Search results for: consent and agency

Authors: Amy Gooden

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Various modes of consent have been utilized in health research, but open consent has not been explored in South Africa’s AI research context. Open consent entails the sharing of data without assurances of privacy and may be seen as an attempt to marry open science with informed consent. Because all potential uses of data are unknown, it has been questioned whether consent can be informed. Instead of trying to adapt existing modes of consent, why not adopt a new perspective? This is what open consent proposes and what this research will explore in AI health research in South Africa.

Keywords: artificial intelligence, consent, health, law, research, South Africa

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Authors: Shirin Abbas, Sandeep Kumar Dubey

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Intimate partner violence (IPV) is one of the most common forms of gender-based violence (GBV) and is classified as discrimination on the basis of gender. Article 2 of the non-binding UN Declaration on the Elimination of Violence against Women (DEVAW). This was adopted in 1993 as the first international pronouncement regarding violence against women, including physical, sexual, and psychological violence in the family (i.e., domestic violence, marital rape, battery, statutory rape, rape by male members of the family, etc.) While crime against women continues unabated, the Indian government has strongly refuted the 2018 study by the Thomson Reuters Foundation categorizing India as a risky country for women due to the high risk of sexual violence and being forced into slave labour, according to a poll of global experts. This paper has explored consent, agency, and abuse through the lens of intimate partner violence among women from lower income groups in smart cities in the state of Uttar Pradesh, India. Using focused mapping, the paper has explored the situation on IPV internationally and studied the status of working women from lower income groups to ascertain if their lot was any different where IPV was concerned to study. The findings of the study also vindicate global reports which rate India as a country unsafe for women, even within marriage.

Keywords: consent and agency, domestic violence, gender based violence GBV, intimate partner violence IPV

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Authors: Nathan Elvidge

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This paper offers a philosophical argument against the possibility of so-called “ethical porn,” that is, pornographic material produced in a way attempting to remain consistent with feminist principles and female empowerment. One key feature of such material is the requirement for the material to be consensual on the part of the actors or those involved in the material. However, in the contemporary pornography industry, this typically amounts to a single historic act of consent given in exchange for a lump-sum payment which grants the producer lifetime property rights over the explicit material. This paper argues that, by the lights of feminist principles, this situation is inherently unjust and that, as a consequence, the pornography industry requires a radical systematic upheaval before any material produced within it can be considered genuinely ethical. These feminist principles require that for the consumption of pornography to be genuinely ethical, the actors must consent not only to the acts recorded in the material but also to the consumption of that material. This paper argues that this consent to consumption should be treated as on par with other matters of sexual consent and, therefore, that actors should have the right to withdraw consent to the consumption of their material. From this, it is argued to follow that the system of third-party ownership of property rights over someone else’s sexually explicit material legally nullifies this right and therefore is inherently unjust.

Keywords: consent, feminism, pornography, sex work

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Authors: Cecilia Teljas

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Many government agencies use social media to supplement their traditional communication channels. Government agencies are typically risk-averse, which makes social media practices problematic. However, this case study of the social media use of the Swedish social insurance agency shows considerable bi-directional communication between the agency and the public. On one hand, the agency’s aims, strategies, ways of working and experiences related to its social media communication practice are analyzed. On the other hand, the communication by both the agency and the public is studied on one of the agency’s Facebook pages. The results showed that it is possible for an agency to provide relevant and accurate information in real-time in social media if identifying and addressing different segments separately. Furthermore, as a result of context adaption this communication was rather informal and the practice can be considered to manifest positive democratic effects due to the increased availability and inclusion.

Keywords: e-government, social media, case study, discourse analysis

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Authors: Parsa Keyvani, Alistair Phillips, David Warwick

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Background: The current process for gaining patient consent for hand and wrist surgery at University Hospital Southampton (UHS) is paper-based and makes use of generic forms provided by the NHS and no patient information leaflet is available relating to hand and wrist surgery. Aims: To evaluate the process of obtaining clinical consent and suggest ways in which the service can be improved. Methods: A log-book review of four orthopaedic surgeons at UHS was carried out over a three-month period in order to identify the 10 most common types of elective hand and wrist surgeries performed. A literature review was carried out to identify the complications of these surgeries. The surgeries were then divided into 6 types: nerve, bone, ligament, joint, tendon and dupuytren’s surgery. A digitised consent form was created covering the complications of all 6 surgery types. Finally, the surgeons at the orthopaedic department of UHS were asked whether they prefer the old paper-based or the digitised consent form. Results: All of the surgeons felt that the procedure type-based form was easier to read, use and understand. Conclusion: This research highlights a number of problems related to the use of current NHS consent forms. The proposed solution is to use a set of digitised, procedure type-based consent forms. Digital consent forms can be filled in in advance and sent to the patient electronically along with any relevant information leaflets, thus giving them time to absorb the information and come up with any questions before they have their pre-procedure discussion with their doctor. This would allow the doctor to focus the consultation on the patient rather than writing out the consent form and would ultimately be a step forward in making the NHS a global digital leader and fully embrace the opportunity offered by technology.

