B. Saba

Reasonable access to contraceptive services is essential for reproductive autonomy, allowing individuals to decide when to become pregnant. However, 19 million women of reproductive age in the United States live in a pharmacy desert, having no reasonable access to a health center that can provide the full range of contraceptive services. Pharmacists are increasingly positioned to fill the service gap through direct prescribing. To synthesize the available literature on pharmacist-prescribed contraceptive services, exploring implementation, barriers, facilitators, and outcomes to inform pharmacists considering implementation. A literature search was conducted on PubMed for articles between 2015 and 2025 on pharmacist-prescribed contraceptive services. The synthesis of the evidence confirms that, while pharmacist prescribing of contraception services has been shown to attain high degrees of patient satisfaction, one study found that 97% of respondents reported being satisfied or very satisfied, implementation of these services is variable. Case study indicates that implementation of these services is contingent upon integrated service, financial, and staff training models. However, the literature identifies critical barriers to implementation, including the lack of sustainable reimbursement for cognitive services, staffing issues, and regulatory complexities. This gap between state authorization and the presence of these barriers constitutes the critical implementation chasm. Pharmacist-prescribed contraception has shown its effectiveness; however, its public health potential is hindered by modifiable implementation barriers. Closing the gap between authorization and access is dependent upon innovations in payment policy, regulatory harmonization, and implementation of effective strategies. Improves Access: Pharmacist prescriptions of contraception have high access to new users and rural populations. High Satisfaction: One study found 97% of patients reported satisfaction with pharmacist-prescribed contraceptive services. Safe & Effective: 12-month continuation rates are equivalent to physician prescriptions; no differences found. Implementation Requires: Workflow integration, staff training, community outreach, and payment systems. Primary Barrier: Current lack of reimbursement for cognitive services limits implementation potential. Policy Impact: State laws authorize prescribing, but authorization does not guarantee availability.

Is it possible for someone, right now, to become accountable for a wrong committed bysomeone else hundreds of years ago? Barring backwards-causation, it seems moral facts about the past are as indelible as historical facts. We argue, though, that this presumption is mistaken. We can affect the severity of the past wrongs others committed, by adding wrong-making features to their actions. We thereby can become accountable for the portion of that past wrong we worsen. After explicating and defending this principle, we apply it. Doing so reveals a deep connection among three distinct but related moral issues: on benefiting from injustice, on historical reparations, and on accessorial accountability. In excavating thisconnection, we present a univocal analysis of all three moral issues. We end by suggesting that the principle we defend helps unlock a host of other important and topical social issues as well.

Given the high-stakes environment of intensive care units, understanding how nurses navigate moral challenges and engage in ethical decision-making is critical for maintaining patient safety and care quality. One important process in this field is moral disengagement, which is growing in the nursing literature. However, there is a lack of foundational and qualitative studies addressing this issue. This study presents a qualitative content analysis aimed at exploring moral disengagement among nurses working in intensive care units. This qualitative study employed conventional content analysis from June to December 2024 in Tehran, Iran. Purposive sampling was used to recruit participants. Data were collected using in-depth, unstructured interviews at the beginning, followed by semi-structured interviews. Sampling continued until data saturation was reached, resulting in 30 interviews with 25 eligible intensive care unit nurses. The conventional qualitative content analysis approach developed by Graneheim and Lundman was employed. Three main categories with eight subcategories were identified from the initial 765 codes. The findings revealed three main categories: “cognitive justification of unethical behavior,” “protective strategies for personal security,” and “normalization of unconventional practices.” These categories include subcategories such as “externalization of responsibility,” “moral-cognitive justification,” “positive reframing of the event,” “preservation of job position and security,” “psychological stabilization,” “strategic violation of regulations for survival,” “reduction of emotional and psychological pressure,” and “protective framing of behavior.” This study reveals various aspects of moral disengagement among critical care nurses, which can pave the way for future studies to better understand the phenomenon, its related factors, and help with the development of preventive measures.

