Eight focus groups were conducted in four public hospitals in Madrid to explore healthcare professionals’ perceptions of advance directives in order to improve the understanding of their lack of success among physicians and patients. A purposive sample of sixty healthcare professionals discussed ADs and reasons for their infrequent use. Three main themes were identified: perceptions about their meaning, appraisals of their use in clinical practice, and decision-making about them. Healthcare professionals perceived a lack of clarity about their definition and implementation. (...) There is insufficient awareness of their efficacy in improving the quality of clinical relationships and decision-making, and they are often perceived only as a bureaucratic procedure. Advance directives are not integrated in the clinical practice of Madrid’s healthcare specialist services because their application is exceedingly complex, because of insufficient education about them, and because of lack of procedural clarity. Consequently, healthcare professionals are not aware of how ADs could improve clinical decision-making, of when and for whom their use is appropriate, and of who has responsibility for providing ADs-related information to patients. These circumstances contribute to patients’ lack of interest in completing these documents and to physicians’ sceptical views about their usefulness. (shrink)

Hace dos décadas se incorporó a la agenda pública el interés por el embarazo adolescente en tanto expresión de la pobreza y la vulnerabilidad de la población femenina juvenil. Este artículo presenta un análisis integral del problema a través de cuatro entradas: 1) un breve panorama de las políticas públicas adoptadas en estas dos décadas y diagnóstico que les dio origen; 2) profundiza en la magnitud del embarazo de mujeres menores de 20 años (a partir de datos sobre embarazadas y (...) no del número de hijos nacidos vivos de madres) y compara tres registros: 1995-1996 -Censo de alumnas embarazadas en el sistema escolar, MINEDUC-; 2006 y 2009 -CASEN, registro de menores de 20 años embarazadas-; 3) Profundiza en las vulnerabilidades de estas jóvenes a partir de testimonios sobre el sentido y ejercicio de la sexualidad en la experiencia juvenil; 4) Plantea que la condición de madre adolescente conlleva la vulnerabilidad a mayores condiciones de pobreza, y de exclusión a derechos y beneficios otorgados por el sistema educacional, fundamentándolo en el análisis de las bases de datos de la CASEN 2006 y 2009. (shrink)

The embodiment approach has shown that motor neural networks are involved in the processing of action verbs. There is developmental evidence that embodied effects on verb processing are already present in early years. Yet, the ontogenetic origin of this motor reuse in action verbs remains unknown. This longitudinal study investigates the co-occurrence of manual verbs and actions during mother-child daily routines when children were 1 to 2 and 2 to 3 years old. Eight mother-child dyads were video-recorded in 3-month intervals (...) across 12 months, and the timing of verbs and manual actions were coded by independent observers. Results showed that the probability of matched verb-action co-occurrences were much higher than that of random co-occurrences for Group 1 and Group 2, respectively. The distributions of the verb-action temporal intervals in both groups were quite symmetrical and skewed with the peak corresponding to both 0.00 s synchronic intervals and the shortest +5 s interval. Mother-led instances occurred in both groups whereas child-led instances were restricted to Group 2. Mothers pragmatically aligned their verbal productions, since they repeatedly used those verbs they shared with their children’s repertoire. In conclusion, the early multisensory communicative and manipulative scene affords grounding of verb meanings on the ongoing actions, facilitating verb-action pairing in the realm of social interactions, providing a new dimension to the prevailing solipsistic approach to embodiment. (shrink)

. Introductory Remarks THEODOSIUS DOBZHANSKY The problems of reduction in biology are currently of considerable theoretical interest and practical ...

Referees are essential participants in the sport of football. They are responsible for enforcing the rules and achieving the necessary impartiality for the matches. Referees are often target of hostile reactions from fans, players, and coaches. However, few studies have focused on these experiences and the strategies they use to manage them. In order to fill this gap, a qualitative interview-based study was developed to explore the experiences of a group of football referees on aggression, violence, and coping. A thematic (...) analysis was developed combining inductive and deductive processes. Results indicated that the most frequent aggressions experienced were verbal abuse. Most of the aggressions from spectators were of a sexist nature. When aggressions were considered normal by referees, symbolic violence emerged. Racist aggressions were directed to the two Moroccan participants. Problem and emotional-focused coping strategies were identified. The two most common referee responses to coaches’ and players’ verbal abuse were penalties and send-off calls. Smiling and not considering insults as a personal matter were two emotional-focused coping strategies used toward spectator aggressions. Implications for the referees’ job and well-being as well as the quality of football competitions were highlighted to reduce aggressions and violence and to help referees to cope with hostile behaviors. (shrink)

Should the philosophy of biology deal with organismic, or with molecular aspects , or with both ? We are, of course, not the first to appreciate the ...

