Background: Nurses are the largest professional group in healthcare and those who make more decisions. In 2014, the Committee on Bioethics of the Council of Europe launched the “Guide on the decision-making process regarding medical treatment in end-of-life situations”, aiming at improving decision-making processes and empowering professionals in making end-of-life decisions. The Guide does not mention nurses explicitly. Objectives: To analyze the ethical principles most valued by nurses working in palliative care when making end-of-life decisions and investigate if they are (...) consistent with the framework and recommendations of the Guide; to identify what disputed/controversial issues are more frequent in these nurses’ current end-of-life care practices. Design: Qualitative secondary analysis. Participants/context: Three qualitative datasets including 32 interviews from previous studies with nurses working in palliative care in Portugal. Ethical consideration: Ethical approval was obtained from the Ethics Research Lab of the Instituto de Bioética. Ethical procedures are thoroughly described. Findings: All participant nurses referred to autonomy as an ethical principle paramount in end-of-life decision-making. They were commonly involved in end-of-life decision-making. Palliative sedation and communication were the most mentioned disputed/controversial issues. Discussion: Autonomy was highly valued in end-of-life care and decision-making. Nurses expressed major concerns in assessing patients’ preferences, wishes, and promoting advance care planning. Nurses working in palliative care in Portugal were highly involved in end-of-life decision-making. These processes embraced a collective, inclusive approach. Palliative sedation was the most mentioned disputed issue, which is aligned with previous findings. Communication also emerged as a sensitive ethical issue; it is surprising, however, that only three nurses referred to it. Conclusion: While the Guide does not explicitly mention nurses in its content, this study shows that nurses working in palliative care in Portugal are involved in these processes. Further research is needed on nurses’ involvement and practices in end-of-life decision-making. (shrink)

Despite recent efforts by the Artificial Intelligence (AI) community to move towards standardised procedures for documenting models, methods, systems or datasets, there is currently no methodology focused on use cases aligned with the risk-based approach of the European AI Act (AI Act). In this paper, we propose a new framework for the documentation of use cases that we call use case cards, based on the use case modelling included in the Unified Markup Language (UML) standard. Unlike other documentation methodologies, we (...) focus on the intended purpose and operational use of an AI system. It consists of two main parts: firstly, a UML-based template, tailored to allow implicitly assessing the risk level of the AI system and defining relevant requirements, and secondly, a supporting UML diagram designed to provide information about the system-user interactions and relationships. The proposed framework is the result of a co-design process involving a relevant team of EU policy experts and scientists. We have validated our proposal with 11 experts with different backgrounds and a reasonable knowledge of the AI Act as a prerequisite. We provide the 5 use case cards used in the co-design and validation process. Use case cards allows framing and contextualising use cases in an effective way, and we hope this methodology can be a useful tool for policy makers and providers for documenting use cases, assessing the risk level, adapting the different requirements and building a catalogue of existing usages of AI. (shrink)

Is medicalization always harmful? When does medicine overstep its proper boundaries? The aim of this article is to outline the pragmatic criteria for distinguishing between medicalization and over-medicalization. The consequences of considering a phenomenon to be a medical problem may take radically different forms depending on whether the problem in question is correctly or incorrectly perceived as a medical issue. Neither indiscriminate acceptance of medicalization of subsequent areas of human existence, nor criticizing new medicalization cases just because they are medicalization (...) can be justified. The article: (i) identifies various consequences of both well-founded medicalization and over-medicalization; (ii) demonstrates that the issue of defining appropriate limits of medicine cannot be solved by creating an optimum model of health; (iii) proposes four guiding questions to help distinguish medicalization from over-medicalization. The article should foster a normative analysis of the phenomenon of medicalization and contribute to the bioethical reflection on the boundaries of medicine. (shrink)

As one of the characteristics of the nowadays postmodernism, the multiculturalism and the globalization seems to be profoundly related to the heterogenity and to the heteronomy. Globalization is going with the multiculturalism, but in an opposite direction: globalization towards the standardization and multiculturalismtowards fragmentation. Is the Global Village also the Postmodern Village?

