Objective: To measure the stability of life-sustaining treatment preferences amongst older people and analyse the factors that influence stability. Design: Longitudinal cohort study. Setting: Primary care centres, Granada (Spain). Eighty-five persons age 65 years or older. Participants filled out a questionnaire with six contexts of illness (LSPQ-e). They had to decide whether or not to receive treatment. Participants completed the questionnaire at baseline and 18 months later. Results: 86 percent of the patients did not change preferences. Sex, age, marital status, (...) hospitalisation, and self-perception of health and pain did not affect preferences. Morbidity and the death of a relative did. Conclusion: Stability of preferences of older persons in relation to end-of-life decisions seems to be more probable than instability. Some factors, such as the death of a relative or the increase in morbidity, can change preferences. These findings have implications for advance directives (ADs) and advance care planning. (shrink)

Among the many interesting problems considered in this book, I will center my commentary on two issues: on the role of narrative reconstructions as an alternative to objectivist accounts of culture; on the implications of her proposed reformulation of discourse ethics as interactive universalism for the dilemmas of multiculturalism. On the question of the dialogical-narrative reconstructions of identity, a combination of perspectives of participants as well as of external observers is suggested, instead of a shift from the latter to the (...) former. On the more difficult question of the political, legal and moral implications for democratic theory of forms of rational accommodation of cultural differences, I will consider the problem of justification of morality under conditions not only of radical cultural differences but of asymmetries in power and resources among the participants, which seem to present a problem for a model that presupposes a cooperative engagement and free uncoerced consent from all involved. (shrink)

O campo interdisciplinar dos novos estudos sociais das infâncias parte de uma ruptura epistemológica com as abordagens clássicas das ciências que adotam visões biologizantes, essencialistas e universais da criança e encontra na etnografia uma possibilidade de conceituação de criança enquanto sujeito ativo e de infância enquanto categoria social geracional. O reconhecimento desses conceitos de criança e de infância pela etnografia na pesquisa com crianças implica voltar-se para a criança como o outro, o diferente, o estrangeiro. A proposta de ruptura teórico-conceitual (...) na investigação das infâncias exige a implementação de metodologias que focalizem as experiências, os pontos de vista e as vozes das crianças, compreendendo-as enquanto processo, em outras palavras, constante construção. Portanto, para essa perspectiva, a criança não é o objeto do estudo, mas é sujeito que interage com o pesquisador na construção dos sentidos e significados da pesquisa. O texto está organizado em três partes que abordam os aspectos epistemológicos, teórico-conceituais e metodológicos do debate proposto. Ao final, procura-se uma articulação entre os diferentes aspectos da discussão, propondo uma reflexão sobre a ética e a alteridade, reconhecendo que a diferença atravessa as relações humanas e, portanto, é o diferente, o incomum, o incompreensível, o oposto, o desigual, o inalcançável que marca e define a pesquisa com criança. (shrink)

The upbringing of infants in native communities is the concern of authorities and researchers for being a vulnerable population segment. The purpose of the study was to analyze child rearing styles of an Amuesha community in the Peruvian jungle. The phenomenological design allowed interviewing amuesha mothers from Oxapampa in Pasco, until reaching saturation. It was found as results that child rearing practices conform to sociocultural patterns, such as identity and communal heritage culture, which are in extinction due to the presence (...) of exotic factors; in addition to a demand to the State for better education and health services. (shrink)

The purpose of the study was to analyze the coherence of the presentation of hypotheses and conclusions in postgraduate thesis on educational quality, which was carried out with a descriptive design. The population consisted of postgraduate theses on educational quality from four Universities of Lima, supported from 2020 to 2022, and the sample was adequate and representative. After the documentary review and analysis, the statistical analysis allowed us to find as a result a weak linear positive correlation of such variables (...) with a significance much lower than 0.01, which means that there is no optimal logical articulation between elements of the these. (shrink)

Testimonio que recoge algunas experiencias y reflexiones de la artista visual costarricense María Rapela en Alemania y de cómo se involucró en la gestión cultural, coordinando el Fieber Festival, una plataforma colaborativa y auto-gestionada de mujeres artistas migrantes iberoamericanas en Berlín entre el 2011 y el 2017.

