Search Results (124)

Background: In Canada, 30 percent of the older adult population is foreign-born. Immigrant older adults are more likely to experience significant social isolation due to a variety of factors. However, limited research exists on the influence of specific factors. The objective of this study is to understand the economic factors that contribute to social isolation among older immigrants in the Greater Toronto Area (GTA), Canada. Methods: A qualitative interpretive description method was used. Following research ethics boards’ approval, semi-structured individual interviews were conducted with a total of 47 Arabic, Mandarin, and Punjabi-speaking older immigrants in the GTA. The interviews were conducted in their preferred language, audio-recorded, and translated (when needed) into English and transcribed. Thematic analysis of the data was informed by an ecosystemic framework. Results: Six themes were identified: (1) barriers to finding employment; (2) living a “hand-to-mouth life” due to limited income/pension; (3) housing costs that eliminate choices and options; (4) costs (and availability) of transportation as a barrier to getting around; (5) lack of “essential” healthcare coverage; and (6) costs of community programs that prevent “getting out of the house.” These economic factors at micro, meso, and macro levels of society intersected to create desperate situations that contributed to social isolation among older immigrants in the GTA. Conclusions/Implications: Addressing these economic factors is critical to immigrant older adults’ aging in place. Service providers must advocate for accessible physical and financial resources and services including affordable housing and transportation, old age security, and comprehensive healthcare coverage for older immigrants. Future research should focus on economic challenges faced by older adults across other immigrant communities in the GTA as well as in other cities, provinces, and territories. Full article

Background/Objectives: Turnover intention among intensive care unit (ICU) nurses remains consistently higher than that observed in other clinical departments. A weakened professional identity and exposure to ethically challenging situations may further intensify nurses’ intention to leave. This study aimed to examine the influence of moral distress, person-centred care, and nursing professional pride on turnover intention among ICU nurses in South Korea. Methods: A descriptive cross-sectional design was employed using a convenience sample of 203 ICU nurses from three general hospitals in South Korea. Data were obtained between 26 September and 31 October 2024 and analysed using IBM SPSS Statistics for Windows, version 29.0.2.0, with t-tests, one-way analysis of variance, Pearson’s correlation coefficients, and stepwise multiple regression analysis. Results: Two subdomains of nursing professional pride—role satisfaction and willingness to stay—along with gender (male) and the futile care subdomain of moral distress were the main factors influencing turnover intention. These variables collectively explained 24.9% of the variance in turnover intention (F = 17.78, p < 0.001). Conclusions: Strengthening nursing professional pride—particularly role satisfaction and willingness to stay—and reducing futile care-related moral distress may help lower ICU nurses’ turnover intention. Organisational strategies, including ethical management programmes and supportive policies, are recommended to enhance nursing professional pride, alleviate moral distress, and promote long-term nurse retention. Full article

Women in vulnerable living situations with schizophrenia face intersecting challenges, including migration-related trauma, caregiving burdens, and systemic barriers such as cultural dislocation, limited healthcare access, and stigma. These factors heighten vulnerability compared with men and contribute to delayed diagnoses, poor treatment adherence, and adverse outcomes. Advances in artificial intelligence (AI) and digital tools offer potential support, though they should be regarded as complementary rather than stand-alone solutions. This review synthesizes literature on gender-specific care for women with schizophrenia, examining clinical, social, and reproductive needs alongside the impact of migration and psychosocial adversity. Emerging models, including women-focused psychiatric units, perinatal services, and community therapeutic spaces, illustrate holistic approaches that integrate the medical, psychological, and social dimensions of care. Digital interventions, such as smartphone applications, mobile health tools, and digital participation strategies, are considered supportive extensions that offer opportunities to improve access, reduce costs, and enhance continuity of care. Despite this promise, digital tools remain under-validated for women in precarious contexts. Ethical challenges, including algorithmic bias, data privacy risks, and the exclusion of undocumented or marginalized groups, further constrain equitable implementation. This review aims to articulate conceptual linkages among gender, migration, and digital innovation in schizophrenia care, identifying thematic patterns, ethical tensions, and structural limitations in the existing literature. The synthesis provides a foundation for future hypothesis development and interdisciplinary research to advance inclusive and equity-driven mental health interventions. Full article

