En la sociedad en que vivimos es habitual escuchar frases como "tengo estrés" o "estoy estresado". El cuidado de los hijos o de nuestros mayores, los problemas de salud, el trabajo fuera y dentro del hogar o, actualmente, la cada vez más frecuente falta de éste con los subsiguientes problemas económicos asociados, son algunos de los factores a los que aludimos cuando decidimos que tenemos estrés. Pero, realmente ¡qué es el estrés?

The antioxidant role of carotenoids in the living organism was proposed as a possible basis for the honesty of carotenoid‐based signals. However, recent studies have questioned the relevance of carotenoids as powerful antioxidants in vivo. Current evidence does not seem to support the “antioxidant role” hypothesis, but it does not allow us to reject it either. This paper proposes some steps to solve this controversy, such as taking a dynamic approach to antioxidant responses, designing protocols that expose individuals to oxidative (...) challenges, analyzing tissues other than blood, and obtaining measures of antioxidant capacity and oxidative damage simultaneously. However, it should be considered that, irrespective of their antioxidant potential, carotenoids might still give information on oxidative stress levels if they are particularly sensitive to free radicals. Finally, lumping together the immunostimulatory and antioxidant roles of carotenoids should be avoided as these functions are not necessarily associated. (shrink)

La presente investigación se efectuó con el objetivo de evaluar el impacto de la introducción y generalización del resultado científico: La educación en valores mediante la aplicación de medios de enseñanza - aprendizaje en la disciplina de Morfofisiología en la Licenciatura en Enfermería, a través de indicadores diseñados de acuerdo a las particularidades de la investigación. Se aplicaron encuestas, se realizó una revisión documental de bibliografía relacionada con la temática y de documentos de los departamentos e instituciones en que ha (...) incidido este resultado, lo cual permitió constatar la amplia y efectiva aplicación práctica de los resultados obtenidos de forma sistemática, a través de publicaciones, posgrados, presentación en eventos científicos y su generalización en diversas instituciones educacionales. This research was conducted with the objective of assessing the impact of the introduction and generalization of the scientific result: Values education through the application of teaching aids- learning in Morphophysiology subject in the Nursing Degree through indicators designed according to the research characteristics. Surveys were carried, furthermore, a documentary bibliographic review related to the subject matter and a review of documents from departments and institutions affected by this result were made. They enabled to verify the wide and effective practice of the results got in a systematic way, through publications, postgraduate courses and presentations in scientific events as well as its generalization in different educational institutions. (shrink)

The consideration of racial differences in the biology of disease and treatment options is a hallmark of modern medicine. However, this time-honored medical tradition has no scientific basis, and the premise itself, that is, the existence of biological differences between the commonly known races, is false inasmuch as races are only sociocultural constructions. It is time to rid medical research of the highly damaging exercise of searching for supposed racial differences in the biological manifestations of disease. The practice not only (...) condoned but required by the National Institutes of Health of utilizing racial identification as a demographic characteristic with assumed biological implications is at best badly flawed, and at worst unintentionally contributes to perpetuating the fallacy of natural differences between persons of different skin color, which has been used in the past to advance the cause of racial discrimination. (shrink)

A la hora de plantearse la realización de actividades relacionadas con la enseñanza de los aspectos astronómicos, se presentan problemas prácticos evidentes que no ayudan a desarrollar una adecuada actividad científica escolar. Las TIC son un instrumento de gran utilidad para sortear estas dificultades, dado que permiten reproducir los fenómenos celestes y experimentar con ellos. El objetivo de este artículo es, en concreto, reflexionar sobre la utilidad de las simulaciones informáticas para la enseñanza de los aspectos histórico-astronómicos. Como muestra de (...) sus posibilidades se presentan simulaciones que pueden realizarse para visualizar diversos fenómenos astronómicos descubiertos por Galileo Galilei. (shrink)

