La relación médico-paciente (RMP) es una relación profesional-interpersonal base para la gestión de la salud. Nuestro objetivo fue desarrollar un instrumento que permitiera evaluar la presencia de los principios bioéticos en la atención médica recibida en la consulta externa de una institución hospitalaria. El instrumento quedó constituido por 21 reactivos para evaluar su confiabilidad y consistencia. El coeficiente de correlación intraclase fue de 0,81 (_p_.

The COVID-19 pandemic has impacted medical care in many ways; previously, a patient would enter a hospital and had an approximate idea of what would happen upon his admission, the physician informed them about it, but in the last two years this scenario has changed. Therefore, our aim was to identify if bioethical principles are present in the physician–patient relationship and the effect of these in the health care provided, through an observational and descriptive study where patients answered the validated (...) ReMePaB questionnaire that measures the presence of bioethical principles in the physician–patient relationship, on the seventh day of their hospital stay and 24 h after discharge, during the period from 1 August to 5 November 2020. In autonomy, an improvement in the score was observed in the second application compared to the first measurement; in the principle of non-vulnerability, the same scenario was observed for the first and second measurements, respectively. In the principles of beneficence, dignity, and justice, no statistically significant differences were observed. Considering the presence or absence of bioethical aspects in health care in this pandemic creates an area of opportunity to know the feelings of the patient during the care received and to maintain what is done well and improve those aspects that can be improved. (shrink)

Background The COVID-19 pandemic has influenced the approach to the health-disease system, raising the question about the principles of bioethics present in physician–patient relations. The principles while widely accepted may not be sufficient for a comprehensive ethical analysis. Therefore, the aim of this study was to explore the perception of these principles and the physician–patient relationship during a hospital stay through a qualitative approach. Method Sixteen semi-structured interviews took place to know the patients’ perception during their 2020 hospitalization for COVID-19. (...) The data was analyzed through the constant comparison method, creating categories and comparing them. In the end, seven categories were established and were grouped in three: bioethical principles (dignity, charity, vulnerability, autonomy), doctor-patient relationship (participant commitment, informed consent, health staff-patient relationship) and the experience of the disease (illness, the role of the family). Results The research found that most patients described a positive experience, with the feeling of having been well cared for with no sense of discrimination or injustice done. The majority also reported that their autonomy was respected in the treatment decisions. The evaluation of these attitudes is an area of opportunity, especially when the patients' vulnerability is at risk. Conclusions The ethics of virtue offers a better reflection of how human beings manifest themselves by emphasizing the development of virtuous character and behaviors that allow them to realize their values in life. Authorized by the Research Ethics Committee with registration: DI/18/105-B/3/308. (shrink)

Se presenta una propuesta de innovación educativa, dirigida al alumnado de Educación Secundaria, fundamentada en el uso de los itinerarios didácticos teatralizados como recurso didáctico con perspectiva de género. Para su confección se pretende una metodología que privilegia los contenidos procedimentales y que fomenta el pensamiento histórico y, por ende, el pensamiento crítico. Los contenidos seleccionados están relacionados con el siglo XVI y XVII y, más concretamente, con la persecución y procesamiento de mujeres por brujería y hechicería por parte del (...) Tribunal de la Inquisición. Para ello se toma como centro de estudio el proceso que se llevó a cabo en Córdoba contra Leonor Rodríguez, lo que llevará al alumnado a reflexionar y a preguntarse sobre los estereotipos de la mujer en la historia, así como en la actualidad, con la intención de formar a una ciudadanía crítica y comprometida. (shrink)

According to the continuity hypothesis of dreaming and contemporary psychodynamic approaches, dreams reflect waking life. The aim of the present study was to explore the relationship between the COVID-19 pandemic and dreaming in adolescents. A cross-sectional survey was conducted in Italy, Romania and Croatia involving 2,105 secondary school students. No substantial differences between countries were found. Thirty-one percent of the participants reported heightened dream recall, 18% noticed an increase in nightmares during the lockdown, and 15% of the provided dreams included (...) pandemic-related content. The results indicate that subjective emotional reactions to lockdown had a significantly higher correlation to dreaming than objective distress. These findings suggest that attention to dreams should be included in preventive programs for adolescents with pandemic-related stress. (shrink)

