Social Sciences Citation Index (Web of Science)

Background/Objectives: Artificial intelligence reshapes clinical practice, and its effect on the clinician–patient relationship requires reconsideration of the frameworks that have shaped modern medical ethics. When clinicians delegate expertise to algorithms they cannot verify, it becomes unclear who bears clinical responsibility. Methods: This article applies a theoretically grounded normative approach to explore the ethical conditions under which artificial intelligence can be integrated into clinical practice without compromising the moral foundations of medicine. The analysis is primarily based on Pellegrino and Thomasma’s concept of the internal morality of medicine and the clinician’s act of profession. It further draws on Kantian ethics of human dignity, Levinasian relational ethics, virtue ethics, and Vallor’s concept of technomoral wisdom. Results: AI systems do not satisfy the conditions under which moral responsibility can be ascribed to them. Clinical moral agency lies in the capacity to bear three distinct responsibilities—epistemic, relational, and phronetic—none of which can be fulfilled by AI. The implementation of AI in healthcare, therefore, must occur strictly under the condition of Meaningful Human Control, rather than as a technical function of human oversight over algorithmic outputs. To ensure that MHC can function as an effective and ethically grounded safeguard, we propose five normative requirements: primacy of clinical judgement, prohibition of forced automation, traceability and explainability, transparency towards patients, and retaining clinical authority. Dialogue between clinicians and patients should remain the foundation of clinical decision-making. The proposed normative requirements aim to preserve the internal morality of medicine in a form that harmoniously combines both technological progress and established medical ethics.

Childbirth-related post-traumatic stress disorder (CB-PTSD) is an important international health concern. Despite increasing recognition of the public health burden of CB-PTSD, little is known about how CB-PTSD symptoms present across different countries

Existential concerns such as meaninglessness, isolation, freedom, responsibility, and death anxiety represent core dimensions of human suffering and may underlie chronic psychological distress, particularly in patients with personality pathology. Although schema therapy implicitly addresses such themes, their systematic integration has remained conceptually underdeveloped.

Metabolic dysfunction-associated steatotic liver disease (MASLD) is a public health threat in Europe. With an estimated 30.4% prevalence among the adult population in the European Union and United Kingdom, it is the most common chronic liver disease and is closely linked to obesity and type 2 diabetes, which can be considered as indicator conditions. Despite the scale of the burden, the spectrum of MASLD, including its advanced form, metabolic dysfunction-associated steatohepatitis (MASH), is weakly represented—or even absent—from health policy and development agendas. Further, the extent to which regional and national clinical practice guidelines (CPGs) on other liver diseases and related fields incorporate information on MASLD/MASH prevention or management is unclear. In this Series paper, we reviewed policy attention to MASLD/MASH across the European Union and the United Kingdom. We report low policy readiness across European countries to address MASLD/MASH. Only two (7.1%), Romania and Sweden, had a subnational strategy, while 13 (46.4%) referenced MASLD/MASH in other national or subnational action plans, predominantly those for liver disease and obesity. No country included MASLD/MASH in its priority non-communicable disease list. Additionally, 15 (53.6%) countries had national MASLD/MASH CPGs, while 25 (89.3%) mentioned MASLD/MASH in other national CPGs, most often those for obesity, diabetes, cirrhosis, liver transplantation, and primary care, respectively. We conclude that MASLD/MASH remains insufficiently addressed from a policy perspective, which contributes to low readiness to address this public health threat.

Societal gender role norms play a crucial role in shaping men's and women's career aspirations. However, prior research documenting this key role of gendered norms has primarily focused on heterosexual women and men in the global North-West. Previous studies documenting differences in career interests by sexual orientation suggest that gender role norms might affect lesbian, gay and bisexual (LGB) women and men less strongly than heterosexuals. This large-scale, preregistered study sought to document group differences in norm perceptions, career interests and their relationship. To this end, 18,351 university students (n = 3318 LGB, n = 15,033 heterosexual) from 46 countries completed a self-report survey about their gender, sexual orientation, perceptions of societal gender role norms, as well as their personal gender role beliefs and career interests. Analyses revealed that, compared to heterosexual individuals, LGB individuals reported significantly less stereotypical career interests and endorsed less traditional gender role beliefs about careers. As predicted, perceptions of societal gender role norms predicted career interests for heterosexual but not for LGB participants. Moreover, LGB participants showed a weaker relationship between societal gender role norms and own gender role beliefs than straight participants did. Interestingly, we found no evidence that this effect was conditional on the level of LGBT acceptance in different countries sampled. We discuss implications of this new evidence for understanding occupational gender segregation from an intersectional perspective.