The consideration of racial differences in the biology of disease and treatment options is a hallmark of modern medicine. However, this time-honored medical tradition has no scientific basis, and the premise itself, that is, the existence of biological differences between the commonly known races, is false inasmuch as races are only sociocultural constructions. It is time to rid medical research of the highly damaging exercise of searching for supposed racial differences in the biological manifestations of disease. The practice not only (...) condoned but required by the National Institutes of Health of utilizing racial identification as a demographic characteristic with assumed biological implications is at best badly flawed, and at worst unintentionally contributes to perpetuating the fallacy of natural differences between persons of different skin color, which has been used in the past to advance the cause of racial discrimination. (shrink)

El presente artículo describe la conexión entre los espacios culturales rurales de la cultura mapuche y aquellos recreados en centros urbanos y su vinculación con la construcción de la identidad étnica en adolescentes mapuches urbanos. El estudio es cualitativo descriptivo y los datos se abordan desde el enfoque de análisis del discurso de la psicología discursiva y el enfoque de identidades espaciales de Proshansky . La muestra corresponde a treinta adolescentes mapuches hombres y mujeres residentes en la ciudad de Santiago (...) y treinta de la ciudad de Temuco, quienes participaron en entrevistas conducidas por un entrevistador mapuche. Los resultados revelan que el rol de los espacios culturales recreados en contextos urbanos es desarrollar una función mediadora del cambio desde el lugar de origen a nuevos espacios lo que permite reforzar la identidad étnica de los adolescentes. This article describes the connection between Mapuche rural cultural spaces and those re-created in urban areas and their connection with the construction of ethnic identity in urban Mapuche adolescents. This is a qualitative and descriptive study and the data is analyzed through the approach of discourse analysis of discursive psychology and considers the notion of place identity by Proshansky . The research population were thirty Mapuche adolescents living in Santiago and thirty living in Temuco. These adolescents were interviewed by a Mapuche interviewer. The findings reveal that the re-created urban cultural spaces fulfill a mediating role in the change from original places to new ones , which allows these adolescents to reinforce their ethnic identity construction. (shrink)

Resumen Este trabajo determina algunas percepciones y usos de las redes sociales por parte del clero de la Iglesia católica española en su tarea ministerial. Partiendo de una muestra representativa se plantea un estudio cuantitativo en el que queda en evidencia que los clérigos están presentes mayoritariamente en redes cada vez menos frecuentadas por los jóvenes adolescentes, pero el uso que se hace de las mismas para acciones pastorales es limitado, cuando no insuficiente.This work determines some perceptions and uses that (...) the clergy of the Spanish Catholic Church make of social networks in their ministerial work. Based on a representative sample, a quantitative study is proposed in which it is evident that the clergy are present mainly in networks less and less frequented by young adolescents, but the use made of them for pastoral actions is limited, when not insufficient. (shrink)

Actualmente son necesarias propuestas educativas que promuevan la sostenibilidad mediante activismo digital. El objetivo de este estudio fue evaluar la movilización de competencias digitales docentes a través de la creación de storytellings sobre la Fast Fashion. Su análisis mostró cómo estas experiencias pueden propiciar el desarrollo de capacidades de comunicación y colaboración, como son la participación para la creación de contenidos, la participación ciudadana en línea o la capacidad para compartir contenidos. Los vídeos creados relacionan las acciones cotidianas con las (...) consecuencias socioambientales y llaman a la transición hacia formas de consumo conscientes, mostrando su potencial creativo e inspirador. (shrink)

Background: Several countries have recently changed their model of consent for organ donation from opt-in to opt-out. We undertook a systematic review to determine public knowledge and attitudes towards these models in Europe. Methods: Six databases were explored between 1 January 2008 and 15 December 2017. We selected empirical studies addressing either knowledge or attitudes towards the systems of consent for deceased organ donation by lay people in Europe, including students. Study selection, data extraction, and quality assessment were conducted by (...) two or more reviewers independently. Findings: Awareness of the consent model was lower in opt-out countries than in opt-in countries. A majority of the public agrees with opt-in, regardless of the law in their own country. There are ambivalent attitudes regarding the opt-out system. The public tend to prefer opt-in and mandatory choice over opt-out when several options are offered. Interpretation: The assumption that people in opt-out countries are aware of the legal requirements to be excluded from the pool of potential donors is not supported by the results of this review. This is a concern, since ignorance hinders people's autonomy regarding organ donation decision-making. Higher awareness of consent model in opt-in countries may reflect greater efforts to inform the public through campaigns to motivate donation. Legal moves towards opt-out are at odds with people's expressed preferences. Main limitations of this review are the lack of data from some countries, study population heterogeneity, and methodological shortcomings. (shrink)

