Traditionally, the “Imagery Debate” has opposed two main camps: depictivism and descriptivism. This debate has essentially focused on the nature of the internal representations thought to be involved in imagery, without addressing at all the question of action. More recently, a third, “embodied” view is moving the debate into a new phase. The embodied approach focuses on the interdependence of perception, cognition and action, and in its more radical line this approach promotes the idea that perception is not a process (...) involving internal world-models. The anti-representationalist version of the embodied paradigm covers, among others that we shall not discuss here, two quite different positions, namely the enactive approach and sensorimotor theory. Up to now these two anti-representationalist accounts have generally been confounded. In this paper we will argue that despite some important commonalities, enactive and sensorimotor accounts come with distinctive theoretical traits with regard to their approach to imagery. These become manifest when critically examining the role they assign to sensorimotor engagements with the world. We shall argue that enactive and sensorimotor approaches are different in their understanding of the role of embodied action, and these different notions of embodiment lead to different explanatory accounts of perception and imagery. We propose that, due to existing ambiguities in enactivism, the sensorimotor theory is a better framework for a skill-based approach to imagery. (shrink)

Enaction, as put forward by Varela and defended by other thinkers (notably Alva Noë, 2004; Susan Hurley, 2006; and Kevin O’Regan, 1992), departs from traditional accounts that treat mental processes (like perception, reasoning, and action) as discrete, independent processes that are causally related in a sequen- tial fashion. According to the main claim of the enactive approach, which Thompson seems to fully endorse, perceptual awareness is taken to be a skill-based activity. Our perceptual contact with the world, according to the (...) enactionists, is not mediated by representations but is enacted, and the notion of representation, belonging to the classic computational paradigm, has no place in this alternative approach. Though Thompson does not pronounce directly on the issue of representationalism, he is most definitely keeping the company of anti-representationalists, and in that context it is not unreasonable to take his silence for consent. In this paper, we will argue that the enactive approach to imagery is unworkable unless it makes appeal to representations, understood in a particular way. Not understood as pictures, to be sure. Or sentences for that matter. But those aren’t the only options. (shrink)

Cognition is embodied when it is deeply dependent upon features of the physical body of an agent, that is, when aspects of the agent's body beyond the brain play a significant causal or physically constitutive role in cognitive processing. In general, dominant views in the philosophy of mind and cognitive science have considered the body as peripheral to understanding the nature of mind and cognition. Proponents of embodied cognitive science view this as a serious mistake. Sometimes the nature of the (...) dependence of cognition on the body is quite unexpected, and suggests new ways of conceptualizing and exploring the mechanics of cognitive processing. Embodied cognitive science encompasses a loose-knit family of research programs in the cognitive sciences that often share a commitment to critiquing and even replacing traditional approaches to cognition and cognitive processing. Empirical research on embodied cognition has exploded in the past 10 years. As the bibliography for this article attests, the various bodies of work that will be discussed represent a serious alternative to the investigation of cognitive phenomena. Relatively recent work on the embodiment of cognition provides much food for thought for empirically-informed philosophers of mind. This is in part because of the rich range of phenomena that embodied cognitive science has studied. But it is also in part because those phenomena are often thought to challenge dominant views of the mind, such as the computational and representational theories of mind, at the heart of traditional cognitive science. And they have sometimes been taken to undermine standard positions in the philosophy of mind, such as the idea that the mind is identical to, or even realized in, the brain. (shrink)

We taxonomize the varieties of representational reuse and point out that all the sorts of reuse that the brain engages in (1) involve something like a model (or schema or simulator), and (2) are effected in bodily and external media, as well as neural media. This suggests that the real fundamental organizational principle is not neural reuse, but model reuse.

Reseña de Abbattista, M. Lucía. (2019). Justicialismo y cultura en la Guerra Fría. El retorno de Oscar Ivanissevich al Ministerio de Cultura y Educación (Argentina 1974-1975).