En el marco del debate suscitado por el último libro de Tommaso Greco, la re-flexión se centrará en el doble sentido evocado en el título del presente trabajo: confiar en el derecho y en el papel que la confianza juega dentro de él. Frente a la perspectiva antropológico-jurídica dominante, fundada en la desconfianza, la sospecha y el temor, abordamos un paradigma alternativo, basado en la necesidad de fiarse del otro y en el establecimiento de lazos cooperativos, cuyo núcleo reside en (...) un sentido profundo de la responsabilidad, el compromiso y la solidaridad. La fiabilidad y la fidelidad aparecerán, a lo largo de este breve diálogo con el autor, como elementos internos e incluso constitutivos del derecho y, por tanto, algo así como su “centro de gravedad permanente”. (shrink)

What is the meaning of reason in our postmodern society today? Is reason a weapon of domination, or can it also serve as a means for emancipation? Is it possible for reason to understand its "other"--what it is not? Confronting such questions, Bounds of Reason is a compelling discussion of the limits and meaning of rationality as a tool for understanding the ideas of truth, justice and freedom. Emilia Steuerman explores the modernist and postmodernist controversy between Habermas and Lyotard to (...) highlight the problems encountered both by a defense of reason and by the lack of meaning that haunts a world without it. Using Kleinian theory to examine the debate as it is manifested in the main philosophical themes of this century, Steuerman argues that a rational and ethical theory of justice must take into account that which is not rational, symmetrical or transparent--namely a primitive world of love and hatred which colors and shapes our perceptions. (shrink)

The aim of this article is to explore how metaphor is mobilized to frame and describe the lived experience of dementia in a corpus of illness narratives compiled from 10 blogs initiated and maintained by individuals diagnosed with early-onset dementia. The article is set against the background of contemporary healthcare practices and discourse around chronic illness and focuses on the metaphors that patients use to communicate about their dementia experience in relation to three basic psychological needs: autonomy, competence and relatedness, (...) which are essential for human well-being and are heavily challenged in complex medical situations. Results are discussed in terms of the framing metaphors provide of the emotional, psychological impact of dementia and their implications for patient-centered care. This study expands prior work by researching metaphors used for a condition that has been scarcely explored from this point of view and by focusing on the patient’s perspective exclusively. (shrink)

_The Bounds of Reason: Habermas, Lyotard & Melanie Klein on Rationality_ is a highly original yet accessible study of the debate between modernity and postmodernity. Emilia Steuerman clearly explains the modernity/postmodernity dispute by examining the problem that has driven the whole debate: whether the use of reason is an emancipatory or enslaving force. Steuerman clearly sets out this debate by critically examining the arguments of two of its key proponents, Jurgen Habermas and Jean-François Lyotard. She clearly explains Habermas' defence of (...) modernity and his attempt to salvage Enlightenment ideas of truth, justice, and freedom through the use of reason. She contrasts this with Lyotard's postmodernism and his scepticism about the use of reason, and its claims to universalism and objectivity. Throughout, Steuerman contrasts the Habermas-Lyotard debate with important insights from psychoanalytic theory, and shows how Habermas' notions of intersubjectivity and a community of shared language users can be compared and contrasted with Melanie Klein's theory of object relations. (shrink)

_The Bounds of Reason: Habermas, Lyotard & Melanie Klein on Rationality_ is a highly original yet accessible study of the debate between modernity and postmodernity. Emilia Steuerman clearly explains the modernity/postmodernity dispute by examining the problem that has driven the whole debate: whether the use of reason is an emancipatory or enslaving force. Steuerman clearly sets out this debate by critically examining the arguments of two of its key proponents, Jurgen Habermas and Jean-François Lyotard. She clearly explains Habermas' defence of (...) modernity and his attempt to salvage Enlightenment ideas of truth, justice, and freedom through the use of reason. She contrasts this with Lyotard's postmodernism and his scepticism about the use of reason, and its claims to universalism and objectivity. Throughout, Steuerman contrasts the Habermas-Lyotard debate with important insights from psychoanalytic theory, and shows how Habermas' notions of intersubjectivity and a community of shared language users can be compared and contrasted with Melanie Klein's theory of object relations. (shrink)

