We examine ethical considerations in access to facial transplantation (FT), with implications for promoting health equity. As a form of vascularised composite allotransplantation, FT is still considered innovative with a relatively low volume of procedures performed to date by a small number of active FT programmes worldwide. However, as numbers continue to increase and institutions look to establish new FT programmes, we anticipate that attention will shift from feasibility towards ensuring the benefits of FT are equitably available to those in (...) need. This manuscript assesses barriers to care and their ethical implications across a number of considerations, with the intent of mapping various factors relating to health equity and fair access to FT. Evidence is drawn from an evolving clinical experience as well as published scholarship addressing several dimensions of access to FT. We also explore novel concerns that have yet to be mentioned in the literature. (shrink)

What ethical framework should be used as a basis for teaching business ethics? Should business ethics be taught by ethicists in a separate course, by business faculty in business courses, or perhaps by both? These are some of the issues this paper will address. The paper begins with a review of the literature concerning approaches to teaching business ethics. Next, some ethical frameworks for teaching business ethics are considered. Finally, the paper proposes that students should apply their own personal values (...) to business ethical issues in the classroom, thus providing future business leaders with a process for resolving ethical dilemmas. (shrink)

This article presents a case that former President of the United States Donald Trump was a tyrant-like leader in the mold of the tyrant in Plato’s Republic. While he does not perfectly embody the tyrant as presented in the Republic, he captures its core feature. Like the tyrant, Trump is driven by unregulated desires that reflect what Plato describes as an extreme freedom that underlies and threatens democratic regimes. Extreme freedom is manifested in Trump’s disregard for social and legal norms, (...) which mirrors the lawlessness of the tyrant. The people, in turn, interpret that posture as a mark of authenticity. Understanding Trump’s appeal in the United States helps alert friends of democracy to the possible rise of tyrant-like figures. In closing, and as a way of remedying the harm done by the tyrannical soul, the article recommends that society help temper tyrant-like passions in the people through a rededication to civic equality. (shrink)

Depue & Morrone-Strupinsky's (D&M-S's) model of affiliation meets the criteria advanced for the definition of behavior systems and endophenotypes. We argue that its application in psychiatry could be useful for identifying a biological pathophysiology common to a variety of conditions that are currently classified in very different categories of psychiatric nosography, including autism, schizoid personality, primary psychopathy, and dismissing attachment.

A common financial model used in business decisions is the cost/benefit comparison. The costs of a proposed project are compared with the benefits, and if the benefits outweigh the costs, the project is accepted; if the costs exceed the benefits, the project is rejected. This model is applicable when tangible costs and benefits can be reasonably measured in monetary units. However, it is difficult to consider intangible factors in this model because intangible factors cannot be readily quantified in money.While some (...) might argue that the financial model should not apply to healthcare decisions, the fact is that costs do enter into the picture. People may decide to forego needed healthcare because they cannot afford it. Healthcare providers may make choices based in part on the costs of diagnosis and treatment, rather than solely on medical information and what is best for the patient. Should financial issues enter into healthcare decisions – decisions about human health and well being? If so, how should the costs and benefits be measured and evaluated? What are some ethical issues and dilemmas involved in such decisions? (shrink)

The existence of free will has been both an enduring presumption of Western culture and a subject for debate across disciplines for millennia. However, little empirical evidence exists to support the almost unquestioned assumption that, in general, Westerners endorse the existence of free will. The few studies that measure belief in free will have methodological problems that likely resulted in underestimating the true extent of belief. Recently, Rakos et al. (Behavior and Social Issues 17:20–39, 2008 ) found a stronger endorsement (...) of free will when demand characteristics were eliminated. The current study builds on this work by sampling incarcerated adolescents and adults, whose freedom to act is externally constrained. Belief in free will as well as attitudes toward punishment, self-esteem, and locus of control were measured. The results indicate that free will is strongly endorsed in Western society even when freedom to act is severely restricted. However, incarcerated adolescents endorsed free will to a slightly lesser extent than their nonincarcerated counterparts from Rakos et al. (Behavior and Social Issues 17:20–39, 2008 ), while incarcerated and nonincarcerated adults offered equally strong endorsements. The comparable endorsement by adults is consistent with the hypothesis that the belief in agency is an evolutionary adaptation. The small decrease found for incarcerated adolescents may reflect the interaction between developmental factors and the expression of an evolutionary adaptation. Additionally, incarcerated adolescents and adults associated beliefs in free will with viewing punishment as a means of deterrence, rehabilitation, and retribution. Incarcerated adults, but not incarcerated adolescents, associated beliefs in free will with greater self-esteem and with an external locus of control. Finally, though both incarcerated adults and adolescents endorsed free will strongly, the former manifested the belief by emphasizing free agentic choice whereas the latter focused on the personal responsibility that is interwoven with free choice. The implications of these findings are discussed in the context of evolutionary, cultural, and developmental factors. (shrink)

