Prader-Willi syndrome (PWS) is one of the 25 syndromic forms of obesity, in which patients present—in addition to different degrees of obesity—intellectual disability, endocrine disturbs, hyperphagia and/or other signs of hypothalamic dysfunction. In front of a severe/extreme obesity and the failure of non-invasive treatments, bariatric surgery is proposed as a therapeutic option. The complexity of the clinical condition, which could affect the long-term effects of bariatric surgery, and the frequent association with a mild to severe intellectual disability raise some ethical (...) concerns in the treatment of obese PWS adolescents. This article analyses these issues referring to the principles of healthcare ethics: beneficence/non-maleficence (proportionality of treatments; minimisation of risks); respect of autonomy; justice. Based on these principles, three hypothetical scenarios are defined: (1) obese PWS adolescent, capable of making an autonomous decision; (2) obese PWS adolescent with a severe intellectual disability, whose parents agree with bariatric surgery; (3) obese PWS adolescent with a life-threatening condition and a severe intellectual disability, whose parents do not agree with bariatric surgery. The currently available evidence on efficacy and safety of bariatric surgery in PWS adolescents with extreme or severe obesity and the lack of adequate long-term follow-up suggests great caution even in a very life-threatening condition. Clinicians must always obtain a full IQ assessment of patients by psychologists. A multidisciplinary team is needed to analyse the clinical, psychological, social and ethical aspects and organise support for patient and parents, involving also the hospital ethical committee or, if necessary, legal authorities. (shrink)

A fronte del quotidiano rincorrersi di nuovi interrogativi che esigono una risposta dalla bioetica, si assiste alla difficoltà di trovare un solido fondamento al giudizio etico in bioetica. Si confrontano e si scontrano, infatti, teorie etiche tra di loro non sovrapponibili né conciliabili, che portano a soluzioni pratiche tra di loro divergenti e spesso, troppo spesso, dimentiche della centralità della persona umana. Edè proprio la riflessione sulla persona umana, con i suoi diritti, ma anche con i suoi doveri, secondo la (...) lettura del personalismo ontologicamente fondato, il filo conduttore dei contributi contenuti in questo volume...(Dalla quarta di copertina)- In sommario: La nuova genetica - La clonazione umana: aspetti tecnici e considerazioni - Le basi biologiche della sessualità - Natura e interpretazione dei disordini sessuali: l'omosessualità - I disorientamenti sessuali: il ruolo dell'educatore - La sindrome da immunodeficienza acquisita - Orientamenti metodologici nell'educazione sessuale. (shrink)

In this paper, we analyse the most important documents establishing the criteria for the treatment and exclusion of COVID-19 patients, especially in regard to the giving of respiratory support, in Italy and Spain. These documents reflect a tension that stems from limited healthcare resources which are insufficient to save lives that, under normal conditions, could have been saved, or at least could have received the best possible treatment. First, we analyse the healthcare systems of these two countries before the spread (...) of the virus, both of which have seen decreases in the number of intensive care beds and have been marked by financial cuts during the last ten years. It is a fact that a greater number of people, especially those over 70 years of age, have been left without respiratory support treatment, and therefore, there have been a greater number of deaths. It is also a fact that there has been a higher infection rate among healthcare professionals due to the delay in the management of protective measures and the inability to provide adequate care for those in nursing homes, as recognised by WHO. In the context of this health emergency, healthcare professionals have suffered a real ‘moral distress’ because, knowing first-hand the causes of the limitation of resources, they have had to put triage protocols into practice. Finally, we set forth a series of concrete ethical proposals with which to face the successive waves of COVID-19 infection, as well as other future pandemics. (shrink)

Motor learning can be defined as a process that leads to relatively permanent changes in motor behavior through repeated interactions with the environment. Different strategies can be adopted to achieve motor learning: movements can be overtly practiced leading to an amelioration of motor performance; alternatively, covert strategies (e.g., action observation) can promote neuroplastic changes in the motor system even in the absence of real movement execution. However, whether a training regularly alternating action observation and execution (i.e., Action Observation Training, AOT) (...) may surpass the pure motor practice (MP) and observational learning (OL) remains to be established. To address this issue, we enrolled 54 subjects requiring them to learn tying nautical knots via one out of three types of training (AOT, MP, OL) with the scope to investigate which element mostly contributes to motor learning. We evaluated the overall improvement of each group, along with the predictive role that neuropsychological indexes exert on each treatment outcome. The AOT group exhibited the highest performance improvement (42%), indicating that the regular alternation between observation and execution biases participants toward a better performance. The reiteration of this sequence provides an incremental, adjunct value that super-adds onto the efficacy of motor practice or observational learning in isolation (42% > 25% + 10%, i.e., OL + MP). These findings extend the use of the AOT from clinical and rehabilitative contexts to daily routines requiring the learning and perfectioning of new motor skills such as sports training, music, and occupational activities requiring fine motor control. (shrink)