Introducción: Los cambios biológicos, sicológicos, económicos y sociales que se observan durante el envejecimiento conllevan a pensar que en los ancianos existe una serie de factores que favorecen la aparición de una depresión. Objetivo: evaluar la efectividad de una intervención sicológica para disminuir la depresión en adultos mayores de la Casa de abuelos "Dr. Diego Tamayo Figueredo", de Puerto Padre, en el período de noviembre de 2013 - mayo de 2014. Material y métodos: se realizó un estudio de intervención sicológica (...) en una muestra de 12 adultos mayores de la casa de abuelos. Se aplicó un programa de intervención sicológica, así como la Escala de Depresión Geriátrica para realizar la valoración antes y después de la intervención. Se empleó el modelo Cognitivo- Conductual de Beck. Los datos fueron tratados según la estadística descriptiva. Resultados: el porciento más elevado de pacientes correspondió al grupo de ancianos con edades entre los 60 y 90 años de edad. Respecto al sexo, el más frecuente es el masculino. El asma bronquial, la hipertensión arterial y la diabetes Mellitus representaron el mayor porciento de antecedentes patológicos personales. Conclusión: la intervención sicológica resultó efectiva pues se logró disminuir a leve los niveles iniciales de depresión establecida y los considerados con leve a no depresión, por lo tanto se afirma que con su aplicación fue modificado el estado emocional de los adultos mayores que se implicaron en la muestra. Introduction: Biological, psychological, financial and social changes observed during aging lead to think that there is a series of factors that favor the appearance of depression in senior citizens. Objective: Assessing the effectiveness of a psychological intervention in order to reduce depression in senior citizens from "Dr. Diego Tamayo Figueredo" Senior Citizens' House, Puerto Padre, from November 2013 to May 2014. Material and methods: A psychological intervention study was conducted on a sample of 12 senior citizens from the house. A psychological intervention program as well as the Geriatrics Depression Scale were applied before and after the intervention in order to make the assessment. The Beck's cognitive-behavior model was used. Data was processed according to descriptive statistics. Results: The highest percentage of patients corresponded to a group of seniors between 60 and 90 years of age. Regarding sex, males are more common. Bronchial asthma, arterial hypertension and diabetes mellitus represented the highest percentage of personal pathological history. Conclusion: The psychological intervention proved to be effective since initial established depression levels were reduced to minor and those considered as minor were reduced to no depression ; therefore, it is stated that its application modified the state of mind of the senior citizens involved in the sample. (shrink)

The ethics of deceased organ procurement (OP) is supposedly based on individual consent to donate, either explicit (opt-in) or presumed (opt-out). However, in many cases, individuals fail to express any preference regarding donation after death. When this happens, the decision to remove or not to remove their organs depends on the policy’s default option or on family preferences. Several studies show that in most countries the family plays a significant and often decisive role in the process of decision-making for OP. (...) Depending on the country, the family may be allowed to take different kinds of actions in different situations, and this may be granted either by law or by clinical practice only. This adds much complexity to the usual classification of consent policies in two categories: opt-in and opt-out. Here we propose a novel and comprehensive taxonomy of the models of consent for OP according to three variables: (1) the deceased’s wishes, if any, (2) family wishes, if any, and (3) default policies. By analysing these models of consent, we show that they rely on at least three different concepts of autonomy: individual autonomy, relational autonomy, and family autonomy. In light of this analysis, we discuss the ethical debates surrounding two policy approaches: presumed consent and family veto. (shrink)

