BackgroundRespect for confidentiality is important to safeguard the well-being of patients and ensure the confidence of society in the doctor-patient relationship. The aim of our study is to examine real situations in which there has been a breach of confidentiality, by means of direct observation in clinical practice.MethodsBy means of direct observation, our study examines real situations in which there has been a breach of confidentiality in a tertiary hospital. To observe and collect data on these situations, we recruited students (...) enrolled in the Medical Degree Program at the University of Cordoba. The observers recorded their entries on standardized templates during clinical internships in different departments: Internal Medicine; Gynecology and Obstetrics; Pediatrics; Emergency Medicine; General and Digestive Surgery; Maxillofacial Surgery; Plastic Surgery; Orthopedics and Traumatology; Digestive; Dermatology; Rheumatology; Mental Health; Nephrology; Pneumology; Neurology; and Ophthalmology.ResultsFollowing 7138 days and 33157 h of observation, we found an estimated Frequency Index of one breach per 62.5 h. As regards the typology of the observed breaches, the most frequent were related to the consultation and/or disclosure of clinical and/or personal data to medical personnel not involved in the patient’s clinical care, as well as people external to the hospital. As regards their severity, severe breaches were the most frequent, accounting for 46.7 % of all incidents. Most of the reported incidents were observed in public areas, such as corridors, elevators, the cafeteria, stairs, and locker rooms.ConclusionsIn addition to aspects related to hospital organization or infrastructure, we have shown that all healthcare personnel are involved in confidentiality breaches, especially physicians. While most are committed unintentionally, a non-negligible number are severe, repeated breaches, thus suggesting a certain carelessness, perhaps through ignorance about certain behaviors that can jeopardize patient confidentiality. (shrink)

The physician’s duty of confidentiality is based on the observance of the patient’s privacy and intimacy and on the importance of respecting both of these rights, thus creating a relationship of confidence and collaboration between doctor and patient. The main objective of this work consists of analyzing the aspects that are related to the confidentiality of patients’ data with respect to the training, conduct and opinions of doctors from different Clinical Management Units of a third-level hospital via a questionnaire. The (...) present study aimed to define the problem and determine whether the opinions of these professionals correspond to those observed in a previous work conducted at the same center. Of the 200 questionnaires that were collected, 62.5% were from consultants and the rest were from residents with an average of 14.4 ± 12.5 years in professional practice. The respondents noted habitual situations in which confidentiality was breached in the reference hospital. The section on their attitudes and behaviors towards situations related to confidentiality showed a slightly lower average score than that of their medical knowledge; significant differences in these scores were observed between the consultants and residents as well as between the extreme age groups and years of professional practice, thus more inadequate attitudes were consistently noted in younger doctors who had fewer years of experience. Finally, the respondents answered that the training of doctors in the aspects of healthcare law and ethics was the most important measure that the hospital could adopt regarding confidentiality practices. (shrink)

En este artículo proponemos reflexionar en torno a una cuestión que ocupa un lugar central en la práctica educativa, política y evangelizadora, a saber, el problema de la paz. Asunto que toma especial relevancia, sobre todo si se tiene en cuenta el momento coyuntural por el que atraviesa Colombia y en general la sociedad contemporánea. La tesis que sostiene el artículo es que la ausencia de la guerra no supone necesariamente la consecución de la paz, pues ella conlleva a una (...) suerte de condiciones de aceptación de un ethos que naturaliza prácticas bélicas que dividen, atomizan la sociedad creando un sentido de desesperanza y de despolitización. Proponemos que, para afrontar esta situación, es decir, para desnaturalizar dicho ethos hace falta una dimensión espiritual que permita el establecimiento de fuertes lazos sociales y del reconocimiento de las diferencias, la particularidad e individualidad. Para desarrollar esta labor proponemos, entonces, un diálogo a partir de los presupuestos de la espiritualidad y el pensamiento franciscano, especialmente desde los conceptos de fraternidad y de minoridad con la cuestión en mención. Con esto entendemos que el marco de comprensión que nos brindan los presupuestos franciscanos cuenta con un potencial relevante para contribuir al debate sobre de la paz en tiempos actuales del posconflicto colombiano. (shrink)

The introduction of genes into plants encoding potent antibacterial proteins, derived from insects, may significantly augment the level of their resistance to bacterial disease. Using modern techniques, genes of choice can be introduced into plant tissue and this tissue can be manipulated to produce viable plants. The potato has been chosen as the model system, not only because of its plasticity of development, which allows for the relatively easy regeneration of whole plants from transformed tissue, but also because the potato (...) ranks among the top four plants in the world in terms of economic importance. (shrink)

