the proper determination of normative ethical problems. Judgments about the character of normative ethical problems depend in part on background beliefs about what is (or is not) of ethical value. Thus, to distinguish genuinely normative ethical problems, teachers seem to first require knowledge of what is of ethical value, which practical problems themselves cannot generate. To resolve this practical and theoretical problem, Nicolas Tanchuk and Alyssa Emery argue for a Deweyan approach to teacher ethics that asserts two central theses: First, negatively, that inductive evidence warrants skepticism about any normative theory grounded in external reasons — (purported) reasons that are actually or possibly disconnected from an agent's motivational set of beliefs, desires, and dispositions. Second, that a cognitive and affective orientation toward solving problems through learning survives skepticism about external ethical reasons, grounding the commitments of many anti‐oppressive teacher educators.

Effect of the span length for using finite to analogize infinite beam on viscoelastic foundation under a harmonic moving load

Railways with continuous rails are often modeled as infinite beams. In this paper, closed-form solution is firstly derived for the response of an infinite beam supported by viscoelastic foundation under a harmonic moving load by residue theorem method. The most suitable span length will be found for the analogic finite beam to best represent the deflection of the infinite beam for practical reasons. Starting from the equations of motion, closed-form solution is firstly derived for the infinite beam. Then, a FEM modeling procedure will be adopted to conform the validity of the solution derived analytically. The deflection curves of the infinite beam and analogic finite beam are compared for various parameters.

IoT Frameworks for Digital Twin in Underwater Sensor Networks – A Review

A digital twin is a computerised representation of a planned or existing real-world physical framework or operation (a physical twin) that functions as a nearly identical digital equivalent system for practical reasons such as an imitation, amalgamation, evaluation, observation and administration. The digital twin was initially designed since its creation to be the basic concept for product life span management and lives throughout the whole lifespan of the physical thing it represents. This article will explain the concept of digital twin in underwater wireless sensors. The article examines various research works employing the digital twin in UWSN (Underwater Wireless Sensor Networks), and the research work explains the fundamentals of digital twins and their applications.

When You Think of and Identify Yourself as a Nurse, You Will Become More Deontological and Less Utilitarian.

This study aims to examine how the activation of the role of nursee and professional identification as a nurse can influence moral judgments in terms of deontological and utilitarian inclinations. In Study 1, a priming technique was used to assess the impact of activating the nursing concept on moral reasoning. Participants were randomly assigned to either a nursing prime or neutral prime condition. By using a scrambled-sentence task, participants were prompted to think about nursing-related or neutral thoughts. Following the priming task, participants were asked to respond to 20 moral dilemmas. The process dissociation approach was employed to measure the degree of deontological and utilitarian tendencies in their moral reasoning. In Study 2, participants completed the nursing profession identification scale and the moral orientation scale before engaging in moral judgments similar to those in Study 1. The findings revealed that priming the concept of being a nursee resulted in an increase in deontological clinical inclinations while having no significant effect on utilitarian inclinations. Additionally, a positive correlation was observed between identification with the nursing profession and deontological clinical inclinations, whereas a negative correlation was found with utilitarian inclinations. Deliberation orientation acted as a complete mediator in the relationship between nursing professional identification and deontological tendencies and as a partial mediator for utilitarian tendencies.

Examining the relationship between Spirituality, Morality and Resilience among Young Adults

Abstract: This study investigates the relationships between spirituality, resilience, and morality among young adults, with a specific focus on examining how resilience and morality predict spirituality. Utilizing a sample of 207 young adults aged 18-25 years residing in India, the study employs a quantitative approach to analyze data collected through the 3 different scales. The analysis, conducted via multiple linear regression, reveals that both resilience and morality significantly predict spirituality, accounting for approximately 30.5% of its variance. This indicates a substantial relationship between these constructs, suggesting that individuals with higher levels of resilience and moral reasoning are likely to exhibit higher levels of spirituality. The findings challenge previous assumptions aboutthe isolated nature of spirituality, highlighting its complex interplay with other psychological constructs. The study underscores the importance of considering bothresilience and morality in discussions about spirituality, offering valuable insights into thefactors that influence spiritual beliefs and practices among young adults. This research contributes to the broader discourse on spirituality, providing a nuanced understanding of its determinants and emphasizing its interconnectedness with resilience and morality.