The article analyzes the historical experience of creation and development of military medical aircraft in Ukraine from the 1920s. to the present. In particular, reviewed the activity of Design Bureaus of K. Kalinin and O. Antonov. Special attention is paid to the creation of military medical aircraft after Ukraine gained independence in 1991 and their application to evacuate the wounded during Armed conflict in the east of Ukraine in 2014-2016. The first attempt of creation a sanitary aircraft were made in (...) Ukraine back in the 1920s under the leadership of Konstantin Kalinin. In a qualitatively new level was realized military medical aircraft designed by bureau Oleg Antonov, created in the second half of 1970s aircraft emergency resuscitative-surgical care An-26M "Spasatel'" Accumulated experience allowed at the beginning of 2000s a similar purpose for the An-26 "Vita" for the Air Force of Ukraine. Over a longer time, he reminded to be the only one military medical aircraft in Ukraine. Plans of creating mixed air-transport unit air ambulance were not implemented. Successful use of the An-26 "Vita" to evacuate the wounded during repel of Russian aggression in eastern Ukraine helped to intensify work in the field of military medical aircraft.In2015 inmedical version were rebuilt two more An-26. One of them joined the Air Force, and the second - Natinal Service of Emergencies in Ukraine. All three aircrafts are different composition of medical equipment and ability to provide medical care. Their purpose is evacuation of the wounded from the airfield vicinity of the battle area to military medical institutions. (shrink)

Purpose:Human navigation skills are essential for everyday life and rely on several cognitive abilities, among which visual-spatial competences that are impaired in subjects with cerebral palsy. In this work, we proposed navigation tasks in immersive virtual reality to 15 children with CP and 13 typically developing peers in order to assess the individual navigation strategies and their modifiability in a situation resembling real life.Methods:We developed and adapted to IVR an application based on a 5-way maze in a playground that was (...) to be navigated to find a reward. The learning process, navigation strategies, and adaptation to changes were compared between participants with CP and their TD peers and correlated with visual-spatial abilities and cognitive competences.Results:Most participants with CP needed more attempts than TD participants to become proficient in navigation. Furthermore, the learning phase was correlated to visual-spatial memory but not with cognitive competences. Interestingly, navigation skills were comparable between groups after stabilization. While TD participants mainly relied on allocentric strategies based on environmental cues, egocentric strategies based on body motion prevailed in participants with CP. Furthermore, participants with CP had more difficulties in modifying their navigation strategies, caused by difficulties in executive processes beyond the visual-perceptual impairment, with an inefficient shift between implicit and explicit competences.Conclusions:The navigation abilities in participants with CP seem to be different from their TD peers in terms of learning and adaptation to new conditions; this could deeply affect their everyday life and ultimately participation and inclusion. A regular assessing and focused rehabilitative plans could help to better navigate the environment and affect self-perception. (shrink)

Numerose sono le figure – narrative, simboliche, storiche – nelle pagine di Borges, tratte dalla tradizione di una Germania intesa, alla maniera di Tacito, come l’antico nord del mondo. La passione per la germanistica percorre tutta l’opera di Borges per farsi, nell’ultima parte della sua vita, scoperta del mito e ripensamento della poesia, capace di conferire alla sua immagine della letteratura un colore perdutamente romantico.