Reassesses the Italian Resistance movement, historically conceived, and explores the concept of Resistance within the contemporary cultural context from a multidisciplinary perspective.

While dreaming amputees often experience a normal body image and the phantom limb may not be present. However, dreaming experiences in amputees have mainly been collected by questionnaires. We analysed the dream reports of amputated patients with phantom limb collected after awakening from REM sleep during overnight videopolysomnography . Six amputated patients underwent overnight VPSG study. Patients were awakened during REM sleep and asked to report their dreams. Three patients were able to deliver an account of a dream. In all (...) dreaming recalls, patients reported that the amputated limbs were intact and completely functional and they no longer experienced phantom limb sensations. Phantom limb experiences, that during wake result from a conflict between a pre-existing body scheme and the sensory information on the missing limb, were suppressed during sleep in our patients in favour of the image of an intact body accessed during dream. (shrink)

BackgroundChronic airway diseases are prevalent and costly conditions. Interdisciplinary rehabilitation programs that include Acceptance and Commitment-based components could be important to tackle the vicious circle linking progression of the disease, inactivity, and psychopathological symptoms.MethodsA retrospective evaluation of routinely collected data of an interdisciplinary rehabilitation program was performed. The program included group sessions including patient education, breathing exercise, occupational therapy and an ACT-based psychological treatment, and individual sessions of physical therapy. Demographic data, clinical characteristics of the patients and the values of (...) outcome variables before treatment, at discharge, at 3 months, and at 6 months were extracted from medical records. Multiple imputation was employed to address missing data. Linear mixed models were employed to assess changes over time. Multivariable logistic regression was performed to assess predictors of a minimum clinically important change of health status from baseline to the 6-months follow-up.ResultsData from 31 patients with chronic obstructive pulmonary disease and 12 patients with bronchiectasis were extracted. Health status improved from baseline to discharge to the 3 months follow-up, but not to the 6 months follow-up. Anxiety and depression improved across all the time points. Quality of life did not improve over time. Having a worse health status at baseline and fewer depressive symptoms were significantly associated with achieving a minimum clinically important change of health status at 6 months. The effects of the interdisciplinary program were not different for patients with COPD or with bronchiectasis.DiscussionInterdisciplinary programs including ACT-based components are promising treatments for the rehabilitation of patients with chronic airway diseases. (shrink)

The paper focuses on the kind of expertise required by doctors in health communication and argues that such an expertise is twofold: both epistemological and communicative competences are necessary to achieve compliance with the patient. Firstly, we introduce the specific epistemic competences that deal with diagnosis and its problems. Secondly, we focus on the communicative competences and argue that an inappropriate strategy in communicating the reasons of diagnosis and therapy can make patient compliance unworkable. Finally, we focus on the case (...) of diabetes metaphor and propose the deliberate use of metaphors in health communication as an educational tool. On the one hand, metaphors might help doctors in explaining the disease in simpler terms and framing the experience of illness according to patient’s specific needs. On the other hand, metaphors might encourage a change in patient’s beliefs on their own experience of illness, and enable them to reach a shared decision making with doctors. (shrink)

When people combine concepts these are often characterised as “hybrid”, “impossible”, or “humorous”. However, when simply considering them in terms of extensional logic, the novel concepts understood as a conjunctive concept will often lack meaning having an empty extension (consider “a tooth that is a chair”, “a pet flower”, etc.). Still, people use different strategies to produce new non-empty concepts: additive or integrative combination of features, alignment of features, instantiation, etc. All these strategies involve the ability to deal with conflicting (...) attributes and the creation of new (combinations of) properties. We here consider in particular the case where a Head concept has superior ‘asymmetric’ control over steering the resulting concept combination (or hybridisation) with a Modifier concept. Specifically, we propose a dialogical approach to concept combination and discuss an implementation based on axiom weakening, which models the cognitive and logical mechanics of this asymmetric form of hybridisation. (shrink)

The New Economic Windows Series, derived from Massimo Salzano's ideas and work, incorporates material from textbooks, monographs and conference proceedings that deals with both the theoretical and applied aspects of various sub-disciplines ...