ObjectiveTo investigate the association of pre-existing migraine in patients hospitalised and who recovered from severe acute respiratory syndrome coronavirus 2 infection with the presence of post-coronavirus disease symptoms.BackgroundNo study has investigated the role of migraine as a risk factor for development of post-COVID symptoms.MethodsA case-control study including individuals hospitalised during the first wave of the pandemic was conducted. Patients with confirmed previous diagnosis of migraine were considered cases. Two age- and sex-matched individuals without a history of headache per case were (...) also recruited as controls. Hospitalisation/clinical data were collected from hospital medical records. Patients were scheduled for a telephone interview. A list of post-COVID symptoms was systematically evaluated, but participants were invited to freely report any symptom. The Hospital Anxiety and Depression Scale and the Pittsburgh Sleep Quality Index were used to assess anxiety/depressive symptoms and sleep quality. Multivariable conditional logistic regression models were constructed.ResultsOverall, 57 patients with confirmed diagnosis of migraine and 144 non-migraine controls who had recovered from COVID-19 were assessed at 7.3 months after hospital discharge. The number of post-COVID symptoms in the migraine group was significantly greater than in the non-migraine group. Fatigue was significantly more prevalent in the migraine group. However, no between-groups difference in the prevalence of headache as a post-COVID symptom was detected.ConclusionPatients with a history of migraine who recovered from COVID-19 exhibited more long-term fatigue as post-COVID sequelae than those without migraine. Some of the pathophysiological changes associated with migraine could predispose to the occurrence of post-COVID symptoms. (shrink)

Social theory has paid little attention to air, despite its centrality to bodily existence and air pollution being named the world’s biggest public health crisis. Where attention to air is found, the body is largely absent. On the other hand, conceptualizing the body without life-sustaining breath fails to highlight breathing as the ongoing metabolic bodily act in which the materiality of human and more-than-human intermingle and transmute one another. Political ecology studies how unequal power structures and knowledge production reproduce human–environment (...) relations, including a nascent focus on the body and air – but as separate issues. This article argues that a political ecology of air would productively fuse with a political ecology of the body to bring the visceral realm into intersectional analysis of air’s contemporary materialities. A feminist political ecology situates explicitly air-and-breathing-bodies, their intimately posthuman, relational, elemental and corpomaterial intra-action, at the heart of such analysis. (shrink)

BackgroundFor many decades, the debate on children’s competence to give informed consent in medical settings concentrated on ethical and legal aspects, with little empirical underpinnings. Recently, data from empirical research became available to advance the discussion. It was shown that children’s competence to consent to clinical research could be accurately assessed by the modified MacArthur Competence Assessment Tool for Clinical Research. Age limits for children to be deemed competent to decide on research participation have been studied: generally children of 11.2 (...) years and above were decision-making competent, while children of 9.6 years and younger were not. Age was pointed out to be the key determining factor in children’s competence. In this article we reflect on policy implications of these findings, considering legal, ethical, developmental and clinical perspectives.DiscussionAlthough assessment of children’s competence has a normative character, ethics, law and clinical practice can benefit from research data. The findings may help to do justice to the capacities children possess and challenges they may face when deciding about treatment and research options. We discuss advantages and drawbacks of standardized competence assessment in children on a case-by-case basis compared to application of a fixed age limit, and conclude that a selective implementation of case-by-case competence assessment in specific populations is preferable. We recommend the implementation of age limits based on empirical evidence. Furthermore, we elaborate on a suitable model for informed consent involving children and parents that would do justice to developmental aspects of children and the specific characteristics of the parent-child dyad.SummaryPrevious research outcomes showed that children’s medical decision-making capacities could be operationalized into a standardized assessment instrument. Recommendations for policies include a dual consent procedure, including both child as well as parents, for children from the age of 12 until they reach majority. For children between 10 and 12 years of age, and in case of children older than 12 years in special research populations of mentally compromised patients, we suggest a case-by-case assessment of children’s competence to consent. Since such a dual consent procedure is fundamentally different from a procedure of parental permission and child assent, and would imply a considerable shift regarding some current legislations, practical implications are elaborated. (shrink)