The focus of this work is the analysis of changes in completed family size and possible determinants of that size over time, in an attempt to characterize the evolution of reproductive patterns during the demographic transition. With this purpose in mind, time trends are studied in relation to the mean number of live births per family (as an indirect measure of fertility), using family reconstitution techniques to trace the reproductive history of each married woman. The population surveyed is a Spanish (...) rural community called Lanciego, located at the southern end of the province of Alava (Basque Country). A total of 24,510 parish records of baptisms, marriages and burials made between 1800 and 1969 were examined to obtain the demographic data set. For each reconstituted family, the variables included in the study were the number of live births per family or family size (FAMS), year of marriage (YEAR), age at marriage of both partners (AMAN, AWOM), wife’s age at the end of marriage (WEND), duration of marriage (MARD), age at first maternity (A1CH), length of reproductive span (REPS) and number of children dying before their first anniversary (MINF). Through a principal component analysis, three factors were found that explained more than 75% of the total variance. Association of variables in factors I and III was particularly useful in characterizing the variability of mean family size in pre-transitional, transitional and post-transitional cohorts. During demographic transition, a decreasing trend is observed in the variables FAMS, REPS and MINF, while variables AWOM, AMAN, WEND and A1CH show a tendency to increase over the 20th century. Results obtained by multiple regression analysis confirm that the best predictors of family size (dependent variable) were REPS and MINF, which between them explained over 85% of the total variation in FAMS (R2=0·853). In Lanciego, birth control seems to be present on the evidence of an increase in age at first maternity and a decrease in age at last parturition, indicating that the beginning of the reproductive span is delayed and its end is brought forward. Interaction between family size and infant mortality is discussed in the light of various hypotheses, including replacement of descendants, the so-called biological effect and the theory of r and k selection. (shrink)

Estudos recentes vêm revisando a composição da literatura que, ao longo do século XVIII serviu como base às ciências em território britânico. Segundo esses estudos, os seiscentistas de fala inglesa dedicaram-se a duas linhagens de texto, originadas em concepções de ciência muito distintas. Uma dessas linhagens tinha como fonte principal a antiga “literatura do segredo” que incluía desde velhos e sigilosos manuais de ofício até os milenares e proibidos tratados de hermética, literatura antes reservada a poucos. Diferente dessa, a outra (...) ]inhagem de textos surgia como um direto da proposta baconiana para a nova ciência: um saber elaborado por muitos e ao alcance de todos. Exemplos conhecidos dessa linhagem são os livros de divulgação utilizados pelos comenianos ingleses ou mesmo os relatórios, atas e memórias das sociedades científicas, geradores dos primeiros embriões de periódicos dedicados às ciências. Todavia, sob essa aparente contraposição das duas linhagens, há indícios de um profícuo diálogo - expresso sobretudo na correspondência e diários pensadores da época. (shrink)

El profesor Juan Guillermo Hoyos y quien esto escribe, con el propósito de divulgar el pensamiento de este genial filósofo entre los estudiantes de nuestro departamento de filosofía -y por tanto con fines exclusivamente internos- tradujimos en 1986 los Remarks on the Foundations of Mathematics, en su versión revisada. Cuando finalizamos nuestro trabajo tuvimos noticia de que Alianza Editorial había publicado en español una traducción de este libro a cargo del señor Isidoro Reguera en 1987.