Background/Objectives: Assisted suicide and suicide prevention remain subjects of intense societal, political, and professional-ethical debate in Germany. Nurses working in residential and home-based long-term care (LTC) play a pivotal role in responding to requests for assisted suicide and in supporting suicide prevention. While international research has explored diverse ethical perspectives and challenges related to these issues, little is known about how LTC nurses in Germany experience and navigate them. This study examines German LTC nurses’ ethical perspectives on assisted suicide and suicide prevention and explores the associated ethical challenges. Methods: A qualitative design employing both in-person and online focus groups was used. Data were analyzed following Mayring’s qualitative content analysis. Results: Twelve focus groups with a total of 96 nurses working in residential and home-based LTC were conducted between February and September 2025. Findings show that nurses perceive assisted suicide and suicide prevention as ethically complex and emotionally demanding. Three overarching themes emerged: (1) Intuitive and Emotional Reactions, (2) Ethical Perception and Ethical Reflection, and (3) Ethical Challenges. Conclusions: This study offers new insights into the diverse ethical perspectives of German LTC nurses on assisted suicide and suicide prevention. It extends existing knowledge through its explicit focus on the ethical issues and implications involved, both in residential and home-based LTC. The ethical challenges identified may enhance understanding of the factors underlying the development of moral distress in Germany and other countries where assisted suicide is a legal option. To help nurses navigate these ethically demanding situations, strategies at multiple levels are required. These include continuous ethics education, an open ethical culture, role definitions and clear professional guidance, alongside societal support for equitable access to general healthcare and suicide prevention services. Full article

This study explores the dynamics of engaged spiritualities within contemporary Buddhist communities in Italy. By employing an ethnographic approach, the research examines how physical space fosters spiritual experiences, facilitates social interactions, and serves as a site for personal and collective transformation. The study integrates insights from religious studies, anthropology, and neuroscience to analyse the cognitive and emotional effects of meditation while also engaging with Foucault’s theories on power and space to understand Buddhist centres as structured environments that shape individual and collective subjectivities. The research highlights how engaged Buddhism in Italy adapts traditional practices to contemporary challenges, particularly in response to mental health concerns among university students. Through participant observation and interviews conducted during mindfulness and contemplative education programmes, the study demonstrates how meditation contributes to psychological well-being, emotional regulation, and social connection. This analysis aligns with theoretical discussions on the conceptualisation of spirituality in modern societies, illustrating how engaged spiritualities manifest in secular and pluralistic contexts. The findings suggest that Buddhist spaces in Italy function not only as sites of religious practice but also as transformative environments where power relations are renegotiated, identity is reconstructed, and alternative ways of living emerge. The study further explores how scientific advancements in neuroscience inform spiritual practices, shedding light on the reciprocal relationship between spiritual yearning and scientific inquiry. Finally, the research contributes to the debate on the future of engaged spiritualities in the face of global crises. It argues that while Buddhist communities in Italy preserve traditional wisdom, they also actively shape new forms of spiritual engagement that respond to contemporary social, political, and environmental challenges. This work situates engaged Buddhism as a key player in fostering alternative models of coexistence, well-being, and ethical responsibility in the modern world. Full article

As AI decision support systems play a growing role in high-stakes decision making, ensuring effective integration of human intuition with AI recommendations is essential. Despite advances in AI explainability, challenges persist in fostering appropriate reliance. This review explores AI decision support systems that enhance human intuition through the analysis of 84 studies addressing three questions: (1) What design strategies enable AI systems to support humans’ intuitive capabilities while maintaining decision-making autonomy? (2) How do AI presentation and interaction approaches influence trust calibration and reliance behaviors in human–AI collaboration? (3) What ethical and practical implications arise from integrating AI decision support systems into high-risk human decision making, particularly regarding trust calibration, skill degradation, and accountability across different domains? Our findings reveal four key design strategies: complementary role architectures that amplify rather than replace human judgment, adaptive user-centered designs tailoring AI support to individual decision-making styles, context-aware task allocation dynamically assigning responsibilities based on situational factors, and autonomous reliance calibration mechanisms empowering users’ control over AI dependence. We identified that visual presentations, interactive features, and uncertainty communication significantly influence trust calibration, with simple visual highlights proving more effective than complex presentation and interactive methods in preventing over-reliance. However, a concerning performance paradox emerges where human–AI combinations often underperform the best individual agent while surpassing human-only performance. The research demonstrates that successful AI integration in high-risk contexts requires domain-specific calibration, integrated sociotechnical design addressing trust calibration and skill preservation simultaneously, and proactive measures to maintain human agency and competencies essential for safety, accountability, and ethical responsibility. Full article

