La nueva enfermedad del coronavirus de 2019 (Covid-19), producida por el coronavirus del Síndrome Respiratorio Agudo Severo 2 (SARS-CoV-2), es una pandemia que está creando una creciente crisis sanitaria mundial, dada su novedad, su alcance y sus inicialmente limitadas opciones de tratamiento eficaz. En efecto, se sabe poco acerca de las intervenciones no farmacéuticas óptimas para evitar la morbilidad y mortalidad causadas por él, y también se conoce poco sobre la rentabilidad y aspectos éticos de dichas intervenciones. Por lo tanto, (...) éste es el primer análisis ético y de rentabilidad de las medidas de contención del Covid-19 que se conoce (así como de las medidas de cuarentena de la población para cualquier pandemia en particular), con el fin de ayudar a los sistemas de salud y a los gobiernos a garantizar la atención clínica más rentable que pueda proporcionarse equitativamente al mayor número posible de pacientes, durante esta pandemia y en las futuras crisis mundiales que sean similares. Este análisis utilizó la metodología adoptada por los Centros para el Control y la Prevención de Enfermedades (CDC), cifras comúnmente aceptadas como entradas, y los supuestos mínimos tanto extremos como del mundo real para proporcionar los resultados más sólidos y confiables posibles. El análisis de costos indicó que en los escenarios extremos, o en el mejor de los casos para las medidas de contención del Covid-19 durante la cuarentena de la población, hay una relación de costo-efectividad de $154.86 millones de dólares gastados por cada muerte evitada, y un costo neto de $1.92 billones a nivel mundial. En el mundo real, esta intervención tiene una proporción de 2,520 millones de dólares gastados por cada muerte evitada y un costo neto de 1,99 billones de dólares. La ética del contrato social personalista, tal y como se articula en el popular sistema ético de derechos y deberes de las Naciones Unidas, pone de manifiesto la especial preocupación por el hecho de que estos confinamientos pueden derivar en injusticias poco éticas perpetuadas por los Estados, de manera que socavan las vidas y las libertades individuales, al tiempo que afectan de manera des- proporcionada a las comunidades de menores ingresos, especialmente a las minorías raciales. Este estudio sugiere, por tanto, que la práctica prevalente de la cuarentena entre la población, en comparación con las precauciones de tipo estándar y las intervenciones más específicas, puede proporcionar un beneficio neto inadecuado por su costo financiero y ético. En un momento de escasez mundial, que pone a prueba la capacidad de los sistemas sanitarios para detectar y atender adecuadamente a los pacientes con Covid-19, especialmente en los países en desarrollo y en las comunidades desatendidas, este estudio respalda que se dediquen menos recursos a intervenciones con una relación costo- beneficio poco clara, y más recursos a intervenciones más asequibles, éticas y equitativas, con mayores pruebas de sus beneficios netos para salvar vidas. (shrink)

A transformational model of professional identity formation, anchored and globalized in workplace conversations, is advanced. Whilst the need to theorize the aims and methods of clinical education has been served by the techno-rational platform of ‘reflective practice’, this platform does not provide an adequate psychological tool to explore the dynamics of social episodes in professional learning and this led us to positioning theory. Positioning theory is one such appropriate tool in which individuals metaphorically locate themselves within discursive action in everyday (...) conversations to do with personal positioning, institutional practices and societal rhetoric. This paper develops the case for researching social episodes in clinical education through professional conversations where midwifery students, in practice settings, are encouraged to account for their moment-by-moment interactions with their preceptors/midwives and university mentors. It is our belief that the reflection elaborated by positioning theory should be considered as the new epistemology for professional education where professional conversations are key to transformative learning processes for persons and institutions. (shrink)

We are happy to feature four invited submissions by Lisa Guenther, Kym Maclaren, Bonnie Mann, and Gayle Salamon, all of whom respond to the questions motivating our inaugural issue. Both Salamon and Maclaren offer a response to the question “What is critical phenomenology?” by exploring the productive relationship between critical theory and phenomenology. Salamon does this by tracing the history of the term critical phenomenology. Maclaren further explores the productive relationship between critical theory and phenomenology en route to her analysis (...) of intimacy. Focusing on the phenomena of shame and long-term solitary confinement, Mann and Guenther take up that question by performing the work of critical phenomenology. Mann also offers suggestions regarding critical or, as she calls it, feminist phenomenology’s relation to the tradition—both of classical phenomenology and feminist philosophy. Guenther shows how the work of critical phenomenology is already at play in the practices of resistance among prisoners in the Security Housing Unit of Pelican Bay State Prison in California. (shrink)