The papers presented in this volume in honour of Alfonso Maieru cover some of the major topics of his research area. The institutional and intellectual life of university training in the Middle Ages, including the peculiar tradition of related works, is the focus of the papers by Louis Jacques Bataillon, William J. Courtenay, Jacqueline Hamesse, Zenon Kaluza, Loris Sturlese and Olga Weijers. Three papers, by Jacopo Costa, Pasquale Porro and Thomas Ricklin, deal with philosophical problems in Dante'sMonarchia and Convivio. (...) The complex interrelations between logic and the other main aspects of medieval philosophy, with a particular attention to theology, metaphysics and natural philosophy, are the core of the other papers by Stefano Caroti, Sten Ebbesen, Barbara Faes de Mottoni, Simo Knuuttila, Alain de Libera, Olga Lizzini, Costantino Marmo, Claude Panaccio, Ivan Bendwell, Irene Rosier-Catach, Lambert Marie de Rijk, Leonardo Sileo, Luisa Valente, and Albert Zimmermann. A larger number of friends and colleagues of Alfonso Maieru than those who appear as contributors and editors of this volume have warmly welcomed its publication. We could say, therefore, that it is absolutely contingent that the Editors are: Stefano Caroti (Universita degli Studi di Parma), Ruedi Imbach (Universite de Paris-Sorbonne), Zenon Kaluza (Centre d'Etudes des Religions du Livre, C.N.R.S), Loris Sturlese (Universita degli Studi di Lecce) and Giorgio Stabile(Universita degli Studi di Roma "La Sapienza"). (shrink)

La Meditacion. Luis Mojica Sandoz. Editorial Universitaria, Universidad de Puerto Rico 1979, Apartado de Correos X, Rio Piedras, P. R. 00931.

IntroductionThe assessments of the motor symptoms in Parkinson’s disease are usually limited to clinical rating scales, and it depends on the clinician’s experience. This study aims to propose a machine learning technique algorithm using the variables from upper and lower limbs, to classify people with PD from healthy people, using data from a portable low-cost device. And can be used to support the diagnosis and follow-up of patients in developing countries and remote areas.MethodsWe used Kinect®eMotion system to capture the spatiotemporal (...) gait data from 30 patients with PD and 30 healthy age-matched controls in three walking trials. First, a correlation matrix was made using the variables of upper and lower limbs. After this, we applied a backward feature selection model using R and Python to determine the most relevant variables. Three further analyses were done using variables selected from backward feature selection model, movement disorders specialist, and all the variables from the dataset. We ran seven machine learning models for each model. Dataset was divided 80% for algorithm training and 20% for evaluation. Finally, a causal inference model using the DoWhy library was performed on Dataset B due to its accuracy and simplicity.ResultsThe Random Forest model is the most accurate for all three variable Datasets followed by the support vector machine. The CIM shows a relation between leg variables and the arms swing asymmetry and a proportional relationship between ASA and the diagnosis of PD with a robust estimator.ConclusionsMachine learning techniques based on objective measures using portable low-cost devices are useful and accurate to classify patients with Parkinson’s disease. This method can be used to evaluate patients remotely and help clinicians make decisions regarding follow-up and treatment. (shrink)

Introduction: Clinical policies control several aspects of clinical practice, including individual treatment and care, resource management and healthcare professionals’ etiquette. This article presents Clinical Policy Ethics Assessment Tool, an ethical assessment tool for clinical policies that could be used not only by clinical ethics committees but also by policy committees or other relevant groups. Aim: The aim of this study was to find or create a tool to identify ethical issues and/or confirm ethical validity in nursing practice policies, protocols and (...) guidelines. Methodology: The development of Clinical Policy Ethics Assessment Tool involved first a literature review, followed by modification of the Research Protocol Ethics Assessment Tool, which was created to identify research protocols’ ethical issues, and finally, a trial of Clinical Policy Ethics Assessment Tool to ensure its reliability and validity. Ethical consideration: The policies analysed trialling Clinical Policy Ethics Assessment Tool were in the public domain and did not contain any confidential information. Despite that, Clinical Policy Ethics Assessment Tool also had the approval of a research ethics committee. Results: Research Protocol Ethics Assessment Tool was chosen as the template for a Clinical Policy Ethics Assessment Tool, to which several modifications were added to adapt it to work within a nursing practice context. Clinical Policy Ethics Assessment Tool was tested twice, which resulted in a general test–retest reliability coefficient = 0.86, r = 0.84, α1 = 0.817, α2 = 0.824 and interclass correlation coefficient = 0.874. Discussion: Contemporary nursing practice in a developed country is often ruled by clinical policies. The use of Clinical Policy Ethics Assessment Tool could confirm the ethical validity of those clinical practice policies, impacting on nurses’ education, values and quality of care. Conclusion: Clinical Policy Ethics Assessment Tool has the potential to detect ethical issues and facilitate the correction and improvement of clinical policies and guidelines in a structured way. This is especially so as it has shown reliability in detecting issues in clinical policies involving human participants and in encouraging policymakers to consider common ethical dilemmas in nursing practice. (shrink)