Objectives To increase postmortem organ donation rates, several countries are adopting an opt-out (presumed consent) policy, meaning that individuals are deemed donors unless they expressly refused so. Although opt-out countries tend to have higher donation rates, there is no conclusive evidence that this is caused by the policy itself. The main objective of this study is to better assess the direct impact of consent policy defaults per se on deceased organ recovery rates when considering the role of the family in (...) the decision-making process. This study does not take into account any indirect effects of defaults, such as potential psychological and behavioural effects on individuals and their relatives. -/- Design Based on previous work regarding consent policies, we created a conceptual model of the decision-making process for deceased organ recovery that included any scenario that could be directly influenced by opt-in or opt-out policies. We then applied this model to internationally published data of the consent process to determine how frequently policy defaults could apply. -/- Main outcome measures We measure the direct impact that opt-in and opt-out policies have per se on deceased organ recovery. -/- Results Our analysis shows that opt-in and opt-out have strictly identical outcomes in eight out of nine situations. They only differ when neither the deceased nor the family have expressed a preference and defaults therefore apply. The direct impact of consent policy defaults is typically circumscribed to a range of 0%–5% of all opportunities for organ recovery. Our study also shows that the intervention of the family improves organ retrieval under opt-in but hinders it under opt-out. -/- Conclusions This study may warn policy makers that, by emphasising the need to introduce presumed consent to increase organ recovery rates, they might be overestimating the influence of the default and underestimating the power granted to families. (shrink)

Since 1968, the irreversible loss of functioning of the whole brain, called brain death, is assimilated to individual’s death. The almost universal acceptance of this neurological criterion of death had decisive consequences for the contemporary medicine, such as the withdrawal of mechanical ventilation in these patients and organ retrieval for transplantation. The new criterion was successfully accepted in part because the assimilation of brain death state to death was presented by medicine --and acritically assumed by most of societies-- as a (...) scientific and objective fact. Nevertheless, many people do not think that the patients suffering brain death are actually dead. We show here that those people are not necessarily wrong. It can be argued that, in fact, the justification of the neurological criterion is not scientific but moral. We outline the thesis that the problem surrounding the vital status of brain dead patients is due to a confusion between factual and normative questions. Furthermore, we claim that the donation of organs and the withdrawal of life-support could be ethically acceptable even if the patients suffering brain death are considered as alive. As an alternative to the dead donor rule, we propose a justification for organ donation of brain-dead patients based on the (moral) concepts of harm and consent : what truly justifies the procurement of organs on those patients is not that they are dead, but that they wish to donate their organs and that, since they have irreversibly lost their brain, they cannot be harmed. (shrink)

Se realizó un estudio cuali-cuantitativo en la Comunidad Rural "El León" de la provincia de Camagüey. Se utilizó el método etnográfico y la evaluación del Análisis de la Situación de Salud en el periodo 2007-2015 con el objetivo de describir las características socio históricas y de salud de esta población, conjuntamente con profesionales de enfermería comunitaria. Se crearon instrumentos validados por expertos. Se aplicaron grupos focales, observación participante, entrevistas en profundidad a informantes clave, socioculturales, estructuradas abiertas y la cerrada para (...) combinarla con los resultados del Análisis de la Situación de Salud en el proceder cuantitativo. Se triangularon sus resultados. Se evidenció: falta de sentido de pertenencia de los pobladores, indisciplinas sociales que perjudican la comunidad y su salud, deterioro de las relaciones interpersonales, sistema eco cultural deficiente, y se identificó la necesidad de emprender otras acciones comunitarias que provoquen el cambio y modifiquen el cuadro de salud comunitaria. The quantitative and qualitative in the Community Rural accomplished a study itself "The Lion" of Camagüey's province. The 2007-2015 for the sake of describing the characteristics utilized the ethnographic method and the evaluation of Health's Analysis of the Situation in the period itself member historic and of health of this population together with nursing professionals, communal. They created instruments validated by experts. They applied focal groups, participating observation, you interview key, socio cultural to informants in depth, structured open and the closed to combine it with the results of Health's Analysis of the Situation in the quantitative action. They triangulated his results. It became evident: The inhabitants's pointlessness of possession, social indiscipline that the community and his health, deterioration of personal relations, system harm cultural deficient echo, and the need to undertake another communal actions was identified that they provoke the change and modify the picture of communal health. (shrink)

