Introduction: Clinical policies control several aspects of clinical practice, including individual treatment and care, resource management and healthcare professionals’ etiquette. This article presents Clinical Policy Ethics Assessment Tool, an ethical assessment tool for clinical policies that could be used not only by clinical ethics committees but also by policy committees or other relevant groups. Aim: The aim of this study was to find or create a tool to identify ethical issues and/or confirm ethical validity in nursing practice policies, protocols and (...) guidelines. Methodology: The development of Clinical Policy Ethics Assessment Tool involved first a literature review, followed by modification of the Research Protocol Ethics Assessment Tool, which was created to identify research protocols’ ethical issues, and finally, a trial of Clinical Policy Ethics Assessment Tool to ensure its reliability and validity. Ethical consideration: The policies analysed trialling Clinical Policy Ethics Assessment Tool were in the public domain and did not contain any confidential information. Despite that, Clinical Policy Ethics Assessment Tool also had the approval of a research ethics committee. Results: Research Protocol Ethics Assessment Tool was chosen as the template for a Clinical Policy Ethics Assessment Tool, to which several modifications were added to adapt it to work within a nursing practice context. Clinical Policy Ethics Assessment Tool was tested twice, which resulted in a general test–retest reliability coefficient = 0.86, r = 0.84, α1 = 0.817, α2 = 0.824 and interclass correlation coefficient = 0.874. Discussion: Contemporary nursing practice in a developed country is often ruled by clinical policies. The use of Clinical Policy Ethics Assessment Tool could confirm the ethical validity of those clinical practice policies, impacting on nurses’ education, values and quality of care. Conclusion: Clinical Policy Ethics Assessment Tool has the potential to detect ethical issues and facilitate the correction and improvement of clinical policies and guidelines in a structured way. This is especially so as it has shown reliability in detecting issues in clinical policies involving human participants and in encouraging policymakers to consider common ethical dilemmas in nursing practice. (shrink)

Contemporary healthcare practice has been progressively more regulated to increase efficiency, service user safety and practice quality. However, ethical issues in clinical practice that have not been implemented into regulations are undervalued by policymakers and healthcare institutions Considering the issues found by other authors, the use of a simple tool for policymakers to consider recurrent ethical issues could reduce those issues in a policy-driven clinical practice. The lack of tools to support structured ethical assessment of clinical policies was the main (...) reason to create the Clinical Policy Ethics Assessment Tool, but we realised of its possible advantages: limiting ethical dilemmas posed by policies, ensuring ethical practice by the use of policies and developing a consistent process for policymakers, institutions and healthcare professionals. Nonetheless, even if a tool can be implemented and it supports the creation of policies that reduce ethical issues, if the healthcare professionals are not aware of them they will not be implemented and the issues will continue. (shrink)

Contemporary healthcare practice has been progressively more regulated to increase efficiency, service user safety and practice quality. However, ethical issues in clinical practice that have not been implemented into regulations are undervalued by policymakers and healthcare institutions Considering the issues found by other authors, the use of a simple tool for policymakers to consider recurrent ethical issues could reduce those issues in a policy-driven clinical practice. The lack of tools to support structured ethical assessment of clinical policies was the main (...) reason to create the Clinical Policy Ethics Assessment Tool, but we realised of its possible advantages: limiting ethical dilemmas posed by policies, ensuring ethical practice by the use of policies and developing a consistent process for policymakers, institutions and healthcare professionals. Nonetheless, even if a tool can be implemented and it supports the creation of policies that reduce ethical issues, if the healthcare professionals are not aware of them they will not be implemented and the issues will continue. (shrink)