Angiogenesis is central to both the growth and metastasis of solid tumours. Anti‐angiogenic strategies result in blood vessel regression accompanied by tumour cell apoptosis. Radiotherapy and many chemotherapeutic agents kill tumours by inducing apoptotic cell death. We propose that, in addition to its role as an angiogenic factor, vascular endothelial growth factor (VEGF) can act as a survival factor for tumour cells protecting them from apoptosis. Thus anti‐angiogenics, in particular those directed against VEGF, have multiple anti‐tumour effects. We suggest that (...) anti‐VEGF strategies prevent vessel growth and block a tumour cell survival factor, VEGF, rendering tumour cells more sensitive to chemotherapy and radiotherapy. In addition, as chemotherapy and radiotherapy have been shown to increase VEGF expression, anti‐VEGF strategies may overcome therapy‐ induced tumour cell resistance. BioEssays 24:280–283, 2002. © 2002 Wiley Periodicals, Inc.; DOI 10.1002/bies.10043. (shrink)

This dialogue (trilogue) is an attempt to critically discuss the technoscientific convergence that is taking place with biodigital technologies in the postdigital condition. In this discussion, Sarah Hayes, Petar Jandrić and Michael A. Peters examine the nature of the convergences, their applications for bioeconomic sustainability and associated ecopedagogies. The dialogue paper raises issues of definition and places the technological convergence (‘nano-bio-info-cogno’) – of new systems biology and digital technologies at the nano level – in an evolutionary context to speculate, (...) on the basis of the latest research, future possibilities. The paper also reviews these developments within familiar landscapes of posthumanism and postmodernism, raises the question of political bioeconomy and the role of postdigital education within it. (shrink)

Readable and accessible collection of papers re thinking machines.

University education is full of promise. Indeed universities have the capacity to create and shape, through staff and students, all kinds of enthralling ‘worlds’ and ‘new possibilities of life’. Yet students are encouraged increasingly to view universities as simply a means to an end, where neoliberal education delivers flexible skills to directly serve a certain type of capitalism. Additionally, the universal challenge of technological unemployment, alongside numerous other social issues, has become educationalised and portrayed in HE policy, as an issue (...) to be solved by universities. The idea that more education can resolve the problem of technological unemployment is a political construction which has largely failed to deliver its promise. In this article, we look at educationalisation in hand with technologisation and we draw on a Critical Discourse Analysis of HE policies, to demonstrate the problems arising from taken for granted visions of neoliberal social development related to education,... (shrink)

Knowledge of the responsibilities of engineers is the foundation for answering ethical questions about the work of engineers. This paper defines the responsibilities of engineers by considering what constitutes the nature of engineering as a particular form of activity. Specifically, this paper focuses on the ethical responsibilities of engineers qua engineers. Such responsibilities refer to the duties acquired in virtue of being a member of a group. We examine the practice of engineering, drawing on the idea of practices developed by (...) philosopher Alasdair MacIntyre, and show how the idea of a practice is important for identifying and justifying the responsibilities of engineers. To demonstrate the contribution that knowledge of the responsibilities of engineers makes to engineering ethics, a case study from structural engineering is discussed. The discussion of the failure of the Sleipner A Platform off the coast of Norway in 1991 demonstrates how the responsibilities of engineers can be derived from knowledge of the nature of engineering and its context. (shrink)

The extent to which we generalize a novel property from a sample of familiar instances to novel instances depends on the sample composition. Previous property induction experiments have only used samples consisting of novel types (unique entities). Because real‐world evidence samples often contain redundant tokens (repetitions of the same entity), we studied the effects on property induction of adding types and tokens to an observed sample. In Experiments 1–3, we presented participants with a sample of birds or flowers known to (...) have a novel property and probed whether this property generalized to novel items varying in similarity to the initial sample. Increasing the number of novel types (e.g., new birds with the target property) in a sample produced tightening, promoting property generalization to highly similar stimuli but decreasing generalization to less similar stimuli. On the other hand, increasing the number of tokens (e.g., repeated presentations of the same bird with the target property) had little effect on generalization. Experiment 4 showed that repeated tokens are encoded and can benefit recognition, but appear to be given little weight when inferring property generalization. We modified an existing Bayesian model of induction (Navarro, Dry, & Lee, 2012) to account for both the information added by new types and the discounting of information conveyed by tokens. (shrink)

This volume explores how Catholicism began and continues to open its doors to the wider world and to other confessions in embracing ecumenism, thanks to the vision and legacy of the Second Vatican Council. It explores such themes as the twentieth century context preceding the council; parallels between Vatican II and previous councils; its distinctively pastoral character; the legacy of the council in relation to issues such as church-world dynamics, as well as to ethics, social justice, economic activity. Several chapters (...) discuss the role of women in the church before, during, and since the council. Others discern inculturation in relation to Vatican II. The book also contains a wide and original range of ecumenical considerations of the council, including by and in relation to Free Church, Reformed, Orthodox, and Anglican perspectives. Finally, it considers the Council’s ongoing promise and remaining challenges with regard to ecumenical issues, including a groundbreaking essay on the future of ecumenical dialogue by Cardinal Walter Kasper. (shrink)