Lucia Schwarz urges a reconsideration of the implications of species egalitarianism, which is an essential element of the position in environmental ethics that Paul Taylor calls “respect for nature.” Species egalitarianism’s claim that every living thing has equal inherent worth appears to lead to counterintuitive conclusions, such as that killing a human being is no worse than killing a dandelion. Species egalitarians have generally responded by explaining that species egalitarianism is compatible with recognizing moral differences between killing different types (...) of living things, and that some killing is morally permissible. Schwarz raises doubts about whether this deflationary defensive strategy is philosophically justified, and suggests that taking seriously the supposedly repugnant implications of species egalitarianism may have a salutary effect on the overall debate. (shrink)

To promote ethical practices, healthcare managers must understand the ethical challenges encountered by key stakeholders. To characterize ethical challenges in Veterans Administration (VA) facilities from the perspectives of managers, clinicians, patients, and ethics consultants. We conducted focus groups with patients (n = 32) and managers (n = 38); semi-structured interviews with managers (n = 31), clinicians (n = 55), and ethics committee chairpersons (n = 21). Data were analyzed using content analysis. Managers reported that the greatest ethical challenge was fairly (...) distributing resources across programs and services, whereas clinicians identified the effect of resource constraints on patient care. Ethics committee chairpersons identified end-of-life care as the greatest ethical challenge, whereas patients identified obtaining fair, respectful, and caring treatment. Perspectives on ethical challenges varied depending on the respondent's role. Understanding these differences can help managers take practical steps to address these challenges. Further, ethics committees seemingly, are not addressing the range of ethical challenges within their institutions. (shrink)

Although ethics consultation is offered as a clinical service in most hospitals in the United States, few valid and practical tools are available to evaluate, ensure, and improve ethics consultation quality. The quality of ethics consultation is important because poor quality ethics consultation can result in ethically inappropriate outcomes for patients, other stakeholders, or the health care system. To promote accountability for the quality of ethics consultation, we developed the Ethics Consultation Quality Assessment Tool. ECQAT enables raters to assess the (...) quality of ethics consultations based on the written record. Through rigorous development and preliminary testing, we identified key elements of a quality ethics consultation, established scoring criteria, developed training guidelines, and designed a holistic assessment process. This article describes the development of the ECQAT,.. (shrink)

This paper describes the significance of key empirical findings from the recent and landmark study Caring and Aging with Pride: The National Health, Aging and Sexuality Study (with Karen I. Fredriksen‐Goldsen as the principal investigator), on lesbian, gay, bisexual, and transgender aging and health disparities. We will illustrate these findings with select quotations from study participants and show how nonconscious bias (i.e., activation of negative stereotypes outside conscious awareness) in the clinical encounter and health care setting can threaten shared decision‐making (...) and perpetuate health disparities among LGBT older adults. We recognize that clinical ethicists are not immune from nonconscious bias but maintain that they are well situated to recognize bias and resulting injustice by virtue of their training. Further, we discuss how clinical ethicists can influence the organization's ethical culture and environment to improve the quality and acceptability of health care for LGBT older adults. (shrink)

This book explores when, and using what means, global political actors are morally justified in promoting their own ideas of justice in foreign societies. It develops ethical principles we can use to judge when such activities (“reform interventions”) are justified. In so doing, it re-conceives the traditional boundaries of politics and lays the foundation for a politically-engaged cosmopolitanism.

This article describes three characteristics of the Japanese Leadership Style (JLS): self-realization, appreciation of diverse abilities, and trust in others, which have both positive and negative ethical implications. In addition to illustrating how JLS allows Japanese corporations to avoid some of the ethical problems plaguing U.S. corporations, the authors will explain how these characteristics engender the loyalty and initiative of Japanese employees which promote incremental innovation and competitive advantages. Implicit in this discussion is the premise that both the American and (...) Japanese business communities, by analyzing their own ethical issues and leadership styles, can learn from each other. (shrink)