Introduction: Nurses who work in an emergency department regularly care for acute patients in a fast-paced environment, being at risk of suffering high levels of burnout. This situation makes them especially vulnerable to be accountable for decisions they did not have time to consider or have been pressured into. Research objective: The objective of this study was to find which factors influence ethical, legal and professional accountability in nursing practice in an emergency department. Research design: Data were analysed, codified and (...) triangulated using qualitative ethnographic content analysis. Participants and research context: This research is set in a large emergency department in the Midlands area of England. Data were collected from 186 nurses using participant observation, 34 semi-structured interviews with nurses and ethical analysis of 54 applicable clinical policies. Ethical considerations: Ethical approval was granted by two research ethics committees and the National Health Service Health Research Authority. Results: The main result was the clinical nursing accountability cycle model, which showed accountability as a subjective concept that flows between the nurse and the healthcare institution. Moreover, the relations among the clinical nursing accountability factors are also analysed to understand which factors affect decision-making. Discussion: The retrospective understanding of the factors that regulate nursing accountability is essential to promote that both the nurse and the healthcare institution take responsibility not only for the direct consequences of their actions but also for the indirect consequences derived from previous decisions. Conclusion: The decision-making process and the accountability linked to it are affected by several factors that represent the holistic nature of both entities, which are organised and interconnected in a complex grid. This pragmatic interpretation of nursing accountability allows the nurse to comprehend how their decisions are affected, while the healthcare institution could act proactively to avoid any problems before they happen. (shrink)

BackgroundDepression is a prevalent condition that has a significant impact on psychosocial functioning and quality of life. The onset and persistence of depression have been linked to a variety of biological and psychosocial variables. Many of these variables are associated with specific lifestyle characteristics, such as physical activity, diet, and sleep patterns. Some psychosocial determinants have an impact on people’ health-related behavior change. These include personal factors such as sense of coherence, patient activation, health literacy, self-efficacy, and procrastination. This study (...) aims to analyze the association between the severity of depression, lifestyle patterns, and personal factors related to health behavior. It also aims to analyze whether personal factors moderate the relationship between lifestyles and depression.MethodsThis study is a secondary data analysis of baseline data collected at the start of a randomized controlled trial. A sample of 226 patients with subclinical, mild, or moderate depression from primary healthcare centers in two sites in Spain was used, and descriptive, bivariate, multivariate, and moderation analyses were performed. Depression was the primary outcome, measured by Beck II Self-Applied Depression Inventory. Lifestyle variables such as physical exercise, adherence to Mediterranean diet and sleep quality, social support, and personal factors such as self-efficacy, patient activation in their own health, sense of coherence, health literacy, and procrastination were considered secondary outcomes.ResultsLow sense of coherence, poor sleep quality, low patient activation, and sedentarism are predictors of having more depressive symptoms. Moderation analyses were not significant.DiscussionLifestyle and personal factors are related to depressive symptomatology. Our findings reveal that sense of coherence, patient’s activation level, sedentarism, and sleep quality are associated with depression. Further research is needed regarding adherence to Mediterranean diet, minutes walking per week and the interrelationship between lifestyles, personal factors, and depression. (shrink)

Partiendo de un nuevo documento que fecha la conversión de la antigua mezquita de Bāb al-Mardūm en capilla en 1183, un siglo después de la conquista de Toledo por Alfonso VI, se ha tratado de indagar en el proceso de cristianización de las mezquitas urbanas y rurales de Toledo entre los siglos XI y XIII: el papel desempeñado en su reparto y el de sus habices por el Rey, la Iglesia y los diferentes grupos de población, el destino de (...) aquellas mezquitas que no se consagraron, o las semejanzas y las particularidades del proceso toledano respecto al llevado a cabo en otras regiones andalusíes. Para acabar, se plantean algunas preguntas e hipótesis sobre la función y el carácter de la propia mezquita, fundada por Aḥmad ibn al-Ḥadīdī en el año 390/999-1000. (shrink)

A popular accusation against moral relativism is that it goes too far in its vindication of tolerance. The idea behind accusations like this can be summarized in the slogan, frequently attributed to relativism, that “anything goes”. The aim of this paper is to defend moral relativism from the accusation that it is an “anything goes” view; from the accusation that it forces us to suspend our judgment in cases in which we do not think we should even be allowed to. (...) In the end, relativism is not an “anything goes” view because it is not a view about what goes, but about the way things go—about what goes on when we say that something is morally right or wrong. There is indeed a view, sometimes called “relativism”, that forces us to suspend our judgment about practices that do not allow for such comfort, but it is not so much moral relativism as moral contextualism. Apparently, though, the most salient alternative to “anything goes” views such as contextualism is not moral relativism. It is moral objectivism, according to which there is a fact of the matter about moral issues. However, I show that moral objectivism too ends up being an “anything goes” view unless the objectivist takes herself to be endowed with “God’s point of view”, which I prove troublesome. (shrink)

The purpose of Baghramian and Coliva’s book is twofold. On the one hand, it aims at identifying a consistent set of commitments shared by all theories that have.

