En la atención médica y en la investigación en salud resulta indispensable favorecer la toma de decisiones de los pacientes y/o participantes bajo el principio de autonomía. En particular, esta capacidad, consignada en la Convención de los Derechos de las Personas con Discapacidad, se concreta mediante la detección de necesidades de asistencia, ajustes y apoyos que dan paso a una plena y efectiva capacidad de ejercicio. Las reflexiones bioéticas hechas desde la perspectiva principialista, personalista y de los Derechos Humanos ofrecen (...) elementos para potenciar la autonomía de las personas con discapacidad, promoviendo la figura de asistencia personal y enfatizando el interés superior, la gradualidad y la revisión judicial permanente como principios de figuras sustitutivas. (shrink)

The case of Charlie Gard sparked an ongoing public and academic debate whether in court decisions about medical treatment for children in England & Wales the best interests test should be replaced by a harm threshold. However, the literature has scantly considered (1) what the impact of such a replacement would be on future litigation and (2) how a harm threshold should be introduced: for triage or as standard for decision-making. This article directly addresses these gaps, by first analysing reported (...) cases in England & Wales about medical treatment in the context of a S31 order, thus using a harm threshold for triage and second comparing court decisions about medical treatment for children in England & Wales based on the best interest test with Dutch and German case law using a harm threshold. The investigation found that whilst no substantial increase of parental discretion can be expected an introduction of a harm threshold for triage would change litigation. In particular, cases in which harm is limited, currently only heard when there are concerns about parental decision-making, may be denied a court hearing as might cases in which the child has lost their capacity to suffer. Applying a harm threshold for triage in decisions about withholding or withdrawing life-sustaining treatment might lead to a continuation of medical treatment that could be considered futile. (shrink)

An additional compartment of vaccinated individuals is considered in a SIS stochastic epidemic model with infection reintroduction. The quantification of the spread of the disease is modeled by a continuous time Markov chain. A well-known measure of the initial transmission potential is the basic reproduction number $$R_0$$, which determines the herd immunity threshold or the critical proportion of immune individuals required to stop the spread of a disease when a vaccine offers a complete protection. Due to repeated contacts between the (...) typical infective and previously infected individuals, $$R_0$$ overestimates the average number of secondary infections and leads to, perhaps unnecessary, high immunization coverage. Assuming that the vaccine is imperfect, alternative measures to $$R_0$$ are defined in order to study the influence of the initial coverage and vaccine efficacy on the transmission of the epidemic. (shrink)

There have been two main lines in the literature on restricted games: the first line was started by Myerson (1977) that studied graph-restricted games an the second one was initiated by Faigle (1989). The present paper provides a unified way to look on the literature and establishes connections between the two different lines on restricted games. The strength and advantages of this unified approach becomes clear in the study of the inheritance of the convexity from the game to the restricted (...) game where an interesting result by Nouweland and Borm (1991) on the convexity of graph-restricted games is turned into a direct consequence of the corresponding result by Faigle (1989), by means of this relation. (shrink)

The logic BN4 was defined by R.T. Brady in 1982. It can be considered as the 4-valued logic of the relevant conditional. E4 is a variant of BN4 that can be considered as the 4-valued logic of entailment. The aim of this paper is to define reduced general Routley-Meyer semantics for BN4 and E4. It is proved that BN4 and E4 are strongly sound and complete w.r.t. their respective semantics.

Atran conjectures that a triggering algorithm for a living- kind module could involve inputs from other modules that detect animacy and intentionality. Here we further speculate about how algorithms for detecting specific intentions could be used to trigger between- or within-species categorization. Such categorization may be adaptively important in Eldredge's energy and information realms.

Este trabajo consiste en una reconstrucción de los motivos de reflexión en ese ámbito privilegiado de la experiencia filosófica al que de la mano de Habermas, vamos a denominar pensamiento postmetafísico, como superación mediadora de la eterna disputa entre el pensar metafísico y el pensar antimetafísico. En él desarrollaremos aquellas categorías empírico-trascendentales que van a constituir las condiciones de posibilidad de esta nueva experiencia filosófica, a saber, racionalidad procedimental, razón sin trascendencia, razón comunicativa, giro lingüístico y deflación de lo extracotidiano.

