Paula Modersohn-Becker, widely considered to have been one of the most important independent Expressionist painters of the early twentieth century, was thirty-one years old when she gave birth to her first child. Following the then-common practice of putting women to bed rest for two-four weeks after delivery, she died of massive pulmonary embolism when she was first allowed to stand, eighteen days after giving birth. Paula had foreseen her death at a young age and was apprehensive about her pregnancy, yet (...) she painted herself as pregnant in her best known self-portrait, thus underlining the importance of the pregnancy in her life. In the light of knowledge available at the time, the authors present a brief discussion of the life and death of Paula Modersohn-Becker as a reflection on the potential dangers of blindly following conventional wisdom in the medical profession. (shrink)

Jean Hamburger is considered the founder of the concept of medical intensive care and the first to propose the name Nephrology for the branch of medicine dealing with kidney diseases. One of the first kidney grafts in the world, in 1953, and the first dialysis session in France, in 1955, were performed under his guidance. His achievements as a writer were at least comparable: Hamburger was awarded several important literary prizes, including prix Femina, prix Balzac and the Cino del Duca (...) prize, awarded, among others, to Jorge Luis Borges and Konrad Lorenz.Here we would like to offer a selected reading of a “golden” book, “Conseils aux étudiants en medicine de mon service”, the first book dedicated to patient-physician relationship in Nephrology, written when dialysis and transplantation were becoming clinical options. The themes include: the central role of the patient, who should be known by name, profession, life style, and not by disease; the importance of the setting of the care; the need for truth-telling and for leaving hope; the role of research not only in the progression of science, but also in the daily clinical practice. (shrink)

Jean Hamburger (1909--1992) is considered the founder of the concept of medical intensive care (reanimation medicale) and the first to propose the name Nephrology for the branch of medicine dealing with kidney diseases. One of the first kidney grafts in the world (with short-term success), in 1953, and the first dialysis session in France, in 1955, were performed under his guidance. His achievements as a writer were at least comparable: Hamburger was awarded several important literary prizes, including prix Femina, prix (...) Balzac and the Cino del Duca prize (1979), awarded, among others, to Jorge Luis Borges and Konrad Lorenz.Here we would like to offer a selected reading of a "golden" book, "Conseils aux etudiants en medicine de mon service" ("Advice to the Medical Students in my Service"), the first book dedicated to patient-physician relationship in Nephrology, written when dialysis and transplantation were becoming clinical options (1963). The themes include: the central role of the patient, who should be known by name, profession, life style, and not by disease; the importance of the setting of the care; the need for truth-telling and for leaving hope; the role of research not only in the progression of science, but also in the daily clinical practice. (shrink)

Starting dialysis at an advanced age is a clinical challenge and an ethical dilemma. The advantages of starting dialysis at “extreme” ages are questionable as high dialysis-related morbidity induces a reflection on the cost- benefit ratio of this demanding and expensive treatment in a person that has a short life expectancy. Where clinical advantages are doubtful, ethical analysis can help us reach decisions and find adapted solutions. Mr. H is a ninety-year-old patient with end-stage kidney disease that is no longer (...) manageable with conservative care, in spite of optimal nutritional management, good blood pressure control and strict clinical and metabolic evaluations; dialysis is the next step, but its morbidity is challenging. The case is analysed according to principlism (beneficence, non-maleficence, justice and respect for autonomy). In the setting of care, dialysis is available without restriction; therefore the principle of justice only partially applied, in the absence of restraints on health-care expenditure. The final decision on whether or not to start dialysis rested with Mr. H (respect for autonomy). However, his choice depended on the balance between beneficence and non-maleficence. The advantages of dialysis in restoring metabolic equilibrium were clear, and the expected negative effects of dialysis were therefore decisive. Mr. H has a contraindication to peritoneal dialysis (severe arthritis impairing self-performance) and felt performing it with nursing help would be intrusive. Post dialysis fatigue, poor tolerance, hypotension and intrusiveness in daily life of haemodialysis patients are closely linked to the classic thrice-weekly, four-hour schedule. A personalized incremental dialysis approach, starting with one session per week, adapting the timing to the patient’s daily life, can limit side effects and “dialysis shock”. An individualized approach to complex decisions such as dialysis start can alter the delicate benefit/side-effect balance, ultimately affecting the patient’s choice, and points to a narrative, tailor-made approach as an alternative to therapeutic nihilism, in very old and fragile patients. (shrink)