Questo contributo mette in luce la molteplice funzione politica di uno schema agiografico centrale nella rappresentazione della giovinezza di Bernardino da Siena: il suo servizio durante la peste del 1400 presso l’Ospedale di Santa Maria della Scala di Siena. La memoria di questo episodio si prestava ad essere utilizzata tanto dall’Osservanza minoritica quanto in diversi contesti locali. In questo racconto Bernardino è presentato come capace di rispondere ai bisogni della città non solo attraverso le proprie virtù, ma radunando altre (...) persone e convincendole a impegnarsi per il bene comune, anche a rischio della propria vita. L’episodio, così come è raccontato dagli agiografi, incorpora la prima predica fatta dal giovane Bernardino ai membri della confraternita dell’Ospedale. Il testo indica programmaticamente la necessità per i laici di anteporre il bonum commune al bonum proprium e delinea un ruolo di leadership dei frati dell’Osservanza nel cuore delle città. Inoltre, se a Siena la memoria della peste del 1400 serviva a sottolineare il rapporto tra il santo e le istituzioni della città, la raffigurazione di tale episodio in alcuni affreschi dipinti a Lodi nel 1476 non soltanto veicolava un modello di spiritualità laicale ma serviva a promuovere e legittimare la riforma ospedaliera in corso a Lodi. (shrink)

The period, from the middle of the fifteenth century, and in particular the fruition of the Franciscan Observance under the leadership of Bernardino of Siena, John of Capistrano and James of the Marches, through the end of the Council of Trent , lasts about a century. It is a century that has recently been the focus of much attention in our research group.2 The hypothesis in this essay is that this century was marked more by continuities than fractures, and in (...) which many problems came to the fore. Therefore, this was a period of instability but also of great vitality:3 “not a starting point, but the climax,” as Paolo Prodi wrote.4The booklet of Paolo Giustiniani and Pietro Quirini, the so-called Libellus ad .. (shrink)

The chapter explores comparatively the attention to the practical dimension that—each in his own way—Michel Foucault, Friedrich Nietzsche, and the classic pragmatist thinker William James pay when confronted with the challenge of providing a non-skeptical response to the relativist stance on truth that arose in the post-Kantian age. Particular focus will be given to the extent to which these three authors conceived of the practical framework as the only one that allows us to meaningfully address and determine truth.

The paper aims to investigate some aspects of Ernst Mach’s epistemology in the light of the problem of human orientation in relation to the world (Weltorientierung), which is a main topic of Western philosophy since Kant. As will be argued, Mach has been concerned with that problem, insofar as he developed an original pragmatist epistemology. In order to support my argument, I firstly investigate whether Mach defended a nominalist or a realist account of knowledge and compare his view to those (...) elaborated by other pragmatist thinkers, such as W. James, H. Vaihinger and H. Poincaré. Secondly, the question of what does it mean, for Mach, to orient ourselves in science is addressed. Finally, it will be argued that, although Mach tried to keep his epistemology restricted to a mere operational and economical account of science, that question involves the wider plane of practical philosophy. (shrink)

Razón, poesía, historia.--La cuestión del estoicismo español.--El querer.

Dibujar el pensamiento de Seneca es dibujar su figura viva, trazar el esquema de su persona. Seneca es un mediador que para alzarse sobre nosotros necesita de nuestra necesidad, pues solo apoyado en nuestra indigencia tiene sentido. Maria Zambrano lleva a cabo un lucido estudio de la figura y significacion del pensador cordobes y presenta una seleccion de sus escritos.