Se realizó una intervención comunitaria en el asentamiento rural "El León" de Camagüey basada en los resultados de un estudio anterior. Su objetivo fue implementar un sistema de acciones socio-sanitarias colectadas en un manual que organizó contenidos de antropología socio cultural, psicología y sociología de la salud, fue conducida por profesionales de enfermería cuyo encargo social les asigna una mayor permanencia e intercambio con los pobladores. Se potenció el trabajo comunitario a partir de febrero de 2010. La investigación constituyó un (...) diseño mixto, con un estudio cuasi experimental sin grupo control combinado con métodos cualitativos. La evaluación final efectuada en el periodo 2013-2015 exhibió modificaciones positivas en indicadores del Análisis de la Situación de Salud y el entorno comunitario. Se demostró la importancia de la aplicación de las acciones comunitarias por el personal de enfermería como agente de cambio de desarrollo local y protagonista de sostenibilidad. A community intervention was carried out at the rural settlement "El León". Its objective was to implement a system of actions led by nursing professionals whose social role assigns them longer permanence and interchange with the inhabitants of the community. Community work was fostered from February 2010 with social and sanitary actions based on socio-cultural anthropology, psychology and health sociology knowledge. The investigation had a mixed design, being a quasi-experimental study without control group combined with qualitative methods. The final evaluation, which took place from 2013-2015, showed positive modifications in Health Analysis indicators and community environment. The importance of the application of community actions by nursing personnel as agents of change for local development and sustainability leaders was demonstrated. (shrink)

The study here is a qualitative research based on multiple case studies of banking service providers to analyze the role of corporate social responsibility (CSR) in the definition of the corporate identity of these kinds of organizations. The results show that, although companies increasingly integrate CSR into their business strategies, there are some aspects of its management such as its communication or the measurement of its results that detract from its success. These results have important implications for those managers pursuing (...) an effective management of CSR policies and strategies in their organizations, especially as the information comes from 6 of the biggest and most important banking institutions in a European country, with a declared assets (loans) volume which represents 62.75% of the total assets in the national banking industry, and thus largely representing the possible heterogeneity of the market in terms of company size, location, legal status, and management styles. (shrink)

Este trabajo tiene como objetivo comentar algunas prohibiciones del padre Miguel Ángel de Tamburini y del padre Francisco Retz explicando los conceptos fundamentales de dichas prohibiciones a través de un método analítico y relacionándolos posteriormente bajo un método sintético con los argumentos presentados. Esto último permitirá realizar una reconstrucción de las prohibiciones cuyo ensamble se consolidará en argumentos breves. Asimismo, evaluar cuáles pueden ser las causas o los fundamentos que subyacen en las prohibiciones mismas, es decir, evaluar las causas de (...) su veto. Finalmente, determinar las implicaciones filosóficas de las prohibiciones desde Descartes, Leibniz y Spinoza y sus correspondientes visiones de la Creación, la voluntad, el determinismo y el principio de individuación. (shrink)

Induced abortion is a worldwide practice and its legalisation is a persistent demand of the women’s movement. Although in the academic literature there are numerous studies that address the study of fertility, nowhere near as much attention has been given to the analysis of induced abortion and its determining factors, and even less to the consideration of gender equality as a variable through which to understand it. This article focuses on the influence of gender equality on the rate of induced (...) abortion in different European countries. To that end the authors have constructed an econometric panel data model with information from 26 European countries for the period 2006–2011. They have analysed comparative indicators of the gender gap in terms of education, employment and wages. In addition, they have taken into account sociodemographic covariables such as the average age of motherhood, the migration rate and the percentage of births to unmarried mothers in each country. Also, as contextual factors the authors used the Human Development Index and an indicator of the legislation on abortion in the countries studied, as well as the percentage of the population who identify as having religious beliefs. The results show that the induced abortion rate is conditioned not only by national legislation on abortion, but also by gender equalities, specifically that as gender inequality decreases, so too does the frequency of induced abortions. These findings have clear political implications, showing as they do how improvements in the status of women, particularly with respect to their social and economic rights, impact on women’s reproductive decisions. (shrink)