Background:Decision-making and assessment in emergency situations are complex and result many times in ethical conflicts between different healthcare professionals.Aim:To analyse and describe situations that can generate ethical conflict among nurses working in emergency situations.Methods:Qualitative analysis. A total of 16 emergency nurses took part in interviews and a focus group.Ethical considerations:Organisational approval by the University Hospital, and informed consent and confidentiality were ensured before conducting the research.Result/conclusion:Two categories emerged: one in ‘ethical issues’ and one in ‘emotions and feelings in caring’. The (...) four ethical subcategories are presented: Autonomy, the first sub category: first, the nurse’s ability to practise care on an emergency ward and, second, to support the patient and/or relatives in terms of care and medical treatment. The conflicts arise when the nurse ends up in the middle between the patient and the physician responsible for the diagnosis and treatment from a nature scientific perspective. Reification of injured body: patient was often reified and fragmented, becoming just a leg or arm. Different factors contributed in this perspective. Pain: pain relief was often inadequate but more effectively treated in the emergency medical services than at the emergency department. The nurses highlighted the phenomenon of suffering because they felt that pain was only an object, forgetting the patients’ care need, like separating mind from body. Death: the nurses felt that the emergency services are only prepared to save lives and not to take care of the needs of patients with ‘end-of-life’ care. Another issue was the lack of ethical guidelines during a cardiac arrest. Resuscitation often continues without asking about the patient’s ‘previous wishes’ in terms of resuscitation or not. In these situations, the nurses describe an ethical conflict with the physician in performing their role as the patient’s advocate. The nurses express feelings of distress, suffering, anger and helplessness. (shrink)

In the fiftieth disputation of his Disputationes metaphysicae (1597), Francisco Suárez distinguishes three notions of time. Suárez offers an account of the ways in which the predicate ‘when’ can be taken and presents a more general perspective based on the principle of duration, rather than the Aristotelian definition of time. His view differs from Aristotle’s and Aquinas’ account because Suárez emphasizes that time cannot be reduced to the number of the movement of the last sphere in the Aristotelian model of (...) the cosmos. The intrinsic duration of a thing is its true time; this duration can be taken in an absolute or a relative sense. In an absolute sense, intrinsic time is an internal property of a thing that cannot be really distinguished from existence itself and cannot be compared with other durations. In a relative sense, we can imagine this intrinsic duration as filling up a certain interval within an infinitely extended imaginary succession. This imaginary succession is an ens rationis. The third concept of time is the Aristotelian notion: this is just an extrinsic time, a measurement of one movement by means of a comparison with another movement, especially the motion of the last sphere. Finally, in order to show the value of Suárez’s insights, I compare them with some contemporary issues in the analytic philosophy of time. (shrink)

O presente artigo investiga a relação entre a construção de formalizações e a criação de novidades na ação de projetar Ambientes Virtuais de Aprendizagem (AVAs). Para tanto, realiza um estudo de caso sobre a ação de projetar AVAs no Núcleo de Tecnologia Digital Aplicada à Educação (Nuted) da Universidade Federal do Rio Grande do Sul (UFRGS). Entende-se que o debate acerca desse tema contribui para uma reflexão sobre os desenvolvimentos científico e tecnológico em informática na educação, bem como sobre sua (...) natureza interdisciplinar. Tal abordagem agrega uma perspectiva teóricometodológica piagetiana, a qual orientou os questionamentos, a elocução conceitual, a coleta e a análise dos dados. Com isso, enfoca-se o jogo entre forma e conteúdo que caracteriza a ação de projetar, de modo que os observáveis apontados e as coordenações realizadas pelos projetistas se configuram como os observáveis deste estudo. (shrink)

En el texto se exponen algunas reflexiones sobre la importancia que tiene el rescatar los conocimientos tradicionales de las comunidades rurales, indígenas y campesinas sobre las prácticas agrícolas y alimenticias como recurso y mecanismo para favorecer la seguridad alimnetaria y de esta manera la sustentabilidad comunitaria. Se parte de una revisión bibliográfica sobre el tema, y se exponen casos específicos, como ejemplo, donde la experiencia se ha convertido en una oportunidad de algunas comunidades para hacer valer sus derechos de manejo (...) de la tierra, los procesos que se requieren para la diversidad de cultivos, de su propio sistema de producción y de esta forma mitigar los efectos de la pobreza y consolidad una propuesta alterna para el ejercicio de la soberanía y seguridad alimentaria de las comunidades. (shrink)