En este artículo se realiza una relectura de las inscripciones de carácter religioso de las puertas de la Mezquita de Córdoba en época califal. A pesar de que no todas se han conservado, el estudio de conjunto reveló suficientes elementos singulares como para sugerir nuevas hipótesis en torno al sentido y la intencionalidad de los textos coránicos escogidos. Las inscripciones, tanto interiores como exteriores, conforman un programa epigráfico perfectamente coherente y dotado de un complejo significado ligado al contexto político, social (...) y religioso de la época. El programa incluye asimismo alusiones a la polémica anti-cristiana en el siglo x. En ese sentido, la mezquita cordobesa constituye un valioso documento histórico del Califato omeya de al-Andalus. (shrink)

En el artículo se recogen los relatos que las fuentes árabes, sobre todo andalusíes, proporcionan sobre las primeras fundaciones religiosas de al-Andalus. Las tradiciones de la Conquista, en este aspecto, muestran similitudes con el modelo de islamización puesto en práctica previamente en otros ámbitos del Mediterráneo islámico y con la historiografía árabe de los Futuh. Por razones de prestigio religioso y de legitimidad política, los autores insisten en aspectos como la orientación de las primeras mezquitas, atribuyéndolas a Musà o a (...) los tabi¿un, o en la destrucción de iglesias para levantar mezquitas sobre ellas. En estas tradiciones encontramos, sin embargo, escasos datos sobre las características arquitectónicas de estos primeros oratorios andalusíes por lo que es imprescindible la información aportada hasta ahora por la arqueología. El caso de la mezquita de Córdoba muestra la importancia de analizar en conjunto ambas aportaciones. (shrink)

Partiendo de un nuevo documento que fecha la conversión de la antigua mezquita de Bāb al-Mardūm en capilla en 1183, un siglo después de la conquista de Toledo por Alfonso VI, se ha tratado de indagar en el proceso de cristianización de las mezquitas urbanas y rurales de Toledo entre los siglos XI y XIII: el papel desempeñado en su reparto y el de sus habices por el Rey, la Iglesia y los diferentes grupos de población, el destino de (...) aquellas mezquitas que no se consagraron, o las semejanzas y las particularidades del proceso toledano respecto al llevado a cabo en otras regiones andalusíes. Para acabar, se plantean algunas preguntas e hipótesis sobre la función y el carácter de la propia mezquita, fundada por Aḥmad ibn al-Ḥadīdī en el año 390/999-1000. (shrink)

Feature selection is a widely studied technique whose goal is to reduce the dimensionality of the problem by removing irrelevant features. It has multiple benefits, such as improved efficacy, efficiency and interpretability of almost any type of machine learning model. Feature selection techniques may be divided into three main categories, depending on the process used to remove the features known as Filter, Wrapper and Embedded. Embedded methods are usually the preferred feature selection method that efficiently obtains a selection of the (...) most relevant features of the model. However, not all models support an embedded feature selection that forces the use of a different method, reducing the efficiency and reliability of the selection. Neural networks are an example of a model that does not support embedded feature selection. As neural networks have shown to provide remarkable results in multiple scenarios such as classification and regression, sometimes in an ensemble with a model that includes an embedded feature selection, we attempt to embed a feature selection process with a general-purpose methodology. In this work, we propose a novel general-purpose layer for neural networks that removes the influence of irrelevant features. The Feature-Aware Drop Layer is included at the top of the neural network and trained during the backpropagation process without any additional parameters. Our methodology is tested with 17 datasets for classification and regression tasks, including data from different fields such as Health, Economic and Environment, among others. The results show remarkable improvements compared to three different feature selection approaches, with reliable, efficient and effective results. (shrink)