Organ trafficking is officially banned in several countries and by the main Nephrology Societies. However, this practice is widespread and is allowed or tolerated in many countries, hence, in the absence of a universal law, the caregiver may be asked for advice, placing him/her in a difficult balance between legal aspects, moral principles and ethical judgments.In spite of the Istanbul declaration, which is a widely shared position statement against organ trafficking, the controversy on mercenary organ donation is still open and (...) some experts argue against taking a negative stance. In the absence of clear evidence showing the clinical disadvantages of mercenary transplantation compared to chronic dialysis, self-determination of the patient may conflict with other ethical principles, first of all non-maleficence. The present paper was drawn up with the participation of the students, as part of the ethics course at our medical school. It discusses the situation in which the physician acts as a counselor for the patient in the way of a sort of “reverse” informed consent, in which the patient asks advice regarding a complex personal decision, and includes a peculiar application of the four principles to the donor and recipient parties. (shrink)

Este estudo investigou práticas educativas de pais e educadores sociais e estratégias de coping adotadas por crianças abrigadas. Participaram da pesquisa 20 crianças, entre sete e 11 anos. Elas responderam a duas entrevistas, que objetivavam identificar práticas educativas e problemas nos ambientes ..

1. Introduzione Perché, tra tutto ciò “che è”, scegliere di studiare proprio il denaro? Essenzialmente per due motivi. Anzitutto, col denaro abbiamo a che fare tutti i giorni, si tratta quindi di un ente che ha un ruolo rilevante nella vita dell’uomo contemporaneo, di più, direi che oggi esso abbia un ruolo centrale negli interessi degli uomini, pensiamo solo a quanti lo usano come criterio di scelta nella propria vita. Tuttavia, e qui arriviamo al secondo motivo, il denaro nella sua (...) struttur... (shrink)

To provide a possible interpretation of the passive attitude often exhibited by pupils in the context of school trips, the article does not follow the path of moralistic judgement, but starts from the essence of the teaching profession, which consists in showing the world to the students. The article adopts the thesis of the presence, in many school trips, of an excessive cognitive load and affirms the need to devote the same attention to teaching in these learning contexts as in (...) class work. Graduality is proposed as the key to a learning experience based on a motivation that arises from the discovery of reality. (shrink)

Many of the earliest books, particularly those dating back to the 1900s and before, are now extremely scarce and increasingly expensive. We are republishing these classic works in affordable, high quality, modern editions, using the original text and artwork.

The article proposes two anthropological movements as guidelines for an education in democratic citizenship more capable of overcoming reductionisms and trivializations: a return to oneself, suggested by Hannah Arendt and a movement towards others, suggested by Edgar Morin. The text also takes the opportunity to formulate a reflection on the relevance of the global educational challenge of compulsory schooling for the construction of a more sensitive and open humanity.

Scopo del saggio è confrontare alcune tra le principali visiones della letteratura occidentale – tra cui la Visio Pauli e la Commedia – e le diverse redazioni della tradizione islamica dell’ascensione celeste e viaggio oltremondano del profeta Muhammad, nel tentativo di stabilire se le affinità, tematiche e strutturali, osservabili tra i due gruppi di testi siano frutto di semplice poligenesi o vadano piuttosto spiegate con rapporti di effettiva intertestualità.Tra le visiones, la tradizione mirajica e la Commedia si instaura dunque un (...) dialogo a tre voci, o di sinfonia, i cui temi principali si arricchiscono e si richiamano a vicenda. Dante, primo comparatista, è in grado di reinventare, armonizzandoli, elementi strutturali e tematici provenienti sia dalle visiones latine che dalla tradizione islamica del Isra’ wa’ l Mi‘râj.The purpose of this essay is to make a confrontation between the main important visiones of the Occidental Literature – also the Visio Pauli and the Dante’s Commedia – anche the various redactions of the Islamic Isra’ wa-l mi’râj. The confrontation is in order to establish if the remarked affinities are just due to polygenesis or rather caused by concrete intertestuality.Between the visiones, the mirajic tradition and the Commedia we are in front of a three voices dialogue: it’s like a symphony, in which the themes enriches themselves and, at least, the arrive to Dante for being harmonized. Dante is the first comparatist. (shrink)