Keywords: digitised consent form, elective surgery, hand surgery complications, informed consent, procedure type-based consent form

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Authors: Martin S. Mulyadi

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This research investigates the corporate governance disclosure behavior of Indonesian corporations with type II agency problems. The primary cause of the 1990s Asian financial crisis has been attributed to poor corporate governance practices in Indonesia. Most importantly, these poor practices were commonly found in family-owned and government-owned corporations. There are a lot of publicly listed family-owned and government-owned corporations in Indonesia. Agency theory refers to these corporations as corporations with type II agency problems. This research employs agency theory to analyzes corporate governance practice and disclosures in such settings and found that government-owned corporations perform better than family-owned corporations.

Keywords: corporate governance, corporate disclosures, agency theory, type II agency problems

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Authors: Erik Kuravsky

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One of the problems with a post-structuralist account of agency is that it appears to reject the freedom of an acting subject, thus seeming to deny the very phenomenon of agency. However, this is only a problem if we think that human beings can be agents exclusively in terms of being subjects, that is, if we think agency subjectively. Indeed, we tend to understand traditional theories of human freedom (e.g., Plato’s or Kant’s) in terms of a peculiar ability of the subject. The paper suggests to de-subjectivize agency with the help of Heidegger’s later thought. To do it, ir argues that classical theories of agency may indeed be interpreted as subject-oriented (sometimes even by their authors), but do not have to be read as such. Namely, the claim is that what makes agency what it is, what is essential in agency, is not its belonginess to a subject, but its ontological configuration. We may say that agency “happens,” and that there is a very specific ontological characteristics to this happening. The argument of the paper is that we can find these characteristic in the classical accounts of agency and that these characteristics are sufficient to distinguish human freedom from other natural phenomena. In particular, it offers to think agency not as one of human characteristics, but as an ontological event in which human beings take part. Namely, agency is a (non-human) characteristic of the different modes in which the experienceable existence of beings is determined by Being. To be an agent then is to participate in such ontological determination. What enables this participation is the ways human beings non-thematically understand the ontological difference. For example, for Plato, one acts freely only if one is led by an idea of the good, while for Kant the imperative for free action is categorial. The agency of an agent is thus dependent on the differentiation between ideas/categories and beings met in experience – one is “free” from contingent sensibility in terms of what is different from it ontologically. In this light, modern dependence on subjectivity is evident in the fact that the ontological difference is thought as belonging to one’s thinking, consciousness etc. That is, it is taken subjectively. A non-subjective account of agency, on the other hand, requires thinking this difference as belonging to Being itself, and thinking human beings as a medium within which occurs the non-human force of ontological differentiation.

Keywords: Heidegger, freedom, agency, poststructuralism

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Authors: Alejandra Cardenas, Ona Flores, Fabiola Gretzinger

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Since the 1990s, legal strategies for the promotion and protection of maternal health rights have achieved significant gains. Successful litigation in courts around the world have shown that these rights can be judicially enforceable. Governments and international organizations have acknowledged the importance of a human rights-based approach to maternal mortality and morbidity, and obstetric violence has been recognized as a human rights issue. Despite the progress made, maternal mortality has worsened in some regions of the world, while progress has stagnated elsewhere, and mistreatment in maternal care is reported almost universally. In this context, issues of maternal autonomy and decision-making during pregnancy, labor, and delivery as a critical barrier to access quality maternal health have been largely overlooked. Indeed, despite the principles of autonomy and informed consent in medical interventions being well-established in international and regional norms, how they are applied particularly during childbirth and pregnancy remains underdeveloped. National and global legal standards and decisions related to maternal health were reviewed and analyzed to determine how maternal autonomy and decision-making during pregnancy, labor, and delivery have been protected (or not) by international and national courts. The results of this legal research and analysis lead to the conclusion that a few standards have been set by courts regarding pregnant people’s rights to make choices during pregnancy and birth; however, most undermine the agency of pregnant people. These decisions recognize obstetric violence and gender-based discrimination, but fail to protect pregnant people’s autonomy, privacy, and their right to informed consent. As current human rights standards stand today, maternal health is the only field in medicine and law in which informed consent can be overridden, and patients can be forced to submit to treatments against their will. Unconsented treatment and loss of agency during pregnancy and childbirth can have long-term physical and mental impacts, reduce satisfaction and trust in health systems, and may deter future health-seeking behaviors. This research proposes a path forward that focuses on the pregnant person as an independent agent, relying on the doctrine of self-determination during pregnancy and childbirth, which includes access to the necessary conditions to enable autonomy and choice throughout pregnancy and childbirth as a critical step towards our approaches to reduce maternal mortality, morbidity, and mistreatment, and realize the promise of access to quality maternal health as a human right.