Dans l'espace spirituel de la civilisation occidentale contemporaine il s'opere un croisement entre deux paradigmes mentaux selon lesquels le rapport entre le transcendant et le phenomenologique est percu d'une maniere fondamentalement differente: il est question des paradigmes de pre-renaissance et de la modernite. Dans le paradigme pre-renaissant, l'univers est percu comme etant ontologiquement divise en deux realites subordonnees, ce qui introduit le Transcendant dans le monde. Avec les progres des sciences, le paradigme mental se bätit sur l'idee principale de l'unidimensionnalite (...) du reel. Or. le monde se retrouve ainsi depourvu de sa dimension transcendante. La solution proposee dans l'expose serait la formation d'un nouveau paradigme mental qui assurerait ä l'homme une presence spirituelle dans le monde. (shrink)

Literary narratives are well recognised for their power to foster engagement with complex social themes. Transmedia narratives, which present the same story in different media, can help advance both critical multimodal discourse studies and multiliteracies pedagogies. To harness this potential, we need to develop methods for systematically relating media affordances to discourse-semantic patterns and the broad social themes these patterns construct in narratives, and ensure these methods build on the knowledge learners bring to the classroom. This article introduces a social (...) semiotic method for analysing transmedia narratives and illustrates its ability to reflect the persuasive power of narrative and build on young children's critical multimodal awareness. This is achieved through a case study comprising data from three adaptations of the same award-winning narrative - animated film (Joyce, W. (Producer), Joyce, W., & Oldenburg, B. (Directors) (2011). The fantastic flying books of Mr Morris Lessmore [Motion Picture]. Moonbot Studios), interactive app (Moonbot Studios. (2011). The fantastic flying books of Mr Morris Lessmore (Version 1.4). [Mobile Application Software]), and traditional-format picture book (Joyce, W. (2012). The fantastic flying books of Mr Morris Lessmore. Illustrations by William Joyce and Joe Bluhm. Moonbot Books) - and mother-child interactions with the book and the app. (shrink)

In the present paper we would like to investigate the concept of mythothought as defined by two philosophers, Ernst Cassirer and Lucian Blaga, and the way in which the term may be applied to a chosen corpus of poetry from Romania, Wales and Ireland.

We could ask: how national could be a culture or another? The modernist or postmodernist perspectives seems to be unilateral here. Could be transmodernism the right sollution? The distictions between modernism, postmodernism and transmodernism are actually a pretext to set into discussion again the old dispute between Culture, regarded as a humanity universal feature and national cultures, perceived as a human community tradition symbol (community that claims a territory, a language, a religious belief and a certain government form).

Education is widely accepted as important source of future economic growth and is strongly supported by public sources. Most of this support is oriented toward traditional education and industries. However, several studies show importance of creativity education as important feature for innovation and future growth. However, public support of creative industries is relatively new and most of policy measures that have been implemented are still not fully evaluated and understood. There si a strong need to look much more closer on (...) way how public education influence creative industries and what policies could be placed to strengthen positive effects of this education also in the long run. This article represents an output of the research about the creative industries support policy in Slovakia in the field of education activities. It is containing basic literature overview comparing support policies for traditional sectors and the creative industries. We analyzed conceptual documents at the national level and basic strategic documents in the regions and selected cities of the country. We also realized several interviews in different creative economy industries. Generally, creative industries in Slovakia are much less in the centre of public support policy compare to traditional industry sectors. This is also the same in case of education. Despite of wide varietyof support tools used in the world, only few of them are applied in Slovakia. Interestingly, creative industries do not strongly require more creativity in education in schools. We found out the most important support in the field of education should not be related to creativity itself, but more on the complementary skills as ICT or entrepreneurship. We also found very limited role of universities and other public institutions in creative industries success stories. (shrink)