D. Álvaro Pelayo, nombrado obispo de Silves, hoy diócesis de Faro, Algarve, en el año 1334, entró en conflicto con el rey de Portugal, Alfonso IV (1325-57). Le escribió dos cartas en las que se puede observar que también tuvo que defender la autonomía jurisdiccional del poder espiritual, con vistas a la política centralizadora a la que el rey, siguiendo los pasos de su padre. D. Dinis (1279-1325), daba continuidad, con el propósito de restringir el espacio político del alto (...) clero lusitano. Unos pocos años después (1347), por la misma razón, el conflicto de las relaciones de poder entre las dos autoridades volvió a recrudecerse. Nuestro propósito aquí es doble: analizar los hechos históricos relacionados con los dos mencionados conflictos, por una parte, y los aspectos doctrinales contenidos en las dos referidas cartas, por otra, con vistas a mostrar la coherencia de pensamiento y actitud de D. Álvaro Pelayo. (shrink)

The availability of willing providers of medical assistance in dying in Canada has been an issue since a Canadian Supreme Court decision and the subsequent passing of federal legislation, Bill C14, decriminalised MAiD in 2016. Following this legislation, Hamilton Health Sciences in Ontario, Canada, created a team to support access to MAiD for patients. This research used a qualitative, mixed methods approach to data collection, obtaining the narratives of providers and supporters of MAiD practice at HHS. This study occurred at (...) the outset of MAiD practice in 2016, and 1 year later, once MAiD practice was established. Our study reveals that professional identity and values, personal identity and values, experience with death and dying, and organisation context are the most significant contributors to conscientious participation for MAiD providers and supporters. The stories of study participants were used to create a model that provides a framework for values clarification around MAiD practice, and can be used to explore beliefs and reasoning around participation in MAiD across the moral spectrum. This research addresses a significant gap in the literature by advancing our understanding of factors that influence participation in taboo clinical practices. It may be applied practically to help promote reflective practice regarding complex and controversial areas of medicine, to improve interprofessional engagement in MAiD practice and promote the conditions necessary to support moral diversity in our institutions. (shrink)

In debates about the proper analysis of demonstrative expressions, ostensive gestures and speaker intentions are often seen as competing for primary importance in securing reference. Underlying some of these debates is the mistaken assumption that ostensive gestures always make the demonstrated object maximally salient to interlocutors. When we abandon this assumption and focus on an object’s mutually-recognized salience itself, rather than on how the object came to be salient, we can work towards a more promising analysis with a uniform treatment (...) of demonstrative reference whether or not there is an ostensive gesture, and whether reference is ordinary or deferred. (shrink)

Fashion design is a feminized occupation, but there is a widespread perception that gay male designers are advantaged in receiving awards, publicity, and praise. This article develops the notion of a “glass runway” to explain this inequality. First, using design canons and lists of award recipients, I show that men, especially gay men, receive more consecration than women. Second, I show how men and women are consecrated differently by analyzing the content of 157 entries in Voguepedia’s design canon and 96 (...) fashion media articles. Attributions of value and legitimacy construct a gendered image of the ideal fashion designer through discourses of art and culture that reinforce essentialist ideas about gender difference. Because cultural value is ambiguous, processes of valorization are shaped by gender essentialism, pushing male cultural producers down the glass runway and into the spotlight of fame, consecration, and legitimation. Finally, the case of fashion design offers insights into how intersecting inequalities can shape the glass runway. Gay designers experience both valorization and discrimination from intersections of gender and sexuality. (shrink)

Within the class of indexicals, a distinction is often made between “pure” or “automatic” indexicals on one hand, and demonstratives or “discretionary” indexicals on the other. The idea is supposed to be that certain indexicals refer automatically and invariably to a particular feature of the utterance context: ‘I’ refers to the speaker, ‘now’ to the time of utterance, ‘here’ to the place of utterance, etc. Against this view, I present cases where reference shifts from the speaker, time, or place of (...) utterance to some other object, time, or place. I consider and reject the claim that these counterexamples to the automatic indexical theory all involve non-literal uses of indexicals and argue that they cannot be explained away on the grounds that they involve conversational implicature or pretense. (shrink)

Розкрито сутність поняття «рейтинг». Доведено значущість рейтингової оцінки для суб’єктів фінансового ринку, зокрема для страхових компаній, потенційних страхувальників, інвесторів та кредиторів.