Keywords: autonomy in childbirth and pregnancy, choice, informed consent, jurisprudential analysis

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Authors: Emma Carr, Bilal Aslam-Pervez, David Laraway

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Litigation against surgeons and hospitals continues to increase in Western countries. While verbal consent is all that is required legally, it has for a long time been considered that written consent offers proof of discussion and interaction between the surgeon and the patient. Inadequate consenting of patients continues in the United Kingdom leaving surgeons and Health Trusts open to litigation. We present a standardised consent form which improves patient autonomy and engagement. The General Medical Council recommends that all material risks relevant to the patient are discussed and recorded prior to undergoing surgery, regardless of how likely they are to occur. Current literature was reviewed to evaluate complications associated with surgical management of mandible fractures. Analysis of risks on 52 consent forms were analysed within the Glasgow OMFS department, leading to a procedure-specific form being designed and implemented. This audit showed that the documentation of risks on consent forms was extremely variable- with uncommon risks not being recorded. Interestingly, not a single consent form was found which highlighted all the risks associated with mandible fractures. Our re-audit data confirms 100% of risks being discussed when a procedure specific form is utilised. Our hope, is to introduce further forms for inclusion on the BAOMS website and peripheral distribution. The forms are quick and easy to print and leave more time for consultation with the patient. Whilst we are under no illusion that the forms may not decrease the incidence of intended litigation, we feel confident that they will decrease the chances of it being successful.

Keywords: consent, litigation, mandible fracture, surgery

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Authors: Rafaella Nogaroli

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It is presented hypothetical cases in the context of AI algorithms to support clinical decisions, in order to discuss the importance of doctors to respect AI ethical principles. Regarding the principle of transparency and explanation, there is an impact on the new model of patient consent and on the understanding of qualified information. Besides, the human control of technology (AI as a tool) should guide the physician's activity; otherwise, he breaks the patient's legitimate expectation in a specific result, with the consequent transformation of the medical obligation nature.

Keywords: medical law, artificial intelligence, ethical principles, patient´s informed consent, medical obligations

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Authors: Arnold Sanda Layuk

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Fraud in the disclosure of financial statements by management shows that agency conflict is an important issue in the company. The conflict has consequences for the agency costs that must be borne and has an impact on the firm's performance. The effect of agency costs on firm performance is investigated in this study, as well as whether several variables such as corporate governance mechanisms can positively moderate the agency cost and firm performance relationship. The agency cost is measured by the asset utilization ratio and discretionary expenditure ratio. The firm's performance is represented by the return on equity. Data was collected from the manufacturing companies listed on the Indonesia Stock Exchange from 2015 to 2019, then regressed on the panel data using the panel corrected standard error model (PCSE). According to the findings, agency costs are negatively related to firm performance, which supports previous empirical research findings. It also found that the agency cost and firm performance relationship is significantly moderated by board size and ownership concentration as the representatives of corporate governance mechanisms. It suggests that corporate governance can become tools to reduce agency costs and increase firm performance as well. The empirical evidence adds to previous research on agency conflict, particularly in emerging markets. These findings are expected to supplement previous research and provide additional information to shareholders in order to control opportunistic management decisions that affect their investments and discretionary operational expenses.

Keywords: agency cost, corporate governance, asset utilization ratio, firm performance

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Authors: Anna Sanczyk

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Teacher agency plays a crucial role in effective teaching, supporting diverse students, and providing an enriching learning environment; therefore, it is significant to gain a deeper understanding of language teachers’ sense of agency in teaching linguistically and culturally diverse students. This paper presents an overview of qualitative research on how language teachers exercise their agency in diverse classrooms. The analysis of the literature reveals that language teachers strive for addressing students’ needs and challenging educational inequalities, but experience educational constraints in enacting their agency. The examination of the research on language teacher agency identifies four major areas where language teachers experience challenges in enacting their agency: (1) implementing curriculum; (2) adopting school reforms and policies; (3) engaging in professional learning; (4) and negotiating various identities as professionals. The practical contribution of this literature review is that it provides a much-needed compilation of the studies on how language teachers exercise agency amid educational constraints. The discussion of the overview points to the importance of teacher identity, learner advocacy, and continuous professional learning and the critical need of promoting empowerment, activism, and transformation in language teacher education. The findings of the overview indicate that language teacher education programs should prepare teachers to be active advocates for English language learners and guide teachers to become more conscious of complexities of teaching in constrained educational settings so that they can become agentic professionals. This literature overview illustrates agency work in English language teaching contexts and contributes to understanding of the important link between experiencing educational constraints and development of teacher agency.

Keywords: advocacy, educational constraints, language teacher agency, language teacher education

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Authors: Chia-Ying Lin

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This paper explains how to enhance doctor-patient communication and nurse-patient communication through multiple intelligence signing methods and user-centered. It is hoped that through the implementation of the "electronic consent", the problems faced by the paper consent can be solved: storage methods, resource utilization, convenience, correctness of information, integrated management, statistical analysis and other related issues. Make better use and allocation of resources to provide better medical quality. First, invite the ｍedical records department to assist in the inventory of paper consent in the hospital: organising, classifying, merging, coding, and setting. Second, plan the electronic consent configuration file: set the form number, consent form group, fields and templates, and the corresponding doctor's order code. Next, Summarize four types of rapid methods of electronic consent: according to the doctor's order, according to the medical behavior, according to the schedule, and manually generate the consent form. Finally, system promotion and adjustment: form an "electronic consent promotion team" to improve, follow five major processes: planning, development, testing, release, and feedback, and invite clinical units to raise the difficulties faced in the promotion, and make improvements to the problems. The electronic signature rate of the whole hospital will increase from 4% in January 2022 to 79% in November 2022. Use the saved resources more effectively, including: reduce paper usage (reduce carbon footprint), reduce the cost of ink cartridges, re-plan and use the space for paper medical records, and save human resources to provide better services. Through the introduction of information technology and technology, the main spirit of "lean management" is implemented. Transforming and reengineering the process to eliminate unnecessary waste is also the highest purpose of this project.