For decades, the discussion on children’s competence to consent to medical issues has concentrated around normative concerns, with little progress in clinical practices. Decision-making competence is an important condition in the informed consent model. In pediatrics, clinicians need to strike a proper balance in order to both protect children’s interests when they are not fully able to do so themselves and to respect their autonomy when they are. Children’s competence to consent, however, is currently not assessed in a standardized way. (...) Moreover, the correlation between competence to give informed consent and age in children has never been systematically investigated, nor do we know which factors exactly contribute to children’s competence. (shrink)

The aim of this article is to show how context, in its multiple forms, as well as having influence in localization, organization, government, and business of firms, is also fundamental on an epistemological level because it acts directly on the dynamics of scientific knowledge construction. It will be shown how context takes on the role of a constraint that strongly influences the growth of the endless possibilities from which a scientific knowledge emerges, and how epistemology has to rethink the definition (...) of science, taking into account that it evolves in relation with its multiple contexts with which it reinvents itself every day. (shrink)

O presente artigo traz reflexões que envolvem infância e experiência a partir da área da educação e, particularmente, das ponderações em torno das pesquisas com crianças pequenas e da educação infantil. Os apontamentos impõem limites relativos a este lugar de estudo e delimita estes como parte de uma crítica e autocrítica da educação e das possibilidades de consolidação de uma Pedagogia da Infância. Nesta direção, no artigo se toma para esta reflexão a análise do sentido da experiência para as principais (...) teorias educacionais ou projetos educativos para a educação na infância, a fim de levar a uma demarcação dos contornos da experiência educativa na/da infância institucionalizada. Para tal, apresenta alguns elementos relativos à experiência educativa como experiência social a partir de estudos empíricos que dão visibilidade às ações das crianças como parte de suas vidas nos coletivos infantis. Por fim, indica como desafios para a possível consolidação de uma Pedagogia da Infância uma aproximação da Pedagogia às manifestações infantis, a criança em situação e as possibilidades de os processos educativos se pautarem na escuta, na dialogicidade e nas relações, possibilitando incluir, nas práticas educativas, as significações produzidas pelas próprias crianças em seus contextos de vida e suas manifestações culturais e expressivas. (shrink)

Although law is established on a strong presumption that persons younger than a certain age are not competent to consent, statutory age limits for asking children’s consent to clinical research differ widely internationally. From a clinical perspective, competence is assumed to involve many factors including the developmental stage, the influence of parents and peers, and life experience. We examined potential determining factors for children’s competence to consent to clinical research and to what extent they explain the variation in competence judgments.

Although it has acquired an extraordinary social diffusion, entrepreneurial education has a certain lack of definition associated with its conceptualisation and meaning. It seems clear that entrepreneurial education is linked to the economic sphere, but it is not limited to the productive sector. The idea of entrepreneurial education has been progressively enriched, being linked to the development of skills for personal growth and social progress. Further clarification of the meaning and scope of entrepreneurial education is, therefore, needed. Thus, it is (...) relevant to analyse entrepreneurial identity in the context of personal identity via the theoretical–explanatory investigation of a model developed in two phases. A critical analysis leads us to study the different factors that intervene in the configuration of this identity in an attempt to construct a systemic map of entrepreneurial action. Between the private and the public, entrepreneurs seek new ways of facing the challenges of our times, trying to find new ways of regenerating the links between individuals and institutions and with society in general. In this sense, we show how entrepreneurial educational ecosystems acquire relevance insofar as they consider the subject as the principle of action rather than merely the result of various contextual factors. (shrink)

Este artículo reseña: Andrés GARCÍA INDA, La dulce militancia. Crítica de la razón indignada,prólogo de Chaime Marcuello Servós, ediciones Mensajero, Bilbao, 2020, 167 pp.