Artificial intelligence (AI) is transforming pharmaceutical science by shifting drug delivery research from empirical experimentation toward predictive, data-driven innovation. This review critically examines the integration of AI across formulation design, smart drug delivery systems (DDSs), and sustainable pharmaceutics, emphasizing its role in accelerating development, enhancing personalization, and promoting environmental responsibility. AI techniques—including machine learning, deep learning, Bayesian optimization, reinforcement learning, and digital twins—enable precise prediction of critical quality attributes, generative discovery of excipients, and closed-loop optimization with minimal experimental input. These tools have demonstrated particular value in polymeric and nano-based systems through their ability to model complex behaviors and to design stimuli-responsive DDS capable of real-time therapeutic adaptation. Furthermore, AI facilitates the transition toward green pharmaceutics by supporting biodegradable material selection, energy-efficient process design, and life-cycle optimization, thereby aligning drug delivery strategies with global sustainability goals. However, challenges persist, including limited data availability, lack of model interpretability, regulatory uncertainty, and the high computational cost of AI systems. Addressing these limitations requires the implementation of FAIR data principles, physics-informed modeling, and ethically grounded regulatory frameworks. Overall, AI serves not as a replacement for human expertise but as a transformative enabler, redefining DDS as intelligent, adaptive, and sustainable platforms for future pharmaceutical development. Compared with previous reviews that have considered AI-based formulation design, smart DDS, and green pharmaceutics separately, this article integrates these strands and proposes a dual-framework roadmap that situates current AI-enabled DDS within a structured life-cycle perspective and highlights key translational gaps. Full article

This article addresses the recent conflict in the Netherlands between a national ethnographic museum, the Wereldmuseum Berg en Dal (formerly Afrika Museum), and a Catholic congregation, the Congregation of the Holy Spirit, both of which legally own half of the museum’s collection. The case highlights the challenging situations faced by ethnographic museums with missionary legacies in the Netherlands over the past few decades. This article critically examines not only the handling of the conflict between the Wereldmuseum and the Spiritan fathers based on current legal frameworks and museum policies, but also the motives behind their initial collaboration. Finally, it proposes alternative practices for a more ethical approach to African heritage, contributing to debates about museum reconfiguration and ethical restitution. Full article

Background: Central nervous system (CNS) tumors during pregnancy are rare but present significant diagnostic, therapeutic, and ethical challenges. These include both primary and metastatic lesions, which share overlapping clinical features and management complexities. Their clinical course is influenced by gestational physiological changes, which can mask symptoms and delay diagnosis, thereby increasing maternal and fetal risks. Objective: This review aims to synthesize current evidence on the epidemiology, pathophysiology, clinical presentation, diagnostic strategies, treatment options, prognosis, and ethical considerations related to CNS tumors in pregnant patients. Methods: A comprehensive literature review was conducted, including retrospective and prospective studies, clinical guidelines, and systematic reviews focusing on brain and spinal tumors diagnosed during pregnancy. Particular attention was given to the impact of gestational age, tumor histology, and maternal condition on treatment outcomes. Results: Hormone-sensitive tumors such as meningiomas and prolactinomas may exhibit accelerated growth during pregnancy due to elevated progesterone and prolactin levels. Diagnosis is often delayed due to symptom overlap with normal gestational changes. MRI without contrast remains the imaging modality of choice. Glucocorticoids and selected chemotherapy agents can be cautiously used depending on gestational age. Surgical resection, particularly in the second trimester, has been shown to be safe and effective in appropriate clinical scenarios. Multidisciplinary coordination is essential. Prognosis varies based on tumor type and timing of intervention, with maternal survival prioritized in high-risk situations. Ethical management hinges on patient autonomy, informed consent, and proportionality of medical interventions. Conclusions: CNS tumors during pregnancy require early recognition, individualized treatment planning, and ethical vigilance. Multidisciplinary collaboration is vital to optimizing outcomes for both mother and fetus. Future efforts should focus on developing standardized protocols and expanding evidence through multicenter studies. Full article

