IntroductionRheumatologists are the primary healthcare professionals responsible for patients with rheumatic diseases and should acquire medical ethical competencies, such as the informed consent process. The objective clinical structured examination is a valuable tool for assessing clinical competencies. We report the performance of 90 rheumatologist trainees participating in a station designed to evaluate the ICP during the 2018 and 2019 national accreditations.MethodsThe station was validated and represented a medical encounter in which the rheumatologist informed a patient with systemic lupus erythematosus with (...) clinically active nephritis about renal biopsy. A trained patient–actor and an evaluator were instructed to assess ICP skills in obtaining formal informed consent, delivering bad news and overall communication with patients. The evaluator used a tailored checklist and form.ResultsCandidate performance varied with ICP content and was superior for potential benefit information but significantly reduced for potential complications and biopsy description. Only 17.8% of the candidates mentioned the legal perspective of ICP. Death was omitted by the majority of the candidates ; after the patient–actor challenged candidates, only 57.1% of them gave a clear and positive answer. Evaluators frequently rated candidate communications skills as superior, but ≥1 negative aspect was identified in 69% of the candidates.ConclusionsEthical competencies are mandatory for professional rheumatologists. It seems necessary to include an ethics competency framework in the curriculum throughout the rheumatology residency. (shrink)

This paper criticizes genetic naturalism, namely, the task of explaining how reason emerges from nature. We take into account Donald Davidson’s anomalous monism and his analogy of triangulation. Our aim is to criticize both the metaphysical suppositions of anomalous monism and its consequences for genetic naturalism. We propose that those suppositions and those consequences prevent the genetic question to be appropriately raised and, therefore, mislead the research for a reasonable answer to that.

In this paper we deal with some new axiom schemes for Peano's Arithmetic that can substitute the classical induction, least-element, collection and strong collection schemes in the description of PA.

RESUMEN En este trabajo discutimos tres formulaciones semánticas del condicional: la material, la estricta y la relevante. Defendemos que, desde un punto de vista formal, el condicional relevante responde mejor a nuestras intuiciones que los otros dos. Ahora bien, dado que la interpretación semántica del mismo es terreno disputado, proponemos hacerlo pragmáticamente. Dividimos el texto en tres secciones. En la primera proponemos el criterio de adecuación para evaluar distintas teorías de los condicionales: la teoría no debe dar lugar a los (...) casos más conocidos de sobregeneración inferencial. En la segunda mostramos que el condicional material y el condicional estricto sobregeneran, pues ambos admiten paradojas bien conocidas. En la última mostramos que si se interpreta pragmáticamente, el condicional relevante bloquea la aparición de las paradojas que los dos anteriores no pueden evitar, y, en esa medida responde mejor que ellos al criterio establecido y, por tanto, a nuestras intuiciones. ABSTRACT In this paper we discuss three semantic formulations of conditional: material, strict and relevant. Our aim is to show that the relevant conditional shapes our intuitions better than the other two. Since the semantic interpretation of the relevant conditional is an unsettled issue nowadays, we propose a pragmatic interpretation of it. In the first part of the paper we present the criteria to which a theory of conditionals must answer, i.e. the theory must not overgenerate. In the second one, we show that the material and the strict conditionals overgenerate because both lead to paradoxes. In the last part we show that the relevant conditional with a pragmatic interpretation solves the problem of the other conditionals. (shrink)