Revisión del libro Violencia, espionaje y represión estatal. Seis estudios de caso sobre el pasado reciente argentino por D. D´Antonio (comp.).

In this paper we discuss expected and reported effects on care provider-patient relations of the introduction of electronic patient records (EPRs) in consultation settings by reviewing exemplary studies and literature on the subject from the past decade. We argue that in order for such assessments to be meaningful, talk of effects of “the” EPR needs to be replaced by an “unpacking” of EPR systems into their constituent parts and functionalities, the effects of which need to be assessed individually. Following from (...) this principle, the paper discusses EPR systems ranging from simple data entry and retrieval systems to more sophisticated multi-user and multifunctional on-line systems. On a second level, our analysis of the literature is informed by the question which model of ideal patienthood underlies the assessment of effects of EPRs. To this end, we identify three “models of patienthood” implicit in writing about benefits and drawbacks of EPRs for patients: the autonomy, the consumer, and the holistic models, and argue that assumptions concerning these models need to be reflected upon more critically to improve understanding of what exactly EPR use does to the doctor-patient relationship. (shrink)

This book examines the human ability to participate in moments of joint feeling. It presents an answer to the question concerning the nature of our faculty to share in what might be called episodes of collective affective intentionality. The proposal develops the claim that our capacity to participate in such episodes is grounded in an ability central to our human condition: our capacity to care with one another about certain things. The author provides a phenomenologically adequate account of collective affective (...) intentionality that takes seriously the idea that feelings are at the core of our emotional relation to the world. He details a form of group emotional orientation that relies on the fact that the participating individuals have come to share a number of concerns. Readers will learn that at the heart of a collective affective intentional episode, one does not merely find a set of shared concerns, but also a particular mode of caring. In the end, the argument presented in this monograph makes plausible the idea that the emotions through which humans participate in moments of affective intentional community express our nature. In addition, it shows that the debate on collective affective intentionality also permits us to better understand the relationship between two conflicting philosophical pictures of ourselves: the idea that we are essentially social beings and the claim that we are creatures for whom our personal existence is an issue. Thus, aiming at an elucidation of the nature of our ability to feel together, the book offers a detailed account of what it is to situationally express our human nature by caring about something in a properly joint manner. (shrink)

In the article, I examine Hélène Cixous's play La Ville parjure ou le Réveil des Erinyes as a political contribution to the debate over memory and justice. The focus is on the question of how the telling of a story of atrocities may be therapeutic to both the victim and to society. I stress Cixous's alternative way of addressing justice: through forgiveness instead of criminal prosecution or other forms of retribution or reconciliation. Referring to Jacques Derrida's work, the main argument (...) revolves around the question of whether forgiveness for unspeakable crimes should be unconditional or conditional. Instead of seeing Cixous's play as an unequivocal stance on restorative justice in general, and on conditional forgiveness in particular, I stress that the main protagonist, the Mother, is not willing to forgive the crime itself because of its unforgivable nature. (shrink)

El objetivo del trabajo de investigación fue evaluar la relación entre el uso de una red social y el rendimiento académico en la materia de matemáticas. Para el método de investigación se trabajó con una muestra de 570 alumnos inscritos en la materia de matemáticas, la cual se dividió en estratos. Se llevó a cabo en una universidad pública del norte de México. La investigación fue longitudinal y correlacional. Los principales resultados indican que a mayor interacción académica en una red (...) social, mejor rendimiento académico en matemáticas. Lo cual puede ser aplicable para ciencias exactas en Instituciones de Educación Superior. (shrink)

Las feministas han reconocido la importancia de defender la capacidad de pensar de las mujeres y de pensarse a sí mismas; es necesario ir más allá: sólo logramos devolver el respeto a las dominadas duraderas producidas por el machismo patriarcal en el que aún vivimos, al establecer que su facultad de juzgar radica en el uso del diálogo que comparte con los hombres, además de su diferencia de sexo y que sólo podemos disipar todas las presuntas dudas planteadas por violadores (...) e intelectuales que se han mantenido machistas respecto a su facultad femenina de juzgar mostrando su origen en una segunda naturaleza común del lenguaje así como su eficacia. Apoyaremos nuestro análisis con un caso que fue noticia en los medios televisivos de Francia. (shrink)