The article begins with an analysis of the learning process, described as a transition from a condition of “not knowing ” to a condition of “knowing something more”. Referring to John Dewey’s theory, it underlines the need, on the part of the teacher, to understand the specific condition of the learner, which is closely related to the uncomfortable posture of learning, in order to make possible a truly meaningful pathway. To foster this experience, the author proposes, in conclusion, two thoughts: (...) the first is focused on the competence to proactively and interactively regulate the lessons, the second on a “principle of excess” which constantly places the teacher in the position of “giving”. (shrink)

Autor (2020) desenvolveu duas semânticas informacionais para a Lógica Sentencial Clássica, decorrentes da utilização de formais normais. A abordagem informacional em questão utiliza unidades mínimas de informação (infons) para realizar o trabalho lógico. Neste artigo, expandiremos a aplicação da abordagem informacional às lógicas sentenciais polivalentes finitas mediante um procedimento dedicado à extração de unidades mínimas de informação (infons). Tal procedimento decorre do trabalho com tablôs semânticos para Lógicas Sentenciais Polivalentes Finitas desenvolvido por Carnielli (1982).

BackgroundEven though virtual reality is more and more considered for its power of distraction in different medical contexts, the optimal conditions for its use still have to be determined in order to design interfaces adapted to therapeutic support in oncology.ObjectiveThe objective of this study was to examine the benefits of VR using two immersion methods and comparing them with each other in a population of women with breast cancer who have undergone breast surgery, during scar massage sessions.MethodsIn a physiotherapy center, (...) each patient participated in four experimental conditions in a random order: two sessions used virtual immersion, one session proposed musical listening and the fourth one was a standard session care. The impact of the level of patient involvement in the virtual world was apprehended through the evaluation of the feeling of presence; the estimation of elapsed time of the physiotherapy sessions and particular attention was paid to the evaluation of patient emotional state.ResultsOur study showed an increase in positive emotions and a decrease in anxiety regardless which support methods were offered. Participatory VR created a feeling of more intense spatial presence.ConclusionOur results highlight the importance of the context in which VR should be offered. The presence of the practitioner and his interactions with the patient can provide a context just as favorable in reducing anxiety as the emotional regulation tools used. The use of technological tools should be favored when the practitioner is unavailable during the treatment phase or, even, in order to reduce the monotonous nature of repetitive therapeutic sessions. (shrink)

O texto se debruça sobre os princípios constantes no Plano de Desenvolvimento Institucional de quatro Instituições Comunitárias de Ensino Superior, duas localizadas no Rio Grande do Sul e duas situadas em Santa Catarina. O propósito é analisá-los segundo três categorias analíticas tomadas das obras de Paulo Freire: abertura para o diálogo; autonomia; e emancipação. A análise documental retrata os procedimentos adotados na construção dos dados empíricos, segundo a abordagem de Bacellar. O estudo observa o atual cenário da Educação Superior, que (...) indica um processo de mercantilização que desafia os movimentos das universidades, especialmente das universidades comunitárias devido à natureza pública não estatal, sem fins lucrativos e legitimadas pela Lei n. 12.881/2013. O argumento central do texto se constrói em torno da seguinte problematização: Como articular a lógica de mercado com uma formação profissional humana e de qualidade, em oposição à objetificação dos projetos de formação e de atuação profissional? Entre os resultados do estudo, estão o relevo dos propósitos das universidades comunitárias e indicadores articulados com a geração de capital humano e com a geração de capital de conhecimento, considerados como possíveis alternativas para posicionar as ICESs como instituições que não serão absorvidas pelo cenário da Educação como um negócio, não obstante as fronteiras permeáveis entre o dentro e o fora da academia. (shrink)