Background:Ambulance professionals often address conflicts between ethical values. As individuals’ values represent basic convictions of what is right or good and motivate behaviour, research is needed to understand their value profiles.Objectives:To translate and adapt the Managerial Values Profile to Spanish and Swedish, and measure the presence of utilitarianism, moral rights and/or social justice in ambulance professionals’ value profiles in Spain and Sweden.Methods:The instrument was translated and culturally adapted. A content validity index was calculated. Pilot tests were carried out with 46 (...) participants.Ethical considerations:This study conforms to the ethical principles for research involving human subjects and adheres to national laws and regulations concerning informed consent and confidentiality.Findings:Spanish professionals favoured justice and Swedish professionals’ rights in their ambulance organizations. Both countries favoured utilitarianism least. Gender differences across countries showed that males favoured rights. Spanish female professionals favoured justice most strongly of all.Discussion:Swedes favour rights while Spaniards favour justice. Both contexts scored low on utilitarianism focusing on total population effect, preferring the opposite, individualized approach of the rights and justice perspectives. Organizational investment in a utilitarian perspective might jeopardize ambulance professionals’ moral right to make individual assessments based on the needs of the patient at hand. Utilitarianism and a caring ethos appear as stark opposites. However, a caring ethos in its turn might well involve unreasonable demands on the individual carer’s professional role. Since both the justice and rights perspectives portrayed in the survey mainly concern relationship to the organization and peers within the organization, this relationship might at worst be given priority over the equal treatment and moral rights of the patient.Conclusion:A balanced view on ethical perspectives is needed to make professionals observant and ready to act optimally – especially if these perspectives are used in patient care. Research is needed to clarify how justice and rights are prioritized by ambulance services and whether or not these organization-related values are also implemented in patient care. (shrink)

This paper considers the process of becoming an international public intellectual, taking the case of Maria Montessori (1870–1952), the Italian physician who became an authority on education and, u...

Background:The acquisition of experience is a major concern for nurses in intensive care units. Although the emotional component of the clinical practice of these nurses has been widely studied, greater examination is required to determine how this component influences their learning and practical experience.Objective:To discover the relationships between emotion, memory and learning and the impacts on nursing clinical practice.Research design:This is a qualitative phenomenological study. The data were collected from open, in-depth interviews. A total of 22 intensive care unit nurses (...) participated in this research between January 2012 and December 2014.Ethical considerations:The School of Nursing Ethics Committee approved the study, which complied with ethical principles and required informed consent.Findings:We found a clear relationship between emotion, memory and the acquisition of experience. This relationship grouped three dimensions: (1) satisfaction, to relieve the patient’s pain or discomfort, give confidence and a sense of security to the patient, enable the presence of family members into the intensive care unit and provide family members with a realistic view of the patient’s situation; (2) error experience, which nurses feel when a patient dies, when they fail to accompany a patient in his or her decision to abandon the struggle to live or when they fail to lend support to the patient’s family; and (3) the feel bad–feel good paradox, which occurs when a mistake in the patient’s care or handling of his or her family is repaired.Conclusion:Emotion is a capacity that impacts on nurses’ experience and influences improvements in clinical practice. Recalling stories of satisfaction helps to reinforce good practice, while recalling stories of errors helps to identify difficulties in the profession and recognise new forms of action. The articulation of emotional competencies may support the development of nursing ethics in the intensive care unit to protect and defend their patients and improve their relationships with families in order to maximise the potential for patient care. (shrink)

A main objective of this study is to assess the opinions of 50 behavioral health patients on selective control over their behavioral and physical health information. We explored patients' preferences regarding current consent models, what health information should be shared for care and research and whether these preferences vary based on the sensitivity of health information and/or the type of provider involved. The other objective of this study was to solicit opinions of 8 behavioral health providers on patient-driven granular control (...) of health information and potential impact on care.Electronic surveys were implemented at an outpatient Behavioral Health facility that provides care for behavioral health patients with non-serious mental illnesses. The Patient Survey included questions regarding patients' demographics and about their concerns and preferences for data sharing for care and research. The Provider Survey included questions about their view on the current consent process and perceptions on barriers and facilitators to implement patient-controlled granular consent models.This novel study provides valuable preliminary data that can help guide future studies to better understand privacy choices of this underrepresented patient group. (shrink)