The aim of this study was to describe how patients’ participation in the care they received was documented in their health care records during the last three months of their lives. Two hundred and twenty-nine deceased adult persons were randomly identified from 12 municipalities in a Swedish county and their records were selected from different health care units. Content analysis was used to analyse the text. Four categories of patient participation were described: refusing offered care and treatments; appealing for relief; (...) desire for everyday life; and making personal decisions. The most common way for these patients to be involved in their care at the end of their life was by refusal of the treatment and care offered. Characteristic of the different ways of participation were the diverse activities represented. The description of patients’ involvement in their life situation at this time indicated their dissociation from the health care offered more than consenting to it. (shrink)

Diese Situation wird als eine Kumulation aller Ungleichheiten beschrieben, die einen Menschen treffen können: soziale Klassenungleichheit, sexuelle Ungleichheit und Ungleichheit aufgrund der Rasse. Durch die Zuspitzung dieser Ungleichheiten lässt sich die große Zahl afrikanischer Migrantinnen erklären. Die Suche nach sozialer, ziviler und bürgerlicher Gleichheit, die nach dem Modell der von Männern propagierten und zur Schau gestellten Selbstbeherrschung gedacht ist, kann in dem Maße nicht erfolgreich sein, wie sie versucht, sich einem Macho-Modell zu unterwerfen, das der Natur des Menschen widerspricht. Weil (...) die zeitgenössische Anthropologie uns lehrt, dass dieser die Sprache erfinden musste, um sich das Leben zu ermöglichen und es jedes Mal neu zu harmonisieren, wenn er in eine Sackgasse gerät, weil die dialogische Vorstellungskraft, die den Dialog der Seele mit sich selbst antreibt, den Platon entdeckt hatte, durch das Gesetz der Wahrheit geregelt wird, müssen afrikanische Frauen erkennen, dass sie die Objektivität der ihnen auferlegten und der von ihnen selbst erfundenen Lebensbedingungen beurteilen müssen, um ihre Wahrheitsurteile mit ihren männlichen Partnern teilen zu können und um sich von jeglicher Herrschaft zu emanzipieren, unabhängig von ihrer Geschlechtszugehörigkeit. (shrink)

Classical verse work expounding early Vedantic approach in Hindu philosophy.

BackgroundThis article aims to contribute to a better conceptualization of pain and suffering by providing non-essential and non-naturalistic definitions of both phenomena. Contributions of classical evidence-based medicine, the humanistic turn in medicine, as well as the phenomenology and narrative theories of suffering and pain, together with certain conceptions of the person beyond them are critically discussed with such purpose.MethodsA philosophical methodology is used, based on the review of existent literature on the topic and the argumentation in favor of what are (...) found as better definitions of suffering and pain.ResultsPain can be described in neurological terms but cognitive awareness, interpretation, behavioral dispositions, as well as cultural and educational factors have a decisive influence on pain perception. Suffering is proposed to be defined as an unpleasant or even anguishing experience, severely affecting a person at a psychophysical and existential level. Pain and suffering are considered unpleasant. However, the provided definitions neither include the idea that pain and suffering can attack and even destroy the self nor the idea that they can constructively expand the self; both perspectives can b e equally useful for managing pain and suffering, but they are not defining features of the same. Including the existential dimension in the definition of suffering highlights the relevance of suffering in life and its effect on one’s own attachment to the world. An understanding of pain and suffering life experiences is proposed, meaning that they are considered aspects of a person’s life, and the self is the ever-changing sum of these experiences.ConclusionsThe provided definitions will be useful to the identification of pain and suffering, to the discussion of how to relieve them, and to a better understanding of how they are expressed and experienced. They lay the groundwork for further research in all these areas, with the twofold aim of a) avoiding epistemological mistakes and moral injustices, and b) highlighting the limitations of medicine in the treatment of suffering and pain. (shrink)