Resumen:El objetivo de este artículo es analizar la disputa en torno a las ciencias sociales de Theodor Adorno y Karl Popper de 1961, publicada en el libro La disputa del positivismo en la sociología alemana. Los ejes del análisis son: Qué es la ciencia, cuál es su método. Para cumplir el objetivo, explicitaremos cada uno de los puntos antes mencionados, para luego, en una tercera etapa contrastar las aproximaciones de ambos autores. En las conclusiones se discuten las posibles derivas políticas (...) a las cuales conducen las concepciones de los autores.Palabras clave: conocimiento; ciencia; método; sociología; valores. (shrink)

Este trabajo analiza el lenguaje subjetivo empleado por el intelectual y político andalusí Lisān al-Dīn Ibn al-Ḫaṭīb (m. 1375) en su obra de exilio Nufāḍat al-ǧirāb. El objetivo es explorar la utilidad de un enfoque lingüístico en la comprensión del lugar que ocupa este texto dentro del proceso de transición cultural del Occidente islámico hacia el paradigma moderno europeo. El estudio se divide en tres partes: en la primera, se hace una breve introducción al autor, a su contexto socio-político y (...) al contenido de la obra; en la segunda, se plantea una metodología cuantitativo-cualitativa a través de la cual se estructura el texto misceláneo digitalizado en función de sus géneros y se especifica un esquema de anotación que permite extraer las instancias de los fenómenos lingüísticos más destacados; y en la tercera, se procede al análisis de los datos obtenidos en torno a la acción, la emoción y la evaluación. El análisis muestra una compleja codificación de la subjetividad en la Nufāḍa donde, a diferencia del Taʿrīf de Ibn Ḫaldūn, las marcas de expresión en primera persona, aunque significativas, son escasas. Sin embargo, se identifica un abundante uso de adjetivos evaluativos a lo largo de la obra, con una riqueza léxica que permite revelar de forma explícita el punto de vista del sujeto autor. Este hallazgo demuestra la utilidad de una metodología híbrida en la aproximación a textos histórico-literarios premodernos, así como la necesidad de incorporar el análisis lingüístico, empírico y comparativo al estudio de la transición epistemológica señalada. (shrink)

El presente artículo tiene como propósito criticar y reformular la teoría de valores del autor y filósofo argentino Risieri Frondizi. Para ello, se someterán a falsacionismo las tesis según las cuales la cualidad estructural es, primero, estructuralista y no analítica y, segundo, empírica, de acuerdo con la metodología holista de la ciencia. La crítica, así, se desarrollará a partir de los siguientes interrogantes. Inicialmente, ¿el autor acude al holismo o al reduccionismo como enfoques metodológicos de desarrollo? Finalmente, ¿cuál es la (...) distinción lógica entre el valor como cualidad sui géneris y el valor como cualidad estructural? (shrink)

Quoting Flaubert through time, Mieke Bal and Michelle Williams Gamaker’s Madame B brings Madame Bovary’s reflections on love and emotions to the present day, in a productive anachronism. Their work produces an intertemporal space where the past is relevant for the present, and the present enables us to understand the past. Intimacy and routine are central in their exploration of Flaubert’s contemporaneity. Those issues are precisely one of the keys in Karl Ove Knausgård’s project of literary autobiography, where he expands (...) narration foreclosing the ellipsis and giving visibility to small things and emotions; a project with some resonances with Munch’s crude-obscene uses of intimacy. This essay explores how both proposals, Bal and Williams Gamaker in film, and Knausgård in literature, can serve us to connect present and past sensibilities and, more than that, demonstrate resistances to the hegemonic discourses of temporality. (shrink)

La gestación subrogada se ha convertido en los últimos años en un tema de radical actualidad en nuestras sociedades. Son muchas las personas que en los países ricos han aprovechado las nuevas posibilidades de utilizar un “vientre de alquiler” para alcanzar sus anhelos de paternidad o maternidad. No obstante, esta práctica atenta a menudo contra la dignidad de la mujer portadora, sostenida sobre un principio de autonomía basado en un ficticio libre consentimiento propio de la bioética neoliberal, ciego por otro (...) lado al principio bioético de justicia. (shrink)