Background People who are at elevated risk of suicide stand to benefit from internet-based interventions; however, research in this area is likely impacted by a range of ethical and practical challenges. The aim of this study was to examine the ethical issues and practical barriers associated with clinical studies of internet-based interventions for suicide prevention. Method This was a mixed-methods study involving two phases. First, a systematic search was conducted to identify studies evaluating internet-based interventions for people at risk of (...) suicide, and information pertaining to safety protocols and exclusion criteria was extracted. Second, investigators on the included studies were invited to complete an online survey comprising open-ended and forced-choice responses. Quantitative and qualitative methods were used to analyse the data. Results The literature search identified 18 eligible studies, of which three excluded participants based on severity of suicide risk. Half of the 15 suicide researchers who participated in the survey had experienced problems obtaining ethics approval, and none had encountered adverse events attributed to their intervention. Survey respondents noted the difficulty of managing risk in online environments and the limitations associated with implementing safety protocols, although some also reported increased confidence resulting from the ethical review process. Respondents recommended researchers pursue a collaborative relationship with their research ethics committees. Conclusion There is a balance to be achieved between the need to minimise the risk of adverse events whilst also ensuring interventions are being validated on populations who may be most likely to use and benefit from them. Further research is required to obtain the views of research ethics committees and research participants on these issues. Dialogue between researchers and ethics committees is necessary to address the need to ensure safety while also advancing the timely development of effective interventions in this critical area. (shrink)

Researchers working in the field of ecosystem services (ES) have long acknowledged the importance of recognising multiple values in ecosystems and biodiversity. Yet the operationalisation of value pluralism in ES assessments remains largely elusive. The aim of this research is to present a taxonomy of values and valuation methods to widen the evaluative space for ES. First, we present our preanalytic positions in regards to the values and valuation of ES. Second, we review different value definitions that we deem relevant (...) for the discussion of ES valuation. Third, we propose a taxonomy of ES values based on different conceptions of human-nature relationships. Finally, we present a taxonomy of different methods that can be used to recognise plural values in ES. This taxonomy for a plural valuation can help ES scientists and practitioners with their aim of representing people's multiple and context-specific ways of valuing nature. The taxonomy can also serve to pay broader attention to ES values that are overlooked or misrepresented in assessments that restrict their focus to monetary valuations. (shrink)

The current COVID-19 crisis may have an impact on the mental health of professionals working on the frontline, especially healthcare workers due to the increase of occupational psychosocial risks, such as emotional exhaustion and secondary traumatic stress. This study explored job demands and resources during the COVID-19 crisis in predicting emotional exhaustion and STS among health professionals. The present study is a descriptive and correlational cross-sectional design, conducted in different hospitals and health centers in Spain. The sample consisted of 221 (...) health professionals with direct involvement in treating COVID-19. An online survey was created and distributed nationwide from March 20 to April 15 which assessed: sociodemographic and occupational data, fear of contagion, contact with death/suffering, lack of material and human protection resources, challenge, emotional exhaustion, and STS. Descriptive findings show high levels of workload, contact with death/suffering, lack of MHPR and challenge, and are moderately high for fear of contagion, emotional exhaustion, and STS. We found an indirect significant effect of lack of MHPR on predicting emotional exhaustion through the workload and on STS through fear of contagion, contact with death/suffering, and workload. To conclude, this study examines the immediate consequences of the crisis on health professionals' well-being in Spain, emphasizing the job demands related to COVID-19 that health professionals are facing, and the resources available in these health contexts. These findings may boost follow-up of this crisis among health professionals to prevent them from long-term consequences. (shrink)

Algunos críticos de la ciencia afirman que es sólo un punto de vista entre otros, sin alguna autoridad epistémica especial. No obstante, en este artículo se defiende que la idea de que la investigación científica involucra una perspectiva o punto de vista no impone una restricción a su ideal de objetividad. Primero se presentan algunas aclaraciones sobre la noción de punto de vista, luego se atiende al concepto de objetividad científica, y por último se enfrentan algunos desafíos que se desprenden (...) de la noción de punto de vista y amenazan rasgos de la objetividad científica vinculados con su autoridad epistémica. -/- Some critics of science claim that it is only a point of view among others, lacking any special epistemic authority. However, this paper contends that conceiving scientific inquiry as something that involves a perspective or a point of view does not pose a constraint on its ideal of objectivity. We first put forward some clarifications on the notion of point of view, followed by some observations on scientific objectivity; finally, we face some of the challenges that rise from the notion of point of view and threaten features of scientific objectivity tied to its epistemic authority.]. (shrink)

