Background Older patients in emergency care often have complex needs and may have limited ability to make their voices heard. Hence, there are ethical challenges for healthcare professionals in establishing a trustful relationship to determine the patient’s preferences and then decide and act based on these preferences. With this comes further challenges regarding how the patient’s autonomy can be protected and promoted. Aim To describe nurses’ experiences of dealing with older patients’ autonomy when cared for in emergency departments (EDs). Research (...) design This study adopted reflective lifeworld theory and a phenomenological design. Participants and research context A total of 13 open-ended interviews were performed with nurses working at two EDs in Sweden. Ethical considerations The study was reviewed by the Ethical Advisory Board in South East Sweden and conducted according to the Declaration of Helsinki. All participants gave consent. Findings Nurses’ experiences of dealing with older patients’ autonomy in EDs are characterized by moving in a conflicting uphill struggle, indicating obscure thoughts on how patient autonomy can be protected in an ethically challenging context. The phenomenon is further described with its meaning constituents: ‘Being hampered by prioritization under stress’, ‘Balancing paternalism and patient autonomy’, ‘Making decisions without consent in the patient’s best interests’ and ‘Being trapped by notions of legitimate care needs’. Conclusion Stressful work conditions and lacking organizational strategies in EDs contribute to nurses maintaining unjustified paternalistic care, regardless of the patient’s ability and medical condition, and questioning who has legitimacy for participating in decisions about care. The nurses’ protection and promotion of older patients’ autonomy is dependent on the opportunity, ability and willingness to create a patient relationship where the patient’s voice and preferences are valued as important. Consequently, strategies are needed to improve patient autonomy in EDs based on the idea of ‘relational autonomy’. (shrink)

Neuroscientific research in relation to antisocial behavior has strongly grown in the last decades. This has resulted in a better understanding of biological factors associated with antisocial behavior. Furthermore several neuroscientific instruments and interventions have been developed that have a relatively low threshold for use in the criminal justice system to contribute to prevention or reduction of antisocial and criminal behavior. When considering implementation in the criminal justice system, ethical aspects of the use of neuroscientific instruments and interventions need to (...) be taken into account. With respect to ethics in relation to neurocriminology much of the literature focuses on identifying and debating risks and value conflicts. This is important and necessary, but the positive contribution of neuroscientific applications may therefore get less attention in the ethical literature. Yet, ethicists can help criminal justice researchers and practitioners to identify ways in which neuroscience could add positively to important values in (young) offender rehabilitation. It is argued that this role of ethicists in interdisciplinary teams deserves more emphasis. As an illustration, this contribution focuses on how neuroscientific knowledge, instruments and interventions may contribute to autonomy of (young) offenders. (shrink)

A large number of Swedish public authorities produce ‘platform of values’ texts that present core values. This article presents a study of how such texts and practices, including the core values they revolve around, are legitimized. Using Van Leeuwen’s legitimation framework, three different data sets are analysed: 47 ‘platform of values’ texts, a focus group discussion with seven senior HR officers, and a quantitative questionnaire study answered by civil servants at three public authorities. The analysis shows how the existence of (...) ‘platform of values’ texts and practices is legitimized through rationalizations, above all by describing the texts as concrete means for reaching specific ends and, with regard to the choice of core values, through a custom-conformity type of authority. Thus, this article addresses discursive transformations of contemporary organizations with a particular focus on available discursive space for critical thinking in the wake of New Public Management and related developments. (shrink)

Background It is a common ethical challenge for ambulance clinicians to care for patients with impaired decision-making capacities while assessing and determining the degree of decision-making ability and considering ethical values. Ambulance clinicians’ ethical competence seems to be increasingly important in coping with such varied ethical dilemmas. Ethics rounds is a model designed to promote the development of ethical competence among clinicians. While standard in other contexts, to the best of our knowledge, it has not been applied within the ambulance (...) service context. Thus, the aim of this study was to describe ambulance clinicians’ experiences of participating in ethics rounds. Methods This was a qualitative descriptive study, evaluating an intervention. Data were collected through sixteen interviews with ambulance clinicians who had participated in an intervention involving ethics rounds. The analysis was performed by use of content analysis. Results Two themes describe the participants’ experiences: (1) Reflecting freely within a given framework, and (2) Being surprised by new insights. The following categories form the basis of the themes; 1a) Gentle guidance by the facilitator, 1b) A comprehensible structure, 2a) New awareness in the face of ethical problems, and 2b) Shared learning through dialogue. Conclusion Incorporating structured ethics rounds seems to create a continuous development in ethical competence that may improve the quality of care in the ambulance service. Structured guidance and facilitated group reflections offer ambulance clinicians opportunities for both personal and professional development. An important prerequisite for the development of ethical competence is a well-educated facilitator. Consequently, this type of ethics rounds may be considered a useful pedagogical model for the development of ethical competence in the ambulance service. (shrink)