Keywords: smart signature, electronic consent, electronic medical records, user-centered, doctor-patient communication, nurse-patient communication

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Authors: Shulamit Sternin, Raymond M. McKie, Carter Winberg, Robb N. Travers, Terry P. Humphreys, Elke D. Reissing

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Issues surrounding sexual consent negotiation have become a major topic of societal concern. The majority of current research focuses on the complexities of sexual consent negotiations and the multitude of nuanced issues that surround the consent obtainment of heterosexual adults in post-secondary educational institutions. To date, the only study that has addressed sexual consent negotiation behaviour in same-sex relationships focused on the extent to which individuals used a variety of different verbal and nonverbal sexual consent behaviours to initiate or respond to sexual activity. The results were consistent with trends found within heterosexual individuals; thus, suggesting that the current understanding of sexual consent negotiation, which is grounded in heterosexual research, can serve as a strong foundation for further exploration of sexual consent negotiation within same-sex relationships populations. The current study quantitatively investigated the differences between heterosexual men and gay and bisexual men (GBM) in their understanding of sexual consent negotiation. Exploring how the perceptions of GBM differ from heterosexual males provides insight into some of the unique challenges faced by GBM. Data were collected from a sample of 252 heterosexual men and 314 GBM from Canada, the United States, and Western Europe. Participants responded to the question, 'do you think sexual consent and sex negotiation is different for heterosexual men compared to gay men? If so, how?' by completed an online survey. Responses were analysed following Braun & Clarke’s (2006) six phase thematic analysis guidelines. Inter-rater coding was validated using Cohen’s Kappa value and was calculated at (ϰ = 0.84), indicating a very strong level of agreement between raters. The final thematic structure yielded four major themes: understanding of sexual interaction, unique challenges, scripted role, and universal consent. Respondents spoke to their understanding of sexual interaction, believing GBM sexual consent negotiation to be faster and more immediate. This was linked to perceptions of emotional attachment and the idea that sexual interaction and emotional involvement were distinct and separate processes in GBM sexual consent negotiation, not believed to be the case in heterosexual interactions. Unique challenges such as different protection concerns, role declaration, and sexualization of spaces were understood to hold differing levels of consideration for heterosexual men and GBM. The perception of a clearly defined sexual script for GBM was suggested as a factor that may create ambiguity surrounding sexual consent negotiation, which in turn holds significant implications on unwanted sexual experiences for GBM. Broadening the scope of the current understanding of sexual consent negotiation by focusing on heterosexual and GBM population, the current study has revealed variations in perception of sexual consent negotiation between these two populations. These differences may be understood within the context of sexual scripting theory and masculinity gender role theory. We suggest that sexual consent negotiation is a health risk factor for GBM that has not yet been adequately understood and addressed. Awareness of the perceptions that surround the sexual consent negotiation of both GBM and heterosexual men holds implications on public knowledge, which in turn can better inform policy making, education, future research, and clinical treatment.

Keywords: sexual consent, negotiation, heterosexual men, GBM, sexual script

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Authors: Muhammad Farooq

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The present article explores the woman's consent as a paramount element in contracting a Muslim marriage. Also, whether permission of the wali (guardian) is a condition per se for a valid nikah (marriage deed) in the eye of law and Sharia. The researcher attempts to treat it through the related issues, inter alia; the marriage guardian, the women's legal capacity to give consent whether she is a virgin or nonvirgin and how that consent is to be given or may be understood. Does her laugh, tears or salience needs a legal interpretation as well as other female manifestations of emotion explained by the Muslim jurists? The silence of Muslim Family Law Ordinance 1961 (hereafter; MFLO 1961) in this regard and the likely reasons behind such silence is also inquired in brief. Germane to the theme, the various cases in which the true notion of woman's consent is interpreted by courts in Pakistan are also examined. In order to address the issue in hand, it is proposed to provide a brief overview of a few contemporary writers' opinions in which the real place of woman's consent in Muslim marriage is highlighted. Key to the idea of young Muslim woman's marriage, the doctrine of kafa'a (equality or suitability) between the man and woman is argued here to be grounded in the patriarchal and social norms. It is, therefore, concluded that such concept was the result of analogical reasoning and has less importance in the present time. As such it is not a valid factor in current scenarios to validate or invalidate marital bonds. A standard qualitative convention is used for this research. Among primary and secondary sources; for examples, Qur'an, Sunnah, Books, Scholarly articles, texts of law and case law is used to point out the researcher's view. In summation, the article is concluded with a bold statement that a young woman being a party to the contract, is absolutely entitled to 'full and free' consent for the Muslim marriage contract. It is the woman, an indispensable partaker and her consent (not the guardian' permission) that does validate or invalidate the said agreement in the eye of contemporary personal law and in Sharia.

Keywords: consent of woman, ejab (declaration), Nikah (marriage agreement), qabol (acceptance), sui juris (of age; independent), wali (guardian), wilayah (guardianship)

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Authors: Majdi Anwar Quttainah, William Paczkowski, Ali Muhammad

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Determining the value of a privately held firms confound those in academia as well as practitioners in the fields of appraisal, forensic accounting, and law. Divergent parties to the transfer look to apply the valuation technique to serve their own best interests. This paper seeks to explore how agency theory induces owners to choose the form of their businesses at inception and how this choice will affect the appraisers’ valuation of the firm at the transfer of ownership.