This paper describes a practice innovation: the addition of formal weekly discussions of patients with prolonged PICU stay to reduce healthcare providers’ moral distress and decrease length of stay for patients with life-threatening illnesses. We evaluated the innovation using a pre/post intervention design measuring provider moral distress and comparing patient outcomes using retrospective historical controls. Physicians and nurses on staff in our pediatric intensive care unit in a quaternary care children's hospital participated in the evaluation. There were 60 patients in (...) the interventional group and 66 patients in the historical control group. We evaluated the impact of weekly meetings to establish goals of care for patients with longer than 10 days length of stay in the ICU for a year. Moral distress was measured intermittently and reported moral distress thermometer scores fluctuated. "Clinical situations" represented the most frequent contributing factor to moral distress. Post intervention, overall moral distress scores, measured on the moral distress scale revised, were lower for respondents in all categories, and on three specific items. Patient outcomes before and after PEACE intervention showed a statistically significant decrease in PRISM indexed LOS, a statistically significant increase in both code status changes DNR, and in-hospital death, with no change in patient 30 or 365 day mortality. The addition of a clinical ethicist and senior intensivist to weekly inter-professional team meetings facilitated difficult conversations regarding realistic goals of care. The study demonstrated that the PEACE intervention had a positive impact on some factors that contribute to moral distress and can shorten PICU length of stay for some patients. (shrink)

The Ethics Consultation Quality Assessment Tool (ECQAT) establishes standards by which the quality of ethics consultation records (ECRs) can be assessed. These standards relate to the ethics question, consultation-specific information, ethical analysis, and recommendations and/or conclusions, and result in a score associated with one of four levels of ethics consultation quality. For the ECQAT to be useful in assessing and improving the quality of healthcare ethics consultations, individuals who rate the quality of ECRs need to be able to reliably use (...) the tool.We developed a short course to train ethics consultants in using the ECQAT, and evaluated whether the participants (1) achieved an acceptable level of calibration in matching expert-established quality scores for a set of ethics consultations, and (2) were satisfied with the course. We recruited 28 ethics consultants to participate in a virtual, six-session course. At each session participants and faculty reviewed, rated, and discussed one to two ECRs. The participants’ calibration in matching expert-established quality scores improved with repeated exposure at all levels of ethics consultation quality. Participants were generally more accurate when assessing consultation quality at the dichotomous level of “acceptable” (scores of three or four) versus “unacceptable” (scores of one or two) than they were with a more specific score. Participants had higher rates of accuracy with the extreme ratings of “strong” (level four) or “poor” (level one). Although participants were highly satisfied with the course, only a minority of participants achieved the prespecified acceptable level of calibration (that is, 80 percent or greater accuracy between their score and expert-established scores). These results suggest that ECQAT training may require more sessions or need modification in the protocol to achieve higher reliability in scoring. Such trainings are an important next step in ensuring that the ECQAT is a tool that can be used to promote improvement in ethics consultation quality. (shrink)

Our goal in producing this special issue is to encourage our colleagues to incorporate topics related to LGBT populations into bioethics curricula and scholarship. Bioethics has only rarely examined the ways in which law and medicine have defined, regulated, and often oppressed sexual minorities. This is an error on the part of bioethics. Medicine and law have served in the past as society's enforcement arm toward sexual minorities, in ways that robbed many people of their dignity. We feel that bioethics (...) has an obligation to discuss that history and to help us as a society take responsibility for it.We can address only a small number of topics in this special issue of the Hastings Center Report, and we selected topics we believe will stimulate discourse. Andrew Solomon offers an elegant overview of the challenges that bioethics faces in articulating a solid basis for LGBT rights. Timothy F. Murphy asks whether bioethics still faces issues related to lesbian, gay, and bisexual people, given the deletion of homosexuality as a disease and the progress toward same‐sex marriage. Jamie Lindemann Nelson's essay addresses the search for identity for transgender persons and the role of science in that search. Two articles, those by Brendan S. Abel and by Jack Drescher and Jack Pula, take up the complex issue of medical treatment for children who reject their assigned birth gender. Celia B. Fisher and Brian Mustanski address the special challenges of engaging LGBT youth in research, balancing the need for better information about this vulnerable group against the existing restrictions on research involving children. Tia Powell and Edward Stein consider the merits of legal bans on psychotherapies intended to change sexual orientation, particularly in the light of current research on orientation. Mary Beth Foglia and Karen I. Fredricksen‐Goldsen highlight health disparities and resilience among LGBT older adults and then discuss the role of nonconscious bias in perpetuating disparities. Stephan Davis and Nancy Berlinger assess the challenges of access to care and health policy for transgender persons. Edward J. Callahan et al. tackle the ways in which diverse aspects of medicine should change to better incorporate the needs of LGBT patients, including through use of the electronic medical record, education of health professionals, and recruitment efforts for LGBT health professionals. Virginia Ashby Sharpe and Uchenna S. Uchendu describe multifaceted efforts within Veterans Administration facilities to create change for LGBT veterans across the largest integrated health care network in the United States. Lance Wahlert and Autumn Fiester find a mixed record in the use of case studies in teaching about LGBT issues. (shrink)