Traces the development of the samurai, both in the way they regarded themselves and their role in society.

A bold and visionary book that reveals the false and catastrophically damaging images at the root of the oppression of women and the rape of Earth's resources, ...

Interpersonal respect can be differentiated into two kinds: horizontal respect, i.e. treating someone with dignity; and vertical respect, i.e. genuinely honoring someone’s merits. With the present research, we draw on motivation theory to explore their interplay in leadership relations. Specifically, we argue for a moderated mediation hypothesis in that leaders’ horizontal respect for their subordinates fundamentally speaks to subordinates’ self-determination and that the message of respectful leadership is enhanced by the vertical respect subordinates have for their leaders. As a result, (...) subordinates are more satisfied with their jobs, which should also show in a decreased willingness to leave. The proposed model was supported in two survey studies and an experimental scenario study —thus suggesting that perceived leader behavior needs to be complemented by leader standing. (shrink)

Research integrity climate is an important factor that influences an individual’s behavior. A strong research integrity culture can lead to better research practices and responsible conduct of research. Therefore, investigations on organizational climate can be a valuable tool to identify the strengths and weaknesses of each group and develop targeted initiatives. This study aims to assess the perceptions on integrity climate in three universities in Hungary. A cross-sectional study was conducted with PhD students, postdocs, and professors from three Hungarian universities. (...) The survey included demographic questions, such as gender, age, scientific field, academic rank, and the Survey of Organizational Research Climate. A total of 432 participants completed the survey. Our results show that postdocs and assistant professors perceived integrity climate more negatively than PhD students and full professors in every survey scale. Contrarily, PhD students perceive more positively than the other groups. Disciplinary differences show that researchers in the Biomedical sciences perceive regulatory bodies to be fairer when evaluating their projects than those in the Natural sciences. Natural sciences also perceive more negatively how the department values integrity when compared to Humanities. Humanities perceive more positively Advisor/Advisee Relations than Biomedical Sciences. Our results suggest that institutions should pay more attention to early career researchers, especially insecure and temporary positions like postdocs and assistant professors. They should provide RCR resources, socialize them in RCR, and set more reasonable expectations. Moreover, department leaders should develop initiatives to foster better integrity climates. (shrink)

Defining the lives of a majority of the world's population, the question of 'the city' has risen to the fore as one the most urgent issues of our time "e; uniting concerns across the terrain of climate policies, global financing, localised struggles and multi-disciplinary research. Deleuze and the City rests on a conviction that philosophy is crucially important for advancing knowledge on cities, and for allowing us to envisage new forms of urban life toward a more sustainable future. It gathers (...) some of the most original thinkers and accomplished scholars in contemporary urban studies, showing how Deleuze and Guattari's philosophical project is essential for our thinking through the multi-scalar, uneven and contested landscapes that constitute 'the city' today. Case studies range from the 'laboratory urbanism' of an Austrian ski resort and a 'sustainable' Swedish shopping mall to the 'urbicidal' refurbishments of Haifa. (shrink)

This article argues that the influence of heteronormativity on the conceptualization of women and technology in feminist constructivist technology studies creates serious problems for the analysis. This research aims to understand the coproduction of gender and technology in society, but does not approach the two elements in a symmetrical fashion. Hence, ethnographic studies can only exemplify how the gender of technology producers is reflected in the technology created. Masculine gender identity is stabilized as a cause for the masculinity of a (...) technology that is shaped by social relationships. The criticism is fleshed out in a close examination of case study accounts of ethnographies among producers and users of technology. It is argued that a habitual reproduction of heteronormativity, present in the surrounding culture and in the technological communities studied, has prevented the adoption of approaches to the subject conducive to the objective of this feminist research. Acknowledging that destabilizing gender can undermine the critical thrust of feminist critique, the paper turns towards queer theory for ideas about how to produce criticism that does not rely on the stability of identity. The article closes with suggesting how a queer feminist approach could contribute to different readings of life with technology. (shrink)