This article presents a set of principles for knowledge modeling in knowledge organization systems in specific domains. It discusses the representational problem, comparing the abstraction mechanisms present in the theories related to representation in concept systems, taken from foundational authors of information science, computer science, and terminology approaches. Parallel to this context, several representational possibilities arise to assist the modeler in the activity of elaborating models of representation. It describes the application of theoretical and methodological principles when organizing, representing, and (...) managing navigation on learning paths in the corporate education field. As a concept proof, it exposes a conceptual model of learning paths and discusses a literature review on this subject to verify to what extent these principles are being applied. It concludes that we can consider the principles discussed in this study as relevant, since they expand the modelers’ freedom, not making him hostage to a specific model. (shrink)

A REALIDADE DAS SERRAS CENTRAIS POTIGUARES E A QUESTÃO DO DESENVOLVIMENTO REGIONAL SOB A PERSPECTIVA DO DIREITO, DESENVOLVIMENTO E SUSTENTABILIDADE.

Objetivo: El siguiente artículo tiene como propósito la revisión de la literatura existente cuyo enfoque sea las herramientas tecnológicas utilizadas para el abordaje del paciente con síntomas de salud mental, de manera virtual, para describir las ventajas, la eficacia, la efectividad y los beneficios de estas herramientas, a partir de la literatura encontrada. Métodos: se realizó una búsqueda en las bases de datos Pubmed, Elsevier, UpToDate, Journal of Medical Internet Research y Google Académico. Se identificó un total de 58 artículos (...) que versan sobre la eficacia y efectividad de las diferentes modalidades digitales (tales como aplicaciones, cuestionarios en línea, mensajes de texto, etc.) que tratan la salud mental. Resultados: la búsqueda realizada arrojó un total de 58 artículos. Tras la eliminación de duplicados, el número fue de 50 artículos. Después de la caracterización de la información basada en la revisión de la totalidad del contenido, fueron elegidos 30 artículos para que sirvieran como base para la construcción de la síntesis de datos. Conclusiones: las herramientas virtuales utilizadas en salud mental ofrecen un sin fin de beneficios para prestar un servicio con un acceso más sencillo a la población, de forma económica y efectiva, sin temor a que los pacientes sean estigmatizados al momento de buscar ayuda, como se pudo evidenciar en los artículos presentados. Además, las herramientas digitales utilizadas en psiquiatría han demostrado ser eficaces y seguras, sin embargo, son de reciente aparición y cuentan con una cantidad limitada de estudios que demuestren objetivamente su eficacia en esta área. (shrink)

Actualmente la educación requiere la autonomía en el aprendizaje de los alumnos. Por ello, se realizó la siguiente investigación usando el aula invertida como metodología para mejorar la autonomía de los alumnos en materias como Desarrollo Humano, Instrumentos de Evaluación y Estrategias de Enseñanza de la Lengua Inglesa.Desde septiembre de 2021, los alumnos del programa educativo de Técnico Superior Universitario en Lengua Inglesa, trabajaron de manera híbrida, por esta razón, la metodología del aula invertida fue una herramienta útil para desarrollar (...) las competencias requeridas por el programa educativo, además de la autonomía. (shrink)

Se describe una propuesta de intervención comunitaria en convivencia escolar, a partir de los resultados obtenidos en una investigación previa (Rodríguez, Vaca, Hewitt & Martínez, 2009) que buscaba caracterizar las formas de interacción en un contexto escolar. Si bien el punto de partida lo constitu..

Recensión de Gil Ruíz, Juana María (ed.) (2018). El Convenio de Estambul como marco de derecho antisubordiscriminatorio. Dykinson, Madrid, 398 páginas.

En reseña de:GIL RUIZ, Juana María (coord.), Acoso sexual y acoso por razón de sexo: actuación de las administraciones públicas y de las empresas, Consejo General de Poder Judicial, Colección Justicia y sociedad, n.º 36, Barcelona, 2013, pp. 352.

Dans cet essai, je tente de répondre à quelques-unes des objections habituellement adressées au cosmopolitisme, en prenant en considération la perspective de ceux que cette doctrine risque d’affecter, à savoir, les immigrants. J’argue que certaines de ces objections se fondent sur des conceptions simplifiées à l’excès et empiriquement inexactes de ce que sont la communauté et l’identité culturelle. J’examine aussi en détail la controverse entourant les possibles implications autoritaristes — ou impérialistes — des propositions visant à faire d’un système moral-légal (...) un modèle pour le monde. L’objectif général de cet article est d’explorer les conditions permettant l’établissement d’une règle de justice cosmopolitique, dans un contexte mondial marqué par des différences culturelles et une extrême inégalité dans l’accès aux ressources et au pouvoir décisionnel. Certaines questions relatives à la motivation morale sont aussi abordées. (shrink)