This chapter explores Nietzsche’s and Wittgenstein’s views on language and knowledge, establishing a philosophical dialogue between two different positions, which are based on a similar anti-essentialist and instrumentalist concern. The chapter will first focus on Nietzsche’s conception of language as the expression of valuational perspectives developing through the natural and cultural history of mankind. It will then consider Wittgenstein’s account of language as the inherited background of our practical engagement with the world. Finally, by bringing Nietzsche’s and Wittgenstein’s views together, (...) the last section reflects on the crucial strategic move they make in their respective battle against the bewitchment of our intelligence by means of language. -/- . (shrink)

Reciprocal libertarianism is a version of left-wing libertarianism that combines self-ownership with an egalitarian distribution of resources according to reciprocity. In this paper, I show that reciprocal libertarianism is a coherent and appealing view. I discuss how reciprocal libertarians can handle conflicts between self-ownership and reciprocity, and I show that reciprocal libertarianism can be realised in a framework of individual ownership of external resources or in a socialist scheme of common ownership (libertarian socialism). I also compare reciprocal libertarianism with left-libertarian (...) approaches: I argue that a reciprocity-sensitive version of left-libertarianism (reciprocal left-libertarianism) is coherent and morally superior to traditional left-libertarianism, on grounds of incorporating a distinctively solidaristic and recognition-oriented aspect of equality. The policy implications of reciprocal libertarianism will differ depending on which rights people can have over external resources, but all reciprocal libertarian views acknowledge the existence of social rights that people have as co-operators. (shrink)

Spectroscopy is a scientific topic at the interface between Chemistry and Physics, which is taught at high school level in relation with its fundamental applications in Analytical Chemistry. In the first part of the paper, the topic of spectroscopy is analyzed having in mind the well-known Johnstone’s triangle of chemistry education, putting in evidence the way spectroscopy is usually taught at the three levels of chemical knowledge: macroscopic/phenomenological, sub-microscopic/molecular and symbolic ones. Among these three levels, following Johnstone’s recommendations the macroscopic (...) one is the most useful for high school students who learn spectroscopy for the first time. Starting from these premises, in the second part of the paper, we propose a didactic sequence which is inspired by the historical evolution of spectroscopic instruments from the first spectroscopes invented by Gustav Kirchhoff and Robert Bunsen in 1860 to the UV–vis spectrophotometers which became common since the 1960s. The idea behind our research is to analyze the conceptual advancements through the history of spectroscopy and to identify the key episodes/experiments and spectroscopic instruments. For each of them, a didactic activity, typically an experiment, is then proposed underlining the relevant aspects from the chemistry education point of view. The present paper is the occasion to reflect on the potentialities of an historical approach combined with a laboratorial one, and to discuss the role of historical instruments and related technological improvements to teach spectroscopy. (shrink)

In this paper I discuss the role played by Ernst Mach on Nietzsche’s thought. Starting from the contents of his Beiträge zur Analyse der Empfindungen, I’ll show the close similarities between their view on both human knowledge and the scientific world description. In his writing on science Nietzsche shares Mach’s critique to the 19th century mechanism and its metaphysical ground, as much as his way of defining the substantial notions such as matter, ego and free will. Moreover, my investigation will (...) make it clear that Mach cannot be seen as a direct source of Nietzsche’s thought, since the latter wrote many times on the same subjects long before his first reading one of his works. Rather, it is possible to consider the writings of Lange, Spir and Spencer as the first sources of Nietzsche’s views on the main themes Mach dealt with in his work from 1886. (shrink)

Hilary Putnam is one of the world’s leading philosophers. His highly original and often provocative ideas have set the agenda for a variety of debates in philosophy of science, philosophy of mind and philosophy of language. His now famous philosophical thought experiments, such as the ‘Twin earth’ and ‘the brains in the vat’ have become part of the established canon in philosophy and cognitive science. _Reading Putnam_ is an outstanding overview and assessment of Hilary Putnam’s work by a team of (...) international contributors, and includes replies by Putnam himself. Divided into clear sections, it contains chapters on key aspects of Putnam’s large body of writing, including: Scientific realism and the changes that Putnam’s thought has undergone on this topic analyticity and ontology, including the important interconnections between the views of Putnam and Quine Putnam’s arguments concerning externalist views of meaning and reference, questions of conceptual relativity, and his preoccupation with ethics through a denial of the fact–value dichotomy Putnam’s developing views on perception. Offering an excellent survey of Putnam’s work, _Reading Putnam_ is essential for those studying philosophy of mind, philosophy of language, and philosophy of science, as well as for anyone interested in contemporary philosophy. (shrink)

