Adolescence is the period of growth between childhood and adulthood. This period of development, which goes from 13 to 18 years, is usually presented as critical, due to the profound modifications of physiological and psychological order in this research we worked with a sample of 60 students, from Secondary School No. 8, morning and evening shift. An instrument was made with 45 variables, 5 of them signalytic: age, gender, an average of the previous cycle, performing some extracurricular activity, and shift. (...) The information was processed in the SPSS and STATISTIC programs. The conclusions showed that the student, by showing a need to learn, is able to develop different academic skills through different factors, such as motivation, thus improving their school performance. Thus proposes the development of an intervention model, for training teachers, on motivation methods in the classroom; As well as conferences on the importance of the topic of adolescent motivation and the factors involved in improving academic performance, teachers and parents will be taught and publicity will be developed on the importance of school motivation in adolescents and how it intervenes from home, at school and how this influences academic results. (shrink)

In this article I discuss the history of Italian Jews from the Emancipation to the racial laws of 1938 and their present-day attitudes to Judaism and the State of Israel. My aim is to suggest how the policy of social integration enabled Italian Jews to construct a new identity without losing their ancestral heritage. The example of Italian Jewry is relevant to understanding the growing need in today‘s European Union—now comprising 27 countries with different languages, cultures, and values—of revising the (...) concept of national identity and of exploring ways of constructing a new European identity. (shrink)

The history of Italian Jews from 1861 to 1938 is often viewed as the period in which they totally assimilated into the Italian nation. This article, however, argues that rather than their assimilation it was a period of their integration into Italian society. Various approaches to this question are presented, including a review of the literature, with a view to reconsidering the relationship between Jewish culture and Italian culture, or rather non-Jewish culture. Italian Jewish history is shown not to be (...) separated from, but to be “internal” to Italian social, cultural, and political history—part of the dynamic process of change that occurred during this period not only in Italy but throughout Europe. (shrink)

Acting in the present in anticipation of the future is argued to be a behavioral correlate of mental time travel (MTT). Yet, it is important to consider how other future-directed behaviors figure into a theory of MTT and future thinking more broadly. Developmental science can help in this formulation.

Humans are able to transcend the present and mentally travel to another time, place, or perspective. Mentally projecting ourselves backwards (i.e., episodic memory) or forwards (i.e., episodic foresight) in time are crucial characteristics of the human memory system. Indeed, over the past few years, episodic memory has been argued to be involved both in our capacity to retrieve our personal past experiences and in our ability to imagine and foresee future scenarios. However, recent theory and findings suggest that semantic memory (...) also plays a significant role in imagining future scenarios. We draw on Tulving’s definition of episodic and semantic memory to provide a critical analysis of their role in episodic foresight tasks described in the developmental literature. We conclude by suggesting future directions of research that could further our understanding of how both episodic memory and semantic memory are intimately connected to episodic foresight. (shrink)

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

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

Children are vulnerable to adverse effects of food advertising. Food commercials are known to increase hedonic, taste-oriented, and unhealthy food decisions. The current study examined how promoting resilience to food commercials impacted susceptibility to unhealthy food decision-making in children. To promote resilience to food commercials, we utilized the food advertising literacy intervention intended to enhance cognitive skepticism and critical thinking, and decrease positive attitudes toward commercials. Thirty-six children aged 8–12 years were randomly assigned to the food advertising literacy intervention or (...) the control condition. Eighteen children received four brief intervention sessions via video over 1 week period. In each session, children watched six food commercials with interspersed embedded intervention narratives. While watching food commercials and narratives, children were encouraged to speak their thoughts out loud spontaneously (“think-aloud”), which provided children's attitudes toward commercials. Eighteen children in the control condition had four control sessions over 1 week, and watched the same food commercials without intervention narratives while thinking aloud. The first and last sessions were held in the laboratory, and the second and third sessions were held at the children's homes. Susceptibility to unhealthy food decision-making was indicated by the decision weights of taste attributes, taste perception, food choices,ad libitumsnacking, and cognitive and affective attitudes toward food commercials. As hypothesized, the intervention successfully decreased susceptibility to unhealthy food decision-making evidenced by reduced decision weights of the taste in food decisions, decreased tasty perception of unhealthy foods, and increased cognitive skepticism and critical thinking toward food commercials. In addition, as children's opinions assimilated to intervention narratives, their cognitive skepticism and critical thinking toward commercials increased. The aforementioned results were not shown in the control condition. However, this brief intervention was not enough to change actual food choices or food consumption. Results of this study suggest that promoting resilience to food commercials by enhancing cognitive skepticism and critical thinking effectively reduced children's susceptibility to unhealthy food-decision making. (shrink)

Early last year, the GenEthics Consortium (GEC) of the Washington Metropolitan Area convened at George Washington University to consider a complex case about genetic testing for Alzheimer disease (AD). The GEC consists of scientists, bioethicists, lawyers, genetic counselors, and consumers from a variety of institutions and affiliations. Four of the 8 co-authors of this paper delivered presentations on the case. Supplemented by additional ethical and legal observations, these presentations form the basis for the following discussion.