ObjectiveCancer researchers have found midlife couples to have poorer outcomes compared to older couples due to the off-time nature of the illness for them. It is unknown if young couples, who are under-represented in cancer studies and overlooked for supportive programs, are at further risk. This study explored the moderating roles of survivor age and sex on the associations between active engagement and protective buffering and depressive symptoms in couples surviving cancer.MethodsThe exploratory study comprised 49 couples 1–3 years post-diagnosis. Multilevel (...) modeling was used to explore the moderating roles of survivor age and sex, controlling for interdependent data.ResultsApproximately, 37% of survivors and 27% of partners met clinical criteria for further assessment of depression, with 50% of couples having at least one member meeting the criteria. Survivors and their partners did not significantly differ on depressive symptoms, active engagement, or protective buffering. Male survivors reported significantly higher levels of active engagement by their partners than female survivors and female survivors reported significantly higher levels of protective buffering by their partners than male survivors. We found some evidence to suggest that survivor age and sex may play moderating roles between active engagement and protective buffering and depressive symptoms. Older partners and female survivors appeared to experience more positive effects from engaging in positive dyadic behaviors than younger partners and male survivors.ConclusionFindings not only confirm the important role of dyadic behaviors for couples surviving cancer together, but also the important roles of survivor age and sex may play in whether such behaviors are associated with lower levels of depressive symptoms. Future research that examines these complex associations over time and across the adult life span in diverse populations is needed. (shrink)

Michael A. PetersBeijing Normal University, Beijing, PR China;There is an ecology of bad ideas, just as there is an ecology of weeds– Gregory Bateson (1972, p. 492)While there are classical anteced...

Over several decades, ethics and law have been applied to medical education and practice in a way that reflects the continuation during the twentieth century of the strong distinction between facts and values. We explain the development of applied ethics and applied medical law and report selected results that reflect this applied model from an empirical project examining doctors’ decisions on withdrawing/withholding treatment from patients who lack decision-making capacity. The model is critiqued, and an alternative “constitutive” model is supported on (...) the basis that medicine, medical law, and medical ethics exemplify the inevitable entanglement of facts and values. The model requires that ethics and law be taught across the medical education curriculum and integrated with the basic and clinical sciences and that they be perceived as an integral component of medical evidence and practice. Law, in particular, would rank as equal in normative authority to the relevant clinical scientific “facts” of the case, with graduating doctors having as strong a basic command of each category as the other. The normalization of legal knowledge as part of the clinician’s evidence base to be utilized in practice may provide adequate consolation for clinicians who may initially resent further perceived incursions on their traditional independence and discretion. (shrink)

Motivated by discourses that link early child development and health, nurses engage in seemingly benign surveillance of children. These practices are based on knowledge claims and technologies of developmental science, which remain anchored in assumptions of the child body as an incomplete form with a universal developmental trajectory and inherent potentiality. This paper engages in a critical discursive analysis, drawing on Donna Haraway's conceptualizations of technoscience and figuration. Using a contemporary developmental screening tool from nursing practice, this analysis traces the (...) effects of this tool through production, transformation, distribution, and consumption. It reveals how the techniques of imaging, abstraction, and measurement collide to fix the open, transformative child body in a figuration of the developing child. This analysis also demonstrates how technobiopower infuses nurses' understandings of children and structures developmentally appropriate expectations for children, parents, and nurses. Furthermore, it describes how practices that claim to facilitate healthy child development may inversely deprive children of agency and foster the production of normal or ideal children. An alternative ontological perspective is offered as a challenge to the individualism of developmental models and other dominant ideologies of development, as well as practices associated with these ideologies. In summary, this analysis argues that nurses must pay closer attention to how technobiopower infuses practices that monitor and promote child development. Fostering a critical understanding of the harmful implications of these practices is warranted and offers the space to conceive of human development in alternate and exciting ways. (shrink)