Because previous scholars have offered few comprehensive models to understand the benefits of corporate social responsibility image in terms of customer behaviour, the authors of this paper propose a hierarchy of effects model to study how customer perceptions of the social responsibility of companies influence customer affective and conative responses in a service context. The authors test a structural equation model using information collected directly from 1,124 customers of banking services in Spain. The findings demonstrate that corporate social responsibility image (...) influences customer identification with the company, the emotions evoked by the company and satisfaction positively. Identification also influences the emotions generated by the service performance and customer satisfaction determines loyalty behaviour. The findings have significant implications for service managers because they demonstrate that there are two paths to explain the satisfaction and loyalty of service customers. The first path is composed of the beliefs and emotions generated by the company at the institutional level. The second path is composed of the thoughts, attitudes, emotions and feelings generated by the company’s services. (shrink)

How should automated vehicles react in emergency circumstances? Most research projects and scientific literature deal with this question from a moral perspective. In particular, it is customary to treat emergencies involving AVs as instances of moral dilemmas and to use the trolley problem as a framework to address such alleged dilemmas. Some critics have pointed out some shortcomings of this strategy and have urged to focus on mundane traffic situations instead of trolley cases involving AVs. Besides, these authors rightly point (...) out the political nature of the most interesting debates involving AVs. However, in our view, they do not offer an adequate account of the distinction between ethics and politics and still see their proposals as contributions to the ethics of AVs. We argue that many of the interesting questions about how AVs should behave, both in emergency and other situations, are of political, and not moral, nature. This view is based on a conception of politics and political normativity that we have developed elsewhere and that we call “political minimalism.” Additionally, we show that this proposed perspective has significant consequences for the design, management, and regulation of transport systems. (shrink)

Fundamentación: el desarrollo de la cultura profesional docente colaborativo se sustenta en los postulados vigotskianos, donde se concibe al profesor como un sujeto comprometido con las demandas y exigencias de la sociedad. Objetivo: socializar las categorías de análisis que se deben tener en cuenta en un colectivo docente para el desarrollo de una cultura profesional colaborativa en el proceso de formación del profesional de la educación superior. Método: se realizó un estudio etnográfico en la Universidad José Martí Pérez, de (...) Sancti Spíritus, apoyada en la metodología cualitativa y un grupo de técnicas posibilitó la recogida de la información. Resultados: se obtuvieron las categorías de análisis que están estrechamente asociadas al deber ser de un docente universitario, portador de esta cultura. Conclusiones: a partir de la coincidencia de criterios sobre los aspectos teóricos y la reflexión colectiva emergieron elementos indispensables en un colectivo para lograr la cultura profesional docente colaborativa a la cual se aspira, elaborados al tener en cuenta su estructura de contenido y forma. Background: the development of collaborative professional teaching culture is based on Vigotskian statements, where the teacher is seen as an individual compromised with the demanding and needs of the society. Objective: Socialize the analytical categories that should be taken into consideration in a teaching staff for the development of collaborative professional teaching culture in the process formation of the professional of higher education. Method: an ethnographic study was carried out in the University José Marti Pérez, from Sancti Spiritus, based on a qualitative methodology and a group of techniques that make data collection possible. Results: The analytical categories obtained were closely linked to the requirements of a university teacher that has this culture. Conclusions: starting from common criteria about theoretical aspects and group reflection, vital elements emerged in the teaching staff to get the collaborative professional teaching culture that is needed, elaborated taking into account its structure of content and form. (shrink)