Knowledge and true relations represent the principal task of Theory of Knowledge. This paper argues about various solutions to the justification of knowledge, given by William James, Richard Rorty and Jürgen Habermas. For classic Pragmatism Knowledge and Truth converge with the idea of a guideline, direction and orientation with an effective value for men. The Newpragmatism represented by Rorty tries out the way of the widest possible widening of justification contexts, taking as last referent the features of a western liberal (...) culture. Habermas pleads for a strong idealization in his discussion with Rorty up to the ideal speech situation. (shrink)

La tesis que deseo discutir en este trabajo es la siguiente: las ciencias humanas (ciencias del espíritu según Dilthey, ciencias histórico-hermenéuticas según Habermas) son posibles en la medida en que pueda ser epistemológicamente justificado el método que las hace posibles, a saber, la comprensión hermenéutica del sentido cuyo núcleo central lo constituye el círculo hermenéutico. Se trata, pues, de justificar epistemológicamente la hermenéutica como comprensión del sentido de las vivencias propias y ajenas, para lo cual es preciso analizar la reflexividad (...) y reciprocidad que impregna la estructura del lenguaje ordinario. En el diálogo que Habermas establece con Dilthey en Conocimiento e interés aparecen los suficientes argumentos para dicha fundamentación. Nuestro texto hará especial hincapié en los siguientes tópicos: distinción entre ciencias de la naturaleza y ciencias del espíritu, comprensión hermenéutica del sentido, lenguaje ordinario y reflexividad, especificidad del círculo hermenéutico, ciencia y contexto vital, y, finalmente, haremos un balance de la interpretación habermasiana de Dilthey a partir de las relaciones entre ciencias histórico-hermenéuticas e interés práctico del conocimiento. (shrink)

I propose in this paper a reflection, a self-analysis, about my extensive teaching experience, not from a formal point of view of the specificity of the program and the subjects of my courses, but about the singularity of the teaching activities. The commitment with the students, with the topic taught and with the Institution in which I have the honor to work, constitute the fundamental motive that leads and conducts my profession as teacher. My explanation displays ten items. Each of (...) them presents a speculation about one of the ideal elements of the good teacher all of us aim to be. For that reason this essay is not a positivist description of the teaching reality, but it expects to reconstruct the critical demarcation between the ideality which all of us try to achieve and the empirical reality that constantly pull us in the opposite direction. The coercion without coercions of the exemplariness pushes us to maintain alive the faith in the appropriation of the nature and soul of the ideal teacher. (shrink)

The purpose of this article is to explore the concept of Philosophy within the works written by Wittgenstein if we take into account the ambivalent sense of the term phármakon. Thus, it will be outlined a contest of paradoxes between, on the one hand, healthiness, sanity, and the adaptable confidence produced by western rationality materialized into objective science, and, on the other hand, sickness, insanity, the world of perplexities, and the realm of desire and death, essential to philosophical thought. Bearing (...) in mind last Wittgenstein’s approaches, we will understand the Tractatus both critical to the deficiencies of western Reason and imprisoned within them. But the “enchanting” power of western Reason, conducting to identify rationality and scientificity in that work, will be conjured in the last Wittgenstein through the opening of plural realms of rationality and of discourses. In this way, philosophical questions will be rescued from silence and absurdity. (shrink)

We contribute to feminist and gender scholarship on cultural notions of motherhood by analyzing the importance of motherhood among mothers and non-mothers. Using a national probability sample of U.S. women ages 25-45, we find a continuous distribution of scores measuring perceptions of the importance of motherhood among both groups. Employing OLS multiple regression, we examine why some women place more importance on motherhood, focusing on interests that could compete with valuing motherhood, and controlling for characteristics associated with becoming a mother. (...) Contrary to cultural schemas that view mother and worker identities as competing, we find that education level is not associated with the importance of motherhood for either group and that valuing work success is positively associated with valuing motherhood among mothers. Consistent with feminist explanations for delayed fertility, valuing leisure is negatively associated with valuing motherhood for non-mothers. (shrink)

