La punción lumbar es un procedimiento invasivo, no exento de riesgos y para hacerlo es necesario solicitar el consentimiento informado del paciente o de un familiar. En este trabajo se aportan elementos éticos y prácticos necesarios para la realización de un correcto consentimiento informado en los pacientes a quienes se practica este proceder. Se propone un modelo de consentimiento informado para este fin que incluye información sobre: la explicación del procedimiento, contraindicaciones, complicaciones y cuidados después del procedimiento. Se resalta que (...) el consentimiento informado para la punción lumbar, más que una exigencia institucional o legal, constituye una exigencia ética para el médico y un derecho exigible por parte de los pacientes por lo que urge instituirlo como práctica sistemática. Lumbar puncture is an invasive procedure, not exempt of risks and to do so it is necessary to request the consent of the patient or a family member. This paper provides practical and ethical elements necessary to carry out a proper informed consent in patients to whom this procedure is practiced. Proposes a model of informed consent for this purpose which includes information on: the explanation of the procedure, contraindications, complications and care after the procedure. It highlights that informed consent for lumbar puncture, rather than a legal, or institutional requirement constitutes an enforceable right by patients and an ethical requirement for medical by which urges to establish it as a systematic practice. (shrink)

Bioethical dilemmas can emerge in research and clinical settings, from end-of-life decision-making to experimental therapies. The COVID-19 pandemic raised serious ethical challenges for healthcare organizations, highlighting the need to conduct needs assessments of the bioethics infrastructures of healthcare organizations. Clinical ethics committees (CECs) also create equitable policies, train staff on ethics issues, and play a consultative role in resolving the difficulty of complex individual cases. The main objective of this project was to conduct a needs assessment of the bioethics infrastructure (...) within a comprehensive hospital system. A cross-sectional anonymous online survey, including quantitative and qualitative formatted questions. The survey was sent to five key leaders from the organization’s hospitals. Survey questions focused on the composition, structure, function, and effectiveness of their facilities’ bioethics infrastructure and ethics-related training and resources. Positive findings included that most facilities have active CECs with multidisciplinary membership; CECs address critical issues and encourage team members to express clinical ethics concerns. Areas of concern included uncertainty about how CECs function and the process for resolving clinical ethics dilemmas. Most reported no formal orientation process for CEC members, and many said there was no ongoing ethics education process. The authors conclude that if CECs are a critical institutional resource where the practice of medicine and mission intersect, having well-functioning ethics committees with trained and oriented members demonstrates an essential commitment to the mission. The survey revealed that more needs to be done to bolster the bioethics infrastructure of this institution. (shrink)

BackgroundFunctional changes after spinal cord injury are related to changes in cortical plasticity. These changes can be measured with electroencephalography and has potential to be used as a clinical biomarker.MethodIn this longitudinal study participants underwent a total of 30 sessions of robotic-assisted gait training over a course of 6 weeks. The duration of each session was 30 min. Resting state EEG was recorded before and after 30-session rehabilitation therapy. To measure gait, we used the Walking Index for Spinal Cord Injury (...) Scale, 10-Meter- Walking Test, Timed-Up-and-Go, and 6-Min-Walking Test. Balance was measured using Berg Balance Scale.ResultsFifteen participants with incomplete SCI who had AIS C or D injuries based on American Spinal Cord Injury Association Impairment Scale classification were included in this study. Mean age was 35.7 years and the mean time since injury was 17.08 months. All participants showed clinical improvement with the rehabilitation program. EEG data revealed that high beta EEG activity in the central area had a negative correlation with gait and balance measured at baseline, in a way that greater high beta EEG power was related to worse clinical function at baseline. Moreover, improvement in gait and balance had negative correlations with the change in alpha/theta ratio in the parietal area.ConclusionIn SCI, functional impairment and subsequent improvement following rehabilitation therapy with RAGT correlated with the change in cortical activity measured by EEG. Our results suggest that EEG alpha/theta ratio may be a potential surrogate marker of functional improvement during rehabilitation. Future studies are necessary to improve and validate these findings as a neurophysiological biomarker for SCI rehabilitation. (shrink)

El objetivo principal de este estudio es analizar los cambios producidos en la percepción del alumnado de 1.º de Bachillerato, respecto a la enseñanza de la historia, tras la implementación de una unidad didáctica que fomenta la enseñanza de competencias de pensamiento histórico mediante la gamificación. La investigación es de tipo cuantitativo y se sustenta en la realización y análisis de un pretest y postest a estudiantes que cursan la asignatura de Historia del Mundo Contemporáneo. Los resultados evidencian que el (...) alumnado percibe diferencias en el uso de recursos como el libro de texto y las TIC y en el aprendizaje de habilidades, como el análisis de fuentes y la identificación de cambios y continuidades en el tiempo. En conclusión, esta unidad didáctica aportó una mayor motivación gracias a la gamificación y contribuyó a un aprendizaje de la historia basado en competencias. (shrink)