ArgumentThis paper challenges three assumptions common in the literature on expertise: that expertise is linearly derived from scientific knowledge; that experts always align with the established institutional order; and that expertise is a property acquired by individuals. We criticize these ideas by juxtaposing three distinct expert practices involved with flood risk management in England. Virtual engineering is associated with commercial consultancy and relies on standardized software packages to assess local flood inundation. Mathematical experimentation refers to academic scientists creating new digital (...) renderings of the physical dynamics of flooding. Participatory modeling denotes research projects that aim to transform the relationships between experts and local communities. Focusing on different modes of modeling we contribute an analysis of how particular models articulate with specific politics of knowledge as experts form relationships with flood risk management actors. Our empirical study also shows how models can contribute to re-distribution of expertise in local flood risk management. (shrink)

The mind-body problem lies at the heart of the clinical practice of both psychiatry and psychosomatic medicine. In their recent publication, Schwartz and Wiggins address the question of how to understand life as central to the mind-body problem. Drawing on their own use of the phenomenological method, we propose that the mind-body problem is not resolved by a general, evocative appeal to an all encompassing life-concept, but rather falters precisely at the insurmountable difference between.

Neuroscientific research in relation to antisocial behavior has strongly grown in the last decades. This has resulted in a better understanding of biological factors associated with antisocial behavior. Furthermore several neuroscientific instruments and interventions have been developed that have a relatively low threshold for use in the criminal justice system to contribute to prevention or reduction of antisocial and criminal behavior. When considering implementation in the criminal justice system, ethical aspects of the use of neuroscientific instruments and interventions need to (...) be taken into account. With respect to ethics in relation to neurocriminology much of the literature focuses on identifying and debating risks and value conflicts. This is important and necessary, but the positive contribution of neuroscientific applications may therefore get less attention in the ethical literature. Yet, ethicists can help criminal justice researchers and practitioners to identify ways in which neuroscience could add positively to important values in offender rehabilitation. It is argued that this role of ethicists in interdisciplinary teams deserves more emphasis. As an illustration, this contribution focuses on how neuroscientific knowledge, instruments and interventions may contribute to autonomy of offenders. (shrink)

Neuroscientific research in relation to antisocial behavior has strongly grown in the last decades. This has resulted in a better understanding of biological factors associated with antisocial behavior. Furthermore several neuroscientific instruments and interventions have been developed that have a relatively low threshold for use in the criminal justice system to contribute to prevention or reduction of antisocial and criminal behavior. When considering implementation in the criminal justice system, ethical aspects of the use of neuroscientific instruments and interventions need to (...) be taken into account. With respect to ethics in relation to neurocriminology much of the literature focuses on identifying and debating risks and value conflicts. This is important and necessary, but the positive contribution of neuroscientific applications may therefore get less attention in the ethical literature. Yet, ethicists can help criminal justice researchers and practitioners to identify ways in which neuroscience could add positively to important values in offender rehabilitation. It is argued that this role of ethicists in interdisciplinary teams deserves more emphasis. As an illustration, this contribution focuses on how neuroscientific knowledge, instruments and interventions may contribute to autonomy of offenders. (shrink)