Schools are an essential part of students’ lives and can promote and facilitate their well-being. Although research on well-being among school-aged children and adolescents has distinguished subjective well-being from social well-being, very few studies examined student’s social well-being at school. SWS is understood as students’ valuation of the circumstances and functioning of their school. This framework posits that the context of the schools can shape students’ perception of feeling integrated and making significant contributions to their schools. However, not much is (...) known regarding the joint contribution of individual, family, and school characteristics to students’ SWS. This study analyzed these joint contributions in a nationally representative sample of 6,389 children and adolescents enrolled in 5th–11th grades. Findings show that being female and younger were individual predictors of SWS. Students’ satisfaction with their family and fewer changes of schools were also significant contributors. When students’ perceptions of their schools were incorporated, the individual and family characteristics decreased or lost significance. In the full model, the highest contribution to SWS was explained by the school-level aggregated perception of school climate. These findings call for integrated policies and practices to foster students’ sense of belonging, feeling integrated, and contribution to their schools, with a focus on school-level interventions to improve SWS through positive and engaging school climates that foster students’ sense of agency. (shrink)

School achievement and failure have become growing political and social concerns due to the negative consequences of school failure for individuals and society. The inclusive educational movement, which calls for equal access, permanence, participation, and promotion of all students worldwide, poses many challenges for schools and school systems. As a public policy strategy, some countries have provided additional funds for incorporating non-teaching professionals such as school psychologists and social workers in regular K-12 schools. However, there is lack of research on (...) the effects of these psychosocial professionals on student outcomes. This national multilevel study explored the effect of psychologists (n= 8,469) and social workers (n= 3,524) on indicators of eighth-grade (n= 147,531) and 10th-grade (n= 106,347) students' academic achievement and dropout in Chile. A multilevel secondary analysis was performed using national records of non-teaching professionals working as school staff members, achievement scores on the national SIMCE test, and dropout rates based on official records. Results showed that after controlling for individual and school variables known to affect achievement and dropout, schools with psychologists and social workers working as staff members had lower short- and long-term dropout rates. The presence and higher number of school psychologists per school was positively associated with higher math achievement, with a reduced effect in low-SES schools. Lower-SES schools with more social workers had higher math scores. These results support policies that increase funding for school psychologists and social workers, since their incorporation partly explains better school achievement and less school failure when controlling for individual and school characteristics, but emphasize the need to further explore the mechanisms through which school achievement and failure are developed with the support of psychologists and social workers in schools. We discuss the need to regulate the type of prevention and intervention strategies from a whole-school, evidence-based approach, as well as to incorporate psychosocial training modules and comprehensive guidelines as part of professional training programs and as certified requisites for working in schools. (shrink)

El objetivo de este trabajo es analizar el impacto del aprendizaje adaptativo ante Covid-19 en la Facultad de Ciencias Económicas Administrativas de la Universidad Autónoma del Carmen.Para este estudio se realizó una revisión documental de los conceptos teóricos abordados y posteriormente se hizo un análisis descriptivo de una muestra de 291 estudiantes.Los resultados muestran que la mayoría de los estudiantes logró un desempeño satisfactorio, usando de manera preferente la plataforma Teams, aunque también se utilizaron otras plataformas como apoyo. Con esto (...) se concluye que la comunidad universitaria se adaptó rápidamente al entorno virtual impuesto por la pandemia. (shrink)

This article presents a study on the perception of students pursuing technical careers, on aspects related to the quality of virtual education during times of covid-19 pandemic. The data analyzed were obtained from surveys of 75 students of various educational levels in aspects such as quality in teaching, accessibility to virtual resources, teacher training, continuity of the curriculum, equal conditions, and the influence of policy on the quality of education in general. It was concluded that the educational process in its (...) virtual modality is acceptable from the point of view of intrinsic advantages such as flexibility and yet there is also a change of focus in the educational institution that pays attention to providing a better virtual educational process diverting attention from equally important processes such as the communication of internal and external actions to the institution. Keywords: Virtual education, challenges, pandemic, COVID-19. (shrink)

In our time there is growing interest in developing a systematic approach to oncologic patients and end-of-life care. An important goal within this domain is to identify the values and ethical norms that guide physicians’ decisions and their recourse to technological aids to preserve life. Though crucial, this objective is not easy to achieve.