Following Goldman’s seminal work, most contemporary philosophical contributions on the novice-expert relation have adopted a normative, expert-focused approach. In this paper, we aim to shift the focus of the philosophical analysis towards the characteristics of the novices, and how they might determine the choices that experts make. On the bases of recent empirical evidence from social psychology, we discuss how novices evaluate the messages that they receive and distinguish diverse kinds of novices according to their competence in message assessment. Building (...) on that analysis, we discuss the difficulties of approaches to expertise that focus only on the standpoint of novices or assume novices are homogeneous. In our analysis, we introduce the standpoint of experts, and we pay special attention to the heterogeneity of novices. This approach allows us to identify and address the difficulties faced by experts in the context of science communication. In the last part of the paper, we characterise and discuss the problem of experts when choosing a strategy in the issuing of a public campaign to advise or inform certain populations of novices. (shrink)

En los escenarios universitarios cada vez resulta menos extraño toparse con investigaciones que indagan por la escritura filosófica proveniente de centros no hegemónicos de producción de conocimiento. Nosotros, que hemos tenido la oportunidad de acercarnos al pasado del ejercicio de la filosofía en el actual territorio colombiano, quisimos hacer una convocatoria pública de escritos dedicados a identificar temas, preguntas y formas en que la variopinta comunidad de la filosofía local está escribiendo su propia historia.

El presente artículo ofrece una aproximación a las líneas fundamentales de la fenomenología de la conciencia amorosa de Joaquín Xirau. El objetivo es mostrar cómo el amor puede erigirse en el fundamento ontológico, axiológico y gnoseológico de la realidad y, por tanto, en la clave de bóveda del arco sujeto-objeto de la conciencia. Si el despliegue de la Modernidad ha conducido la existencia del hombre al nihilismo, la conciencia amorosa se postula como una vía razonable de salvación. Al ser restituida (...) la realidad del mundo en su doble dimensión, ontológica y axiológica, puede recobrarse una experiencia de sentido plenaria y orgánica de aquella. (shrink)

El libro de María González Navarro se presenta a sí mismo como una “nueva hermenéutica” (23). La novedad involucra dos aspectos: uno que llamaremos metateórico y otro hermenéutico en propiedad. Hablando metateóricamente, el libro presenta una hermenéutica gadameriana vigorizada y robustecida por las teorías pragma-dialécticas de la argumentación. Desde el punto de vista hermenéutico propiamente dicho, la novedad reposa en que se considera que la interpretación correcta está indesligablemente vinculada a la argumentación abductiva.

Analizamos las relaciones no siempre presentes entre deportes, barrios y políticas públicas en Chile en el marco de las vinculaciones entre Estado y sociedad civil en la que el barrio y los clubes deportivos, pese a su gran presencia y aporte a la sociabilidad, han estado ausentes. Hasta antes del golpe de Estado de 1973, la sociedad civil tenía una gran fortaleza, y muchas de sus instituciones, como los clubes deportivos, gozaban de buena salud institucional y sobre todo de autonomía. (...) El colapso institucional del año 1973 quebró las confianzas y tras un proceso muy largo, las instituciones deportivas volvieron a reconfigurarse. Las políticas neoliberales también alcanzaron al mundo del deporte. El Estado subsidiario, a través de proyectos concursables, presta ayuda al desarrollo de estas instituciones de base. (shrink)

Este trabajo examina parte del pensamiento de Kant de cara a precisar en qué sentido puede pensarse la universalidad como una exigencia para la filosofía moral y cómo las investigaciones de ese autor pueden contribuir a esclarecer esta cuestión. El análisis de los argumentos muestra algunas inconsistencias lógicas en el desarrollo del problema de la universalización moral que los especialistas han tratado de explicar, a partir de las cuales sugerimos que una alternativa de análisis gramatical al estilo de Wittgenstein puede (...) ayudar a clarificar. El trabajo es, pues, crítico y pro positivo y conlleva una interpretación programática de tesis kantianas. (shrink)

El propósito central enfatiza la comprensión histórico-cultural de la diversidad y la diferencia como productoras de escenarios donde la tolerancia debe redimir la exclusión y fomentar la equidad; explica, reflexiva y críticamente, algunas ideas que subrayan la urgen te necesidad de replantear los d..