Background and aim Difficult moral situations assume more critical importance in pediatric wards since children are more vulnerable than adults. Given that professional ethics is a substantial part of children treatment, the present study was conducted to determine the ethical performance of nurses from the perspective of mothers and nurses in the pediatric wards of Be'esat Hospital in Hamadan. Materials and methods The present descriptive-analytical study was conducted on 58 nurses and 263 mothers of children referred to the pediatric wards of Be'esat Hospital in Hamadan in 2019. The study samples were randomly selected. Data collection tools included the demographic form and Ethical Performance Assessment Questionnaire developed by Beykmirza et al. The obtained data were analyzed in SPSS software version 23using descriptive and inferential statistics. Results As evidenced by the obtained results, the mean ethical performance of nurses from the perspective of nurses and mothers were reported as 86.72 ± 6.397 and 69.92 ± 18.09. From the mothers' viewpoint, 27%, 39.2%, and 33.8% of nurses had weak, moderate and good levels of performance, respectively. On the other hand, from the nurses' perspective, 24.6% and 75.4% of nurses had moderate and good levels of performance, respectively. The obtained results were indicative of a statistically significant difference between the performance score as reported by mothers and nurses (P < 0.001). Conclusion Considering that the majority of mothers rated the ethical performance of nurses as weak and moderate, it is suggested that professional ethical principles be implemented in the form of Retraining programs in an attempt to improve the ethical performance of nurses.

This essay examines why the recent recognition of human rights violations against women, as exemplified by Amnesty International's 1995 report on women, remains bound to the limitations of traditional approaches to human rights. The essay argues that despite Amnesty International's commitment to incorporating violations against women into its activities, it nevertheless upholds questionable assumptions about the gendered subject, gender relations within the family, and the relationship between the family and the state

Part 2 is the formal sequel to The Consistency Principle: The First Cause of Physical Law. The first paper introduced a bold idea: that the laws of physics may arise from a deeper requirement that reality be globally self-consistent. This sequel strengthens that idea. It argues that the central functional, K, is not an arbitrary choice, but the unique structure required by basic principles such as symmetry, locality, invariance, scale-consistency, and the orderly flow of information. From this single condition — δK = 0 — the paper shows how core features of quantum theory can emerge, including unitary evolution and the Born rule, without treating them as separate postulates. It also extends the framework to open systems, where it naturally gives rise to irreversible behavior and the arrow of time. Finally, the paper connects the Consistency Principle to gravity. By varying K with respect to geometry, Einstein’s equations appear in the continuum limit, suggesting that gravity itself may emerge from informational consistency. Together, Parts 1 and 2 present the Consistency Principle as a possible unified foundation for physics: a single organizing idea from which quantum mechanics, spacetime, thermodynamics, and gravity may all arise.

The greatest breakthroughs in physics have often come from uncovering a single organizing principle beneath nature’s complexity. From least action to entropy maximization, the deepest laws suggest that the universe may not be governed by isolated rules, but by a more fundamental demand for coherence. Yet even quantum mechanics and general relativity — our most successful descriptions of reality — still begin with assumptions. Spacetime, energy, mass, measurement, and geometry are treated as primitive ingredients rather than as features to be explained. This work explores a deeper possibility: that physical law emerges from the global self-consistency of information. We introduce a consistency functional, K(ρ), and propose that reality corresponds to the informational state ρ that extremizes it. Within this framework, spacetime geometry may arise from patterns of correlation, energy may emerge from entropy gradients, and the familiar laws of physics may be understood as consequences of enforcing consistency across the universe’s full informational structure. On this view, relations such as E = mc² are not simply inserted as starting assumptions, but may be recovered as emergent expressions of a deeper constraint. Quantum mechanics and gravitation, rather than standing as separate foundations, become complementary manifestations of informational coherence. The Consistency Principle offers a possible route toward a unified origin of physical law: a framework in which reality is not merely described by equations, but shaped by the requirement that the universe be globally self-consistent.