Deconstructing nursing's paradoxical relationship with the concept of complexity.

Although nursing seems to understand itself and its practice as complex, the literature is less clear about what this actually means. While complexity is discussed as an attribute of nursing, it is also suggested that complexity in nursing remains misunderstood and poorly articulated, is devalued, is not considered as a measure of health outcomes and remains invisible. Despite the overarching lack of a definition, some nurse scholars have conceptualized complexity as a complex intervention. For these authors, complexity becomes a complex intervention defined as that which is composed of component parts interacting in a variety of ways that influence the delivery of and outcomes of health-related interventions for populations. Conceptualizing complexity as a complex intervention forces nursing to embrace and adopt a received interpretation of complexity as expressed through complexity theory and complexity science. While complexity theory may afford us some tools for thinking about complexity, when we deconstruct nursing complexity to explicitly determinate and quantifiable tasks, this artificially narrowed orientation to complexity reveals an oversimplified explanation of the complexities associated with nursing and serves to blind us to its real qualities. Through a consideration of complexity from a Western philosophical tradition, I demonstrate that when nursing adopts the received interpretation of complexity as a complex intervention, this perspective on complexity contains nursing epistemologically and ontologically. I offer an extended conceptualization of complexity framed upon the consideration that nurses assume complexity and do not reduce it; that nurses have the capacity to not be paralysed by complexity and have developed logics to mobilize it in productive ways. Mobilizing complexity through navigating paradox and contradiction shapes an orientation to complexity that embraces an extended epistemology. This extended epistemology is characterized by a 'yes/and' mindset that expresses the dynamic and generative relationship between forms of knowledge which reflects complexity that characterizes nursing.

It's "Classical Advice!" Why Medical Education Should Go Beyond Science.

This article is a reflection on a new (but ancient) definition of medicine, which considers doctors and patients alike from their complex human experiences. It explores the doctor-patient relationship as well as the practice of medicine itself through an historical lens, by examining some of the scholarship of Galen of Pergamum, the ancient Greek doctor and philosopher of the second century CE. The intention is not to give a new, definite answer, but to use an example from the past to look at the matter from a different, perhaps unusual, perspective.

Partisan Legal Traditions in the Age of Camden and Mansfield.

The 18th century is often treated by scholars as a period of juristic consensus. This article argues, in contrast, that the late 18th century saw the emergence of rival 'Patriot' and 'Tory' legal traditions. Through a detailed study of the jurisprudence of Lords Camden and Mansfield-who were both pillars of the law, as well as political and juristic rivals-we show that they differed systematically in their understanding of the common law, and that those differences had a partisan cast: although they were not crude attempts to instrumentalise law to political ends, their political and jurisprudential commitments influenced each other and emerged from the same intellectual roots. We place these differences in the context of the fragmentation of 18th-century Whig politics, and argue that they have important implications for how we understand and make use of the common law tradition in present-day scholarship.

Edible Insects in Slavic Culture: Between Tradition and Disgust.

Insects are a conventional food in many cultures worldwide. Why therefore are they treated with aversion by the majority of people in Western countries? The aim of this work is to understand cultural norms and historical practices related to insects that can explain why in the countries of the West it is so difficult to accept them as a foodstuff, and why the disgust that they arouse is more common than in other regions of the world. Insects in Western countries are associated with negative experiences resulting from cultural and religious beliefs, traditions, stories, myths and individual experiences. Although there are species of insect that have positive associations, the high number of negative terms popularized the negative image of these creatures in people's minds, as a result of which the concept of insects as a foodstuff arouses disgust in the culture of the West. Understanding the aversion to insects will contribute to the broader understanding of consumer attitudes, cultural influences on consumption, or potential shifts in food choices. It also can help develop strategies or methods that will assist in changing this reluctance and encourage the utilization of insects as a food source.

Characteristics of Using Oriental Medicine Clinics during the Japanese Occupation: An Analysis of the 1931 Seoul Bochun Clinic Account Book.