Desde la conquista española ha existido una dicotomía constante en la identidad peruana, la cual se refleja en el arte y especialmente en la literatura. Es en ella en la que existe un personaje que representa en sus obras de manera magistral los encuentros y desencuentros generados por la interacción constante de esos dos hemisferios culturales presentes en la peruanidad. Es José María Arguedas, quien no solamente retrata dicha realidad, sino que a través del indigenismo logra representar y revalorizar la (...) figura del indio y por consiguiente de lo andino, todo en el marco de la problemática constante que aqueja la búsqueda de lo que consiste ser peruano. Tomando como referencia tres importantes obras de su producción intelectual como son: “Los ríos profundos”, “El Sexto” y “El zorro de arriba y el zorro de abajo”. (shrink)

Error related potentials, which are elicited in the EEG in response to a perceived error, have been used for error correction and adaption in the event related potential -based brain computer interfaces designed for typing. In these typing interfaces, ERP evidence is collected in response to a sequence of stimuli presented usually in the visual form and the intended user stimulus is probabilistically inferred and presented to the user as the decision. If the inferred stimulus is incorrect, ErrP is expected (...) to be elicited in the EEG. Early approaches to use ErrP in the design of typing interfaces attempt to make hard decisions on the perceived error such that the perceived error is corrected and either the sequence of stimuli are repeated to obtain further ERP evidence, or without further repetition the stimulus with the second highest probability is presented to the user as the decision of the system. Moreover, none of the existing approaches use a language model to increase the performance of typing. In this work, unlike the existing approaches, we study the potential benefits of fusing feedback related potentials, a form of ErrP, with ERP and context information in a Bayesian fashion to detect the user intent. We present experimental results based on data from 12 healthy participants using RSVP Keyboard™ to complete a copy-phrase-task. Three paradigms are compared: [P1] uses only ERP/LM Bayesian fusion; [P2] each RSVP sequence is appended with the top candidate in the alphabet according to posterior after ERP evidence fusion; corresponding FRP is then incorporated; and [P3] the top candidate is shown as a prospect to generate FRP evidence only if its posterior exceeds a threshold. Analyses indicate that ERP/LM/FRP evidence fusion during decision making yields significant speed-accuracy benefits for the user. (shrink)

We are witnessing a certain tendency in epistemology to account for the anti-luck intuition in terms of risk. I.e., instead of the traditional anti-luck diagnosis of Gettier cases and fake barn cases, a new anti-risk diagnosis seems to be preferable by many. My goal in this paper is twofold: first, I contribute to motivate that drift; and second, I defend that we ought to partially resist it. An anti-risk diagnosis is valid and preferable for fake barn cases, but we still (...) need an anti-luck diagnosis for classic Gettier cases. The paper thus defends the Solomon-like result that we need both concepts—epistemic luck and epistemic risk—to deal with all the cases where knowledge is undermined. (shrink)

We may succed in the fulfilment of our desires but still fail to properly own our practical life, perhaps because we acted as addicts, driven by desires that are alien to our will, or as “wantons,” satisfying the desires that we simply happen to have (Frankfurt, 1988 ). May we equally fail to own the outcomes of our epistemic life? If so, how may we attain epistemic ownership over it? This paper explores the structural parallellism between practical and epistemic rationality, (...) building on Williamson’s ( 2002 ) suggestion that we should commence with successful performances as the foundation for both domains, be it action or knowledge. By highlighting the limitations of higher-order regulative approaches in epistemology, exemplified by Sosa ( 2007, 2011, 2015, 2021 ), the paper introduces a form of teleological epistemic constitutivism inspired by Velleman ( 2000, 2009 ). The proposal is that epistemic ownership is not attained in the mere pursuit of truth or knowledge, but requires furthermore a struggle to understand what we know. (shrink)

This chapter contains sections titled: Introduction On Law and Morality Legal Rights and Legal Principles Law and Legal Systems Deontic Logic and Legal Philosophy Philosophical Doctrines in Latin America Conclusion References.