: In recent years, research on the family role and entrepreneurship has increased extremely, consolidating itself as a valid and current subject of study. However, a part of the scientific literature seems to lack systematization and the boundaries appear unclear, maybe due to its multidisciplinary nature. This paper presents a systematic analysis of academic research, applying bibliometric indicators and cluster analysis, which define the state of research on the international scene. For this purpose, using three well accepted databases among the (...) research community: Scopus, Web of Science, Business Source, a total of 92 articles were selected and analyzed, published between 1989 and 2019 (until March). The results show that this is a relatively recent field of study, with a multidisciplinary character and in which the most influential authors do not coincide with the most productive scientific journals. A cluster analysis finds out five main areas of literature development: the cluster with the largest percentage of co-occurrences (25%) is the one that relates to the dimensions of entrepreneurship, self-employment and personality; in contrast, the area with a lower percentage of co-occurrences of keywords (12,1%) is refers to family business, succession, economic development and Arabia Saudita. Based on the outcome obtained and the shortcomings above, in the final part of the article, possible points of reflection for future research are exposed, which could be useful to further of this field of study. (shrink)

Social entrepreneurship (SE) enables business consolidation, combined with the production of positive impact and improvements in society. Aligned with 2030 Agenda for the achievement of the United Nations Sustainable Development Goals, it is important to clarify the role of social entrepreneurs, as they are making visible the impact of their creative ideas in several areas, from civic engagement to the environment, health and learning. The main purpose of this study is to specify a model of social entrepreneurial intention (SEI) and (...) explore it by country, based on the dimensions of the Theory of Planned Behavior and how these are mediated by spirituality and optimism. With a convenience sample of 1476 Portuguese and Spanish students, Structural Equation Modeling (SEM) was used. For a deeply understanding, variables within the model were compared by country usingt-rest, and multivariate analysis was done by each one separately. The mean comparison between countries, demonstrated that there are differences only between perceived behavioral control (PBC), Spirituality, Optimism and SEI, with Portuguese students scoring the highest values, in all variables except Optimism. A mediation path was carried out, and Spirituality mediate a significant effect between the three TPB dimensions in Portuguese students, but not in students from Spain. Finally, after discussing the results, theoretical and practical contributions are analyzed, with regard to the field of SE in Portugal and Spain, and alternatives are pointed out for a more social and sustainable entrepreneurial future. (shrink)

In recent years, the study of women entrepreneurship has experienced great growth, gaining a broad consensus among academics and contributing above all to understanding all those factors that explain the difficulty of women in undertaking an entrepreneurial career. This document tries to contribute to the field of study, thanks to a systematic analysis through the publications present in the topic. For this purpose, 2,848 peer-reviewed articles were analyzed, published between 1950 and 2019, using the Scopus database (SCImago Research Group). Through (...) the use of a series of bibliometric indicators it was possible to define the current state of research on the international scene. The analysis revealed that it is a multidisciplinary field of study and that has started to expand further since 2006, culminating in 2019, which makes it become a current and valid object of study. The analysis of the clusters allowed to isolate 6 different lines of research in which emerged, on the one hand, the importance of entrepreneurial education, social entrepreneurship and the socio-cultural context of reference (e.g. culture, family and institutional support) as tools to overcome the gender gap, on the other, the importance that women entrepreneurship assumes in the economic growth of the country (especially in developing economies), promoting social inclusion and combating poverty and discrimination. The study presents an important contribution to reflect on current policies and to outline future lines of investigation. (shrink)