Does household size matter? Crowding and its effects on child development

ABSTRACT There is very little compelling evidence that household size negatively affects child development. In this study, the effects of household size on child development were analysed using data collected for a sample of 1311 four-year-old Jamaican children. Children’s development was assessed using the Griffiths Mental Development Scales across six developmental domains: locomotor, personal-social, language, coordination, performance and practical reasoning. The findings suggest that children’s locomotor and personal-social development are negatively affected by household crowding, with no significant effects observed for other domains. Additional results show that these adverse effects are strongest if the child lives in a single room compared to a separately detached house. This evidence speaks to the need to tailor policies towards access to good housing infrastructure and the provision of recreational spaces to encourage play and social interaction among children.

Teachers as curriculum leaders. What does this mean to school principals?

School leadership and accountability are usually the responsibilities of principals. Principals are expected to lead and manage in matters such as instructions, finance, staff development and community engagement. This solo leadership model is challenge by increasing pressure for high student achievement. The advent of teacher leadership presents teachers as valuable contributors in curriculum matters. Principals’ understanding of teachers as curriculum leaders (TCL) is important if teachers are to provide the much-needed assistance. The current research adopted a multiple-site case study design to explore principals’ understanding of the concept of TCL in schools. Eight participants were purposefully selected; open-ended, semi structured interview guides were piloted prior to data collection. Observation of school meetings provided additional data. The data were thematically analysed and anchored on Grant’s model of teacher leadership. The findings reveal that, to school principals, TCL means teachers performing the roles of curriculum leaders and managers, decision makers, designers of learning programmes and materials, facilitators, assessors, lifelong learners, models, and pastoral caregivers. The findings further express the frustration of principals on the exclusion of teachers from curriculum decision making at the macro and meso levels. The findings are relevant in the advocacy of distributed leadership as they provide practical reasons for principals to create opportunities for teachers to lead in curriculum matters.

Standardized Digital Image Analysis of PD-L1 Expression in Head and Neck Squamous Cell Carcinoma Reveals Intra- and Inter-Sample Heterogeneity with Therapeutic Implications.

For practical reasons, in many studies PD-L1 expression is measured by combined positive score (CPS) from a single tumor sample. This does not reflect the heterogeneity of PD-L1 expression in head and neck squamous cell carcinoma (HNSCC). We investigated the extent and relevance of PD-L1 expression heterogeneity in HNSCC analyzing primary tumors and recurrences (LRs), as well as metastases. Tumor tissue from 200 HNSCC patients was immunohistochemically stained for PD-L1 and analyzed using image-analysis software QuPath v3.4 with multiple specimens per patient. CPS was ≥20 in 25.6% of primary tumors. Intra-tumoral heterogeneity led to a therapeutically relevant underestimation of PD-L1 expression in 28.7% of patients, when only one specimen per patient was analyzed. Inter-tumoral differences in PD-L1 expression between primary tumors and lymph node metastasis (LNM) or LR occurred in 44.4% and 61.5% (CPS) and in 40.6% and 50% of cases (TPS). Overall survival was increased in patients with CPS ≥ 1 vs. CPS < 1 in primary tumors and LNM (hazard ratio: 0.46 and 0.35; p < 0.005); CPS in LR was not prognostic. Our analysis shows clinically relevant intra- and inter-sample heterogeneity of PD-L1 expression in HNSCC. To account for heterogeneity and improve patient selection for immunotherapy, multiple sample analyses should be performed, particularly in patients with CPS/TPS < 1.