Dans l'espace spirituel de la civilisation occidentale contemporaine il s'opere un croisement entre deux paradigmes mentaux selon lesquels le rapport entre le transcendant et le phenomenologique est percu d'une maniere fondamentalement differente: il est question des paradigmes de pre-renaissance et de la modernite. Dans le paradigme pre-renaissant, l'univers est percu comme etant ontologiquement divise en deux realites subordonnees, ce qui introduit le Transcendant dans le monde. Avec les progres des sciences, le paradigme mental se bätit sur l'idee principale de l'unidimensionnalite (...) du reel. Or. le monde se retrouve ainsi depourvu de sa dimension transcendante. La solution proposee dans l'expose serait la formation d'un nouveau paradigme mental qui assurerait ä l'homme une presence spirituelle dans le monde. (shrink)

En el presente artículo me concentraré en el estudio filosófico de los delirios, como un caso ejemplificador del vínculo que pueden establecer la filosofía de la mente y la psiquiatría. Frente a versiones radicalmente naturalistas, que proponen variantes reduccionistas o eliminativistas para la explicación de ciertos fenómenos mentales y sus variantes “anormales”, defenderé una versión moderada de la perspectiva naturalista. Al respecto, señalaré que retener algún grado de simpatía hacia el naturalismo en las investigaciones filosóficas sobre los delirios es necesario (...) para desarrollar teorías sobre las creencias empíricamente informadas que no resulten contradictorias con los desarrollos actuales en psicología cognitiva y neurociencias. No obstante, afirmaré también que una perspectiva exclusivamente naturalista -tanto por parte de la filosofía como de la psiquiatría misma- es incapaz de dar cuenta del contexto normativo en donde juegan las creencias. Los criterios normativos, especialmente externos que se emplean para clasificar ciertas creencias como delirantes no resultan inteligibles bajo una explicación puramente natural. Por el contrario, para comprender las creencias delirantes qua delirantes, será preciso acercarnos a un abordaje híbrido que pueda contemplar las causas naturales del fenómeno así como su evaluación normativa. (shrink)

Avec l’entrée massive dans l’usage du nom « émotion » comme nom générique de toutes les manifestations psychologiques, due à la vulgarisation du discours de spécialité de la psychologie, des arts, etc., il existe la tentation de considérer ce nom, du point de vue linguistique, uniquement comme un hyperonyme et même comme un « nom général », du sommet ou des fondements du lexique. Cet article présente un point de vue nouveau : il montre que, par ses propriétés morphologiques, syntaxiques (...) et anaphoriques, le nom émotion est aussi un nom de base, du même niveau lexical que peur, joie, tristesse, etc., que l’on a pu considérer comme ses hyponymes. (shrink)

Rise of populist politics in the 21s century calls scholars and politicians alike to reflect upon the question of how politics and democracy have been understood. Drawing on the theory of hegemony, this article establishes a distinction between democracy and ‘demography’ as a key line of conceptualization in politics. It highlights a central misunderstanding at the core of the demonization of populism: For radical democratic theory, ‘the people’ is not a demographic, socio-economic, or historically sedimented category tied to some characteristics, (...) but a performative process of ‘being’ and ‘becoming’ ‘the people’ as a self-consciously enacted polity. This statement challenges the taken-for-granted status of subjectivities of political struggle and links this approach to other contemporary discussions of politics, democracy, and populism. After discussing how anti, neo and post-foundational theoretical accounts on populism reveal a dimension of politics and representation, this article emphasizes action and performativity over static categories and models characteristic of political realism and political system approaches. (shrink)

Les hormones sexuelles sont des objets hybrides et complexes à la frontière du sexe et du genre. Dès lors qu’elles sont synthétisées sous forme pharmaceutique, elles peuvent attribuer des caractéristiques sexuelles au corps de manière partiellement exogène à celui-ci. Il s’en suit que l’utilisation clinique qui en est faite est socialement réglementée. À travers une analyse de divers contextes d’utilisation des hormones observés à Bahia, au Brésil, cet article montre que le dualisme sexuel est le produit de pratiques de régulation (...) biomédicales qui visent à encadrer la circulation des hormones. Le sens du terme local « hormônio » n’est pas pleinement recoupé par celui d’hormone, qu’il excède. L’emploi commun qui est fait au Brésil du singulier procure au terme « hormônio » une qualité fluide et homogène. Dans ce contexte, les hormones sont comprises comme une sorte de substance qui peut circuler entre les corps. Cette conceptualisation des hormones comme une substance a des implications pour le statut ontologique des corps et révèle la relative plasticité de la relation sexe/genre. (shrink)