Music can reduce stress and anxiety, enhance positive mood, and facilitate social bonding. However, little is known about the role of music and related personal or cultural variables in maintaining wellbeing during times of stress and social isolation as imposed by the COVID-19 crisis. In an online questionnaire, administered in 11 countries, participants rated the relevance of wellbeing goals during the pandemic, and the effectiveness of different activities in obtaining these goals. Music was found to be the most effective activity (...) for three out of five wellbeing goals: enjoyment, venting negative emotions, and self-connection. For diversion, music was equally good as entertainment, while it was second best to create a sense of togetherness, after socialization. This result was evident across different countries and gender, with minor effects of age on specific goals, and a clear effect of the importance of music in people's lives. Cultural effects were generally small and surfaced mainly in the use of music to obtain a sense of togetherness. Interestingly, culture moderated the use of negatively valenced and nostalgic music for those higher in distress. (shrink)

Resumen. En México, la mercadotecnia promocional se ha erigido como la segunda más grande inversión demercadotecnia, principalmente debido a que las compañías tienden con más frecuencia a subcontratar laresponsabilidad de los aspectos operativos de la mercadotecnia. Las empresas contratantes exigen cada vezmás la garantía de seguridad y certidumbre en la prestación de los servicios, por lo que la calidad de éste seha convertido en un factor determinante en la elección de una agencia de promociones. El presentedocumento técnico busca compartir un (...) caso de estudio relacionado a una empresa de promoción de ventasque enfrenta una alta tasa de deserción de clientes con su consecuente contracción en las ventas, pero quecontradictoriamente está inmersa en un mercado que tiene un crecimiento sostenido del 15 por ciento en losúltimos años. El problema fue abordado desde la perspectiva de la calidad en el servicio y la satisfacción delcliente a través de la aplicación de encuestas Servqual a algunos clientes de la compañía. Dichas encuestaspermitieron: identificar las dimensiones de calidad relevantes en el servicio, detectar las áreas de oportunidadentre el servicio esperado y el servicio real, y la elaboración de un plan de acción que posteriormente fuesistematizado e implementado. Los resultados muestran que la implementación del sistema de calidad redujola deserción de los clientes; además, se descubrió que las dimensiones de calidad del Servqual afectan enproporciones diferentes a la satisfacción del cliente.Palabras Claves. Calidad en el servicio, deserción de clientes, mercadotecnia promocional, promoción deventas, QFD, satisfacción del cliente, Servqual, sistema de calidad.. In Mexico, the promotional marketing has emerged as the second largest marketing investment,mainly because companies tend to outsource most often the operational aspects of marketing. Thosecompanies are increasingly demanding security and certainty in the delivery of services. As a consequence,service quality has become a determining factor in the election of a sales promotion agency. This technicalpaperwork shares a case study related to a sales promotion company facing high customer defection rate withits consequent contraction in sales, but ironically immersed in a market that has a sustained growth of 15 per cent in recent years. Approach of the problem was from quality service and customer satisfaction perspectivethrough the use of Servqual surveys applied to some customers. These surveys allowed: to identify relevantdimensions of quality service, to identify opportunities between the expected service and the actual service,and the development of an action plan which was later systematized and implemented. Results show that theimplementation of the quality system reduced customer desertion. Also, found that the quality dimensions of SERVQUAL affect customer satisfaction in different ways.Keywords. Customer defection, customer satisfaction, quality service, quality system, QFD, sales promotion,Servqual. (shrink)

El fenómeno turístico es uno de los elementos más importantes en relación a los vectores de cambio social. Como objetivo se plantea un análisis bibliométrico-descriptivo sobre el turismo activo y su relación con las prácticas deportivas mediante el estudio de la producción académica en Scopus. Las conclusiones ofrecen un perfilado de los intereses de investigación, temas, tópicos y elementos distintivos de los artículos centrados en esta línea de investigación, resaltando que existen publicaciones muy diversas sobre el tema de la relación (...) entre turismo activo y deporte, donde se contemplan distintos eventos deportivos como oferta turística en una gran variedad geográfica. (shrink)