Keywords: organizational form, agency theory, value

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Authors: Min Bao

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The teacher is at the core of the three fundamental factors in international Chinese language teaching, the other two being the textbook and the method. Professional development of the teacher comprises a self-renewing process that is characterized by knowledge impartment and self-reflection, in which individual agency plays a significant role. Agency makes a positive contribution to teachers’ teaching practice and their life-long learning. This study, taking Chinese teaching and learning in Minsk State Linguistic University of Belarus as an example, attempts to understand agency by investigating the teacher’s strategic adaptation of textbooks to meet local needs. Firstly, through in-depth interviews, teachers’ comments on textbooks are collected and analyzed to disclose their strategies of adapting and localizing textbooks. Then, drawing on the theory of 'The chordal triad of agency', the paper reveals the process in which teacher agency is exercised as well as its rationale. The results verify the theory, that is, given its temporal relationality, teacher agency is constructed through a combination of experiences, purposes and aims, and context, i.e., projectivity, iteration and practice-evaluation as mentioned in the theory. Evidence also suggests that the three dimensions effect differently; It is usually one or two dimensions that are of greater effects on the construction of teacher agency. Finally, the paper provides four specific insights to teacher development in international Chinese language teaching: 1) when recruiting teachers, priority be given on candidates majoring in Chinese language or international Chinese language teaching; 2) measures be taken to assure educational quality of the two said majors at various levels; 3) pre-service teacher training program be tailored for improved quality, and 4) management of overseas Confucius Institutions be enhanced.

Keywords: international Chinese language teaching, teacher agency, textbooks, localization

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Authors: Chanthima Phromket, Jakret Mettathamrong, Parnisara Prajudtasri

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The purpose of this paper is to investigate the relationship between effects of service quality management capability and business alliance effectiveness on the performance of tourist agency business in Thailand: The moderating role of organizational climate. A survey was used as a research instrument and was given to the owner/managers of tourist agency business in Thailand. The model is tested using the data collected from 400 tourist agency business in Thailand. The results indicate that service quality management capability have the positive influence on business alliance effectiveness and performance. Trust, commitment, and cooperation are the antecedents that have a positive effect on the performance, and the results show non-significant when it is moderated by Organizational climate. Thus, contributions and suggestions are also provided for further research.

Keywords: service quality management capability, business alliance effectiveness, organizational climate, tourist agency

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Authors: G. Çetinkaya, M. Yıldız, P. Çetinkaya

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Tourism is one of the world’s largest industries and its total contribution to the global economy in 2014 was US$7.6 trillion, which equates to 9.8% of total economy GDP in 2014. Mountains are important regions for tourism industry and its second most popular tourist destinations after coastal regions. Hiking and trekking are most popular activity in mountains region and it is estimated that more than 50 million people visit mountains each year. So that hiking was come out to individual activity and it’s to be a massive event. Nowadays hiking is commercialized and mostly it’s become organized by travel agency and tour operators. Travel agency which is offering hiking activities to know the demands of the individuals involved in these activities and is required to submit to it for services. The aim of this study to determined hiking participant expectation from hiking by travel agency perspective. 34 travel agency officials participated in the study. Data were collected by questionnaire developed by the researchers. Results show that according to travel agency officials “visual quality” is the most important expectation factor for hikers. And other expectation factors are “safety”, “accessibility”, “unspoiled local service”, “walking grade”, “expert guidance service”, “popularity of trail”, “uncrowded trail”, “substructure facilities”, “relevant cost”, “guidebook” and “suitable climatic conditions”.

Keywords: expectation, hikers, travel agency, mountain tourism

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Authors: Rosie Cooper, Tracey Chantler, Ellen Pringle, Sadie Bell, Emily Edmundson, Heidi Nielsen, Sheila Roberts, Michael Edelstein, Sandra Mounier Jack