The Habermasian concept of ‘interest’ has had a profound effect on the characterization of scientific disciplines. Going beyond issues unrelated to the theory itself, intra‐theoretical interest characterizes the specific ways of approaching any science‐related discipline, defining research topics and methodologies. This approach was developed by Jürgen Habermas in relation to empirical–analytical sciences, historical–hermeneutics sciences, and critical sciences; however, he did not make any specific references to health sciences. This article aims to contribute to shaping a general epistemological framework for health (...) sciences, as well as its specific implications for the medical and nursing areas, via an analysis of the basic knowledge interests developed by Habermas. (shrink)

This collection of specially commissioned essays puts top scholars head to head to debate the central issues in the lively and fast growing field of philosophy ...

Information on the risks and benefits related to surgical procedures is essential for patients in order to obtain their informed consent. Some disciplines, such as sociolinguistics, offer insights that are helpful for patient—professional communication in both written and oral consent. Communication difficulties become more acute when patients make decisions through an informed consent document because they may sign this with a lack of understanding and information, and consequently feel deprived of their freedom to make their choice about different treatments or (...) surgery. This article discusses findings from documentary analysis using the sociolinguistic SPEAKING model, which was applied to the general and specific informed consent documents required for laparoscopic surgery of the bile duct at Torrecárdenas Hospital, Almería, Spain. The objective of this procedure was to identify flaws when information was provided, together with its readability, its voluntary basis, and patients’ consent. The results suggest potential linguistic communication difficulties, different languages being used, cultural clashes, asymmetry of communication between professionals and patients, assignment of rights on the part of patients, and overprotection of professionals and institutions. (shrink)

Este trabajo examina los diferentes reparos que el recurso a las ideas procedentes de la cultura pública como base de su concepción de la justicia le ha procurado a Rawls. Ese examen se propone establecer dos conclusiones. Primera, frente a quienes sugieren que, con la apelación a tales fundamentos, la solidez del método de justificación que Rawls articula se resiente gravemente y los que esgrimen que, con esa apelación, Rawls renuncia a las pretensiones de universalidad que son consustanciales a la (...) doctrina liberal, intenta poner de manifiesto que el papel que esas ideas cumplen en la justificación de una concepción política de la justicia como la suya únicamente muestra la congruencia que la obra de Rawls exhibe en la manera de entender la naturaleza de la justificación y la clase de elementos sobre los cuales se articula. Segunda, frente a quienes sostienen que el método de justificación empleado por Rawls entraña alguna forma de relativismo o etnocentrismo, trata de evidenciar que ese método no conduce a ese tipo de posiciones, por más que tome como base nuestros juicios considerados y nociones políticas fundamentales. (shrink)

Este artículo se hace cargo de la recepción y relevancia de la dialéctica aristotélica en el siglo xx. Ésta tiene un uso científico, fundamental en la construcción y desarrollo de la ciencia, que permite, razonando a partir de éndoxa, establecer el valor de verdad de las proposiciones y aprehender los principios comunes de la ciencia así como los principios propios de las ciencias particulares. El procedimiento diaporético teorizado por el Estagirita es método y no conocimiento, a diferencia de Platón, pero (...) hunde sus raíces en la dialéctica platónica del Parménides. (shrink)

The past decade has seen a flurry of social scientific research on the use of racial categories in human genetics research. This literature has critically analyzed how U.S. race relations are being shaped by and themselves shaping research on human biological difference and disease. Recent work, however, suggests that the particular configurations of science and ethnoracial politics in the US are not exportable. Instead, research on human biology in other contexts reveals the importance of not just racial categories, but national, (...) ethnic, regional and linguistic classifications of bodies and communities... (shrink)