After the establishment of the independent Slovak Republic, legal and institutional ground rules were set for providing asylum to foreigners present on the territory of the Slovak Republic. The national legislation of the last twenty years was adopted in compliance with international treaties and the European Union instruments covering asylum matters. In the field of asylum policy, the Slovak Republic complies with its traditional pillars and supports new forms of protection following the new challenges faced by the international community. The (...) currently valid Asylum Act regulates the international protection of aliens in the Slovak Republic, by defining the conditions and procedures related to granting asylum and provision of subsidiary protection and temporary shelter. The Asylum Act also covers the rights and obligations of different categories of persons, stay in asylum facilities and, partially, the integration of persons that are granted asylum. This article describes and analyses the development of the Slovak asylum legal framework and the concept of asylum policy. Furthermore, it looks at different protection statuses granted to foreigners and finally deals with the refugee migration trends in the Slovak Republic. (shrink)

To promote ethical practices, healthcare managers must understand the ethical challenges encountered by key stakeholders. To characterize ethical challenges in Veterans Administration facilities from the perspectives of managers, clinicians, patients, and ethics consultants. We conducted focus groups with patients and managers ; semi-structured interviews with managers, clinicians, and ethics committee chairpersons. Data were analyzed using content analysis. Managers reported that the greatest ethical challenge was fairly distributing resources across programs and services, whereas clinicians identified the effect of resource constraints on (...) patient care. Ethics committee chairpersons identified end-of-life care as the greatest ethical challenge, whereas patients identified obtaining fair, respectful, and caring treatment. Perspectives on ethical challenges varied depending on the respondent's role. Understanding these differences can help managers take practical steps to address these challenges. Further, ethics committees seemingly, are not addressing the range of ethical challenges within their institutions. (shrink)

Aborder Montaigne en pédagogue du jugement, c'est renouveler une lecture qui permit à Gabriel Compayré, Émile Faguet ou Pierre Villey de recommander la lecture d'un auteur réputé sceptique en dépit de son scepticisme. Comment bien juger? La connaissance des règles et l'aptitude à raisonner ne suffisent pas pour faire un bon jugement. En se confiant courageusement et lucidement à son jugement personnel, Montaigne apprend à penser en situation d'incertitude, tout en renouant avec l'expérience et les grands auteurs.

El objetivo de este texto es investigar sobre los posibles puntos de encuentro entre la psicoterapia existencial, un paradigma psicológico arraigado en las filosofías de la existencia, y el posicionamiento del profesor Marino Pérez Álvarez, quien se define a sí mismo como conductista radical, respecto a su manera de entender la existencia humana y el modelo más adecuado de psicoterapia. Para ello se proponen seis puntos de encuentro: necesidad de una fundamentación filosófica para la psicología, crítica al cientificismo y al (...) modelo médico, interpretación de los trastornos mentales como problemas de la vida cotidiana, recuperación del paciente como protagonista de la terapia, crítica a la psicología positiva y crítica al dualismo cartesiano. (shrink)