El artículo tiene como finalidad justificar por qué es importante incluir las pedagogías propias de los pueblos originarios en los programas de formación docente de educación básica a nivel nacional, como valores compartidos de su patrimonio cultural tangible e intangible. Este patrimonio cultural es el pilar histórico de México, que por supuesto no se encuentra sólo en los pueblos originarios, sino que responde a un proceso histórico social determinado de la nación y que, a pesar de la conquista europea, siguió (...) prevaleciendo en las pedagogías y valores propios de los pueblos originarios. Proponemos cristalizar estos patrimonios culturales de los pueblos originarios para ser considerados como pedagogías propias en los programas de formación docente y desde este campo de formación compartir los valores culturales a través de sus saberes, sabidurías y prácticas culturales que han prevalecido a lo largo de la historia y que den cuenta en los planes y programas de estudio con igualdad y equidad cultural en el Sistema Educativo Nacional. Asimismo, se exponen los procesos de contradicción que los pueblos originarios han vivido y han asumido a lo largo de las políticas educativas dirigidas a la educación indígena. Finalmente, se plantean algunas consideraciones para estos programas de formación docente. (shrink)

El pensamiento y la actividad del movimiento feminista se ha traducido en una conquista de realidades nuevas y diferentes tendentes a lograr la transformación de la situación de dependencia y sumisión de las mujeres respecto a los hombres. Si bien es cierto que a lo largo de este proceso de emancipación las mujeres han cosechado un innegable éxito en las sociedades democráticas, al menos en lo que se refiere a la construcción legislativa, se mantiene una desigual posición de hombres y (...) mujeres en ámbitos diversos. En este sentido, la aplicación de la Ley de Dependencia, ejemplo en nuestro país de ampliación de los derechos sociales, puede tener el efecto no deseado de contribuir al mantenimiento de los roles tradicionales de hombres y mujeres. (shrink)

"Como pensar hoje na escrita da história? Como enfrentar a página em branco que não se apresenta como um espaço neutro, mas um espaço onde quem escreve - o historiador - deixa rastros do passado e também os seus próprios rastros? Essas são algumas das questões colocadas pelos ensaios que compõem "Arte e pensamento: operações historiográficas". Num primeiro momento, são fornecidos o ritmo, o tom e os compassos por meio de discussões e reflexões sobre uma teoria da experiência para a (...) escrita da história, sobre a historicidade do artístico, sobre o inespecífico do contemporâneo, sobre o pensamento na fronteira, sobre a nomeação dos anônimos em Machado de Assis. A partir dessas harmonizações dissonantes e consoantes, iniciam-se 3 operações que delineiam o segundo momento do livro, cuja intenção maior é fazer operar a escrita da história na imbricada conjunção história-arte-pensamento."--Contratapa. (shrink)

Research on mental health of non-professional caregivers has focused on caregivers of people with specific diseases, especially dementia. Less is known about caregivers of people with other diseases. The aims of this study were (a) to determine the caregivers’ emotional state in a random sample of caregivers of people in situations of dependency, (b) to analyze the association between each disease of the care-recipient (a variety of 23 diseases included in the International Classification of Diseases) and the emotional state of (...) the caregiver, and (c) based on the theoretical model, to analyze the relationship of the different study variables in the appearance of the emotional distress of the caregiver. A sample of 491 non-professional caregivers was selected randomly (89.0% women, average age 55.3 years). Trained psychologists collected sociodemographic and care-related characteristics and evaluated the global emotional distress, somatic symptoms, anxiety-insomnia, social dysfunction, depression, probable mental disorder case, self-esteem and social support. It was found that (a) the caregivers showed moderate emotional distress, and 33.8% presented a probable mental disorder. (b) Caring for a care-recipient with cat's cry syndrome or epilepsy was related to suffering from social dysfunction, and caring for a care-recipient with autism was related to having a probable mental health case. (c) Social support mediated the relationship between social class, daily hours of care, monthly family income, self-esteem and global emotional distress. There is an important impact on the emotional state of the caregivers. This impact was similar in caregivers of care-recipients with different diseases, except in caregivers caring for a care-recipient with cat's cry syndrome or epilepsy (related to social dysfunction), and in caregivers caring for a care-recipient with autism (related to having a probable mental health case). (shrink)