In light of the accelerated growth of artificial intelligence (AI), large language models (LLMs) have become a central topic of interest in scientific research and practical applications across various fields. The present paper aims to perform a comprehensive systematic review of the scientific literature on LLMs in education published between 2023 and 2024, based on a dataset from the Web of Science, which includes 507 documents from 322 sources. The accelerated dynamics of research in this field are confirmed by the high annual growth rate of 369.66%. The study identifies the themes presented in the scientific literature by using thematic maps and analyzing the evolution of said thematic maps. In addition, Latent Dirichlet Allocation (LDA) and BERTopic are used to outline the research field more clearly. Due to LDA’s ability to discover high-level research topics using probabilistic discovery and BERTopic’s ability to capture deeper semantic patterns and the emergence of various topics by searching, this paper first identifies the main research topics in the extracted dataset, which are then discussed in the paper through a review of applications. As a result, a range of applications are discovered in areas related to teaching and learning, academic assessment, integrity, academic feedback, medical education, ethics, bias, regulation, and social challenges. The conclusions provide a roadmap for researchers, practitioners and stakeholders in highlighting the current situation of LLMs in educational practice, while opening the door for future explorations in this domain. Full article

This entry delineates artificial intelligence (AI) ethics and the field’s core ethical challenges, surveys the principal normative frameworks in the literature, and offers a historical analysis that traces and explains the shift from ethical monism to ethical pluralism. In particular, it (i) situates the field within the trajectory of AI’s technical development, (ii) organizes the field’s rationale around challenges regarding alignment, opacity, human oversight, bias and noise, accountability, and questions of agency and patiency, and (iii) compares leading theoretical approaches to address these challenges. We show that AI’s development has brought escalating ethical challenges along with a maturation of frameworks proposed to address them. We map an arc from early monisms (e.g., deontology, consequentialism) to a variety of pluralist ethical frameworks (e.g., pluralistic deontology, augmented utilitarianism, moral foundation theory, and the agent-deed-consequence model) alongside pluralist governance regimes (e.g., principles from the Institute of Electrical and Electronics Engineers (IEEE), the United Nations Educational, Scientific and Cultural Organization (UNESCO), and the Asilomar AI principles). We find that pluralism is both normatively and operationally compelling: it mirrors the multidimensional problem space of AI ethics, guards against failures (e.g., reward hacking, emergency exceptions), supports legitimacy across diverse sociotechnical contexts, and coheres with extant principles of AI engineering and governance. Although pluralist models vary in structure and exhibit distinct limitations, when applied with due methodological care, each can furnish a valuable foundation for AI ethics. Full article

Relative and absolute decoupling between economic growth and environmental pressures is one of the most contested topics in ecological economics. This article situates the decoupling debate within a philosophical and normative framework, building on recent critical contributions and on empirical evidence that challenges the green growth narrative. Through a critical analysis of key methodologies, including the TDI, LMDI decomposition, the CAPRO ratio, and MRIO models, it shows that the choice of indicators is not neutral but carries implicit assumptions about progress, ecological limits, and climate justice. The review of empirical results indicates that robust, sustained absolute decoupling is rare and often undermined by rebound effects, outsourcing, or temporary crisis-driven contractions, whereas relative decoupling dominates. On this basis, the article advances a multi-level decoupling synthesis that integrates empirical indicators with normative thresholds such as planetary boundaries, sufficient absolute decoupling, and climate justice, thereby reframing sustainability assessment from the narrow question of technical feasibility to the broader issue of ecological and ethical legitimacy. Full article