Durante su desarrollo el niño se enfrenta a eventos que plantean demandas difíciles de satisfacer como la enfermedad y la hospitalización. La Organización Mundial de Salud define la salud como un estado de completo bienestar físico, mental y social, pero no existe consenso en la literatura sobre el término bienestar. El objetivo del artículo es realizar una revisión bibliográfica acerca del concepto bienestar en niños, asociado al proceso salud - enfermedad y a la hospitalización. Los niños experimentan bienestar cuando predominan (...) sus emociones positivas, estas favorecen la salud, las negativas, pueden provocar estados patológicos y son frecuentes en la hospitalización. Esa realidad amerita ser transformada. El bienestar en niños hospitalizados constituye un reto para las ciencias médicas para penetrar las bases del nivel secundario de atención. Throughout their development, children face events that pose hard-to-satisfy demands for them such as illness and hospitalization. The World Health Organization defines health as a state of complete physical, mental, or social well-being; however, there is no consensus in literature about the term "well-being". The objective of the article is to do a bibliographic review on the concept of children well-being associated to the health-illness process and to hospitalization. Children experience the state of well-being when positive emotions, which favor health, prevail. Negative feelings, on the other hand, can cause pathological states and they are common in hospitalization. That reality merits transformation. Hospitalized children's well-being presents a challenge for medical sciences in order to get inside the basis of secondary health care attention. (shrink)

Commitment has been perceived as a strategic topic in organizations due to its positive effect on retaining talent, increasing performance, or boosting employees’ innovative behavior. However there are many focis of commitment in the workplace, which has represented a challenge to human resources management, who need implement measures to improve the employee’s commitment. Recent research has suggested a need to conduct studies about commitment, namely antecedents and the relationship between different focis, to understand the dynamic and directionality between them. Hence, (...) the purpose of this work is to analyze how employees’ emotional awareness relates with two focis of commitment, also assessing the mediating role of affective commitment to the leader. The study uses structural equation modeling and Lisrel to test the hypotheses considering the multidimensionality of organizational commitment, employees emotional awareness, and the affective commitment to the leader, under the scope of Social Exchange Theory. The Mackinon’s Z Test was used to assess the mediation role of affective commitment to the leader. The sample is composed for 403 employees from two multinational companies. The results provide empirical evidence about the mediating role of affective commitment to the leader in the relationship between employees’ emotional awareness and organizational commitment, and the employees’ emotional awareness as an antecedent of commitment. The implications for theory and practice are discussed. (shrink)

O presente tem como finalidade analisar a terapia do reencontro mediado como resgate da cidadania e cultura da paz. Modelo esse proposto por Luiz Alberto Warat. em uma concepção transformadora da mediação, construída para fomentar a autonomia e emancipação dos sujeitos numa relação conflitiva, como um novo paradigma de autoconhecimento. A metodologia utilizada será o hipotético dedutivo e como técnica de pesquisa indireta em doutrinas. A discussão e aprofundamento se dá pelos conceitos da teoria do reencontro mediado proposto com o (...) resgate da cidadania e da cultura de paz. O tema é de abrangente e se justifica pelo debate em torno da mediação na teoria do reencontro mediado. (shrink)

Background: Nurses are the largest professional group in healthcare and those who make more decisions. In 2014, the Committee on Bioethics of the Council of Europe launched the “Guide on the decision-making process regarding medical treatment in end-of-life situations”, aiming at improving decision-making processes and empowering professionals in making end-of-life decisions. The Guide does not mention nurses explicitly. Objectives: To analyze the ethical principles most valued by nurses working in palliative care when making end-of-life decisions and investigate if they are (...) consistent with the framework and recommendations of the Guide; to identify what disputed/controversial issues are more frequent in these nurses’ current end-of-life care practices. Design: Qualitative secondary analysis. Participants/context: Three qualitative datasets including 32 interviews from previous studies with nurses working in palliative care in Portugal. Ethical consideration: Ethical approval was obtained from the Ethics Research Lab of the Instituto de Bioética. Ethical procedures are thoroughly described. Findings: All participant nurses referred to autonomy as an ethical principle paramount in end-of-life decision-making. They were commonly involved in end-of-life decision-making. Palliative sedation and communication were the most mentioned disputed/controversial issues. Discussion: Autonomy was highly valued in end-of-life care and decision-making. Nurses expressed major concerns in assessing patients’ preferences, wishes, and promoting advance care planning. Nurses working in palliative care in Portugal were highly involved in end-of-life decision-making. These processes embraced a collective, inclusive approach. Palliative sedation was the most mentioned disputed issue, which is aligned with previous findings. Communication also emerged as a sensitive ethical issue; it is surprising, however, that only three nurses referred to it. Conclusion: While the Guide does not explicitly mention nurses in its content, this study shows that nurses working in palliative care in Portugal are involved in these processes. Further research is needed on nurses’ involvement and practices in end-of-life decision-making. (shrink)

University students will be our future business leaders, and will have to address social problems caused by business by implementing solutions such as social entrepreneurship ventures. In order to facilitate the learning process that will foster social entrepreneurship, however, a more holistic pedagogy is needed. Based on learning theory, we propose that students’ social entrepreneurship actions will depend on their learning about CSR and their absorptive capacity. We propose that instructors and higher education institutions can enhance this absorptive capacity by (...) exploiting Web 2.0 technologies. We tested our proposition with a sample of 425 university students using structural equation modeling and found support for the proposed relationships. (shrink)

A course in professional ethics for civil engineers was taught for the first time in Spain during the academic year 2007/08. In this paper a survey on the satisfaction and expectation of the course is presented. Surprisingly the students sought moral and ethical principles for their own ordinary lives as well as for their profession. Students were concerned about the law, but in their actions they were more concerned with their conscience, aware that it can be separate from the law.