PurposeMāori culture is a central aspect inAotearoa/New Zealand's national identity. Beginning in the 1970s biculturalism saw the indigenous culture and values acknowledged and incorporated in wider public discourse and policy. The purpose of this paper is to investigate whether New Zealand's cyberspace accommodates Māori. It explores how the web space is influenced by biculturalism and in turn what an understanding of this web space can tell us about biculturalism inAotearoa.Design/methodology/approachA brief introduction to biculturalism in New Zealand provides the background to (...) the investigation of the country's web space. Recent access statistics enquire whether Māori are actually connected to the internet. The exploration of the structure of the internet is informed by newspaper articles and online documents relating to the development of two Māori specific second‐level domain name spaces. A word‐frequency analysis within a sample of 21 websites provides an overview into the use of the Māori language in cyberspace.FindingsThe paper shows that although Māori have the lowest access rate to the internet compared to other ethnic groups in New Zealand, their influence on the country's web space is nonetheless far‐reaching. Developments regarding Māori language uses over the last years are generally progressive. Māori culture and ongoing social changes are increasingly accommodated on the internet – Māori have been actively shaping the web space. However, these efforts do require the support and acceptance of the wider Internet community. The linguistic and structural developments taking place online since the mid 1990s were influenced by the bicultural thinking, public discourse and practice of the time.Originality/valueThis paper draws together the Māori success‐stories in their endeavour to assert their cultural needs in New Zealand's cyberspace. It highlights that the understanding ofAotearoaas being a bicultural country influenced developments taking place online potentially will lead to a truly bicultural web space in the near future. (shrink)

“Anchoring” is a tactic used to manipulate negotiation outcomes. It exploits the fact that people base their estimates of unknown quantities on initial values. If they are given these initial values, their estimations are influened by them. We will address whether there is a rational justification for people to be manipulated by anchoring. We will also look at how to recognize in a negotiation situation whether the anchor effect is being used against you, how to use the anchor effect to (...) your benefit, or at least how to defuse it if it is being used against you. (shrink)

BackgroundEthical problems in everyday healthcare work emerge for many reasons and constitute threats to ethical values. If these threats are not managed appropriately, there is a risk that the patient may be inflicted with moral harm or injury, while healthcare professionals are at risk of feeling moral distress. Therefore, it is essential to support the learning and development of ethical competencies among healthcare professionals and students. The aim of this study was to explore the available literature regarding ethics education that (...) promotes ethical competence learning for healthcare professionals and students undergoing training in healthcare professions.MethodsIn this integrative systematic review, literature was searched within the PubMed, CINAHL, and PsycInfo databases using the search terms ‘health personnel’, ‘students’, ‘ethics’, ‘moral’, ‘simulation’, and ‘teaching’. In total, 40 articles were selected for review. These articles included professionals from various healthcare professions and students who trained in these professions as subjects. The articles described participation in various forms of ethics education. Data were extracted and synthesised using thematic analysis.ResultsThe review identified the need for support to make ethical competence learning possible, which in the long run was considered to promote the ability to manage ethical problems. Ethical competence learning was found to be helpful to healthcare professionals and students in drawing attention to ethical problems that they were not previously aware of. Dealing with ethical problems is primarily about reasoning about what is right and in the patient’s best interests, along with making decisions about what needs to be done in a specific situation.ConclusionsThe review identified different designs and course content for ethics education to support ethical competence learning. The findings could be used to develop healthcare professionals’ and students’ readiness and capabilities to recognise as well as to respond appropriately to ethically problematic work situations. (shrink)

This exploratory study analyzes the extent of alignment between the formal and hidden curricula in responsible management education. Based on case study evidence of a school that has signed the United Nations Principles for Responsible Management Education, we found poor alignment between the school’s explicit RME claims and students’ lived experiences. While the formal curriculum signaled to students that RME was important, the school’s hidden curriculum sent a number of tacit messages that led students to question the relevance and applicability (...) of responsible management. The tacit messages that students received occurred along three “message sites” related to how the formal curriculum was delivered, how students and lecturers interacted, and how the school was governed. On the basis of these findings we develop a proposition that can guide further research in this area, i.e., the connotative level of language use is an important site of misalignments between what lecturers say in relation to RME and how students interpret the meaning of their lecturers’ words. We also discuss further implications of our findings for strengthening the alignment between schools’ formal RME claims and their hidden curriculum. (shrink)

Children who experience well-being are engaging more confidently and positively with their caregiver and peers, which helps them to profit more from available learning opportunities and support current and later life outcomes. The goodness-of-fit theory suggests that children’s well-being might be a result of the interplay between their temperament and the environment. However, there is a lack of studies that examined the association between children’s temperament and well-being in early childhood education and care, and whether this association is affected by (...) ECEC process quality. Using a multilevel random coefficient approach, this study examines the association between toddlers’ temperament and well-being in Norwegian ECEC and investigates whether process quality moderates this association. Results reveal an association between temperament and well-being. Staff-child conflict moderates the association between shyness and well-being, and between activity and well-being. Moreover, high emotional behavioral support moderates the association between activity and well-being. Extra attention should be paid by the staff to these children’s needs. (shrink)