Next SectionObjectives To evaluate the adequacy of paediatric informed consent and its augmentation by a supplemental computer-based module in paediatric endoscopy. Methods The Consent-20 instrument was developed and piloted on 47 subjects. Subsequently, parents of 101 children undergoing first-time, diagnostic upper endoscopy performed under moderate IV sedation were prospectively and consecutively, blinded, randomised and enrolled into two groups that received either standard form-based informed consent or standard form-based informed consent plus a commercial (Emmi Solutions, Inc, Chicago, Il), sixth grade level, (...) interactive learning module (electronic assisted consent). Anonymously and electronically, the subjects' anxiety (State Trait Anxiety Inventory), satisfaction (Modified Group Health Association of America), number of questions asked, and attainment of informed consent were assessed (Consent-20). Statistics were calculated using t test, paired t test, and Mann Whitney tests. Results The ability to achieve informed consent, as measured by the new instrument, was 10% in the control form-based consent group and 33% in the electronic assisted consent group (p<0.0001). Electronically assisting form-based informed consent did not alter secondary outcome measures of subject satisfaction, anxiety or number of questions asked in a paediatric endoscopy unit. Conclusions This study demonstrates the limitations of form-based informed consent methods for paediatric endoscopy. It also shows that even when necessary information was repeated electronically in a comprehensive and standardised video, informed consent as measured by our instrument was incompletely achieved. The supplemental information did, however, significantly improve understanding in a manner that did not negatively impact workflow, subject anxiety or subject satisfaction. Additional study of informed consent is required. Clinical trial registration number ClinicalTrials.gov Identifier NCT00899392. (shrink)

There are various equivalent formulations of the Church-Turing thesis. A common one is that every effective computation can be carried out by a Turing machine. The Church-Turing thesis is often misunderstood, particularly in recent writing in the philosophy of mind.

Om ironiens funktion i Søren Kierkegaards forfatterskab belyst ud fra Kierkegaards disputats om ironien.

Unit I. Fundamental characteristics of the common law. The source of law -- The jury -- The adversary system of trial -- Retroactivity: a return to stare decisis -- Unit II. The courts and their jurisdiction. Court systems in the United States -- Court system in England -- Unit III. Constitutional law. Judicial review -- Equal protection -- Freedom of speech -- Appendix I. Constitution of the United States -- Appendix II. Table of Supreme Court cases -- Appendix III. Common (...) case citations. (shrink)

Gegenstand der Erörterung ist die Offenlegung des faktischen und potentiellen Ethikbezugs von Technik. Grundlegend für jede Ethik ist ein je bestimmtes Verständnis des Menschen und seiner Wirklichkeit. Diese prinzipielle Positionalität ist gegenüber diskurs- und verfahrensethischen Ansätzen ebenso festzuhalten wie gegenüber utilitaristischen Nivellierungen grundlagentheoretischer Fragen. Die vorliegende Untersuchung aus evangelischer Perspektive zeigt anhand der Analyse zweier technikphilosophischer Konzeptionen der Gegenwart (G. Ropohl, W. Ch. Zimmerli) die Relevanz von Technikethik nicht nur für Techniker, sondern bezüglich menschlichen Handelns im allgemeinen.

Iyengar Yoga Wisdom & Practice" is a practical and an inspiring anthology of Iyengar's insights into yoga, life and the path to peace and happiness. Yoga practice lies at the heart of the book, and it is illustrated with over 60 new step-by-step sequences of yoga postures specially shot in India and accompanied by Iyengar's illuminating observations on technique, their significance, and their benefits. This book not only presents Iyengar's practical advice on how to perform key yoga postures, but also (...) draws on a wide range of other material taken from interviews and world lecture tours, to the many texts Iyengar has written about yoga and about his own life's journey. (shrink)

Presupposing no familiarity with the technical concepts of either philosophy or computing, this clear introduction reviews the progress made in AI since the inception of the field in 1956. Copeland goes on to analyze what those working in AI must achieve before they can claim to have built a thinking machine and appraises their prospects of succeeding.There are clear introductions to connectionism and to the language of thought hypothesis which weave together material from philosophy, artificial intelligence and neuroscience. John Searle's (...) attacks on AI and cognitive science are countered and close attention is given to foundational issues, including the nature of computation, Turing Machines, the Church-Turing Thesis and the difference between classical symbol processing and parallel distributed processing. The book also explores the possibility of machines having free will and consciousness and concludes with a discussion of in what sense the human brain may be a computer. (shrink)