Este artículo es el resultado de una investigación del programa de Maestría en Educación de la universidad la Gran Colombia; se propuso como objetivo general determinar cómo construyen la categoría “valor” estudiantes de grado once de dos colegios de la ciudad de Bogotá, con edades que oscilan entre quince y diecinueve años respectivamente. El enfoque metodológico fue de carácter cualitativo en el cual se utilizaron las técnicas de recolección de información: grupos focales y entrevistas a profundidad, que tuvieron el propósito (...) de recoger e interpretar la asignación de sentidos y representaciones expresadas en las narrativas de los actores participantes. Algunos de los hallazgos sugieren que las percepciones de la población objeto de estudio sobre la categoría “valor” están relacionadas con procesos de subjetivación que se construyen en la vida cotidiana en dinámicas complejas y no necesariamente lineales, como resultados de acuerdos sociales. De otra parte, existe una tendencia significativa a construir la categoría “valor” de acuerdo con las necesidades, intereses y motivaciones que se generan en el contexto escolar, lo que produce conflictos, contradicciones y valoraciones morales que muchas veces devienen en lucha de fuerza con las instituciones. Se destaca entre otras conclusiones, el juego en que se sumergen los estudiantes a partir de prácticas éticas asociadas a la categoría “valor” de carácter teleológico, porque las conductas intentan evitar un castigo o alcanzar un premio; y autotélicas porque los comportamientos producen felicidad en el hacer. (shrink)

Traces scholarly thought from the nineteenth-century birth of evolutionary biology to the mapping of the human genome through forty-eight essays, arranged in chronological order, each preceded by a one-page essay that explains the significance of the chosen work.

Traces scholarly thought from the nineteenth-century birth of evolutionary biology to the mapping of the human genome through forty-eight essays, arranged in chronological order, each preceded by a one-page essay that explains the significance of the chosen work.

The Global Health Security Agenda (GHSA) is a multilateral, multisectoral partnership comprised of more than 70 countries, international organizations, foundations, and businesses to strengthen global health security.

Inserte lugares de la memoria funcionan como marcas significativas de una historia reconstruida desde el presente, que conforman distintos paisajes culturales, que son representaciones simbólicas de territorios como la Ciudad Deportiva Magdalena Mixiuhca y sus geosímbolos deportivos.El objetivo es entender desde el Método de la Hermenéutica Profunda, la Teoría de los Sistemas Complejos y el Pensamiento Complejo, como estos lugares de alta significación del deporte resultan fundamentales en la trasferencia de significados y emociones, que identifican a este espacio apropiado física (...) y simbólicamente, concluyendo que esto es porque detonan recuerdos evocativos de acontecimientos emblemáticos que consolidan diversas identidades colectivas. (shrink)

Actualmente, la discusión sobre los problemas éticos de las nuevas tecnologías suele enfocarse en los dilemas que, de manera concreta y generalmente aislada, supone el uso de unas y otras tecnologías; frente a ello, lo que se propone en este artículo es considerar la problematicidad de nuestro entramado tecnológico, dentro de lo que podemos denominar “nuestra tecnosfera”, para, de ese modo, discutir nuestro presente como un horizonte problemático, en que se redefine el sentido ético de la realidad antropológica. De este (...) modo, y contando como referente teórico la reflexión sobre la técnica de Zubiri y de Ellacuría, proponemos la idea de “hacerse verdaderamente cargo del mundo” como medio para repensar éticamente las nuevas tecnologías (nuestras). (shrink)

Scientific research is growingly increasingly reliant on "microwork" or "crowdsourcing" provided by digital platforms to collect new data. Digital platforms connect clients and workers, charging a fee for an algorithmically managed workflow based on Terms of Service agreements. Although these platforms offer a way to make a living or complement other sources of income, microworkers lack fundamental labor rights and basic safe working conditions, especially in the Global South. We ask how researchers and research institutions address the ethical issues involved (...) in considering microworkers as "human participants." We argue that current scientific research fails to treat microworkers in the same way as in-person human participants, producing de facto a double morality: one applied to people with rights acknowledged by states and international bodies (e.g., the Helsinki Declaration), the other to guest workers of digital autocracies who have almost no rights at all. We illustrate our argument by drawing on 57 interviews conducted with microworkers in Spanish-speaking countries. (shrink)