Psychotic-like experiences are a phenomenon that occurs in the general population experiencing delusional thoughts and hallucinations without being in a clinical condition. PLEs involve erroneous attributions of inner cognitive events to the external environment and the presence of intrusive thoughts influenced by dysfunctional beliefs; for these reasons, the role played by metacognition has been largely studied. This study investigates PLEs in a non-clinical population and discriminating factors involved in this kind of experience, among which metacognition, as well as psychopathological features, (...) seems to have a crucial role. The aim of this study was to extend the knowledge about the relationship between metacognition, psychopathology, and PLEs, orienting the focus on metacognitive functioning. The sample consisted of 207 Italian participants voluntarily recruited online, who gave consent to participate in the study. The average age of the sample was 32.69 years. Subjects affected by psychosis, neurological disease, and drug addiction were excluded from the analyses. The following scales were used to investigate PLEs: Peters et al. Delusions Inventory, Launay-Slade Hallucinations Scale-Extended Revised, Prodromal Questionnaire-Brief, and Revised Hallucination Scale. To assess general psychopathological features, the Behavior and Symptom Identification Scale was administrated. The Metacognition Self-Assessment Scale was chosen to evaluate metacognitive functioning. From hierarchical regression analyses, it emerged that the presence of anxiety, depression, and impulsive/addictive symptoms constitute a remarkable vulnerability factor for PLEs, in line with previous evidence regarding the relationship between general psychopathology and PLEs. Metacognition negatively predicts PLEs, and its presence does not affect the significance of psychopathological variables, suggesting that metacognitive abilities seem to play a protective role for the occurrence of PLEs among non-clinical individuals, and such ability operates as an independent predictor along with other variables. These results are explained by the role of metacognitive functions, which allow individuals to operate many mental processes such as interpreting sensorial events as real or illusory, understanding behaviors, thoughts, and drives of others, and questioning the subjective interpretation of facts. (shrink)

L'examen du parcours personnel et littéraire d'Assia Djebar, femme, écrivain et algérienne, est l'axe de l'approche de Vera Lucia Soares. Pour analyser les différentes composantes de son objet d'étude Soares a recours à quelques-uns des théoriciens les plus renommés ­ Roger Chartier, Paul Ricoeur, Todorov, entre autres ­ et les utilise de façon magistrale pour disséquer l'oeuvre d'Assia Djebar, sous les angles les plus divers. Il faut aussi signaler la bibliographie spécialisée sur laq..

Depuis une dizaine d’années, plusieurs études ont renouvelé l’approche de la pauvreté dans l’Antiquité, comme celles d’E. Galbois et S. Rougier-Blanc (éd.), La Pauvreté en Grèce ancienne : formes, représentations, enjeux (Bordeaux, Ausonius, 2014), ou de M. Atkins et R. Osborne (éd.), Poverty in the Roman World (Cambridge UP, 2006). Mais quelle représentation la cité dans son ensemble se faisait-elle de ce phénomène? Dans Poverty in Athenian Public Discourse, Lucia Cecchet se penche sur l’im...

L'examen du parcours personnel et littéraire d'Assia Djebar, femme, écrivain et algérienne, est l'axe de l'approche de Vera Lucia Soares. Pour analyser les différentes composantes de son objet d'étude Soares a recours à quelques-uns des théoriciens les plus renommés ­ Roger Chartier, Paul Ricoeur, Todorov, entre autres ­ et les utilise de façon magistrale pour disséquer l'oeuvre d'Assia Djebar, sous les angles les plus divers. Il faut aussi signaler la bibliographie spécialisée sur laq...

Given a space in an elementary submodel M of H, define XM to be X∩M with the topology generated by . It is established, using anti-large-cardinals assumptions, that if XM is compact and its regular open algebra is isomorphic to that of a continuous image of some power of the two-point discrete space, then X=XM. Assuming in addition, the result holds for any compact XM satisfying the countable chain condition.