Background Clients are invited to play a role in decisions about their care. Collaborative deliberation comprises constructive engagement, recognition of alternative actions, comparative learning, construction and elicitation of preferences and preference integration. Collaborative deliberation between clients and professionals is a process that requires an interest in each other, sharing of views on alternatives and preferences and integrating into decisions. The aim is to gain insight into collaborative deliberation in consultations and the clients’ perception of arranging long-term care. Design A descriptive (...) qualitative study to explore collaborative deliberation in consultations between clients and professionals. Six organisations providing long-term care were included. Data collection of nine clients involved observations of consultation with field notes and audio-records, interviews with clients and professionals shortly and 3–6 months after the consultation and questionnaires to collect background information. The data were analysed by deductive content analysis. Findings Constructive engagement was visible in all consultations. Clients and professionals showed respect, empathy and curiosity towards each other. In most consultations, two or more alternative actions are recognised and discussed. Comparative learning appears to be two sided, the client and the professional learn from each other's knowledge and experiences. Construction and elicitation of preference, and preference integration, seems to be present, but difficult to recognise in all consultations. Discussion/conclusion Although all propositions could be identified, there seems room for improvement in preference elicitation and integration of these preferences in the discussions on courses of action. Assistance seems needed with preference elicitation, both for the clients and for the professional. (shrink)

BackgroundThe areas of Research Ethics (RE) and Research Integrity (RI) are rapidly evolving. Cases of research misconduct, other transgressions related to RE and RI, and forms of ethically questionable behaviors have been frequently published. The objective of this scoping review was to collect RE and RI cases, analyze their main characteristics, and discuss how these cases are represented in the scientific literature.MethodsThe search included cases involving a violation of, or misbehavior, poor judgment, or detrimental research practice in relation to a (...) normative framework. A search was conducted in PubMed, Web of Science, SCOPUS, JSTOR, Ovid, and Science Direct in March 2018, without language or date restriction. Data relating to the articles and the cases were extracted from case descriptions.ResultsA total of 14,719 records were identified, and 388 items were included in the qualitative synthesis. The papers contained 500 case descriptions. After applying the eligibility criteria, 238 cases were included in the analysis. In the case analysis, fabrication and falsification were the most frequently tagged violations (44.9%). The non-adherence to pertinent laws and regulations, such as lack of informed consent and REC approval, was the second most frequently tagged violation (15.7%), followed by patient safety issues (11.1%) and plagiarism (6.9%). 80.8% of cases were from the Medical and Health Sciences, 11.5% from the Natural Sciences, 4.3% from Social Sciences, 2.1% from Engineering and Technology, and 1.3% from Humanities. Paper retraction was the most prevalent sanction (45.4%), followed by exclusion from funding applications (35.5%).ConclusionsCase descriptions found in academic journals are dominated by discussions regarding prominent cases and are mainly published in the news section of journals. Our results show that there is an overrepresentation of biomedical research cases over other scientific fields compared to its proportion in scientific publications. The cases mostly involve fabrication, falsification, and patient safety issues. This finding could have a significant impact on the academic representation of misbehaviors. The predominance of fabrication and falsification cases might diverge the attention of the academic community from relevant but less visible violations, and from recently emerging forms of misbehaviors. (shrink)

Good academic practice is more than the avoidance of clear-cut cheating. It also involves navigation of the gray zones between cheating and good practice. The existing literature has left students’ understanding of gray zone practices largely unexplored. To begin filling in this gap, we present results from a questionnaire study involving N = 1639 undergraduate students from seven European countries representing all major disciplines. We show that large numbers of these students are unable to identify gray area issues and lack (...) sensitivity to the context dependence of these. We also show that a considerable proportion of students have a poor understanding of concepts like plagiarism and falsification, not only in gray zone scenarios, but also in cases of relatively clear-cut cheating. Our results are similar across the faculties and countries of study, and even for students who have attended academic integrity training. We discuss the implications of this for academic integrity training. (shrink)