In case of special engineering projects of important relevance it is interesting to pay attention to several possible risks; some of them are in the field of morality or ethics. Due to the social importance of these risks, additional considerations or even additional warranties are justified.

Research on adolescent-to-parent violence associates specific psychosocial characteristics with adolescents who assault their parents, whether they are within or outside the juvenile justice system, or whether these characteristics are shared by other adolescents convicted of other crimes. The aim of this paper is to compare three groups of adolescents. Those who have been sentenced for APV are compared with adolescents who have committed other crimes, and with a group who have not been involved in the justice system. The sample used (...) consists of 148 male participants between the ages of 14 and 21. A comparison is made regarding type of self-reported behavior, frequency of drug use, academic performance, exposure to violence, self-concept, and parents’ conflict resolution tactics. The results obtained indicate that adolescents with judicial measures, regardless of the crime committed, differ from those who have not been in trouble with the justice system in terms of them having suffered violence in the street, the frequency with which they use drugs and in their academic achievement. Likewise, adolescents convicted of APV differ from the other two groups in the frequency with which they are victims of violence at home, in that their mothers use the tactic of asking somebody else for help as a way of solving marital conflicts, and in having a more negative family self-concept. The results are discussed highlighting the importance of taking into account whether a sample is judicial, clinical, or community, and the specific APV behaviors which are measured. (shrink)

Background The expressions of a “wish to hasten death” or “wish to die” raise ethical concerns and challenges. These expressions are related to ethical principles intertwined within the field of medical ethics, particularly in end-of-life care. Although some reviews were conducted about this topic, none of them provides an in-depth analysis of the meanings behind the “wish to hasten death/die” based specifically on the ethical principles of autonomy, dignity, and vulnerability. The aim of this review is to understand if and (...) how the meanings behind the “wish to hasten death/die” relate to and are interpreted in light of ethical principles in palliative care. Methods We conducted a meta-ethnographic review according to the PRISMA guidelines and aligned with Noblit and Hare’s framework. Searches were performed in three databases, Web of Science, PubMed, CINAHL, with no time restrictions. Original qualitative studies exploring the meanings given by patients, family caregivers and healthcare professionals in any context of palliative and end-of-life care were included. A narrative synthesis was undertaken. PROSPERO registration CRD42023360330. Results Out of 893 retrieved articles, 26 were included in the analysis, accounting for the meanings of a total of 2,398 participants. Several factors and meanings associated with the “wish to hasten death” and/or “wish to die” were identified and are mainly of a psychosocial and spiritual nature. The ethical principles of autonomy and dignity were the ones mostly associated with the “wish to hasten death”. Ethical principles were essentially inferred from the content of included articles, although not explicitly stated as bioethical principles. Conclusions This meta-ethnographic review shows a reduced number of qualitative studies on the “wish to hasten death” and/or “wish to die” explicitly stating ethical principles. This suggests a lack of bioethical reflection and reasoning in the empirical end-of-life literature and a lack of embedded ethics in clinical practice. There is a need for healthcare professionals to address these topics compassionately and ethically, taking into account the unique perspectives of patients and family members. More qualitative studies on the meanings behind a wish to hasten death, their ethical contours, ethical reasoning, and implications for clinical practice are needed. (shrink)

Establecido lo que es el uso de razón, estudia ahora el momento en que el hombre llega a él y la obligación de orientar entonces su vida al bien con el deseo o propósito de llevarlo a la práctica. En los que han crecido y se han educado en un ambiente de fe en Dios como máximo bien, su obligación moral es ordenarse a Él y proponerse actuar conforme a sus mandamientos. En los que han nacido y vivido en ambientes (...) desconocedores de Dios, su obligación es la de orientarse al bien en conformidad con el bagaje de sus conocimientos. Le inquieta el tema: cómo en ese momento les queda, particularmente a los últimos, abierto el camino de la salvación y la vida eterna. (shrink)