This article analyzes the "account book" of Kim Young-hoon (1882-1974), which summarizes information about patients at his Bochun Clinic in Seoul (then Gyeongseong) in 1931. Kim Young-hoon was a pivotal figure in the medical scene throughout the Korean Empire, the Japanese occupation, and the early years of the Republic of Korea. He left behind a large amount of documentation during his 60 years of practice at the Bochun Clinic, which he opened in the spring of 1909. In particular, the 1931 "account book" offers an insight into the daily life histories of his patients. Among the patient-visitors recorded in the account book, there were many influential people of the time, ranging from privileged individuals to anti-Japanese independence activists, from those in political and economic fields to those in academic and entertainment fields. At the same time, a significant number of lower-class people also visited the Clinic. Geographically, patients were centered in the city center of the capital, Gyeongseong, but were also widely distributed throughout the country. There are indications that those from the rural areas stayed in the homes of their acquaintances in Seoul. As such, the account book provides a tangible, concrete picture of the clinic's management for the year 1931, including visitor demographics, visiting diagnoses, telephone consultations, and the total cost of medicinal prescriptions. Because the account book is a one-year statistic, it has its limitations; however, it is the smallest unit that can be analyzed statistically. It provides insights into how many people came in over the course of a year and how much they spent. The expenditures are kept per individual family. The patient's name, prescribed medication, and the price of the medicine are mandatorily included, and in many cases, the place of residence and family relationships are also noted. The account book shows several layers of householders, servants, and employees in the extended family; it also shows people in various occupations. A few privileged families accounted for nearly half of the total expenditures, and the powerful visited frequently, utilizing Oriental medicine for many of their daily needs. For some, the Bochun Clinic is reminiscent of the royal temples of the dynasties. Patients come from the center and suburbs of Seoul, as well as from all over the country. In one year, more than one thousand types of prescriptions are issued and the total cost of medicines is about 33 seom (≒180 liters of rice). Although there is a concentration of high-frequency prescriptions, more than a thousand prescriptions are prescribed only once, which shows that the practice is specialized for each individual. Patient visits, consultations, and telephone use are observed, and the use of new drugs, quinine, and special ginseng as one-herb medication (danbang) are also noticeable. The statistical analysis of the 1931 Bochun Clinic "account book" can serve as a milestone for comparative analysis of the patterns of herbal medicine use before and after that year. Meanwhile, the Bochun Clinic "account book" shows the continuation of traditional practices of herbal medicine by both the powerful and the masses. On the one hand, Koreans responded to the coercive tide of modernity symbolized by the Imperial Governorate of Japan, but on the other hand, they were unwilling to let go of tradition and their own authority. While actively embracing the tide of civilization, Koreans also internalized their own rationality and sought to open a new path forward, a sentiment discernible between the lines of the "account book."

Impact of COVID-19 on celebration of death, mortuary, and funerary customs in Bangladesh: A qualitative study.

Introduction: During the COVID-19 pandemic, restrictions significantly impacted religious activities related to death celebrations, mortuary practices, and funerary rituals in Bangladesh. Bereaved families faced a harsh reality, unable to perform the full rituals for their loved ones due to the pandemic outbreak. This study explores the adjustments and modifications made in cultural rituals and how they affected bereaved families and close relatives. Objective: This study aims to explore how the COVID-19 pandemic impacted the observance of death rituals in Bangladesh and the effects on bereaved families and close relatives. Methods: This study employed a qualitative approach and gathered data through 3 key informant interviews (KIIs) and 58 in-depth interviews (IDIs) conducted between December 2020 and January 2021. Purposive sampling was employed to recruit participants from three distinct groups: (1) individuals who had experienced the death of a relative during the pandemic, (2) caregivers who provided support to those experiencing loss, and (3) volunteers actively involved with funeral and burial services. This selection strategy ensured a diverse range of perspectives on the impact of the pandemic on death rituals. Results: The pandemic forced people to observe funerals or make significant sacrifices to traditional practices reluctantly. Disruptions to long-standing traditions and widespread emotional toll were as various segments of society struggled to find closure in saying goodbye to loved ones. Due to the severity of the pandemic, people became heavily reliant on priests, crematorium workers, and funeral volunteers for mortuary services. Both Hindu and Muslim religions discouraged family gatherings during post-burial rituals. The fear of contracting the virus further limited bereaved families' ability to bid farewell to their deceased loved ones properly. Conclusion: This research highlights the profound impact of the pandemic on death rituals and the resulting emotional distress for bereaved families in Bangladesh. The findings are pivotal in guiding the development of concrete policies for future pandemic preparedness and response. Such policies might encompass guidelines for safe and culturally sensitive mortuary practices, psychosocial support and grief counseling initiatives for affected communities, and strategies to mitigate religious anxieties during public health emergencies.