Unfounded—conspiracy and health—beliefs about COVID-19 have accompanied the pandemic worldwide. Here, we examined cross-nationally the structure and correlates of these beliefs with an 8-item scale, using a multigroup confirmatory factor analysis. We obtained a two-factor model of unfounded (conspiracy and health) beliefs with good internal structure (average CFI = 0.98, RMSEA = 0.05, SRMR = 0.04), but a high correlation between the two factors (average latent factor correlation = 0.57). This model was replicable across 50 countries (total N = 13,579), (...) as evidenced by metric invariance between countries (CFI = 0.96, RMSEA = 0.06, SRMS = 0.07) as well as scalar invariance across genders (CFI = 0.98, RMSEA = 0.04, SRMS = 0.03) and educational levels (CFI = 0.98, RMSEA = 0.04, SRMS = 0.03). Also, lower levels of education, more fear of COVID-19, and more cynicism were weakly associated with stronger conspiracy and health beliefs. The study contributes to knowledge about the structure of unfounded beliefs, and reveals the potential relevance of affective (i.e., fear of COVID-19) and cognitive (i.e., cynicism) factors along with demographics, in endorsing such beliefs. In summary, we obtained cross-cultural evidence for the distinctiveness of unfounded conspiracy and health beliefs about COVID-19 in terms of their structure and correlates. (shrink)

Unfounded—conspiracy and health—beliefs about COVID-19 have accompanied the pandemic worldwide. Here, we examined cross-nationally the structure and correlates of these beliefs with an 8-item scale, using a multigroup confirmatory factor analysis. We obtained a two-factor model of unfounded (conspiracy and health) beliefs with good internal structure (average CFI = 0.98, RMSEA = 0.05, SRMR = 0.04), but a high correlation between the two factors (average latent factor correlation = 0.57). This model was replicable across 50 countries (total N = 13,579), (...) as evidenced by metric invariance between countries (CFI = 0.96, RMSEA = 0.06, SRMS = 0.07) as well as scalar invariance across genders (CFI = 0.98, RMSEA = 0.04, SRMS = 0.03) and educational levels (CFI = 0.98, RMSEA = 0.04, SRMS = 0.03). Also, lower levels of education, more fear of COVID-19, and more cynicism were weakly associated with stronger conspiracy and health beliefs. The study contributes to knowledge about the structure of unfounded beliefs, and reveals the potential relevance of affective (i.e., fear of COVID-19) and cognitive (i.e., cynicism) factors along with demographics, in endorsing such beliefs. In summary, we obtained cross-cultural evidence for the distinctiveness of unfounded conspiracy and health beliefs about COVID-19 in terms of their structure and correlates. (shrink)

_Introducción_: la Limitación del Esfuerzo Terapéutico (LET) busca reorientar las medidas del acompañamiento terapéutico durante el final de la vida; actualmente existe legislación sobre este tema. _Objetivo: _caracterizar el conocimiento y la claridad conceptual y jurídica del personal de salud del Hospital de San José (HSJ) de Bogotá sobre la LET. _Métodos: _estudio descriptivo transversal usando encuesta de libre preparación. Se estableció claridad conceptual con resultado superior al 70% de respuestas correctas. Datos levantados con cuestionario de selección múltiple vía Formularios (...) Google, tabulados en Microsoft Excel ® y analizados con Stata ® vía estadística descriptiva. _Resultados:_ 36 % de encuestados tuvo claridad conceptual y jurídica sobre LET; el 82,3 % de encuestados diferenciaron LET de eutanasia y el 95,6 %, LET de cuidados paliativos. El 61 % de los encuestados no tuvo conflicto moral/jurídico con LET; el 60 % y el 70 % de los encuestados creen, respectivamente, que suspender el oxígeno y la ventilación mecánica no hacen parte de la LET. Finalmente, el 78,9 % expresó no haber recibido suficiente información sobre el tema. _Conclusiones_: el personal encuestado carece de claridad conceptual suficiente sobre la LET,lo que señala la necesidad de mayor educación al respecto. (shrink)