Background Consent policies for post-mortem organ procurement (OP) vary throughout Europe, and yet no studies have empirically evaluated the ethical implications of contrasting consent models. To fill this gap, we introduce a novel indicator of governance quality based on the ideal of informed support, and examine national differences on this measure through a quantitative survey of OP policy informedness and preferences in seven European countries. -/- Methods Between 2017–2019, we conducted a convenience sample survey of students (n = 2006) in (...) Austria (AT), Belgium (BE), Denmark (DK), Germany (DE), Greece (GR), Slovenia (SI) and Spain (ES), asking participants about their donation preferences, as well as their beliefs and views about the policy in place. From these measures, we computed indices of informedness, policy support, and fulfilment of unexpressed preferences, which we compared across countries and consent systems. -/- Results Our study introduces a tool for analyzing policy governance in the context of OP. Wide variation in policy awareness was observed: Most respondents in DK, DE, AT and BE correctly identified the policy in place, while those in SI, GR and ES did not. Respondents in opt-out countries (AT, BE, ES and GR) tended to support the policy in place (with one exception, i.e., SI), whereas those in opt-in countries (DE and DK) overwhelmingly opposed it. These results reveal stark differences in governance quality across countries and consent policies: We found a preponderance of informed opposition in opt-in countries and a general tendency towards support–either informed or uninformed–in opt-out countries. We also found informed divergence in opt-in countries and a tendency for convergence–either informed or uninformed–among opt-out countries. -/- Conclusion Our study offers a novel tool for analyzing governance quality and illustrates, in the context of OP, how the strengths and weaknesses of different policy implementations can be estimated and compared using quantitative survey data. (shrink)

Goal: To assess public knowledge and attitudes towards the family’s role in deceased organ donation in Europe. -/- Methods: A systematic search was conducted in CINHAL, MEDLINE, PAIS Index, Scopus, PsycINFO, and Web of Science on December 15th, 2017. Eligibility criteria were socio-empirical studies conducted in Europe from 2008 to 2017 addressing either knowledge or attitudes by the public towards the consent system, including the involvement of the family in the decision-making process, for post-mortem organ retrieval. Screening and data collection (...) were performed by two or more independent reviewers for each record. -/- Results: Of the 1482 results, 467 studies were assessed in full-text form, and 33 were included in this synthesis. When the deceased has not expressed any preference, a majority of the public support the family's role as a surrogate decision-maker. When the deceased expressly consented, the respondents' answers depend on whether they see themselves as potential donors or as a deceased's next-of-kin. Answers also depend on the relationship between the deceased and the decision-maker(s) within the family, and on their ethnic or cultural background. -/- Conclusions: Public views on the authority of the family in organ donation decision-making require further research. A common conceptual framework and validated well-designed questionnaires are needed for future studies. The findings should be considered in the development of Government policy and guidance regarding the role of families in deceased organ donation. (shrink)

Families play an essential role in deceased organ procurement. As the person cannot directly communicate his or her wishes regarding donation, the family is often the only source of information regarding consent or refusal. We provide a systematic description and analysis of the different roles the family can play, and actions the family can take, in the organ procurement process across different jurisdictions and consent systems. First, families can inform or update healthcare professionals about a person’s donation wishes. Second, families (...) can authorize organ procurement in the absence of deceased’s preferences and the default is not to remove organs, and oppose donation where there is no evidence of preference but the default is to presume consent; in both cases, the decision could be based on their own wishes or what they think the deceased would have wanted. Finally, families can overrule the known wishes of the deceased, which can mean preventing donation, or permitting donation when the deceased refused it. We propose a schema of 4 levels on which to map these possible family roles: no role, witness, surrogate, and full decisional authority. We conclude by mapping different jurisdictions onto this schema to provide a more comprehensive understanding of the consent system for organ donation and some important nuances about the role of families. This classificatory model aims to account for the majority of the world’s consent systems. It provides conceptual and methodological guidance that can be useful to researchers, professionals, and policymakers involved in organ procurement. (shrink)