The paper presents a theoretical reflection on accessibility, developed through dialogue between an architect and a philosopher. It explores the cultural horizon of a transdisciplinary discipline whose conceptual boundaries remain fluid and examines the role accessibility can play in creating a freer and more inclusive society. At the core of the paper lies the concept of accessibility as a Cultural Generative Ecosystem, a dynamic and evolving construct through which accessibility operates as a transformative force. This ecosystem is embedded within a conceptual framework structured around specific Fields of Inquiry (Relational, Spatial, Institutional) and Domains (Person, Society, Environment). In this perspective, accessibility is presented as a complex process rooted in humanistic values and grounded in care ethics, phenomenological experience, and human rights. The paper highlights the potential of accessibility to counter diversity-related discrimination, promote empowerment, and guide the transformation of human habitats in line with people’s needs and expectations. At the same time, it acknowledges the objective and cultural challenges involved in cultivating an accessibility-oriented mindset. Following a comprehensive theoretical and methodological groundwork that lays the foundation for a broader conceptual reframing of accessibility, the paper identifies six conceptual determinants that define its complexity in the built environment, particularly in relation to disability and the relational nature of public space. These determinants—polysemous, contextual, multi-scalar and relational, corporeal and spatial-temporal, multi-criteria, and multi-component—are examined in relation to the four interwoven dimensions that structure the Cultural Generative Ecosystem of accessibility: technical, social, organizational, and generative. Together, they offer a framework for rethinking inclusive design as a situated, relational, and ethically grounded practice. Full article

Occupational therapy (OT) advocates for rehabilitation and social reintegration within prison systems, yet its integration must consider the ethical and institutional constraints of incarceration. This paper critically examines the Spanish penitentiary system to explore the tensions between the punitive logic of imprisonment and the rehabilitative values of OT. The aim is to assess whether the current institutional structure enables socio-health professionals—particularly occupational therapists—to act coherently with their humanistic and ethical principles. A detailed documentary review was conducted using the Triangular Method of Ontologically Grounded Personalism (Sgreccia), which integrates biological/situational, anthropological, and ethical dimensions. Legislative documents, institutional reports, and academic literature were systematically analyzed to identify ethical challenges affecting professional practice within Spanish prisons. Findings reveal a paradoxical reality: Spain maintains one of the lowest crime rates in the EU yet exhibits a high incarceration rate, reflecting a punitive penal culture. The prison population, mostly adult males convicted of property and public health offenses, experiences significant occupational deprivation, mental illness, and social vulnerability. Ethical dilemmas include dual loyalty, loss of autonomy, and institutional priorities that undermine person-centered rehabilitation. The study underscores profound ethical tensions limiting OT practice in prisons. Addressing these challenges requires institutional and professional transformation toward more participatory and dignity-centered correctional models. Future research should incorporate empirical and qualitative approaches to design ethical frameworks that promote occupational justice and sustainable reintegration. Full article

Food loss and food waste (FLFW) constitute a major global challenge with profound economic, environmental, and social consequences. This study examines how businesses in Greece’s food service and retail sectors perceive and manage food waste, integrating the triple bottom line framework—economic, environmental, and social sustainability—as the guiding analytical lens. The research aims to: (1) analyze perceptions, practices, and barriers to food waste reduction among businesses; (2) explore the relationship between awareness, business policies, technological adoption, and consumer-oriented strategies; and (3) situate the Greek experience within broader European and international contexts to identify transferable lessons for policy and business innovation. Drawing on a structured survey of 250 industry representatives and comparative international evidence, the study finds that although awareness of food waste is widespread, it remains weakly connected to structured policies, technology adoption, or operational practices. Businesses recognize economic opportunities in waste reduction—such as supply chain optimization and near-expiry discounting—but these remain underexploited due to a lack of strong regulatory and financial incentives. The findings highlight that addressing food waste is not only an environmental and ethical necessity but also a strategic opportunity to enhance economic resilience, competitiveness, and sustainability within the agri-food sector. Full article