This study investigated students’ perceptions following a prepared, common presentation regarding academic integrity provided by their residence dons. This peer instruction study utilized both quantitative and qualitative analyses of survey data within a pre-test post-test design. Overall, students reported gains in knowledge, as well as confidence in their knowledge of academic integrity. Notably, students reported increases in their personal value for academic integrity after participating in the presentations. Overall, the quality and content of the presentations were judged positively, and participants’ (...) ratings of the presentation were predictive of increases in personal value of academic integrity, as well as self-reported knowledge and confidence gains. Qualitative analyses supported that the key ideas in the presentation served as the focal material for discussion, but also introduced specific topics that students wanted to explore in greater depth. (shrink)

Many published instruments for assessing adolescent adjustment can be implemented in the school context. However, most of them fail to include a comprehensive and positive theoretical perspective of adolescent development and, even when they do, priority is often given to the clinical perspective, or problems with ecological validity and cost-effectiveness emerge. The Magallanes Adaptation Scale is a 90-item Likert-instrument designed for Spanish-speaking adolescents in order to screen several adjustment areas from a holistic and positive perspective of development. Although some evidence (...) of its psychometric robustness has been tested, no confirmatory analysis of its structure has been published. This paper analyzes the items and the factor structure (exploratory factor analysis and confirmatory factor analysis, using the split-half method) of the scales. Participants were 948 Spanish adolescents (49.84% girls) aged between 11 and 17 and stratified sampled. Thirty-six items were removed from the item analysis. The results of the exploratory factor analysis revealed five factors, excluding mother’s adaptation. Several models were tested during the confirmatory factor analyses, with a 24-item second-order four-factor solution being found to have the best adjustment indicators. The short version proposed in this paper can constitute a helpful tool with screening purposes to help school teachers to assess students’ overall development beyond mere academic performance, although further validity research is needed. (shrink)

The general question to be considered in this paper points to the nature of the world described by chemistry: what is macro-chemical ontology like? In particular, we want to identify the ontological categories that underlie chemical discourse and chemical practice. This is not an easy task, because modern Western metaphysics was strongly modeled by theoretical physics. For this reason, we attempt to answer our question by contrasting macro-chemical ontology with the mainstream ontology of physics and of traditional metaphysics. In particular, (...) we introduce the distinction between stuff-ontology, proper of chemistry, and individual-ontology, proper of physics. These two ontologies differ from each other in the basic categories of their own structures. On this basis, we characterize individual-ontology in such a way that the features of stuff-ontology will arise by contrast with it. (shrink)

A peer instruction model was used whereby 78 residence dons (36 males, 42 females) provided instruction regarding academic integrity for 324 students (125 males, 196 females) under their supervision. Quantitative and qualitative analyses were conducted to assess survey responses from both the dons and students regarding presentation content, quality, and learning. Overall, dons consistently identified information-based slides about academic integrity as the most important material for the presentations, indicating that fundamental information was needed. Although student ratings of the usefulness of (...) the presentations were middling, students did indicate knowledge gains. Both interest and personal value for academic integrity were highly predictive of positive evaluations of the presentations. Dons and students provided suggestions for improvement and identified more global concerns. (shrink)

Campbell, Ulrich, and Grady (2016) should be commended for attempting to contribute to the discussion of what many believe is currently a messy concept. They propose that a broader definition of mo...

L'examen du parcours personnel et littéraire d'Assia Djebar, femme, écrivain et algérienne, est l'axe de l'approche de Vera Lucia Soares. Pour analyser les différentes composantes de son objet d'étude Soares a recours à quelques-uns des théoriciens les plus renommés ­ Roger Chartier, Paul Ricoeur, Todorov, entre autres ­ et les utilise de façon magistrale pour disséquer l'oeuvre d'Assia Djebar, sous les angles les plus divers. Il faut aussi signaler la bibliographie spécialisée sur laq...