Although research on the corporate social responsibility (CSR) dimension of corporate image has notably increased in recent years, the definition and measurement of the concept for academic purposes still concern researchers. In this article, literature regarding the measurement of CSR image from a customer viewpoint is revised and areas of improvement are identified. A multistage method is implemented to develop and to validate a reliable scale based on stakeholder theory. Results demonstrate the reliability and validity of this new scale for (...) measuring customer perceptions regarding the CSR performance of their service providers. With regard to this, CSR includes corporate responsibilities towards customers, shareholders, employees and society. The scale is consistent among diverse customer cohorts with different gender, age and level of education. Furthermore, results also confirm the applicability of this new scale to structural equation modelling. (shrink)

This paper analyses the arguments for and against what we have called automatic organ procurement model in relation to the organs of the deceased. For this purpose, this work provides empirical evidence to assess the potential impact of this model on donation rates and on public opinion. Specifically, we examine first the reasons supporting this model, with special reference to utilitarian and justice arguments. On the other hand, we analyse both the approaches based on the violation of pre mortem and (...) post mortem interests opposing this theoretical model and the rejection the model would generate in the population. Finally, we point out the aspects that, in our opinion, should be exhaustively regulated if this model were implemented. In particular, we refer to the legal status of the human body, the treatments for end-of-life patients, the incentives for health professionals and the recognition of the right to conscientious objection. (shrink)

The debate over the determination of death has been raging for more than fifty years. Since then, objections against the diagnosis of brain death from family members of those diagnosed as dead-have been increasing and are causing some countries to take novel steps to accommodate people’s beliefs and preferences in the determination of death. This, coupled with criticism by some academics of the brain death criterion, raises some questions about the issues surrounding the determination of death. In this paper, we (...) discuss some of the main approaches to death determination that have been theoretically proposed or currently put into practice and propose a new approach to death determination called "weak pluralism" as a reasonable ethical and political alternative to respect diversity in death determination. (shrink)

The multiobjective optimization on the basis of ratio analysis method captures diverse features such as the criteria and alternatives of appraising a multiple criteria decision-making problem. At the same time, the multiple criteria problem includes a set of decision makers with diverse expertise and preferences. In fact, the literature lists numerous approaches to aid in this problematic task of choosing the best alternative. Nevertheless, in the MCDM field, there is a challenge regarding intangible information which is commonly involved in multiple (...) criteria decision-making problem; hence, it is substantial in order to advance beyond the research related to this field. Thus, the objective of this paper is to present a fused method between multiobjective optimization on the basis of ratio analysis and Pythagorean fuzzy sets for the choice of an alternative. Besides, multiobjective optimization on the basis of ratio analysis is utilized to choose the best alternatives. Finally, two decision-making problems are applied to illustrate the feasibility and practicality of the proposed method. (shrink)

Critical thinking is a complex, dynamic process formed by attitudes and strategic skills, with the aim of achieving a specific goal or objective. The attitudes, including the critical thinking attitudes, constitute an important part of the idea of good care, of the good professional. It could be said that they become a virtue of the nursing profession. In this context, the ethics of virtue is a theoretical framework that becomes essential for analyse the critical thinking concept in nursing care and (...) nursing science. Because the ethics of virtue consider how cultivating virtues are necessary to understand and justify the decisions and guide the actions. Based on selective analysis of the descriptive and empirical literature that addresses conceptual review of critical thinking, we conducted an analysis of this topic in the settings of clinical practice, training and research from the virtue ethical framework. Following JBI critical appraisal checklist for text and opinion papers, we argue the need for critical thinking as an essential element for true excellence in care and that it should be encouraged among professionals. The importance of developing critical thinking skills in education is well substantiated; however, greater efforts are required to implement educational strategies directed at developing critical thinking in students and professionals undergoing training, along with measures that demonstrate their success. Lastly, we show that critical thinking constitutes a fundamental component in the research process, and can improve research competencies in nursing. We conclude that future research and actions must go further in the search for new evidence and open new horizons, to ensure a positive effect on clinical practice, patient health, student education and the growth of nursing science. (shrink)