BackgroundMoral distress (MD) is the psychological damage caused when people are forced to witness or carry out actions which go against their fundamental moral values. The main objective was to evaluate the prevalence and predictive factors associated with MD among health professionals during the pandemic and to determine its causes.MethodsA regional, observational and cross-sectional study in a sample of 566 professionals from the Public Health Service of Andalusia (68.7% female; 66.9% physicians) who completed the MMD-HP-SPA scale to determine the level (...) of MD (0-432 points). Five dimensions were used: i) Health care; ii) Therapeutic obstinacy-futility, iii) Interpersonal relations of the Healthcare Team, iv) External pressure; v) Covering up of medical malpractice.ResultsThe mean level of MD was 127.3 (SD=66.7; 95% CI 121.8-132.8), being higher in female (135 vs. 110.3; p<0.01), in nursing professionals (137.8 vs. 122; p<0.01) and in the community setting (136.2 vs. 118.3; p<0.001), with these variables showing statistical significance in the multiple linear regression model (p<0.001; r2=0.052). With similar results, the multiple logistic regression model showed being female was a higher risk factor (OR=2.27; 95% CI 1.5-3.4; p<0.001). 70% of the sources of MD belonged to the dimension "Health Care" and the cause "Having to attend to more patients than I can safely attend to" obtained the highest average value (Mean=9.8; SD=4.9).ConclusionsFemale, nursing professionals, and those from the community setting presented a higher risk of MD. The healthcare model needs to implement an ethical approach to public health issues to alleviate MD among its professionals. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:THE DOMINICAN SCHOOL OF SALAMANCA AND THE SPANISH CONQUEST OF AMERICA: SOME BIBLIOGRAPHICAL NOTES THOMAS F. O'MEARA. O.P. University of Notre Dame Notre Dame, Indiana SALAMANCA, northwest of Madrid and Avila and not far from Spain's border with Portugal, preserves the atmosphere of a medieval, Renaissance, and Baroque university even as it develops the schools and clinics of a contemporary center of studies. There are associations with Teresa of (...) Avila, who spent the night there just after her reform was approved by Rome, with the young Cervantes, with Luis de Leon and Ignatius Loyola, and with John of the Cross, who was a student there. A bridge from the time of Trajan spans the river Tormes, and the Romanesque cathedral still reserves a chapel for the Mozarabic rite. The University of Salamanca The city brings to mind sixteenth century Dominicans like Francisco de Vitoria, often called the founder of international law, and Domingo Bafiez, confessor to Teresa of Avila. The Order of Friars Preachers, however, came to Salamanca in 1222 at the same time that Dominic's missions were taking root in·Paris and Bologna; the friars founded a priory and soon a school under the patronage of St. Stephen (San Esteban). The " Dominican School of Salamanca " means formally the line of great theologians reaching from Diego de Deza at the end of the fifteenth century to Tomas de Lemos, a main protagonist in Rome in 1607 in the controversy over grace entitled De Auxiliis. Today, after seven and a half centuries of existence, the Salamancan SSS 556 THOMAS F. o'MEARA, O.P. Dominicans remain a vital community, active m teaching, research and publishing. My attention was directed to the Dominicans at Salamanca by two volumes of essays reporting on congresses concerning the "Dominicans and the Discovery of the New World." My interest was not church history but the history of theologies of how grace might exist outside of explicit faith and sacramental baptism. The following report is a bibliographical survey of recent research on a theological era and school. Focusing on the thought of the theologians stimulated by the experiences of the missionaries in the Indies, it treats the Dominicans during the first decades after the voyages of Columbus. In the 1480s, as it entered its golden age, the University of Salamanca had a hundred professors and almost 7000 students. University records begin late, but they show that in 1546/47, one hundred thirty-four Dominicans were studying at the university, and in 1598/99, eighty. J. L. Espinel has written. a historical guide to the Dominican buildings and institutions.1 The great period of the Dominican school at the University began with Diego de Deza ( 1480-1486), professor and archbishop of Seville, and Matias de Paz (1518-1519), a professor of Scripture. Francisco de Vitoria (1526-1546) and Domingo de Soto (15321549 ) were its most gifted thinkers, but the school's achievements continued with Melchior Cano (1546-1552), Juan de la Pefia (1561-1565) and Domingo Banez (1581-1604). These t San Esteban de Salamanca, Historia y Gufa, Siglos, XIII-XX (Salamanca: Editorial San Esteban, 1978); see also R. Hernandez, "Convento y estudio de San Esteban," La Universidad de Salamanca (Salamanca: Universidad, 1989), pp. 369ff.; A. Martin Melquiades, "La Escuela de teologia de Salamanca," Atti del Congresso internazionale, Tommaso d'Aquino nel suo settimo centenario, Tommaso d'Aquino nella storia del pensiero, 1 :2 (Naples: Edizione Domenicane Italiane, 1975), pp. 242ff. A Salamancan Dominican of the 1930s, Vicente Beltran de Heredia, pioneered research in the history of the university and in the writings of the Dominican speculative masters. His writings can be found in past issues of Ciencia Tomista (CT), and some of his books and several recent collections of his most important essays are available from Editorial San Esteban. Similarly initial research in the United States can be found in the writings of Lewis Hanke. SALAMANCA AND THE SPANISH CONQUEST 557 are joined by lesser figures like Pedro de Sotomayor (15601564 ), Mancia de Corpus Christi (1564-1576), and Bartolome de Medina (1576-1581). The occupants of the chair in theology of the liturgical hour of prime from Vitoria in 1526 to Bafiez's... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:René Girard and the Rhetoric of ConsumptionKathleen M. Vandenberg (bio)The work of René Girard, so productively applied in so many different fields—in theology, in anthropology, in literature, to name a few—has yet to be recognized or applied in the field of rhetorical studies. Yet there exists, I argue, a need precisely for Girard's theories as the over 2000 year-old discipline enters the twenty-first century.Girard's theory of mimetic or triangular (...) desire can be used as a model for understanding persuasion, because it is, among other things, an "expression of a basic set of ideas on... the dynamics of the self and human relations" (1996, vii). Girard's concern is with human relationships and, in a sense, with how individuals in these relationships act rhetorically upon themselves and others. Girard's mimetic theory hinges on the dynamics of imitation and explains how individuals relate through both the conscious and the unconscious sharing of behaviors, attitudes, and beliefs in certain situations. These situations are clearly rhetorical, as can be seen by examining the definition of the "rhetorical situation" set forth by Lloyd Bitzer, in his seminal 1968 article, "The Rhetorical Situation." Bitzer proposes three conditions that must be met for a rhetorical situation to exist: an exigency or imperfection marked by urgency; a rhetorical audience or an audience that can act; and constraints, or elements that have the power to constrain the decision and action needed to modify the exigency (7). In mass-mediated modern rhetoric, I argue that the exigencies exist externally (in the culture) and internally, the audience is both others and self, and the constraints are the alienation, mystification, and desire generated by hierarchies. Twentieth-century rhetorical theorist Kenneth Burke advises that "we must often think of rhetoric not in terms of some one particular address, but as a general body of identifications that owe their convincingness much more to trivial repetition and dull daily reënforcement than to exceptional rhetorical skill" (1950, 26). Such is the case with this particular form of rhetoric, which is generated and propagated by mimetic contagion and thus is best more narrowly defined as sociological propaganda, a type of propaganda [End Page 259] theorized by Jacques Ellul in Propaganda: The Formation of Men's Attitudes (1975).Ellul, the first to distinguish between political propaganda and sociological propaganda, proposes that the latter encompasses social behaviors "much more vast and less certain" than those of political propaganda (1975, 62). These social behaviors permit the penetration of an ideology in a society, a penetration that is achieved through the active participation of the masses. Sociological propaganda, as Ellul describes it, works from within; it is dependent on the individual's willingness and ability to persuade him- or herself and others. Sociological propaganda, Ellul posits, is created when members of a group behave in such a way as to influence the attitudes, actions, and lifestyles of others; often this behavior is unconscious, unintentional, and spontaneous.In these ways, the rhetoric of sociological propaganda operates in a markedly different fashion than more "traditional" rhetoric, which is largely understood to operate as a unilateral transaction in which an individual orator actively, openly, and orally works to move a relatively passive but physically present audience to act in accordance with the orator's own beliefs through a formally delivered speech. In its reliance on the interaction and cooperation of the many rather than the centrality and dominance of one speaker, in its acceptance of unintentional, spontaneous, and unconscious persuasion, in its dependence on the modern mass media, and in the limitless and nebulous nature of its boundaries in time and space, sociological propaganda constitutes a type of rhetoric heretofore insufficiently addressed by rhetorical studies. Although existing perspectives in rhetorical criticism have certainly addressed some aspects of this rhetoric, sociological propaganda is not easily explained with the terminology of traditional rhetorical criticism or easily approached from traditional rhetorical perspectives.This article asserts that the best way to approach and understand such propaganda is through the perspective of René Girard. Approaching this propaganda from a Girardian perspective permits us to look beyond the symbols of sociological propaganda and analyze our own responsibility in rhetorical... (shrink)