Wilfrid Sellars’ denunciation of the Myth of the Given was meant to clarify, against empiricism, that perceptual episodes alone are insufficient to ground and justify perceptual knowledge. Sellars showed that in order to accomplish such epistemic tasks, more resources and capacities, such as those involved in using concepts, are needed. Perceptual knowledge belongs to the space of reasons and not to an independent realm of experience. Dan Hutto and Eric Myin have recently presented the Hard Problem of Content as an (...) ensemble of reasons against naturalistic accounts of content. In a nutshell, it states that covariance relations—even though they are naturalistically acceptable explanatory resources—do not constitute content. The authors exploit this move in order to promote their preferred radical enactivist and anti-representationalist option, according to which, basic minds—the lower stratum of cognition—do not involve content. Although it is controversial to argue that the Hard Problem of Content effectively dismisses naturalistic theories of representation, a central aspect of it—the idea that information as covariance does not suffice to explain content—finds support among the defenders of classical cognitive representationalism, such as Marcin Miłkowski. This support—together with the acknowledgment this remark about covariance is a point already made by Sellars in his criticism of the Myth of the Given—has a number of interesting implications. Not only is it of interest for the debates about representationalism in cognitive science, where it can be understood as an anticipatory move, but it also offers some clues and insights for reconsidering some issues along Sellarsian lines—a conflation between two concepts of representation that is often assumed in cognitive science, a distinction between two types of relevant normativities, and a reconsideration of the naturalism involved in such explanations. (shrink)

In the literature, the pragmatic dimension of metaphors has been clearly acknowledged. Metaphors are regarded as having different possible uses, especially pursuing persuasion. However, an analysis of the specific conversational purposes that they can be aimed at achieving in a dialogue and their adequacy thereto is still missing. In this chapter, we will address this issue focusing on the classical distinction between the explanatory and persuasive uses of metaphors, which is, however, complex to draw at an analytical level and often (...) blurred and controversial also from a theoretical point of view. Building on the analysis of explanation in different theories and fields of study, we show how it can be conceived as characterized by a cognitive and a pragmatic dimension, where the transference of understanding is used pragmatically for different dialogical goals - such as informing, making a joint decision, and most importantly persuading. In this sense, the cognitive effects of understanding are not incompatible with a persuasive dialogical purpose. This theoretical proposal will be applied to examples drawn from the medical context, to show how a pragmatic approach to explanation can account for the complexity of the cases that can be found in actual dialogical contexts. (shrink)

Léon Brunschvicg's contribution to philosophical thought in fin-de-siècle France receives full explication in the first English-language study on his work. Arguing that Brunschvicg is crucial to understanding the philosophical schools which took root in 20th-century France, Pietro Terzi locates Brunschvicg alongside his contemporary Henri Bergson, as well as the range of thinkers he taught and influenced, including Lévinas, Merleau-Ponty, de Beauvoir, and Sartre. Brunschvicg's deep engagement with debates concerning spiritualism and rationalism, neo-Kantian philosophy, and the role of mathematics in (...) philosophy made him the perfect supervisor for a whole host of nascent philosophical ideas which were forming in the work of his students. Terzi outlines Brunchvicg's defence of neo-Kantian judgement, historical analysis and the inextricability of the natural and humanist sciences to any rigorous system of philosophy, with wide-ranging implications for contemporary scholarship. (shrink)

Léon Brunschvicg's contribution to philosophical thought in fin-de-siècle France receives full explication in the first English-language study on his work. Arguing that Brunschvicg is crucial to understanding the philosophical schools which took root in 20th-century France, Pietro Terzi locates Brunschvicg alongside his contemporary Henri Bergson, as well as the range of thinkers he taught and influenced, including Lévinas, Merleau-Ponty, de Beauvoir, and Sartre. Brunschvicg's deep engagement with debates concerning spiritualism and rationalism, neo-Kantian philosophy, and the role of mathematics in (...) philosophy made him the perfect supervisor for a whole host of nascent philosophical ideas which were forming in the work of his students. Terzi outlines Brunchvicg's defence of neo-Kantian judgement, historical analysis and the inextricability of the natural and humanist sciences to any rigorous system of philosophy, with wide-ranging implications for contemporary scholarship. (shrink)