Intelligent Transportation Systems are expected to automate how parking slots are booked by trucks. The intrinsic dynamic nature of this problem, the need of explanations and the inclusion of private data justify an agent-based solution. Agents solving this problem act with a Believe Desire Intentions reasoning, and are implemented with JASON. Privacy of trucks becomes protected sharing a list of parkings ordered by preference. Furthermore, the process of assigning parking slots takes into account legal requirements on breaks and driving time (...) limits. Finally, the agent simulations use the distances, the number of trucks and parkings corresponding to the proportions of the current European Union data. The performance of the proposed solution is tested in these simulations with three different distances against an alternative with complete knowledge. The difference in efficiency, the number of illegal breaks and the traveled distances are measured in them. Comparing the results, we can conclude that the nonprivate alternative is slightly better in performance while both alternatives do not produce illegal breaks. In this way the simulations show that the proposed privacy protection does not impose a relevant handicap in efficiency. (shrink)

Preserving dignity during the dying process requires reviewing the roles of those involved in the treatment, care methods and decision-making. This article examines the participation and responsibility assigned to nurses regarding decision-making in the final stages of life, as laid out in the Rights to and Guarantee of Dignity for the Individual During the Process of Death Act. This text has been analysed on the levels of socio-cultural practice and discourse practice, using the critical discourse analysis methodology. The results show (...) that, although the law is another result of the social trend of patient empowerment, the responsibility of the nurses is not recognised, and they are left out of the decision-making process in the final stages of life. (shrink)

Many current problems surrounding science revolve around the complex epistemological framework that shapes a new vision of knowledge about reality. The traditional epistemological positions are characterized by the explanation of nature by means of concatenated facts; that is, as bricks attached to each other giving shape to the edifice of science. A conception of this nature showed that the idea of certainty was nothing more than a mere illusion, opening the way, on the contrary, to the idea of the uncertainty (...) of knowledge based on the descriptions of quantum physics, also a product of the non-reductionist conception of reality, thus criticizing the specular representation. This article addresses the main problems surrounding the critical conceptions that the emerging epistemology reveals about knowledge, pointing towards a much more complex vision of reality. (shrink)

In this paper, we examine the importance of two different peer effects as determinants in the adolescent’s decision whether or not to smoke. One is measured at the class level and the other reflects the smoking behaviour of the adolescent’s best friends. A nationally representative wave of Spanish data, collected in different state and private centres of secondary education and vocational training, and several linear probability models are used to estimate the role of peer effects. We find that a 10 (...) % increase in the proportion of classmates is associated with a 3.6 points increment in the probability of smoking. Similarly, if the smoker’s friends go from “only some” to “the majority”, the probability of smoking increases by 39 points. Although both peer effects are significant if introduced separately, the class peer variable is not significant once the closer peer effect is introduced. Our work provides evidence to support the hypothesis that peer effects are important determinants of smoking among adolescents. This has implications for policy-makers, since the existence of peer effects would amplify the effects of interventions. (shrink)

Managers’ commitment to contribute to sustainable development holds the key to their long-term business success and may be a source of competitive advantage. The managerial perception of business ethics is influenced by the level of moral development and personal characteristics of managers. These perceptions are also shaped by forces existing in the environment of the firm, including available resources, societal expectations, sector, and regulations. The resource-based perspective can thus contribute to the analysis of ethical issues offering important insights on how (...) they can influence the environmental strategy of the firm. The findings of this study show that firm resources have a strong influence on business managers’ ethical attitudes. In addition, the application of resource-based rationales to ethical issues can be justified in the following several ways: it influences a managerial perception of natural environment as a competitive opportunity, it requires investments of financial and human resources, flexibility and speed in the adaptation to environmental changes, and it creates new resource-based opportunities through changes in prevention pollution technology, policy process, and market forces. (shrink)