Ethnomedicinal Plants and Herbal Preparations Used by Rural Communities in Tehsil Hajira (Poonch District of Azad Kashmir, Pakistan).

The present study emphasizes the importance of documenting ethnomedicinal plants and herbal practices of the local rural communities of Tehsil Hajira (Pakistan). The aim was to document, explore and quantify the traditional ethnomedicinal knowledge. Ethnobotanical data were collected using semi-structured questionnaires and analyzed using various quantitative indices. The results showed that 144 medicinal plant species from 70 families and 128 genera play an important role in herbal preparations. The most common type of preparation was powder (19.0%), followed by paste (16.7%), aqueous extract (15.7%), decoction (14.7%) and juice (11.0%). Fragaria nubicola (0.94) and Viola canescens (0.93) had the highest relative frequency of mention (RFC), while Berberis lycium (1.22) and Fragaria nubicola (1.18) had the highest use value (UV). Geranium wallichianum (85.5), Ligustrum lucidum (83) and Indigofera heterantha (71.5) were the most important species in the study area with the highest relative importance (RI) value. The diseases treated were categorized into 17 classes, with diseases of the digestive system and liver having the highest Informant Consensus Factor (ICF) value, followed by diseases of the oropharynx and musculoskeletal system. Important plants mentioned for the treatment of various diseases of the gastrointestinal tract are Zanthoxylum alatum, Berberis lycium, Mentha longifolia, Punica granatum, Rubus ellipticus and Viola canescens. New applications of rarely documented plants from this area are: Oxalis corniculata paste of the whole plant to treat vitiligo, Carthamus tinctorius flowers to treat chicken pox, Dioscorea deltoidea tuber powder to treat productive cough, Inula cappa root decoction to treat miscarriage, Habenaria digitata tuber juice for the treatment of fever, Viola canescens leaves and flowers for the treatment of sore throat and Achillea millefolium root and leaf juice for the treatment of pneumonia. These plants may contain interesting biochemical compounds and should be subjected to further pharmacological studies to develop new drugs. Traditional medicinal knowledge in the area under study is mainly limited to the elderly, traditional healers and midwives. Therefore, resource conservation strategies and future pharmacological studies are strongly recommended.

Mapping nut-cracking in a new population of wild capuchin monkeys (Sapajus libidinosus) at Ubajara National Park, Brazil.

Populations of bearded capuchin monkeys (Sapajus libidinosus) vary in their tool use behaviors, with some of this divergence regarded as culturally determined. The use of stone tools, primarily to crack open encased foods, is widespread among bearded capuchins living in dry habitats (Caatinga and Cerrado). Significant diversity in targets, processed foods, material, and size of tools is observed across populations. However, so far, only a few sites have been systematically studied, and we are still distant from a representative picture of the range of variation in capuchins' culture. In this study, we did a systematic assessment of stone tool use sites in the Ubajara National Park (UNP), in the Caatinga region of Ceará, Brazil, recording and measuring stone tools, processed foods, and available lithic resources as part of an extensive comparative research, the CapCult project. We found indirect and direct evidence that capuchin monkeys at UNP customarily use hammerstones and anvils to process at least two species of palm nuts, macauba (Acrocomia aculeata) and the harder babaçu (Attalea speciosa). Most of the anvils were rock surfaces and had leftovers of only one palm nut species. The hammerstones used to process both palm nuts were not significantly different in weight, although the ones used for Ac. aculeata were longer. We found a higher frequency of nut-cracking sites in the drier lowland area of the park, reflecting differences in the density of the most common palm species, Ac. aculeata, and availability of raw stone material. The stone tool use observed in UNP is within the scope of previously reported in savannah capuchin populations. Our study widens the knowledge of stone tool-use diversity in wild capuchin monkeys, which could contribute to shaping conservation policy, including cultural traits.

Unusual Mechanism of Injury during a Wedding Tradition Leading to a Metacarpal Shaft Fracture - A Case Report.

