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

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

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

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

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

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

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

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

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

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

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

Classical verse work expounding early Vedantic approach in Hindu philosophy.

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

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

The COVID-19 pandemic has posed significant burden across different industrial sectors. Generally, an increase in psychological stress experiences has been reported, while the stress and coping responses of specific, potentially burdened populations have received less attention thus far. Thus, the present study investigated relations between individual and organizational factors, indicators of psychological health, and possible mediating effects of four broad coping dimensions in a specific sample of soldier students who engage in a double-role being military affiliates and students of non-military (...) subjects. To this end, we assessed data of soldier students at two measurement points shortly after the second national lockdown in Germany during the COVID-19 pandemic. Personality traits showed expected associations with indicators of psychological health, i.e., positive relations between neuroticism and social loneliness, between extraversion and COVID-19 stress, and negative relations between neuroticism and life satisfaction. Remarkably, organizational variables showed effects above and beyond personality traits on loneliness and life satisfaction. Neither individual, nor organizational factors could predict change in psychological health over time. We found evidence for mediation effects through active coping, avoidant coping, and the use of social support, but not through positive cognitive restructuring. Findings highlight the relative importance of organizational factors besides personality traits for psychological health in a military student sample, holding important implications for designing efficient support systems in the military. (shrink)

The purpose of this study is to analyse the teachings of religious moderation contained in the Wawacan Babad Walangsungsang script. This research employs a qualitative method with philology as the main analysis of the data, namely manuscript inventory, script description, script transfer, and language translation. The script shows the story of Prince Walangsungsang’s journey in search of spirituality, specifically Islam. Interestingly, he learned his spirituality through many non-Muslim teachers until he finally met Sheik Datuk Kahfi in Bukit Amparan Jati. The (...) result of this study shows that upon his spiritual journey while gaining knowledge he experienced magical scenery. The conclusion is the willingness of prince Walangsungsang to learn knowledge and ajimat from Budhaprawa teachers, the openness and support of Budhaprawa teachers about the Prophet’s shari’a and the explanation of Sheikh Datuk Kahfi (Muslim) for the religious search conducted by Prince Walangsungsang shows the beauty of speech that is rich with nuances of religious moderation. Contribution: This research is important as a basic reference for religious moderation, which is rooted in the local wisdom of the Sundanese culture and tradition and can be adopted to spread those in our interaction with other religions. (shrink)

Perspectives of Islamic philosophy; articles.

O trabalho problematiza os impactos do ensino de Sociologia junto aos acadêmicos do curso de Enfermagem da Universidade Estadual do Sudoeste da Bahia, ou seja, analisa as implicações do conhecimento sociológico para esses futuros profissionais. O enfermeiro lida com o contexto social continuamente, seja nas relações multiprofissionais, nas relações com os pacientes ou na compreensão do espaço onde está inserido. Nesse sentido, o conhecimento do campo social, cultural, político e econômico é fundamental para que o mesmo compreenda a dinâmica do (...) processo de trabalho da Enfermagem, tanto na esfera de serviços como na esfera da interação social. O conjunto de respostas dos participantes da pesquisa nos permitiu problematizar desde a forma como a disciplina estava sendo lecionada no curso, a carga horária da mesma, até a importância que os acadêmicos atribuíam à ela na trajetória de sua formação profissional. A pesquisa assumiu o tipo qualitativa, com a aplicação de questionários estruturados e questões abertas, contando com a participação de 22 acadêmicos. Os dados foram analisados numa ótica da busca pela percepção dos relatos de experiência dos acadêmicos, sendo verificados por meio da técnica de análise de conteúdo de Bardin. A pesquisa mostrou-se relevante na medida em que seus resultados forneceram importantes pistas sobre alguns dos desafios a serem enfrentados para um melhor aproveitamento da disciplina de sociologia na grade curricular de cursos dessa natureza. (shrink)

The intentions to simulate human cognition are permanently increasing. Nonetheless, our knowledge about human cognition is based on fragments of different points of view. Hence, it is necessary to examine which demands these points of view make on technologies aiming at simulating human cognition. In this paper it is argued that no technology can function beyond the cognitive abilities of its constructor. It seems that the cognitive limits and constrains of the constructor will also be implanted in the technologies. It (...) is perhaps the right time to think about what kind of future we are going to create by means of an artificial cognition built upon fragmentary, and many times confusing, premises. (shrink)