BackgroundRespect for confidentiality is important to safeguard the well-being of patients and ensure the confidence of society in the doctor-patient relationship. The aim of our study is to examine real situations in which there has been a breach of confidentiality, by means of direct observation in clinical practice.MethodsBy means of direct observation, our study examines real situations in which there has been a breach of confidentiality in a tertiary hospital. To observe and collect data on these situations, we recruited students (...) enrolled in the Medical Degree Program at the University of Cordoba. The observers recorded their entries on standardized templates during clinical internships in different departments: Internal Medicine; Gynecology and Obstetrics; Pediatrics; Emergency Medicine; General and Digestive Surgery; Maxillofacial Surgery; Plastic Surgery; Orthopedics and Traumatology; Digestive; Dermatology; Rheumatology; Mental Health; Nephrology; Pneumology; Neurology; and Ophthalmology.ResultsFollowing 7138 days and 33157 h of observation, we found an estimated Frequency Index of one breach per 62.5 h. As regards the typology of the observed breaches, the most frequent were related to the consultation and/or disclosure of clinical and/or personal data to medical personnel not involved in the patient’s clinical care, as well as people external to the hospital. As regards their severity, severe breaches were the most frequent, accounting for 46.7 % of all incidents. Most of the reported incidents were observed in public areas, such as corridors, elevators, the cafeteria, stairs, and locker rooms.ConclusionsIn addition to aspects related to hospital organization or infrastructure, we have shown that all healthcare personnel are involved in confidentiality breaches, especially physicians. While most are committed unintentionally, a non-negligible number are severe, repeated breaches, thus suggesting a certain carelessness, perhaps through ignorance about certain behaviors that can jeopardize patient confidentiality. (shrink)

In the eukaryotic cell, DNA compaction is achieved through its interaction with histones, constituting a nucleoprotein complex called chromatin. During metazoan evolution, the different structural and functional constraints imposed on the somatic and germinal cell lines led to a unique process of specialization of the sperm nuclear basic proteins (SNBPs) associated with chromatin in male germ cells. SNBPs encompass a heterogeneous group of proteins which, since their discovery in the nineteenth century, have been studied extensively in different organisms. However, the (...) origin and controversial mechanisms driving the evolution of this group of proteins has only recently started to be understood. Here, we analyze in detail the histone hypothesis for the vertical parallel evolution of SNBPs, involving a “vertical” transition from a histone to a protamine‐like and finally protamine types (H → PL → P), the last one of which is present in the sperm of organisms at the uppermost tips of the phylogenetic tree. In particular, the common ancestry shared by the protamine‐like (PL)‐ and protamine (P)‐types with histone H1 is discussed within the context of the diverse structural and functional constraints acting upon these proteins during bilaterian evolution. (shrink)

‘Banality of evil’ was a concept introduced by Hannah Arendt in order to characterize a new form of wickedness embodied in people as Adolf Eichmann and others nazis criminals. Arendt thougt that this perverseness was very awey from the one of ‘radical evil’, a notion built by Kant and employed by Arendt herself in former works. This article seeks to point out that concepts of radical evil and banality of evil are closer than Arendt recognizes.

The physician’s duty of confidentiality is based on the observance of the patient’s privacy and intimacy and on the importance of respecting both of these rights, thus creating a relationship of confidence and collaboration between doctor and patient. The main objective of this work consists of analyzing the aspects that are related to the confidentiality of patients’ data with respect to the training, conduct and opinions of doctors from different Clinical Management Units of a third-level hospital via a questionnaire. The (...) present study aimed to define the problem and determine whether the opinions of these professionals correspond to those observed in a previous work conducted at the same center. Of the 200 questionnaires that were collected, 62.5% were from consultants and the rest were from residents with an average of 14.4 ± 12.5 years in professional practice. The respondents noted habitual situations in which confidentiality was breached in the reference hospital. The section on their attitudes and behaviors towards situations related to confidentiality showed a slightly lower average score than that of their medical knowledge; significant differences in these scores were observed between the consultants and residents as well as between the extreme age groups and years of professional practice, thus more inadequate attitudes were consistently noted in younger doctors who had fewer years of experience. Finally, the respondents answered that the training of doctors in the aspects of healthcare law and ethics was the most important measure that the hospital could adopt regarding confidentiality practices. (shrink)

Este artículo estudia la razón de Zambrano desde sus albores como razón mediadora. Su rechazo del sistema va unido a su comienzo en la intuición y a su decurso temporal, que analizamos en relación con Bergson y Husserl. La razón poética va más allá de ese núcleo intuitivo para revelar re-flexivamente incluso lo invisible. Su inmersión en las profundidades, en la pasividad actuante, en las entrañas, en la multiplicidad de los tiempos es paralela a la fenomenología de la génesis merleau-pontiana, (...) a su poiesis carnal e incluso al telos de una razón ampliada al sentir. Ambos filósofos ejercitan su nueva concepción de la filosofía en la existencia. (shrink)