Introduction: "Joota Chori" is a traditional Indian wedding ritual which involves playful competition between the bride's and the groom's friends, with the aim of hiding and retrieving the groom's shoes. Case Report: We describe a rare case scenario wherein an orthopedic surgeon sustained a metacarpal shaft fracture while gripping the shoe and engaging in a tussle with the groom's friends. Despite feeling a sudden snap and experiencing pain, the surgeon held onto the shoe. The subsequent diagnosis revealed a 4th metacarpal long oblique shaft fracture. Conclusion: This case highlights the uncommon mechanism of injury involving forceful hyperextension of the MCP joint and the potential risks associated with physically intense wedding rituals. It also emphasizes the importance of adequate first aid resources and medical attention at wedding venues to promptly address musculoskeletal injuries.

A Framework for Examining Bioethical Issues from a Sunni Perspective: Maslaha.

All religions should develop convincing responses to emerging bioethical problems stemming from medical and technological advancements. Additionally, believers need to know their faiths' interpretations of bioethical issues to be able to make medical decisions in line with their religious values. Therefore, Islamic bioethics should provide Muslims with conclusive and credible answers regarding newly rising problems in health care by revisiting the religious norms and decrees. However, the diversity in the Islamic denominations, the traditionalist aspect of the Sunni jurisprudence demanding strict compliance with the scriptural texts, the lack of unanimously accepted authority, and the limited number of academic works in Islamic bioethics (at least in English) complicate exploring new standards or rules for new ethical matters. In this view, the present paper aims to delineate two primary Islamic theological schools and propose al-Ghazali's maslaha as a general framework to analyze bioethical issues in the Sunni tradition. Maslaha allows exercising discretion in light of the protection of five fundamental values: religion, life, reason, lineage, and property. Maslaha has the potential to enable Sunni Muslims to appraise contemporary ethical questions, concerns, and dilemmas through an Islamic view and make more autonomous decisions by having religious guidelines.

Effect of traditional Chinese medicine combined group psychotherapy on psychological distress management and gut micro-biome regulation for colorectal cancer survivors: a single-arm phase I clinical trial.

OBJECTIVE: To evaluate the efficacy and feasibility of utilizing Traditional Chinese Medicine (TCM) combined group psychotherapy intervention on psychological distress management and gut micro-biome regulation for colorectal (CRC) survivors. METHODS: A single-arm phase I clinical trial was conducted between December 2020 and December 2021 in Xiyuan Hospital and Beijing Cancer Hospital in China. Inclusion criteria included stage I-III CRC survivors after radical surgery with age between 18 and 75. The intervention was a 6-week online TCM combined group psychotherapy intervention including 90-min communication, TCM lifestyle coaching, self-acupressure guidance, and mindfulness practice led by TCM oncologist and psychiatrist each week. Outcomes were measured by Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS), Fear of Cancer Recurrence Inventor (FCRI), and Quality of Life Questionnaire (QLQ-C30). Fecal samples before and after intervention were collected for 16Sr RNA analysis. RESULTS: We recruited 40 CRC survivors and 38 of them finally completed all interventions with average age of 58±13 years' old. Paired t-test showed that SAS at week 2(35.4±5.8), week 4 (37.9±10.5) and week 6 (31.3±6.4) during the intervention was significantly lower than baseline (42.1±8.3, p<0.05 respectively). SDS score also declined substantially from baseline (38.8±10.7) to week 2 (28.3±8.8, p<0.001) and week 6 (25.4±7.7, p<0.001). FCRI decreased from 19.4±7.2 at baseline to 17.5±7.1 at week 4 (p=0.038) and 16.3±5.8 at week 6 (p=0.008). Although changes of QLQ-C30 were not statistically prominent, symptom burden of insomnia and fatigue significantly alleviated. The abundances of gut microbiota Intestinibacter, Terrisporobacter, Coprobacter, and Gordonibacter were all significantly elevated after intervention. CONCLUSIONS: TCM combined group psychotherapy intervention is feasible and effective to reduce CRC survivors' psychological distress and modulate certain gut bacteria which might be associated with brain-gut axis effect. It is necessary to carry out with phase II randomized controlled clinical trial.

Religious and traditional beliefs and practices as predictors of mental and physical health outcomes and the role of religious affiliation in health outcomes and risk taking.