Background HIV prevention trials conducted among disadvantaged vulnerable at-risk populations in developing countries present unique ethical dilemmas. A key concern in bioethics is the validity of informed consent for trial participation obtained from research subjects in such settings. The purpose of this study was to investigate the effectiveness of a continuous informed consent process adopted during the MDP301 phase III vaginal microbicide trial in Mwanza, Tanzania. Methods A total of 1146 women at increased risk of HIV acquisition working as alcohol (...) and food vendors or in bars, restaurants, hotels and guesthouses have been recruited into the MDP301 phase III efficacy and safety trial in Mwanza. During preparations for the trial, participatory community research methods were used to develop a locally-appropriate pictorial flipchart in order to convey key messages about the trial to potential participants. Pre-recorded audio tapes were also developed to facilitate understanding and compliance with gel-use instructions. A comprehension checklist is administered by clinical staff to all participants at screening, enrolment, 12, 24, 40 and 50 week follow-up visits during the trial. To investigate women's perceptions and experiences of the trial, including how well participants internalize and retain key messages provided through a continuous informed consent process, a random sub-sample of 102 women were invited to participate in in-depth interviews conducted immediately after their 4, 24 and 52 week follow-up visits. Results 99 women completed interviews at 4-weeks, 83 at 24-weeks, and 74 at 52 weeks. In all interviews there was evidence of good comprehension and retention of key trial messages including that the gel is not currently know to be effective against HIV; that this is the key reason for conducting the trial; and that women should stop using gel in the event of pregnancy. Conclusions Providing information to trial participants in a focussed, locally-appropriate manner, using methods developed in consultation with the community, and within a continuous informed-consent framework resulted in high levels of comprehension and message retention in this setting. This approach may represent a model for researchers conducting HIV prevention trials among other vulnerable populations in resource-poor settings. Trial registration Current Controlled Trials ISRCTN64716212. (shrink)

There is a growing consensus in Britain on the importance of character, and on the belief that the virtues that contribute to good character are part of the solution to many of the challenges facing modern society. Parents, teachers and schools understand the need to teach basic moral virtues to pupils, such as honesty, self-control, fairness, and respect, while fostering behaviour associated with such virtues today. However, until recently, the materials required to help deliver this ambition have been missing in (...) Britain. The Knightly Virtues Programme, devised by the Jubilee Centre for Character and Virtues, aims to help solve this challenge. The programme, designed for 9 to 11 year olds, draws on selected classic stories to help teach moral character in schools. This approach has proved to be popular with children and teachers, with more than 5,000 pupils from one hundred schools having participated in the programme so far. Fifty-five of these schools and 3,272 pupils were directly involved in different stages of the research. Based at the University of Birmingham, the Jubilee Centre houses leading academics dedicated to researching the various ways in which good character, which underpins the building blocks of society, can be developed. Recent research from the Centre has shown that the qualities that make up character can be learnt and taught, and suggests that we need a new emphasis on their importance in schools and in professional education. This report from the Centre into the use of classic literature within schools sets out the ways in which the Knightly Virtues Programme is able to develop the virtue literacy of school pupils, and the extent to which an understanding and awareness of good moral character can make positive changes to behaviour. The impact of the programme has been tested using several rigorous research methods, detailed in this report alongside their findings, which provide substantial empirical evidence for the effectiveness of using stories to develop virtue literacy. (shrink)

ObjectiveMost young adults diagnosed with breast or gynecologic cancers experience adverse reproductive or sexual health outcomes due to cancer and its treatment. However, evidence-based interventions that specifically address the RSH concerns of young adult and/or LGBTQ+ survivor couples are lacking. Our goal is to develop a feasible and acceptable couple-based intervention to reduce reproductive and sexual distress experience by young adult breast and gynecologic cancer survivor couples with diverse backgrounds.MethodsWe systematically adapted an empirically supported, theoretically grounded couple-based intervention to address (...) the RSH concerns of young couples coping with breast or gynecologic cancer through integration of stakeholder perspectives. We interviewed 11 couples with a history of breast or gynecologic cancer to review and pretest intervention materials. Three of these couples were invited to review and comment on intervention modifications. Content experts in RSH and dyadic coping, clinicians, and community advisors participated throughout the adaptation process.ResultsFindings confirmed the need for an online, couple-based intervention to support young couples experiencing RSH concerns after breast or gynecologic cancer. Qualitative themes suggested intervention preferences for: A highly flexible intervention that can be tailored to couples’ specific RSH concerns; Active steps to help members of a dyad “get on the same page” in their relationship and family building plans; A specific focus on raising partners’ awareness about how cancer can affect body image and physical intimacy; and Accessible, evidence-based information about RSH for both partners. These results, along with feedback from stakeholders, informed adaptation and finalization of the intervention content and format. The resulting virtual intervention, Opening the Conversation, includes five weekly sessions offering training to couples in communication and dyadic coping skills for addressing RSH concerns.ConclusionThe systematic adaptation process yielded a theory-informed intervention for young adult couples facing breast and gynecological cancers, which will be evaluated in a randomized controlled trial. The long-term goal is to implement and disseminate Opening the Conversation broadly to reach young adult couples with diverse backgrounds who are experiencing RSH concerns in cancer survivorship. (shrink)

This volume offers insights into a unique philosophical landscape and enriches current Heidegger studies by offering fresh perspectives on his philosophy that are based on the traditions of Arabic and Persian Islamic philosophy.