Is God's foreknowledge compatible with human freedom? One of the most attractive attempts to reconcile the two is the Ockhamistic view, which subscribes not only to human freedom and divine omniscience, but retains our most fundamental intuitions concerning God and time: that the past is immutable, that God exists and acts in time, and that there is no backward causation. In order to achieve all that, Ockhamists distinguish ‘hard facts’ about the past which cannot possibly be altered from ‘soft facts’ (...) about the past which are alterable, and argue that God's prior beliefs about human actions are soft facts about the past. (shrink)

The use of platelet rich plasma as a novel treatment is discussed in the context of a qualitative research study comprising 38 interviews with sports medicine practitioners and other stakeholders working within the English Premier League during the 2013–16 seasons. Analysis of the data produced several overarching themes: conservatism versus experimentalism in medical attitudes; therapy perspectives divergence; conflicting versions of appropriate evidence; subcultures; community beliefs/practices; and negotiation of medical decision-making. The contested evidence base for the efficacy of PRP is presented (...) in the context of a broader professional shift towards evidence based medicine within sports medicine. Many of the participants while accepting this shift are still committed to casuistic practices where clinical judgment is flexible and does not recognize a context-free hierarchy of evidentiary standards to ethically justifiable practice. We also discuss a tendency in the data collected to consider the use of deceptive, placebo-like, practices among the clinician participants that challenge dominant understandings of informed consent in medical ethics. We conclude that the complex relation between evidence and ethics requires greater critical scrutiny for this emerging specialism within the medical community. (shrink)

In Subjects That Matter, Namita Goswami attends to philosophy’s institutional and disciplinary failures to reconcile its identitarian claims to universality and reason with the feminist and postcolonial modes of thinking it traditionally keeps at bay. This essay places Goswami’s critique within a context of “the thought from outside,” which, beginning with Foucault’s reading of Blanchot, continuing through the geopolitics of Dussel’s philosophy of liberation, and prominent in Catherine Malabou’s conceptualization of plasticity, demonstrates how political critiques of philosophical hegemony contain an (...) implicit theorization of “literature.” If “literature” gives voice to the thought from outside, does it in turn “decolonize” philosophy? If so, what itinerary of thought ought to follow the relationship between this literary decolonization of philosophy and its imbrication within the fold of philosophical thought? How to conceptualize the plastic relation between inside and outside, between center and periphery, without subordinating the latter to the hegemony of the former? This essay argues for a coherence between Goswami’s and Malabou’s materialist understandings of difference and a conceptualization of literature as an “outside” to philosophy that operates “excentrically” “inside” philosophy. (shrink)

Exploring the darkest side of organizations may have a potential to change our previous assumptions about business life. Scholars both in management and organizational research fields have shown interest in the "bright" side of behavioral life and have looked for the ways to create a positive organizational climate and assumed a positive relation between happiness of employees and productivity. These main assumptions of the Human Relations School have dominated the scientific inquiry on organizational behavior. However, "the dark side of organizational (...) life" may have more explanatory power than "the bright side". Hostility, jealousy, envy, rivalry, gossip, problematic personalities, dislike, revenge, and social exclusion are the realities of business life. A manager may devote most of their time to cope with conflicts, deviant behaviors, ambitious individuals, gossips, and dysfunctional rivalry among employees. It is evident that negative events and interactions among employees cost more time and energy for a manager than the positive side of organizational life. This edited collection specifically focuses on these issues and will be of interest to researchers, academics, and advanced students in the fields of management, organizational studies and behavior, sociology, social psychology, and human resource management. (shrink)

v. 1. Philosophie. Rechtsphilosophie -- v. 2-4. Volkenrecht -- v. 5-6. Rechtsgeschiedenis. Burgerlijk recht. Procesrecht. Octrooirecht. Studie.

Для широкого круга читателей (слушателей, аспирантов, преподавателей) интересующихся данной проблемой.

The Internet is a worldwide network of interconnected computer networks. Access to it is primarily a matter of access to a large amount of information. Interesting is the database of the latest religious movements available on the Internet, as their own web pages of the latest religious movements, and information about them from web pages from other sources. Particularly interesting information is about the newest religious movements that operate in Ukraine.