We applaud Millikan's psychologically plausible version of the causal theory of reference. Her proposal offers a significant clarification of the much-debated relation between concepts and beliefs, and suggests positive directions for future empirical studies of conceptual development. However, Millikan's revision of the causal theory may leave us with no generally satisfying account of concept individuation in the mind.

Gilead et al.'s theory presupposes that traversing temporal, spatial, social, and hypothetical distances are largely interchangeable acts of mental travel that co-occur in human ontogeny. Yet, this claim is at odds with recent developmental data suggesting that children's reasoning is differentially affected by the dimension which they must traverse, and that different representational abilities underlie travel across different dimensions.

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

The vestibulo-ocular reflex (VOR) adaptation is an ideal model for investigating how the neurosteroid 17 beta-estradiol (E2) contributes to the modification of behavior by regulating synaptic activities. We hypothesized that E2 impacts VOR adaptation by affecting cerebellar synaptic plasticity at the parallel fiber–Purkinje cell (PF) synapse. To verify this hypothesis, we investigated the acute effect of blocking E2 synthesis on gain increases and decreases in adaptation of the VOR in male rats using an oral dose (2.5 mg/kg) of the aromatase (...) inhibitor letrozole. We also assessed the effect of letrozole on synaptic plasticity at the PF synapse in vitro, using cerebellar slices from male rats. We found that letrozole acutely impaired both gain increases and decreases adaptation of the VOR without altering basal ocular-motor performance. Moreover, letrozole prevented long-term potentiation at the PF synapse (PF-LTP) without affecting long-term depression (PF-LTD). Thus, in male rats neurosteroid E2 has a relevant impact on VOR adaptation and affects exclusively PF-LTP. These findings suggest that E2 might regulate changes in VOR adaptation by acting locally on cerebellar and extra-cerebellar synaptic plasticity sites. (shrink)

Neurosteroid 17 beta-estradiol (E2) is a steroid synthesized de novo in the nervous system that might influence neuronal activity and behavior. Nevertheless, the impact of E2 on the functioning of those neural systems in which it is slightly synthesized is less questioned. The vestibulo-ocular reflex (VOR) adaptation, may provide an ideal arena for investigating this issue. Indeed, E2 modulates cerebellar parallel fiber-Purkinje cell synaptic plasticity that underlies encoding of VOR adaptation. Moreover, aromatase expression in the cerebellum of adult rodents is (...) maintained at very low levels and localized to Purkinje cells. The significance of age-related maintenance of low levels of aromatase expression in the cerebellum on behavior, however, has yet to be explored. Our aim in this study was to determine whether E2 synthesis exerts an effective and persistent modulation of VOR adaptation in adult male rats. To answer this question, we investigated the acute effect of blocking E2 synthesis on gain increases and decreases in VOR adaptation using an oral dose (2.5 mg/kg) of the aromatase inhibitor Letrozole in peri-pubertal and post-pubertal male rats. We found that Letrozole acutely impaired gain increases and decreases in VOR adaptation without altering basal ocular-motor performance and that these effects were similar in peri-pubertal and post-pubertal rats. Thus, in adult male rats neurosteroid E2 effectively modulates VOR adaptation in both of the periods studied. These findings imply that the adult cerebellum uses E2 synthesis for modulating motor memory formation and suggest that low and extremely localized E2 production may play a role in adaptive phenomena. (shrink)

In this paper we focus on some new normativist positions and compare them with traditional ones. In so doing, we claim that if normative judgments are involved in determining whether a condition is a disease only in the sense identified by new normativisms, then disease is normative only in a weak sense, which must be distinguished from the strong sense advocated by traditional normativisms. Specifically, we argue that weak and strong normativity are different to the point that one ‘normativist’ label (...) ceases to be appropriate for the whole range of positions. If values and norms are not explicit components of the concept of disease, but only intervene in other explanatory roles, then the concept of disease is no more value-laden than many other scientific concepts, or even any other scientific concept. We call the newly identified position “value-conscious naturalism” about disease, and point to some of its theoretical and practical advantages. (shrink)

0. My aims in this paper are largely expository: I am more interested in presenting the picture theory than deciding its truth. Even so, I hope that the arguments by which I develop the theory will do something to support it, since I believe that what I will present as Wittgenstein's view is indeed the truth. This is not an admission of insanity, though some things that have been thought intrinsic to the picture theory are things it would be insane (...) to believe. So clearly the view I will present, when compared to the most embracing interpretations, is a partial and selective one. It would be another kind of madness, one I am just as eagre to disown, to suppose that my own favoured selection is the only possible one. That is pretty well the last remark in this paper about other commentators. I trust my reticence entitles me to be presumed catholic until proven nonconformist. (shrink)