Although the literature on corporate social responsibility has discussed the scope and meaning of CSR extensively, confusion still exists regarding how to define the concept. One controversial issue deals with the changing legal status of CSR. Based on a review of CSR definitions and meta-studies on CSR definitions, we find that the majority of definitions leans toward voluntary CSR. However, some recent regulatory amendments toward mandatory CSR have called into question the established idea of CSR as merely a managerial tool (...) of self-regulation. In this paper, we juxtapose the evolution of CSR in India against the scholarly literature discussing voluntary-versus-mandatory CSR to understand the recent shift toward a new conceptualization of CSR as a form of co-regulation that includes elements of both voluntary and mandatory regulation. The Indian Companies Act 2013 is a remarkable example in that it replaced an older version from 1956, taking a bold step toward the integration of voluntary and mandatory aspects in the application of CSR. We present practical implications of the Indian case for businesses and discuss implications for CSR theory development; we particularly consider the evolution of the business and society relationship from a voluntary soft law approach to CSR to an increasingly hard law approach and transitory hybrid forms in-between like soft–hard law and hard–soft law. (shrink)

In late February and early March 2020, Italy became the European epicenter of the COVID-19 pandemic. Despite increasingly stringent containment measures enforced by the government, the health system faced an enormous pressure, and extraordinary efforts were made in order to increase overall hospital beds’ availability and especially ICU capacity. Nevertheless, the hardest-hit hospitals in Northern Italy experienced a shortage of ICU beds and resources that led to hard allocating choices. At the beginning of March 2020, the Italian Society of Anesthesia, (...) Analgesia, Resuscitation, and Intensive Care issued recommendations aimed at supporting physicians in prioritizing patients when the number of critically ill patients overwhelm the capacity of ICUs. One motivating concern for the SIAARTI guidance was that, if no balanced and consistent allocation procedures were applied to prioritize patients, there would be a concrete risk for unfair choices, and that the prevalent “first come, first served” principle would lead to many avoidable deaths. Among the drivers of decision for admission to ICUs, age, comorbidities, and preexisting functional status were included. The recommendations were criticized as ageist and potentially discriminatory against elderly patients. Looking forward to the next steps, the Italian experience can be relevant to other parts of the world that are yet to see a significant surge of COVID-19: the need for transparent triage criteria and commonly shared values give the Italian recommendations even greater legitimacy. (shrink)

BackgroundHospitals face a disclosure dilemma when large-scale adverse events affect multiple patients and the chance of harm is extremely low. Understanding the perspectives of patients who have received disclosures following such events could help institutions develop communication plans that are commensurate with the perceived or real harm and scale of the event.MethodsA mailed survey was conducted in 2008 of 266 University of Washington Medical Center (UWMC) patients who received written disclosure in 2004 about a large-scale, low-harm/low-risk adverse event involving an (...) incomplete endoscope cleaning process. The survey measured patients’ satisfaction with this disclosure, their concerns about healthcare outcomes, and their recommendations for future communication, given similar circumstances.ResultsSurveys were received from 127 of 266 (48 percent) of eligible respondents; 98 percent thought that UWMC was right to inform them about this event, and mean satisfaction with the disclosure was 7.7 on a 0 to 10 scale. Of the 127 respondents, 64 percent were somewhat or very concerned that the endoscope cleaning problem might cause them health problems; 60 percent reported their impressions of UWMC’s honesty and integrity had increased; 31 percent said their perceptions of the quality of care had increased; 94 percent agreed that institutions should tell patients about any error in their care, even when the risk of harm was low, although 28 percent agreed that such notifications would make them anxious. Respondents who reported concern that the event could cause them health problems were less likely to be satisfied with the institution’s disclosure. Patients cited their right to know information material to their own health and healthcare as an important reason for disclosure.ConclusionRecipients of disclosure of a large-scale, low-harm/low-risk event overwhelmingly supported being told of the event and endorsed notification of patients for similar events in the future. Although informing patients may cause concern for some, institutions should ensure their disclosure policies and procedures reflect their patients’ preferences. (shrink)

Desde Patterson, Estados Unidos, Génova, Italia, Buenos Aires, Argentina o Santiago de Chile, desafiando hasta cientos de miles de kilómetros de distancia, más de medio millón de mujeres tejen porfiadamente, cotidianamente, lazos de amor y cuidado con sus hijos e hijas en Perú. El hilo con que hilvanan estas nuevas formas de ser y hacer familias, transformando el mundo y transformándose, es el cable telefónico. Un nuevo cordón umbilical por el que van y vienen los afectos y cuidados, los enoj..