Establecido lo que es el uso de razón, estudia ahora el momento en que el hombre llega a él y la obligación de orientar entonces su vida al bien con el deseo o propósito de llevarlo a la práctica. En los que han crecido y se han educado en un ambiente de fe en Dios como máximo bien, su obligación moral es ordenarse a Él y proponerse actuar conforme a sus mandamientos. En los que han nacido y vivido en ambientes (...) desconocedores de Dios, su obligación es la de orientarse al bien en conformidad con el bagaje de sus conocimientos. Le inquieta el tema: cómo en ese momento les queda, particularmente a los últimos, abierto el camino de la salvación y la vida eterna. (shrink)

Las copias de los manuscritos de las Relecciones de Francisco de Vitoria se multiplicaron, y enseguida atravesaron el océano, para llegar muy pronto a manos de universitarios y misioneros. En España llegaron a la corte imperial, provocando una rápida censura, y al humanista J. Ginés de Sepúlveda, que asume el texto como favorable a su imperialismo. En ultramar el catedrático agustino Alonso de Veracruz aprueba y enriquece sus argumentos, y el dominico Bartolomé de Las Casas se queda sólo con los (...) condicionantes del propio Vitoria. Creo que esos condicionantes merecen ser conocidos en su entorno para su justa valoración. Lo dedico a los grandes vitoriólogos que honraron con sus estudios a esta revista.The manuscript copies of the Relecciones by Francisco de Vitoria multiplied and crossed the ocean to fall very soon in the hands of university students and missionaries . In Spain they reached the imperial court causing a rapid censorship and the humanist J. Ginés de Sepúlveda who takes the text as in favor of his imperialism. Overseas the Augustinian professor of university Alonso de Veracruz approves and enriches his arguments, the Dominican Bartolome de las Casas remains alone with the own Vitoria’s Condicionnantes. I think that those Condicionantes are worth being known in their context to value them appropriately. I devote it to Vitoria’s great friends who honored this journal with their studies. (shrink)

Handwriting is a complex activity that involves continuous interaction between lower-level handwriting and motor skills and higher-order cognitive processes. It is important to allocate mental resources to these high-order processes since these processes place a great demand on cognitive capacity. This is possible when lower-level skills such as transcription are effortlessness and fluent. Given that fluency is a value in virtually all areas of academic learning, schools should provide instructional activities to promote writing fluency from the first stages of learning (...) to write. In an effort to determine if teaching handwriting enhances writing fluency, we conducted a systematic and meta-analytic review of the writing fluency intervention literature. We selected 31 studies: 21 true and quasi-experimental studies, 4 single-group design, 3 single-subject design, and 3 non-experimental studies, conducted with K-6 students in a regular school setting. A total of 2,030 students participated in these studies. When compared to no instruction or non-handwriting instructional conditions, teaching different handwriting intervention programs resulted in statistically significant greater writing fluency. Moreover, three specific handwriting interventions yielded statistically significant results in improving writing fluency, when compared to other handwriting interventions or to typical handwriting instruction conditions: handwriting focused on training timed transcription skills, multicomponent handwriting treatments, and performance feedback. There were not enough data to calculate the impact of sensory-motor and self-regulated strategy handwriting interventions on writing fluency. The significance of these findings for implementing and differentiating handwriting fluency instruction and guiding future research will be discussed. (shrink)

La Ética es la parte de la filosofía práctica que se ocupa del hecho moral y de los problemas filosóficos que nacen de la conducta humana, la bioética resulta la rama de la ética que se dedica a proveer los principios para la correcta conducta humana; respecto a la vida. En el proceso de atención a los pacientes con enfermedades reumáticas se emplean variados procedimientos. Las nuevas tecnologías han mejorado notablemente su tratamiento integral; estos adelantos científicos deben ser empleados con (...) la intención fundamental de no producir daño y previo consentimiento informado; por lo que resulta necesario argumentar acerca de las implicaciones bioéticas que resultan del empleo de los avances científico-tecnológicos en el tratamiento a los pacientes con enfermedades reumáticas. Ethics is the part of Practical Philosophy that deals with moral facts and philosophical problems that have their roots in human behavior. Bioethics is the branch of Ethics devoted to providing the principles for correct human behavior, with respect to life. Various procedures are used when treating patients with rheumatic diseases. New technologies have considerably improved their integral treatment; these scientific advances must be used with the main purpose of causing no harm and with prior informed consent. Therefore, it is necessary to argue on the bioethical implications that turn out from the use of scientific-technological advances in the treatment of patients with rheumatic diseases. (shrink)