The acquisition and evolution of speech production, discourse and communication can be negatively impacted by brain malformations. We describe, for the first time, a case of developmental dynamic dysphasia (DDD) in a right-handed adolescent boy (subject D) with cortical malformations involving language-eloquent regions (inferior frontal gyrus) in both the left and the right hemispheres. Language evaluation revealed a markedly reduced verbal output affecting phonemic and semantic fluency, phrase and sentence generation and verbal communication in everyday life. Auditory comprehension, repetition, naming, (...) reading and spelling were relatively preserved, but executive function was impaired. Multimodal neuroimaging showed a malformed cerebral cortex with atypical configuration and placement of white matter tracts bilaterally and abnormal callosal fibers. Dichotic listening showed right hemisphere dominance for language and functional magnetic resonance imaging (fMRI) additionally revealed dissociated hemispheric language representation with right frontal activation for phonology and bilateral dominance for semantic processing. Moreover, subject D also had congenital mirror movements (CMM), defined as involuntary movements of one side of the body that mirror intentional movements of the other side. Transcranial magnetic stimulation and fMRI during voluntary unimanual (left and right) hand movements showed bilateral motor cortex recruitment and tractography revealed a lack of decussation of bilateral corticospinal tracts. Genetic testing aimed to detect mutations that disrupt the development of commissural tracts correlating with CMM (e.g., Germline DCC mutations) was negative. Overall, our findings suggest that DDD in subject D resulted from the underdevelopment of the left inferior frontal gyrus with limited capacity for plastic reorganization by its homologous counterpart in the right hemisphere. Corpus callosum anomalies probably contributed to hinder interhemispheric connectivity necessary to compensate language and communication deficits after left frontal involvement. (shrink)

Lower extremity non-contact soft tissue injuries are prevalent in elite futsal. The purpose of this study was to develop robust screening models based on pre-season measures obtained from questionnaires and field-based tests to prospectively predict LE-ST injuries after having applied a range of supervised Machine Learning techniques. One hundred and thirty-nine elite futsal players underwent a pre-season screening evaluation that included individual characteristics; measures related to sleep quality, athlete burnout, psychological characteristics related to sport performance and self-reported perception of chronic (...) ankle instability. A number of neuromuscular performance measures obtained through three field-based tests [isometric hip strength, dynamic postural control and lower extremity joints range of motion ] were also recorded. Injury incidence was monitored over one competitive season. There were 25 LE-ST injuries. Only those groups of measures from two of the field-based tests, as independent data sets, were able to build robust models [area under the receiver operating characteristic curve score ≥0.7] to identify elite futsal players at risk of sustaining a LE-ST injury. Unlike the measures obtained from the five questionnaires selected, the neuromuscular performance measures did build robust prediction models. The inclusion in the same data set of the measures recorded from all the questionnaires and field-based tests did not result in models with significantly higher performance scores. The model generated by the UnderBagging technique with a cost-sensitive SMO as the base classifier and using only four ROM measures reported the best prediction performance scores. The models developed might help coaches, physical trainers and medical practitioners in the decision-making process for injury prevention in futsal. (shrink)

Behavioral interventions have shown promising neuroprotective effects, but the cascade of molecular, brain and behavioral changes involved in these benefits remains poorly understood. Projecte Moviment is a 12-week multi-domain, single-blind, proof-of-concept randomized controlled trial examining the cognitive effect and underlying mechanisms of an aerobic exercise, computerized cognitive training and a combined groups compared to a waitlist control group. Adherence was > 80% for 82/109 participants recruited. In this study we report intervention-related changes in plasma biomarkers and structural-MRI and how they (...) related to changes in physical activity and individual variables and their potential role as mediators in the cognitive changes. Our results show that although there were no significant changes in molecular biomarker concentrations in any intervention group, changes in ICAM-1 and SDF1-α were negatively associated with changes in physical activity outcomes in AE and COMB groups. Brain volume changes were found in the CCT showing a significant increase in precuneus volume. Sex moderated the brain volume change in the AE and COMB groups, suggesting that men may benefit more than women. Changes in molecular biomarkers and brain volumes did not significantly mediate the cognitive-related benefits found previously for any group. This study shows crucial initial molecular and brain volume changes related to lifestyle interventions at early stages and highlights the value of examining activity parameters, individual difference characteristics and using a multi-level analysis approach to address these questions. (shrink)