BackgroundNew disease-modifying ways to treat Parkinson’s disease (PD) may soon become a reality with intracerebral transplantation of cell products produced from human embryonic stem cells (hESCs). The aim of this study was to assess what factors influence preferences of patients with PD regarding stem-cell based therapies to treat PD in the future.MethodsPatients with PD were invited to complete a web-based discrete choice experiment to assess the importance of the following attributes: (i) type of treatment, (ii) aim of treatment, (iii) available (...) knowledge of the different types of treatments, (iv) effect on symptoms, and (v) risk for severe side effects. Latent class conditional logistic regression models were used to determine preference estimates and heterogeneity in respondents’ preferences.ResultsA substantial difference in respondents’ preferences was observed in three latent preference patterns (classes). “Effect on symptoms” was the most important attribute in class 1, closely followed by “type of treatment,” with medications as preferred to other treatment alternatives. Effect on symptoms was also the most important attribute in class 2, with treatment with hESCs preferred over other treatment alternatives. Likewise for class 3, that mainly focused on “type of treatment” in the decision-making. Respondents’ class membership was influenced by their experience in treatment, side effects, and advanced treatment therapy as well as religious beliefs.ConclusionsMost of the respondents would accept a treatment with products emanating from hESCs, regardless of views on the moral status of embryos. Preferences of patients with PD may provide guidance in clinical decision-making regarding treatments deriving from stem cells. (shrink)

Attitudes toward robots influence the tendency to accept or reject robotic devices. Thus it is important to investigate whether and how attitudes toward robots can change. In this pilot study we investigate attitudinal changes in elderly citizens toward a tele-operated robot in relation to three parameters: (i) the information provided about robot functionality, (ii) the number of encounters, (iii) personality type. Fourteen elderly residents at a rehabilitation center participated. Pre-encounter attitudes toward robots, anthropomorphic thinking, and personality were assessed. Thereafter the (...) participants interacted with a tele-operated robot (Telenoid) during their lunch (c. 30 min.) for up to 3 days. Half of the participants were informed that the robot was tele-operated (IC) whilst the other half were naïve to its functioning (UC). Post-encounter assessments of attitudes toward robots and anthropomorphic thinking were undertaken to assess change. Attitudes toward robots were assessed with a new generic 35-items questionnaire (attitudes toward social robots scale: ASOR-5), offering a differentiated conceptualization of the conditions for social interaction. There was no significant difference between the IC and UC groups in attitude change toward robots though trends were observed. Personality was correlated with some tendencies for attitude changes; Extraversion correlated with positive attitude changes to intimate-personal relatedness with the robot (r = 0.619) and to psychological relatedness (r = 0.581) whilst Neuroticism correlated negatively (r = -0.582) with mental relatedness with the robot. The results tentatively suggest that neither information about functionality nor direct repeated encounters are pivotal in changing attitudes toward robots in elderly citizens. This may reflect a cognitive congruence bias where the robot is experienced in congruence with initial attitudes, or it may support action-based explanations of cognitive dissonance reductions, given that robots, unlike computers, are not yet perceived as action targets. Specific personality traits may be indicators of attitude change relating to specific domains of social interaction. Implications and future directions are discussed. (shrink)

This study aims to describe social network and social participation and to assess associations with depressive symptoms in older persons with increased risk for dementia in Germany. We conducted a cross-sectional observational study in primary care patients (aged 60-77) as part of a multicenter cluster-randomized controlled trial (AgeWell.de). We present descriptive and multivariate analyses for social networks (Lubben Social Network Scale and subscales) and social participation (item list of social activities) and analyze associations of these variables with depressive symptoms (Geriatric (...) Depression Scale). Of 1030 included patients, 17.2% were at risk for social isolation (Lubben Social Network Scale < 12). Looking at the subscales, a reduced non-family network was found almost twice as often as a reduced family network. Patients with depressive symptoms had significantly smaller social networks than patients without depression (p < 0.001). They rather engaged in social activities of low involvement level or no weekly social activity at all (p < 0.001). The study shows associations of depressive symptoms with a decreased social network and less social participation in elderly participants. Sufficient non-family contacts and weekly social activities seem to play an important role in mental health and should be encouraged in elderly primary care patients. (shrink)