BACKGROUND: While many studies from sub-Saharan countries, including Zimbabwe, allude to the important role of religion and tradition for young people living with HIV (YPLHIV), most of these studies tend to be descriptive and lack advanced statistical analysis. This study aims to close this gap. METHODS: Data for this study was collected between July and October 2021 from 804 YPLHIV (aged 14-24) in Zimbabwe. The questionnaire included questions regarding participants' conceptions of HIV, their health seeking and risk-taking behaviour, current HIV viral load results, the prevalence of opportunistic infections, their mental health status, and demographic characteristics. The analysis was done using multilevel mixed-effects logistic regression. RESULTS: We found that Traditional religious affiliation was linked to overall lower viral load (OR: 0.34; CI: 0.12-0.96; P: 0.042), Apostolic to more (OR: 1.52; CI: 1-2.3; P: 0.049) and Pentecostal to less (OR: 0.53; CI: 0.32-0.95; P: 0.033) treatment failure. Additionally, conceptions about HIV without spiritual or religious connotation, such as 'seeing HIV as result of a weak body' was associated with lower risk of treatment failure (OR: 0.6; CI: 0.4-1.0; P: 0.063), higher chances for undetectable viral load (OR: 1.4; CI: 1-2; P: 0.061), and overall lower viral load (OR: 0.7; CI: 0.5-1; P: 0.067). Moralizing concepts of HIV, like 'seeing HIV as a result of sin in the family', was linked to higher risk of opportunistic infections (OR:1.8; CI:1.1-3; P: 0.018), and higher risk of treatment failure (OR: 1.7; CI: 0.7-1.1; P: 0.066). Religious objections toward certain forms of therapy, like toward cervical cancer screening, was linked to higher risk of mental problems (OR: 2.2; CI: 1.35-3.68; P: 0.002) and higher risk of opportunistic infections (OR:1.6; CI:1.1-2.1; P: 0.008). Religious affiliations significantly influenced conceptions of HIV, health seeking behaviour, and risk taking. CONCLUSION: To our knowledge, this study is the first to provide evidence about the statistically significant associations between religious and traditional beliefs and practices and current health outcomes and health risk factors of YPLHIV in Zimbabwe. It is also the first to identify empirically the role of religious affiliations as predictors of current viral load results. This new knowledge can inform contextualized approaches to support YPLHIV in Zimbabwe.

Subsidiarity and Participation in an Age of Catholic Mega-Systems.

While the number of Catholic healthcare facilities has held stable over the last several decades, Catholic healthcare has followed the trend of merging facilities and systems into "mega-systems." These consolidations can be beneficial for creating continuums of care, lowering operating costs, ensuring long-term viability, and sharing physical, digital, and human resources. However, with larger systems comes a practical need to be integrated to some degree, and the pressure to standardize policies and practices across regions is present. To address this need and pressure, the Catholic Social Teaching principles of subsidiarity and participation should guide system and local administrators. Subsidiarity and participation encourage all decision making to happen at the most local levels and to include as many of the people those decisions affect as possible. I will review both the pragmatic benefits of keeping decisions as local and rooted as possible as well as the moral benefits of allowing as many administrators and health care professionals to exercise and form their virtues as moral agents. In a time when changes to medical care have created many procedural responsibilities and cut into time spent in moral witness, institutions, even mega-systems, should remain attentive to the ways in which the moral agents of their system are formed and exercised.

Ethnobotanical Insights into Medicinal and Culinary Plant Use: The Dwindling Traditional Heritage of the Dard Ethnic Group in the Gurez Region of the Kashmir Valley, India.

This ethnobiological study addresses the complicated relationship between the Dard ethnic group and their natural environment in the Gurez region of the Kashmir Valley. The study documents their traditional knowledge of the use of plant species for medicinal and culinary purposes. A total of 87 plant species from 41 different families were cataloged, with the Asteraceae family (15 species) and the Lamiaceae family (12 species) being the most commonly used. These plants were found to be used to treat 20 different ailments, with menstrual cramps being the most common (12 species). The fidelity values for these plants ranged from 11.10 to 71.42, demonstrating their importance in traditional medicine. In addition, 17 plant species were found to be useful for gastronomic purposes, with Juglans regia being the most valuable (use value of 0.73). The study also evaluated the conservation status of these plants and found that seven of them are considered critically endangered, ten endangered, and four endangered according to the IUCN classification. This study offers insights into the Dard people's deep connection to their natural environment and has significant implications for policy formulation, cultural conservation, and sustainable use of endemic species, as well as potential applications in pharmaceutical research for therapeutic compounds.