El artículo tiene como objetivo exponer los fundamentos en que se sustenta la metodología de evaluación de impacto social de un programa de salud con vistas a mejorar la calidad de los servicios en el sector. El producto científico presentado muestra el análisis y síntesis de documentos a partir de la bibliografía actualizada publicada en revistas digitales como Salud Pública Cubana; libros y materiales de autores de reconocido prestigio. La propuesta contempla cuatro etapas fundamentales, cuyas bases teóricas fueron asumidas de (...) investigaciones con este objeto de estudio en el contexto nacional e internacional. This article aims at setting out the fundamentals that support the assessment methodology of social impact of a health program in order to improve the quality of health care services provided in the sector. The scientific product presented shows the analysis and synthesis of documents starting from updated bibliography published in digital journals such as Cuban Public Health; books and materials from prestigious authors. The proposal has four main stages which theoretical basis were taken from researches with the same object of study in a national and international context. (shrink)

Este trabajo tiene como objetivo revelar el verdadero nombre de Finlay y la trascendencia de su firma a fin de salvaguardar cómo llega hasta hoy la autenticidad denominativa del científico. Para ello fue necesaria la revisión bibliográfica de diversas fuentes documentales. Destacan las Obras Completas del médico, artículos científicos de revistas indexadas de la nación y el exterior: Educación Médica Superior, Cuadernos de Historia de la Salud Pública, Biomédica, Acimed, Asclepio, entre otras; periódicos, así como entrevistas a especialistas de la (...) Casa Natal de Carlos J. Finlay. This work aims to real the true name of Finlay and the significance of his signature in order to safeguard its authenticity in present times. To this end, the bibliographic revision of several documentary sources was necessary. Revisions were made of his Complete Works, scientific articles indexed in national and foreign scientific journals, newspaper articles and interviews with specialists from the Carlos J. Finlay Birth House Museum. (shrink)

En la actualidad Cuba desarrolla un Programa de Atención Integral al Paciente con Úlcera de Pie Diabético mediante el uso del Heberprot-P, esencial para disminuir la amputación y la discapacidad. El trabajo tiene el objetivo de realizar un diagnóstico sobre la aplicación del Heberprot-P en el Servicio de Angiología del Hospital Provincial Universitario Manuel Ascunce Domenech de Camagüey. Se realizaron encuestas a pacientes para identificar necesidades sentidas relacionadas con el tratamiento y para las actitudes manifiestas, y se hicieron entrevistas al (...) personal médico y de enfermería. El diagnóstico permitió corroborar la necesaria investigación con enfoque social del servicio de salud escogido a nivel territorial. Destaca elevar el trabajo de captación de pacientes desde el nivel primario de salud para garantizar un mayor alcance del programa, así como la trascendencia del apoyo familiar y la relación profesional de la salud- paciente a fin de lograr la calidad requerida. At present Cuba is developing a program concerning the care of patient with ulcer of the diabetes foot by means of Heberprot-P essential to reduce the amputation and disability. The aim of this paper is to carry out a diagnosis about social aspects of the application of the Heberprot-P in the Angiology service at Manuel Ascunce Domenech Hospital in Camaguey. Some surveys were carry out to identify certain needs related with the treatment and the attitude shown and on the other hand some interview were made to the medical and nursing staff. The diagnosis allowed to verify the need of the research with social approach. The paper highlight how to incorporate patients from the primary health level, in order this program has a higher scope and the importance of the family support and the professional relationship to accomplish the quality required. (shrink)

En este trabajo se analiza la vigencia del pensamiento educativo de Félix Varela en Cartas a Elpidio. En particular se estudian sus ideas acerca del método científico en la enseñanza y de la subordinación del bien individual al bien común. Asimismo se toman en consideración las condiciones y el momento histórico en que fue escrita, su alcance local, nacional y latinoamericano en correspondencia con el actual ámbito de la Universidad de Ciencias Médicas y otras personalidades de la cultura. Mediante la (...) revisión bibliográfica de diversas fuentes utilizadas se obtuvieron datos favorables para este análisis. The validity of Felix Varela´s educative thought in Letters to Elpidio was analyzed in this work. His ideas about the scientific method in teaching and the subordination of individual good to common good were particularly studied. The conditions and the historical moment in which it was written, its local, national and Latin-American repercussion in regards to the updated field of the University of Medical Sciences and other personalities of the cultural field were taken into consideration. Favorable data for this analysis were obtained through bibliographic revision of different sources. (shrink)