There is an expectation that all researchers will act ethically and responsibly in the conduct of research involving humans and animals. While research ethics is mentioned in quality indicators and codes of responsible researcher conduct, it appears to have little profile in doctoral assessment. There seems to be an implicit assumption that ethical competence has been achieved by the end of doctoral candidacy and that there is no need for candidates to report on the ethical dimensions of their study nor (...) for examiners to assess this integral aspect of researcher development. In the context of ensuring that institutions are fulfilling their responsibility of producing ethically sensitive and competent researchers, it is salient to investigate whether doctoral thesis examiners make comment about ethical issues in their reports. This study analysed an archive of examiner reports to identify the frequency, magnitude and nature of examiner comment about ethics. Although comment was rare examiners provided: prescriptive instruction on ethical review processes; formative instruction on the design, conduct, and reporting of research projects; and positive or negative judgments about a candidate's ethical competence, the latter often aligned with meeting, or not meeting, 'doctoral standards'. The scarcity of ethics in examination criteria and examiner reports implies a silence that needs to be addressed to ensure graduating candidates are prepared to conduct ethical and responsible research. (shrink)

This essay examines the symbolic significance of blood in the twentieth century and its role in determining the composition of a national community along racial lines. By drawing parallels between Nazi notions of blood and racial purity and historically contemporaneous U.S. policies regarding blood and blood products, Polsky reveals a disturbing proximity in discourse and policy. While the Nazis attempted to locate Jewish racial essence and inferiority in blood and instituted eugenic measures and laws forbidding racial admixture, similar policies existed (...) in the U.S. based on the so-called one drop rule that systematically discriminated against African Americans. (shrink)

Denunciations of child sexual abuse in the sport context have been increasing in the last decades. Studies estimate that between 14 and 29% of athletes have been victim of at least one form of sexual violence in sport before the age of 18. However, studies suggest that many do not disclose their experience of CSA during childhood. This finding is alarming since studies have shown that the healing process usually starts with disclosure. Moreover, little is known about the healing process (...) of CSA experienced in the sport context. The aim of the study is to present a single case study of a CSA in sport to better understand the global experience over time from the perspective of the athlete. A narrative inquiry approach was adopted. Three non-structured interviews were conducted with the participant. Three pathways in the survivor journey have been identified through inductive thematic analysis: pathway to understanding, pathway to disclosure, and pathway to healing. These pathways represent distinct processes but are intertwined as they are dynamic and iterative. Indeed, the survivor explained how she had been, and is still, going back and forth between them. Results are consistent with those found in the literature on CSA in the general population. It suggests that theoretical models of CSA in the general population could be applied to CSA in sport. Practical implications include a need for education and clearer boundaries in the coach-athlete relationship. Sport stakeholders also need to be better equipped to recognize the signs of sexual violence in sport. Our results indicate that qualitative research could be a potential avenue to help victims heal from CSA. It gives them the chance to talk about and make sense of their abuse in a safe space. Finally, our results demonstrate the importance of reviewing the current justice system for victims. It should be based on a trauma-informed approach that places the victim at the center of the judicial process. (shrink)

Empathy is widely touted as a springboard for social change. Within the academy, ‘identification’ is often used to promote the social value of literary and cultural studies. But to what degree have scholars, in seeking to defend the value of literary and cultural studies, conceived the act of reading in problematic ways? ‘An Ethics of Reading’ argues that adopting a Lacanian paradigm of self (reader) and text (other) to discuss the act of textual interpretation reduces a complex event involving multiple (...) actors to a simple dualism, while ineluctably consigning any act of interpretation to simple projection. Turning instead to psychoanalyst Jean Laplanche’s concept of the enigmatic signifier, this article rethinks the relation between reader and cultural text – reconceiving the act of interpretation by situating it within a dynamic of transference, as opposed to projection. When conceived via this Laplanchian framework, reading becomes not only an effective path to cognition and knowledge, but a radical means of subjective transformation. (shrink)