A considerable number of books and papers have analyzed normative concepts using new techniques developed by logicians; however, few have bridged the gap between the English legal culture and the Continental tradition in legal philosophy. This book addresses this issue by offering an introductory study on the many possibilities that logical analysis offers the study of legal systems. The volume is divided into two sections: the first covers the basic aspects of classical and deontic logic and its connections, advancing an (...) explanation of the most important topics of the discipline by comparing different systems of deontic logic and exploring some of the most important paradoxes in its domain. The second section deals with the role of logic in the analysis of legal systems by discussing in what sense deontic logic and the logic of norm-propositions are useful tools for a proper understanding of the systematic structure of law. (shrink)

Introducción -- La verdad lejana : Lévi-Strauss -- Pensamiento en la trinchera : Wittgenstein -- La fuerza del destino : Nietzsche -- El despliegue del Espíritu : Hegel -- El instante frente al despliegue : Kierkegaard -- La imaginación mineral : Novalis -- Filosofía de la sospecha : Kant -- Esencia y formas de la simpatía : Hume -- El primado de la percepción : Berkeley -- La emoción geométrica : Spinoza -- Genio en continuidad : Leibniz -- Ensayo de (...) una vida : Montaigne -- El hombre tranquilo : Tomás de Aquino -- La vida apasionada : Agustín de Hipona -- Emanaciones : Plotino -- Filosofía del caminante : Aristóteles -- La espalda del mundo : Platón --El chamán y el filósofo : Empédocles y Parménides -- En busca del fuego : Heráclito. (shrink)

Pensar a Brasil en el contexto del Bicentenario de la Independencia fue nuestra propuesta. Las celebraciones que prosiguieron al año de 1822 fueron, todas ellas, de carácter oficial y con tenor estatal, para no decir del gobierno. Su misión era conmemorar la libertad, la idea de un futuro promisor, de nación libre y, para esto, se recordaba a las fuerzas armadas, responsables oficiales por la sustentación del grito de “independencia o muerte”, tan evocado en los libros de historia de Brasil (...) y tan reverberado, generación tras generación de brasileños y brasileñas. Nuestra idea de conmemoración – rememorar, evocar, recordar – sin embargo, fue pensada a partir de la academia, del lugar guiado por la investigación, por la ciencia y, por lo tanto, es una conmemoración que involucra la construcción de un conocimiento. Por esto, la propuesta fue la de reunir investigadores de diferentes áreas del conocimiento en la producción de un monográfico que tratara sobre las varias caras de la Historia Brasileña y que revelara al mundo los diferentes matices que tiene esa historia. (shrink)

Judith Butler draws on Emmanuel Levinas’ ethics in order to question processes of humanization and dehumanization taking place through various practices of representation of the face of the other. This is a singular reading leading Levinas’ work to the field of media representations conceived as an agonistic social landscape where the demand of the face is offered or, on the contrary, hidden from us. In that sense, Butler’s cultural transposition of Levinasian ethics entails a politicization of ethics which is indistinguishable, (...) at the end, from an ethic assault to the politics of representation. In this cultural bond among ethics and politics arise fundamental questions on responsibility linking it to the practice of cultural translation while offering alternatives to some common universalist shortcuts of contemporary ethical reflection.Keywords: Cultural translation, ethical responsibility, ethics of alterity. (shrink)

We are witnessing a certain tendency in epistemology to account for the anti-luck intuition in terms of risk. I.e., instead of the traditional anti-luck diagnosis of Gettier cases and fake barn cases, a new anti-risk diagnosis seems to be preferable by many. My goal in this paper is twofold: first, I contribute to motivate that drift; and second, I defend that we ought to partially resist it. An anti-risk diagnosis is valid and preferable for fake barn cases, but we still (...) need an anti-luck diagnosis for classic Gettier cases. The paper thus defends the Solomon-like result that we need both concepts—epistemic luck and epistemic risk—to deal with all the cases where knowledge is undermined. (shrink)

En este trabajo analizo la autonomía y relevancia normativa de las normas permisivas. En especial, mis propósitos principales son revisar dos tesis escépticas: los permisos y las normas permisivas pueden reducirse a otras formas normativas, e.g. derogación de prohibiciones, y no se producen diferencias significativas cuando se permite una conducta que no había sido previamente regulada. Ambas tesis son examinadas en relación a la naturaleza y función del principio de clausura normativa. La conclusión de este trabajo es que las normas (...) permisivas, y en particular las normas de clausura, pueden cumplir una importante función en los sistemas normativos y son una herramienta útil para analizar otros problemas como las lagunas del derecho y la discreción judicial. (shrink)