Spontaneous pregnancy loss is the most common pregnancy complication; 15-25% of clinically confirmed pregnancies end in miscarriage, and when early, undetected pregnancy losses are included, the miscarriage rate can reach as high as 30-60% of all pregnancies. Women who lose their babies in the early stages of pregnancy often experience this as a bereavement. However, in Lithuania, 95.2% of women who had experienced a miscarriage and participated in the study did not receive any psychological support; only 4% of those surveyed stated that they did not need it. However, both in Lithuania and abroad, there is still a lack of research on women's emotional state following a spontaneous pregnancy loss and the impact of interventions on it. Research question: What experiences emerge in the thematic analysis of women who have experienced a spontaneous miscarriage? A qualitative study was conducted using the inductive thematic analysis method. The study participants underwent a 10-session group art therapy programme. After each art therapy session, the study participants reflected on their experiences related to their miscarriage by analyzing the drawings they had created. Verbal data from the reflections were recorded, then transcribed and analysed according to identified themes. The research participants were four women who had experienced a spontaneous pregnancy loss. The study analyses the reflections of three women who participated in all sessions. The thematic analysis revealed four themes characterising the women's core experiences of spontaneous pregnancy loss: defensiveness, the grieving process, a complicated relationship with oneself and others, and awareness and finding meaning.

To synthesize the contributions of this special issue examining how workplace culture, spirituality, religiosity, and mentorship shape positive clinical work environments and inform contemporary nursing management.

To develop and test the effectiveness of an educational intervention designed to enhance mentors' competence in mentoring nursing students in clinical practice across multiple international settings.

Background: Magnetic resonance imaging (MRI) is the reference standard for evaluating temporomandibular joint (TMJ) disorders, particularly for assessing disc position, joint effusion, and degenerative changes. With increasing imaging demands and advances in deep learning, artificial intelligence (AI) has emerged as a potential adjunct to expert interpretation. This systematic review aimed to compare the diagnostic performance of AI-based models with that of human experts in TMJ MRI analysis. Methods: This review was conducted in accordance with the PRISMA 2020 guidelines and prospectively registered in PROSPERO (CRD420251174127). A systematic search of PubMed/MEDLINE, ScienceDirect, Wiley Online Library, and Springer Nature Link was performed for studies published between 2020 and 2026. Eligible studies included human participants undergoing TMJ MRI and evaluated AI, machine learning, or deep learning models against human expert interpretation. Extracted outcomes included sensitivity, specificity, accuracy, area under the receiver operating characteristic curve (AUC), and agreement metrics. Risk of bias was assessed using QUADAS-2. Due to substantial heterogeneity, a narrative synthesis was conducted. Results: Five retrospective diagnostic accuracy studies were included, comprising sample sizes ranging from 118 to 1474 patients. Target conditions included anterior disc displacement, joint effusion, osteoarthritis, and disc perforation. AI models demonstrated strong discriminative performance, with reported AUC values ranging from 0.79 to 0.98. In direct comparisons, AI achieved diagnostic accuracy comparable to experienced radiologists. AI systems frequently demonstrated higher specificity and similar overall accuracy, whereas human experts often showed higher sensitivity. In osteoarthritis assessment, AI performance approached expert level and exceeded that of less experienced readers. All studies were retrospective and predominantly single-center, with heterogeneous reference standards and limited external validation. Conclusions: AI achieves diagnostic performance comparable to experienced clinicians in TMJ MRI interpretation and shows promise as a decision-support tool. Nevertheless, it should be regarded as complementary to, rather than a replacement for, expert radiological assessment pending further rigorous validation.