The use of Thai herbal galactogogue, 'Plook-Fire-Thatu', for postpartum heat re-balancing.

Plook-Fire-Thatu is a traditional Thai medication designed to assist breastfeeding moms. However, no documented clinical research on its efficacy exists. Therefore, the authors recruited women who had a singleton baby vaginally between June 2019 and July 2020 and randomly allocated them to one of three groups: Plook-Fire-Thatu, Domperidone, or Placebo. The test-weight method was used to compare breastmilk amounts. During the hospital stay, all volunteers and newborns were followed for adverse effects. There were three groups of participants: Plook-Fire-Thatu 78, Domperidone 74, and Placebo 76. On the third postpartum day, the Plook-Fire-Thatu group exhibited a statistically significant increase in breastmilk quantity (F=15.11, p≤0.01). The mean body temperature of postpartum women in the Plook-Fire-Thatu group on the third day was significantly higher than in the placebo group. (F=4.22, p=0.016). Participants and infants in the intervention groups experienced a few adverse effects. In comparison to domperidone, Plook-Fire-Thatu has been discovered to be a natural way to increase postpartum breastmilk supply.

Nostalgia Promotes Parents' Tradition Transfer to Children by Strengthening Parent-Child Relationship Closeness.

Parental tradition transfer to children is pivotal for their socialization, identity formation, and culture perpetuation. But what motivates parents to transfer traditions to their children? We hypothesized that nostalgia, an emotion strengthening interpersonal bonds, would promote tradition transfer through parent-child relationship closeness. We tested these hypotheses using cross-sectional (Studies 1 and 4), cross-lagged (Study 2 and preregistered Study 5), and experimental (Studies 3 and 6) designs. In Studies 1 to 3, nostalgia was associated with, had lagged effect on, and promoted tradition transfer. In Studies 4-6, parent-child relationship closeness mediated the link between nostalgia and tradition transfer. The findings enrich our understanding of the vertical transmission of knowledge, customs, and values, offering insight into how intergenerational bonds are reinforced and cultural heritage is maintained.

Palm Sunday in central Mexico: among sellers, palms and syncretism.

BACKGROUND: Domingo de Ramos, or Palm Sunday, is a traditional Christian religious event where devotees use ramos, which are bouquets currently elaborated from palm leaves and other natural elements. In various countries, it is assumed this use of biodiversity leads to the depletion of the species involved. However, other important aspects must be considered, including the role of the people who produce and sell these ramos, the associated symbolism that has been overlooked, as well as commercial aspects that have barely been documented. This ethnobotanical study evaluates the regional-scale cultural, biological and socioeconomic aspects associated with Domingo de Ramos in central Mexico from an emic perspective. METHODS: Ethnographic and commercial information was obtained through interviews with ramos sellers in 28 municipalities in the state of Hidalgo, Mexico. We specifically sought sociodemographic data regarding the interviewees, as well as information pertaining to the ramos themselves and the palms. These aspects were explored with all of the sellers. The free list method was used to describe the uses and key elements associated with the ramos. RESULTS: Although the ramos are used for religious purposes, they have eight different uses in the daily life of the sellers, the main one being "protection." They serve to protect families, crops and animals, as well as against several diseases. Likewise, they are considered valuable for diminishing strong storms. This belief in the protection conferred by the ramos preserves pre-Hispanic concepts and is combined with their use in blessing corresponding to Western beliefs. Ramos are made from 35 introduced and native plant species and comprise a base (made of palm, wheat or sotol), a "reliquia" (palm, rosemary, chamomile and laurel) and natural or artificial flowers. The ramos sellers are mostly adult women of indigenous origin and heads of family. CONCLUSIONS: This study of Domingo de Ramos, carried out at a regional scale, highlights a syncretism that is reflected in both the symbolic importance of ramos palm and in the species used, as well as socioeconomic aspects that had not previously been identified in the study area and reflect the occurrence of complex relationships in non-timber forest products that remain little addressed.