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Introduction: In line with the National Health Service’s (NHS) long-term plan, the NHS is looking to implement more digital health interventions. This study explores a case study in this area: a digital intervention used by NHS Trusts in London to consent adolescents for Human Papilloma Virus (HPV) immunisation. Methods: The electronic consent intervention was implemented in 14 secondary schools in inner city, London. These schools were statistically matched with 14 schools from the same area that were consenting using paper forms. Schools were matched on deprivation and English as an additional language. Consent form return rates and HPV vaccine uptake were compared quantitatively between intervention and matched schools. Data from observations of immunisation sessions and school feedback forms were analysed thematically. Individual and group interviews were undertaken with implementers parents and adolescents and a focus group with adolescents were undertaken and analysed thematically. Results: Twenty-eight schools (14 e-consent schools and 14 paper consent schools) comprising 3219 girls (1733 in paper consent schools and 1486 in e-consent schools) were included in the study. The proportion of pupils eligible for free school meals, with English as an additional language and students' ethnicity profile, was similar between the e-consent and paper consent schools. Return of consent forms was not increased by the implementation of the e-consent intervention. There was no difference in the proportion of pupils that were vaccinated at the scheduled vaccination session between the paper (n=14) and e-consent (n=14) schools (80.6% vs. 81.3%, p=0.93). The transition to using the system was not straightforward, whilst schools and staff understood the potential benefits, they found it difficult to adapt to new ways of working which removed some level or control from schools. Part of the reason for lower consent form return in e-consent schools was that some parents found the intervention difficult to use due to limited access to the internet, finding it hard to open the weblink, language barriers, and in some cases, the system closed a few days prior to sessions. Adolescents also highlighted the potential for e-consent interventions to by-pass their information needs. Discussion: We would advise caution against dismissing the e-consent intervention because it did not achieve its goal of increasing the return of consent forms. Given the problems embedding a news service, it was encouraging that HPV vaccine uptake remained stable. Introducing change requires stakeholders to understand, buy in, and work together with others. Schools and staff understood the potential benefits of using e-consent but found the new ways of working removed some level of control from schools, which they found hard to adapt to, possibly suggesting implementing digital technology will require an embedding process. Conclusion: The future direction of the NHS will require implementation of digital technology. Obtaining electronic consent from parents could help streamline school-based adolescent immunisation programmes. Findings from this study suggest that when implementing new digital technologies, it is important to allow for a period of embedding to enable them to become incorporated in everyday practice.

Keywords: consent, digital, immunisation, prevention

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Authors: W. Zekri

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This paper explores Zohra Drif’s memoir, Inside the Battle of Algiers, which narrates her desires as a student to become a revolutionary activist. She exemplified, in her narrative, the different roles, she and her fellows performed as combatants in the Casbah during the Algerian Revolution 1954-1962. This book review aims to evaluate the concept of women’s agency through education and language learning, and its impact on empowering women’s desires. Close-reading method and thematic analysis are used to explore the text. The analysis identified themes that refine the meaning of agency which are social and cultural supports, education, and language proficiency. These themes aim to contribute to the representation in Inside the Battle of Algiers of a woman guerrilla who engaged herself to perform national acts of resistance.

Keywords: agency, education, learning, women

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Authors: Bernice Badal

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This article addresses a persistent challenge related to teacher agency in knowledge acquisition in professional development (PD) workshops in contexts of educational change, given that scholarship identifies a need for more teacher involvement and amplification of teacher's voices. Theoretical concepts are drawn from Bandura’s Social cognitive theory, incorporating the triadic causation model of agency to examine the reciprocal nature of the context, teacher characteristics, and systemic influences that shape how knowledge is transmitted and acquired in PD workshops. This qualitative study, using a mix of classroom observations and interviews, explored the political, contextual, and personal characteristics of teacher agency in PD through an analysis of data extracted from a PhD study. The narratives of six teachers from three township schools are examined to show how PD efforts in South Africa have failed to take account of the holistic development of teacher agency in knowledge dissemination and how this shapes teacher self-efficacy beliefs about being able to masterfully apply the tenets of the reform. Agency, teacher voice, and contextual considerations were used as markers of the quality of the training provided to understand how knowledge is acquired and meaning is made. The findings suggest that systemic influences of institutionally imposed PD offer partial understandings of the reform, which is offered in traditional formats that do not consider teacher empowerment in knowledge production and the development of teacher agency. Common in all the participants’ responses is the need for more information and training on the prescribed approach for teaching English as a second language; however, this paper holds the view that more information may not solve teachers’ dilemmas. Accordingly, it recommends a restructuring of the programme with facilitators being more cognisant of teacher agency for the development of transformative teachers. The findings of the study contribute to the field of teacher knowledge, teacher training, and professional development in the context of educational reforms.

Keywords: teacher professional development, teacher voice, teacher agency, educational reforms, teacher knowledge

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Authors: Tien Nguyen

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The relationship between mentors and mentees in teaching practicum has received the attention of researchers and been widely investigated. Mentors’ authority and power have captured a large and growing body of the literature in the field of teaching practicum. This article revisits mentor-mentee relationship and shifts the focus to mentees’ agency in planning and delivering lessons, an area which has been under-researched. Drawing on Vygotsky’s Zone of Proximal Development and Harré’s Positioning Theory, this qualitative study examines how mentees responded to mentors’ instructions in practicum. Interviews and classroom observations were conducted with 20 participants including both mentors and mentees across two English language teacher education programs in two different geographical locations in Vietnam. The result indicates that regardless of the similarities and/or differences of the programs, mentees’ agency varied in accordance with their identities in specific contexts. Specifically, mentees follow or resist to mentors’ feedback and instruction in revising their lesson plans and delivery these lessons, depending on their professional identities and institutional conditions. This study contributes to the importance of supporting the agency of mentees in teacher education.