The paper is concerned with the idea that the world is the totality of facts, not of things – with what is involved in thinking of the world in that way, and why one might do so. It approaches this issue through a comparison between Wittgenstein's Tractatus and the identity theory of truth proposed by Hornsby and McDowell. The paper's positive conclusion is that there is a genuine affinity between these two. A negative contention is that the modern identity theory (...) is vulnerable to a complaint of idealism that the Tractatus can deflect. (shrink)

With disparate rates of morbidity and mortality among minoritized communities, COVID-19 illuminated the need for equity-informed practices in public health. Pacia et al posit FQHCs as entities that addressed inequity when others failed. This commentary further situates how FQHCs address the public health crisis of institutional racism and related health inequities every day and presents a FQHC-led Ethics and Equity Framework and Workflow Checklist to guide ethical and equitable engagement with FQHCs.

The somatic mutation theory (SMT) of cancer has been and remains the prevalent theory attempting to explain how neoplasms arise and progress. This theory proposes that cancer is a clonal, cell‐based disease, and implicitly assumes that quiescence is the default state of cells in multicellular organisms. The SMT has not been rigorously tested, and several lines of evidence raise questions that are not addressed by this theory. Herein, we propose experimental strategies that may validate the SMT. We also call attention (...) to an alternative theory of carcinogenesis, the tissue organization field theory (TOFT), which posits that cancer is a tissue‐based disease and that proliferation is the default state of all cells. Based on epistemological and experimental evidence, we argue that the TOFT compellingly explains carcinogenesis, while placing it within an evolutionarily relevant context.magnified imagemagnified imageAna Soto and Carlos Sonnenschein are at Tufts University School of Medicine, Boston, MA, USA. (shrink)

Endocrinologists apply the idea of feedback loops to explain how hormones regulate certain bodily functions such as glucose metabolism. In particular, feedback loops focus on the maintenance of the plasma concentrations of glucose within a narrow range. Here, we put forward a different, organicist perspective on the endocrine regulation of glycaemia, by relying on the pivotal concept of closure of constraints. From this perspective, biological systems are understood as organized ones, which means that they are constituted of a set of (...) mutually dependent functional structures acting as constraints, whose maintenance depends on their reciprocal interactions. Closure refers specifically to the mutual dependence among functional constraints in an organism. We show that, when compared to feedback loops, organizational closure can generate much richer descriptions of the processes and constraints at play in the metabolism and regulation of glycaemia, by making explicit the different hierarchical orders involved. We expect that the proposed theoretical framework will open the way to the construction of original mathematical models, which would provide a better understanding of endocrine regulation from an organicist perspective. (shrink)

At the age of 20, and fresh from his undergraduate studies in mathematics, Ramsey set about writing what would be his first substantial publication, his 1923 Critical Notice of Wittgenstein’s Tractatus. It is hard for modern students of that book, who negotiate its obscurities with generations of previous commentary to serve as guides, to appreciate the task Ramsey confronted; and, to the extent that one can appreciate it, it is hard not to feel intimidated by the brilliance of his success. (...) His Critical Notice made Ramsey the first of Wittgenstein’s interpreters.1 In my view it makes him, still, the best. I want to illustrate that here by considering what light his remarks cast on a single passage of the book, in which Wittgenstein advances what might be called his theory of judgement. (shrink)

The general concept of mental disorder specified in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders is definitional in character: a mental disorder might be identified with a harmful dysfunction. The manual also contains the explicit claim that each individual mental disorder should meet the requirements posed by the definition. The aim of this article is two-fold. First, we shall analyze the definition of the superordinate concept of mental disorder to better understand what necessary criteria actually (...) characterize such a concept. Second, we shall consider the concepts of some individual mental disorders and show that they are in tension with the definition of the superordinate concept, taking pyromania and narcissistic personality disorder as case studies. Our main point is that an unexplained and not-operationalized dysfunction requirement that is included in the general definition, while being systematically violated by the diagnostic criteria of specific mental disorders, is a logical error. Then, either we unpack and operationalize the dysfunction requirement, and include explicit diagnostic criteria that can actually meet it, or we simply drop it. (shrink)

In this paper I review how the notion of gender is understood in psychiatry, specifically in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). First, I examine the contraposition between sex and gender, and argue that it is still retained by DSM-5, even though with some caveats. Second, I claim that, even if genderqueer people are not pathologized and gender pluralism is the background assumption, some diagnostic criteria still conceal a residue of gender dualism and (...) essentialism. Third, I consider gender dysphoria, which is characterized by an incongruence between one’s experienced or expressed gender and one’s assigned gender; since this condition pertains to distress and disability, not to the incongruence per se, it does not pathologize transgender people. Still, I contend that it should be removed from DSM-5 for theoretical reasons. (shrink)