The Decline of Freedom of Expression and Social Vulnerability in Western democracy.

Freedom of expression is a fundamental part of living in a free and open society and, above all, a basic need of every human being and a requirement to attain happiness. Its absence has relevant consequences, not only for individuals but also for the whole social community. This might explain why freedom of expression was, along with other freedoms (conscience and religion; thought, belief, opinion, including that of the press and other media of communication; peaceful assembly; and association), at the core of liberal constitutionalism, and constitutes, since the Second World War, an essential element of constitutional democracies. In a democracy, people should be allowed to express themselves to others freely. The paper, which is divided into five sections, points out that states are obliged to protect the exercise of that freedom not only because its very purpose is the common good and welfare of society but also because it is a requirement of any constitutional democracy. Otherwise, when people cannot express themselves, perhaps out of fear (not from 'war' but from different kinds of social pressure or 'violence' exerted by some lobbies, mass media, or governmental policies that are at odds with respect for the plurality of opinions), vulnerability arises. This weakens not only those individuals that are not allowed to express their thoughts but also those who do not dare to do it - or even not to think for themselves - under certain environmental pressures (exerted by states, international organizations, social media, or financial groups, lobbies, etc.). In the end, the decline of freedom of expression makes most people more vulnerable and jeopardizes the whole democratic system.

Exploring the interplay of environmental conservation within spirituality and multicultural perspective: insights from a cross-sectional study.

The need to protect and sustain environmental resources for future generation remains sacrosanct in global sustainability agenda. This study was aimed at exploring the interplay between environmental conservation and spirituality from a multicultural perspective. While studies on "spirituality" have monumentally gained global attention, a growing number of evidence underscore the critical role of spiritual resources available for ensuring environmental stewardship. In this present study, attempt was made to respond to some critical questions: Is there any significant association between spirituality and environmental responsibility? What is the impact of spiritual leadership on environmental conservation? What key messages do spiritual leaders need to prioritize to encourage environmental conservation? And what are some of the spirituality-related predictors of willingness to engage in global environmental conservation efforts among the respondents? To determine this nexus between spirituality and environmentalism, a cross-sectional study design was adopted. Primary data were collected by means of a validated and adapted instrument from various literature searches. Data collected from a sample of 1,438 respondents were entered on Excel spreadsheet and eventually exported on SPSS version 21 for further analysis. Every segment of the instrument used yielded a Cronbach's alpha reliability test result of no less than 0.70. Descriptive statistics and ordinal logistics regression analysis were employed. The findings revealed that majority of respondents expressed a high level of spirituality (p value < 0.05). Majority (70%) of the respondents believe that everyone has a duty of care toward nature. More than two-third (> 60.0%) would be more inclined to observing environmental conservative measures if their spiritual leaders would continue to give exemplary teachings on environmental conservation. While a few indicators of spirituality yielded direct correlation with the willingness to engage in global environmental conservation efforts, most of the selected indicators reflect willingness. Some of these (predictors) include how often respondents pray, meditate, and fast; caring about people, animals, and the planet; being just happy to be alive; etc. In conclusion, this study reasoned that spirituality could indeed serve as a foundation for environmental conservation campaigns and could reinforce pro-environmental behaviors.

Curriculum framework to facilitate critical thinking skills of undergraduate nursing students: A cooperative inquiry approach.

AIM: Critical thinking (CT) is vital in assisting nurses to function efficiently in the ever-changing health care environment. A CT-based curriculum framework provides the impetus necessary to drive the acquisition of CT skills of students. Yet, there is no known CT-based framework contextualized to developing countries where seniority tradition is a norm. Therefore, the aim of this study was to develop a CT-based curriculum framework to facilitate the development of CT skills of nursing students in developing countries. DESIGN: Cooperative inquiry. METHODS: Using purposive sampling, 11 participants comprising students, educators and preceptors developed a CT-based curriculum framework. RESULTS: Findings were organized into a framework illustrating interconnected concepts required to foster CT skills of nursing students. These concepts include authentic student-facilitator partnership, a facilitator that makes a difference; a learner that is free to question and encouraged to reflect; a conducive and participatory learning environment; curriculum renewal processes and contextual realities.