We believe with the publication of our Lexicon Spinozanum, that we are meeting a need in Spinoza historiography which has been pointed out by scholars, but has never before been satisfied. In the intro duction of his Spinozas philosophische Terminologie (Leipzig, 1913), G. T. Richter promised "a Spinozistic Lexicon in which the meaning of each term is set out on an historical basis in alphabetical order". In 1924, in the Report, i.e., Nachbericht, of his four volume edition of the complete (...) works of Spinoza (Heidelberg), C. Gebhardt promised a complementary volume comprising, among other things, a general index. However, neither the one nor the other were ever published. The hope of seeing this gap quickly filled has been reiterated recently by Di Vona: "The compilation of a Spinozistic index is a task of the history of philosophy, the execution of which would gratify all scholars". (Di V on a, Studi suIt' ontologia di Spinoza, Florence, 1960). We do not know how closely our Lexicon Spinozanum corresponds to what Richter and Gebhardt projected. We believe, however, that there are common requirements at the basis of works of this sort. In our procedure and in the delimitation of our scope, we have set for ourselves two main criteria: that of clarity and that of completeness. We hope we hav:e not deviated from them too much. (shrink)

The pharmaceutical industry and drugs advertisements are sometimes accused of “creating diseases”. This article assesses and describes the role of that industry in fostering medicalization. First, the notions of medicalization and pharmaceuticalization are defined. Then, the problem of distinguishing between harmful overmedicalization and well-founded medicalization is presented. Next, the phenomenon of disease mongering is explained and illustrated by the case analysis of medicalizing pain and suffering in three contexts: (1) the general idea of medicalizing physical pain, (2) the medicalization of (...) grief and (3) disease mongering of pseudoaddiction—a condition promoted in order to increase the demand for opioid pain relievers. (shrink)

Gilbert Simondon ’s work is devoted to the act of knowledge as a specific human experience, common to all the specialized fields. It is a departure toward infinity, an opening to nature, which emerged as soon as philosophy was discovered in Greece. This movement of individuation is rooted in the pre-individual, in the flux of life.

Com o objetivo de ressaltar a importancia da fabulaç áo , como meio de expressáo do exercicio filosofico, em Plat áo , reconstituem-se inicialmente, neste artigo, os principais passos do Teeteto, cujo final aporético decorreria da n áo exploraç áo pelos interlocutores das hipoteses da Reminiscencia e das Ideias, as quais n áo se restringem ao logos mais estrito nem se dissociam do relato mitico. Em seguida, evidencia-se que, sobretudo a partir dos dialogos da maturidade, a recriaç áo poetica da (...) tradiç áo constitui um suporte doutrindrio indispensável.  . (shrink)

Today, scientific research is seen as being largely dominated by the short-term, and by the constant need to gain legitimacy in the eyes of society. This text analyzes the existing literature on the concept of future and seeks to explore some of the main meanings it has for scientists. Based on interviews with researchers working on different projects in Portuguese research centers, the authors scrutinize some of the implications of the recurrent reference to the future in their research agendas. Starting (...) with a review of the literature on the relations between science, time, and future, they show that nowadays, scientists experience some difficulty when dealing with the long-term in science, mostly due to the pressure of the market on innovation. In view of their profiles and discourses, what must be stressed are the risks and challenges playing out in the conflict between the short and the long term in scientific research. (shrink)

An eye-tracking while listening study based on the blank screen paradigm was conducted to investigate the processing of literal and metaphorical verbs of motion. The study was based on two assumpti...