To delay or not to delay: procrastination and suicide prevention

ABSTRACT When mental health professionals or social workers are confronted with a suicidal individual, one approach is to use all means to delay the act of suicide until the desire for death subsides. Encouraging someone to delay suicide while bypassing the individual’s practical reasons for suicide can lead to irrational postponement, which equates to procrastinating suicide. Causing someone to procrastinate in this manner poses a risk of disrespecting the person as a rational agent. However, is it even possible to irrationally delay one’s own act of suicide? Additionally, isn’t it beneficial to do so? The aim of the manuscript is to explore the possibility and value of using procrastination in managing suicidal individuals. First, I will argue that procrastination of a suicide intent is possible, which makes inducing this state of mind in people morally problematic. Second, I will argue that there is no intrinsic value in procrastination, although it does have instrumental value. Procrastination holds instrumental value for individuals who delay an irrational act of suicide. Furthermore, procrastination is valuable for clinical psychology, not by making people irrationally delay suicide but for assessing suicide risk.

Beyond severity: utility as a criterion for setting the scope of RGCS.

Reproductive genetic carrier screening (RGCS) allows prospective parents to identify and act upon their chances of having a child with a genetic condition. In deciding which genetic conditions to include in RGCS, severity is often used as a criterion. However, the concept is inherently complex, subjective and multidimensional, and determinations of severity will remain intractably contested. We propose the concept of utility as a criterion for setting the scope of RGCS, and put forward two central arguments for doing so. First, utility is a more appropriate and effective concept as it responds to context and makes an explicit connection between the purpose of RGCS and the value of information obtained for that purpose: namely, to facilitate reproductive decision-making. Utility comprises both clinical and personal utility, and varies according to the availability and accessibility of reproductive options, including pre-implantation genetic testing, prenatal genetic diagnosis, and termination of pregnancy. Second, there are ethical reasons for preferring utility over severity. Utility is a property of the information gleaned from RGCS, while severity is a property of a genetic condition or of an instance of this condition in a person. While consideration of the severity of genetic conditions is not lost when focusing on utility, the need to rely on value judgements regarding the quality of life of people who live with genetic conditions is circumvented. Therefore, utility should replace severity as justification for the inclusion of genetic conditions in RGCS programmes.

The Crucial Role of Islamic Religious Education in Shaping Children's Character: Psychological and Spiritual Review

The significance of Islamic religious education in shaping children's character is paramount in contemporary society. This study aims to explore the transformative impact of Islamic education on children's moral and spiritual development, utilizing a comprehensive analysis that integrates psychological and spiritual perspectives. A mixed-method approach combining literature review and empirical research elucidates how Islamic education fosters moral reasoning, empathy, and self-regulation among children while nurturing a profound spiritual connection and inner transformation. Here are the steps: 1) Literature Review: Start by compiling a comprehensive literature review about the importance of Islamic religious education in forming children's character. Please focus on the psychological theories that support this argument and their relationship to aspects of spirituality. 2) Empirical Research: conducting empirical research to support the claim. Use appropriate research methods such as surveys, interviews, or observations to collect relevant data from respondents from various backgrounds and ages. The findings underscore the holistic nature of Islamic education in equipping children with the ethical fortitude, emotional resilience, and spiritual consciousness necessary to navigate life's challenges with integrity and purpose. Our research findings demonstrate how Islamic education fosters moral reasoning, empathy, and self-regulation among children while nurturing a deep sense of spiritual connection and inner transformation. By integrating psychological insights with spiritual teachings, Islamic education offers a holistic approach to character development, equipping children with the ethical fortitude, emotional resilience, and spiritual consciousness necessary to navigate life's challenges with integrity and purpose.

Moral reasoning and sexual and reproductive rights: a longitudinal qualitative study with young Christian people

Moral reasoning constitutes the psychological progression of thought, enabling decision-making. Consequently, this research aims to analyze such reasoning in the discourse on sexual and reproductive rights of emerging adult individuals who adhere to the Catholic or Evangelical faith. Through interviews conducted in 2016, 2018, and 2020 with four young individuals, it is noted that the higher stages of moral development are closely linked to the defense and promotion of these rights.