IntroductionCerebral visual impairment is an important cause of visual impairment in western countries. Perinatal hypoxic-ischemic damage is the most frequent cause of CVI but CVI can also be the result of a genetic disorder. The majority of children with CVI have cerebral palsy and/or developmental delay. Early diagnosis is crucial; however, there is a need for consensus on evidence based diagnostic tools and referral criteria. The aim of this study is to develop guidelines for diagnosis and referral in CVI according (...) to the grade method.Patients and MethodsWe developed the guidelines according to the GRADE method 5 searches on CVI were performed in the databases Medline, Embase, and Psychinfo, each with a distinct topic.ResultsBased on evidence articles were selected on five topics: 1. Medical history and CVI-questionnaires 23. 2. Ophthalmological and orthoptic assessment 37. 3. Neuropsychological assessment 5. 4. Neuroradiological evaluation and magnetic resonance imaging 9. 5. Genetic assessment 5.ConclusionIn medical history taking, prematurity low birth weight and APGAR Scores are important. Different questionnaires are advised for children under the age of 3 years, older children and for specific risk groups. In ophthalmological examination, eye movements, specially saccades, accommodation, crowding, contrast sensitivity and visual fields should be evaluated. OCT can show objective signs of trans-synaptic degeneration and abnormalities in fixation and saccades can be measured with eye tracking. Screening of visual perceptive functioning is recommended and can be directive for further assessment. MRI findings in CVI in Cerebral Palsy can be structured in five groups: Brain maldevelopment, white and gray matter lesions, postnatal lesions and a normal MRI. In children with CVI and periventricular leukomalacia, brain lesion severity correlates with visual function impairment. A differentiation can be made between cortical and subcortical damage and related visual function impairment. Additional assessments can be necessary to complete the diagnosis of CVI and/or to reveal the etiology. (shrink)

Este trabalho apresenta um relato de experiência de ações realizadas no enfrentamento do bullying, desenvolvidas em uma escola privada do interior do Rio Grande do Sul. As intervenções foram desenvolvidas a partir de três Projetos: Bullying: Somos bonitos pelas nossas diferenças, bullying não é brincadeira e superando o bullying e outras formas de violência. Participaram da ação os alunos da Educação Infantil ao Ensino Médio, matriculados na Instituição nos anos de 2016, 2017 e 2018. As intervenções foram desenvolvidas pela psicóloga (...) escolar, acadêmicas de psicologia, pela assistente social e pelas orientadoras educacionais. As ações tiveram como intuito oferecer espaços de informação, diálogo e de reflexão sobre a problemática do bullying, a fim de prevenir situações de violência entre os pares. A partir das ações, os alunos puderam conceituar o fenômeno, analisar suas causas e consequências, diferenciar violência de brincadeiras entre os pares e refletir sobre formas de superar essa problemática. (shrink)

PurposeAlthough an increasing body of literature suggests a relationship between brain irradiation and deterioration of neurocognitive function, it remains as the standard therapeutic and prophylactic modality in patients with brain tumors. This review was aimed to abstract and evaluate the prediction models for radiation-induced neurocognitive decline in patients with primary or secondary brain tumors.MethodsMEDLINE was searched on October 31, 2021 for publications containing relevant truncation and MeSH terms related to “radiotherapy,” “brain,” “prediction model,” and “neurocognitive impairments.” Risk of bias was (...) assessed using the Prediction model Risk Of Bias ASsessment Tool.ResultsOf 3,580 studies reviewed, 23 prediction models were identified. Age, tumor location, education level, baseline neurocognitive score, and radiation dose to the hippocampus were the most common predictors in the models. The Hopkins verbal learning and the trail making tests were the most frequent outcome assessment tools. All studies used regression as machine learning method. All models were judged to have a high risk of bias mainly due to issues in the analysis.ConclusionExisting models have limited quality and are at high risk of bias. Following recommendations are outlined in this review to improve future models: developing cognitive assessment instruments taking into account the peculiar traits of the different brain tumors and radiation modalities; adherence to model development and validation guidelines; careful choice of candidate predictors according to the literature and domain expert consensus; and considering radiation dose to brain substructures as they can provide important information on specific neurocognitive impairments. (shrink)