Keywords: mentors, mentees, relationship, agency, professional identity, teacher education

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Authors: Keyvan Kashkouli Nejad, Motoaki Sugiura, Atsushi Sato, Takayuki Nozawa, Hyeonjeong Jeong, Sugiko Hanawa , Yuka Kotozaki, Ryuta Kawashima

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The perception of agency/control is altered with presence of discrepancies in the environment or mismatch of predictions (of possible results) and actual results the sense of agency might become altered. Synofzik et al. proposed a two layer model of agency: In the first layer, the Feeling of Agency (FoA) is not directly available to awareness; a slight mismatch in the environment/outcome might cause alterations in FoA, while the agent still feels in control. If the discrepancy passes a threshold, it becomes available to consciousness and alters Judgment of Agency (JoA), which is directly available in the person’s awareness. Most experiments so far only investigate subjects rather conscious JoA, while FoA has been neglected. In this experiment we target FoA by using subliminal discrepancies that can not be consciously detectable by the subjects. Here, we explore whether we can detect this two level model in the subjects behavior and then try to map this in their brain activity. To do this, in a fMRI study, we incorporated both consciously detectable mismatching between action and result and also subliminal discrepancies in the environment. Also, unlike previous experiments where subjective questions from the participants mainly trigger the rather conscious JoA, we also tried to measure the rather implicit FoA by asking participants to rate their performance. We compared behavioral results and also brain activation when there were conscious discrepancies and when there were subliminal discrepancies against trials with no discrepancies and against each other. In line with our expectations, conditions with consciously detectable incongruencies triggered lower JoA ratings than conditions without. Also, conditions with any type of discrepancies had lower FoA ratings compared to conditions without. Additionally, we found out that TPJ and angular gyrus in particular to have a role in coding of JoA and also FoA.

Keywords: agency, fMRI, TPJ, two layer model

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Authors: Mohammad Naseh Nasrollahi Shahri

Abstract:

The article draws on Michael Bakhtin’s theory of language to examine peer interactions. It represents an analysis of other-repetition in student interactions. Several recent studies have explored various aspects of repetition in multiple contexts. However, other-repetition in peer interactions has not received enough attention. Building on previous studies, this study examines patterns of other-repetition or appropriation in the context of discussion activities performed by EFL learners. The analysis highlights the meaningfulness of other-repetition in a way that distinguishes them from rote-repetition. It is suggested that instances of repetition constitute third spaces between the self and other which provide ideal settings for language learning and demonstrate student agency and engagement.

Keywords: repetition, agency, Bakhtin, dialogue

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Authors: Anita Puspawati

Abstract:

A failure in obtaining informed consent from patient occurs because there is not effective communication skill in doctors. Therefore, the language is very important in communication between doctor and patient. This study uses descriptive analysis method, that is a method used mainly in researching the status of a group of people, an object, a condition, a system of thought or a class of events in the present. The result of this study indicates that the communicative language between doctors and patients will increase the trust of patients to their doctors and accordingşy, patients will provide the informed consent voluntarily.

Keywords: communicative, language, doctor, patient

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Authors: Sydelle Barreto

Abstract:

Sexual liberation has been thought of as a movement, an idea, and an antithesis of material oppression. Within feminism it has consistently resisted definition - different feminist schools of thought had entirely different constructions of what liberated feminine sexuality could look like and how we might get there. This paper will critique the current definition of sexual liberation as being limited and carceral in its perspectives of sexual assault and extremely reductive in its imaginings of sexual liberation. The ultimate goal of this assessment is to potentially outline what true sexual liberation might look like in a way that is inclusive but not ignorant of the realities of the patriarchy. The first critique of sexual liberation included in the paper centers around the limits of consent, carceral feminism and sexual subjectivity. The argument will build off the traditionally sex-negative critiques of consent as being limited in scope by explaining how a lack of nuance is even more dangerous to victims of sexual violations. The discussion will also expand an interrogant of consent to an interrogation of wantedness and desire. If we understand that critiquing the conditions of consent is important, we must also critique the way patriarchy and compulsory sexuality have affected desire. Using the aforementioned concept of compulsory sexuality, the paper will argue that while sexual liberation has begun to include queer and transgender individuals, it is still overwhelmingly allonormative. Sex positivity and its opponents both fail to include asexuality. This ultimately leads to a conflation of sexual liberation with genuine material liberation. Just as we cannot divorce our constructions of sexual liberation from the realities of the patriarchy and rape culture, we should consider compulsory sexuality as its own system of social regulation. The conclusion will begin to construct an alternative vision of sexual liberation, leveraging concepts of sexual subjectivity, including a rejection of carceral feminism as a response to sexual violence, and finally, leading to the beginnings of a deconstruction of compulsory sexuality. The paper concludes with a vision of sexual liberation that does not confuse itself with material liberation or mere sexual oppression, but rather a key way stops on the road to constructing our most authentic sexual selves.

Keywords: feminism, sexual assault, sexual liberation, consent

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Authors: Md. Abdul Karim, Syed Imran Ahmed, Pandora T. Hardtman

Abstract:

Informed consent is one of the basic human and ethical rights for childbearing women. It plays a central role in promoting informed decision making between patients and service providers during the labor process. It gives mothers rights to accept or reject any examination and/or procedure, increases the respect and dignity of the mother during pregnancy, delivery and postpartum care. To assess the practices of this right during normal vaginal delivery and immediate postpartum care in tertiary level hospital setting in Bangladesh, a quantitative study with cross-sectional design was conducted in Dhaka Medical College & Hospital (DMCH) and Sir Salimullah Medical College & Mitford Hospital (SSMCH) in Dhaka in November 2015. A prevalence-based sample size of 190 was calculated where prevalence, confidence interval and level of significance were at 9.7%, 98% and 5% respectively. The respondents were the mothers who gave normal vaginal childbirth within past 24 hours and received postpartum care there. They were selected through systematic random sampling technique and their face-to-face interview of 190 mothers was done using a structured questionnaire. Data were entered into the spreadsheet (MS Excel 2013 version) and descriptive analysis of findings was done. The result shows the complete absence of informed consent practices and mostly absence of consented care such as right to information, respect for choices of preferences for examination and/or procedure of childbearing women. Although 95% of the mothers were informed that they were being proceeded with normal vaginal delivery, their choice of preference was absent during the process. Only consent (not informed consent) was taken from 50%-72% mothers for examination (except breast examination ‘0%’) and 8%-83% for any procedures during postpartum care. Only one-ninth (11%) of the mothers could ask service providers regarding the services they received. No consent was taken from 3% of the mothers- neither in the labor process nor in postpartum care. This current practice doesn’t comply with the Respectful Maternity Care (RMC) Charter 2011. The issue is not even clarified in the current Standard Clinical Management Protocols of the country. So, improvement of the existing protocol and increased awareness are essential to address this right of child-bearing women and to practice it during normal vaginal delivery and postpartum care.

Keywords: informed consent, normal vaginal delivery, respectful maternity care, tertiary level hospital

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Authors: Hsueh Ping Peng

Abstract:

End-stage renal disease most commonly occurs in the elderly population. Elderly people are approaching the end of their lives, and when facing major life-threatening situations, apart from aggressive medical treatment, they can also choose treatment methods such as hospice care to improve their quality of life. The purpose of this study was to investigate factors associated with the awareness and willingness to sign hospice and palliative care consent forms in elderly with end-stage renal disease. This study used both quantitative, cross-sectional study designs. In the quantitative section, 110 elderly patients (aged 65 or above) with end-stage renal disease receiving conventional hemodialysis were recruited as study participants from a medical center in Taipei City. Data were collected using structured questionnaires. Study tools included basic demographic data, questionnaires on the awareness and perception of hospice and palliative care, etc. After collecting the data, data analysis was conducted using SPSS 20.0 statistical software, including descriptive statistics, chi-square test, logistic regression, and other inferential statistics. The results showed that the average age of participants was 71.6 years old, more males than females, average years of dialysis was 6.1 years and most subjects rated their self-perceived health status as fair. Results of the study are summarized as follows: Elderly people with end-stage renal disease did not have sufficient knowledge and awareness about hospice and palliative care. Influencing factors included level of education, marital status, years of dialysis and age, etc. Demographic factors influencing the signing of consent forms included gender, marital status, and age, which all showed significant impacts. Factors taken into consideration when signing consent forms included awareness of hospice care, understanding the relevant definitions of hospice care, and understanding that consent may be modified or cancelled at any time; it was predicted that people who knew more about ways to receive hospice care or more related definitions were more willing to sign the consent forms. In the qualitative study section, 10 participants who signed the consent form, five male, and 5 female, between the ages of 65-90, have completed the semi-structured interviews. Analysis of the interviews revealed six themes: (1) passing away peacefully, (2) autonomy on arrangements of life and death, (3) unwillingness to increase family and social burden, (4) friends and relatives’ experience influencing the decision to give consent, (5) sharing information to facilitate the giving of consent, (6) facing each day with ease, to reflect the experience and factors of consideration for elderly with end-stage renal disease when signing consent forms. The results of this study provides the awareness, thoughts and feelings of elderly with end-stage renal disease on signing consent forms, and serve as a future reference for the dialysis unit to enhance the promotion of hospice and palliative care and related caregiving measures, thereby improving the quality of life and care for elderly people with end-stage renal disease.

Keywords: end-stage renal disease, hemodialysis, hospice and palliative care, awareness, willingness

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Authors: Martina I. Reinhold, Theresa Bacon-Baguley

Abstract:

A core challenge of physician assistant education is preparing professionals for lifelong learning. While this conventionally has encompassed scientific advances, students must also embrace new care delivery models and technologies. Telemedicine, the provision of care via two-way audio and video, is an example of a technological advance reforming health care. During a three-semester sequence of Hospital Community Experiences, physician assistant students were assigned experiences with Answer Health on Demand, a telemedicine collaborative. Preceding the experiences, the agency lectured on the application of telemedicine. Students were then introduced to the technology and partnered with a provider. Prior to observing the patient-provider interaction, patient consent was obtained. Afterwards, students completed a reflection paper on lessons learned and the potential impact of telemedicine on their careers. Thematic analysis was completed on the students’ reflection papers (n=13). Preceding the lecture and experience, over 75% of students (10/13) were unaware of telemedicine. Several stated they were 'skeptical' about the effectiveness of 'impersonal' health care appointments. After the experience, all students remarked that telemedicine will play a large role in the future of healthcare and will provide benefits by improving access in rural areas, decreasing wait time, and saving cost. More importantly, 30% of students (4/13) commented that telemedicine is a technology they can see themselves using in their future practice. Initial results indicate that collaborative interaction between students and telemedicine providers enhanced student learning and exposed students to technological advances in the delivery of care. Further, results indicate that students perceived telemedicine more favorably as a viable delivery method after the experience.

Keywords: collaboration, physician assistant education, teaching innovative health care delivery method, telemedicine

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