Clinical and Care Bioethics Committees at Public and Private Healthcare Institutions of Medium and High Complexity Levels in Cities of the Atlantic Coast of Colombia Comitês de Bioética clínico-assistencial nas instituições de saúde públicas e privadas dos níveis de média e alta complexidade das cidades da Costa Atlântica da Colômbia Care bioethics committees are interdisciplinary groups engaged in providing education to members of said committees, all the staff in the hospital —including professors and students in their internship—, and members of (...) the community. The objective of this study is to determine the situation of clinical and care bioethics committees at healthcare institutions in the Atlantic Coast of Colombia between 2010-2016. The study is cross-sectional, descriptive, and retro-prospective. Twenty-six health institutions that met the inclusion criteria were selected and administered a semi-structured survey. The statistical software SPSS version 22 was used to analyze the information. This study adhered to ethical research guidelines. The name most commonly given to committees is Hospital Ethics Committee. Only half have staff trained in ethics or bioethics and the most outstanding function is education in ethics; however, in the same percentage there are committees whose opinion is divided as their operation is unclear. Committees should follow existing ethical and bioethical models, and bills should be brought forward to help committees at healthcare institutions become more effective as regards their structure and operation. Para citar este artículo / To reference this article / Para citar este artigo Carrillo González S, Lorduy-Gómez J, Muñoz-Baldiris R. Comités de Bioética Clínico-Asistencial en las instituciones de salud públicas y privadas de los niveles de mediana y alta complejidad de las ciudades de la Costa Atlántica de Colombia. Pers Bioet. 2019; 23: 122-136. DOI: https://doi.org/10.5294/pebi.2019.23.1.8 Recibido: 23/08/2018 Aceptado: 25/02/2019. (shrink)

A surgical instrumentation professional is an active member of the surgical team whose essence and formal objective is to maintain life with all the respect and dignity inherent in the human being. The actions of these professionals must be accompanied in a consistent way, so as to protect and preserve life, and thus give meaning to illness, suffering and pain. The objective of this descriptive and cross-sectional study of a prospective nature is to determine what the surgical instrumentation professional knows (...) about bioethical principles and values in light of Colombian Law 1164/ 2007. The target population included surgical instrumentation professionals in the city of Cartagena, specifically, from three health institutions. It was found that veracity, equality and beneficence are the ethical and bioethical principles these professionals know and apply. Those known the least are lesser evil, doing no harm, totality and the principle of the cause of double effect. The values applied the most are: humanity, dignity, responsibility, prudence and confidentiality. It was concluded that the vast majority of surgical instrumentation professionals who were surveyed apply ethical principles and values in their professional practice, but they are unable to name them or to define what they mean. It is suggested the academic community do more to delve into these issues in order to strengthen them for the sake of achieving a comprehensive level of care. (shrink)

Este artículo tiene como objetivo, plantear el concepto de la tecnología como mito, y por lo tanto como un espacio mítico, lugar de enunciación desde donde el ser humano establece la comprensión que tiene de la realidad que le corresponde vivir, y así, plantea su actuar sobre ella. Para ello se presenta brevemente y a manera de barrunto una introducción de un análisis de la coyuntura vivida con la pandemia del Covid-19, que servirá para contextualizar la urgencia de reflexionar sobre (...) el tema central, y que además permitirá bosquejar la conclusión de este escrito. Luego se abordará el problema planteado desde la propuesta económico-teológica del pensador crítico Franz Hinkelammert, quien a lo largo de su obra ha presentado, de manera implícita, un análisis sobre el tema de la tecnología, y quien desarrolla radicalmente la concepción de la tecnología como un mito de la modernidad. Hacer este acercamiento nos obligará a recorrer las reflexiones que este mismo pensador tiene sobre la racionalidad económica perfecta, así mismo que sobre la concepción de la economía que emergió con la revolución industrial y que se radicaliza tras las subsiguientes revoluciones que se plantean en esa línea. A lo largo de este desarrollo argumental nos veremos en la obligación de pasar por otros conceptos clave de la propuesta de Hinkelammert, como el de ideología liberal y su concepción de concepto límite. El de mala infinitud que viene desde la lectura que nuestro autor hace de Hegel. Y por supuesto el concepto de mito y espacio mítico, así como el de tecnología y su vínculo con el imaginario social de progreso que es impuesto dentro de la racionalidad económica y social del sistema-mundo imperante. (shrink)

El presente trabajo se propone rescatar la resistencia y la crítica al poder imperial romano del libro del Apocalipsis como una fuente fundamental para la teología moral cristiana, que lo convirtieron en un foco de luz que ilumina el camino de la conducta humana hacia un mundo mejor. Al mismo tiempo, ofrece pautas para la defensa de la vida en un entorno donde los totalitarismos políticos, económicos y religiosos atentan contra ella. Además, quiere destacar dicha resistencia y crítica como uno (...) de los factores generadores, y por tanto centrales, de la teología del Apocalipsis. Para ello se utilizarán los principios metodológicos de la lectura contextual que parten de la convicción según la cual el texto es una expresión de las vivencias comunitarias del hagiógrafo y de su actitud ante las circunstancias sociales que lo provocaron. El libro busca afectar el entorno, pero este también configura el contenido de la obra escrita. En un segundo momento, con el método se indaga qué de ese momento histórico puede iluminar el presente del lector. En el caso del Apocalipsis, se elegirán los textos en los que el autor presente los temas y actores principales de la trama, a saber: el ser supremo sentado en el trono, el cordero y el mal —simbolizado específicamente en el tercer jinete—, ya que en ellos se juega el mensaje del libro, la soberanía divina que humaniza o la soberanía diabólica deshumanizante. (shrink)

This article analyzes the relation of the epistemological beliefs of students and teachers and the actions deployed in the classroom. The framework is the study of personal epistemology, which was developed, among other researchers, by Hofer, Pintrich and Schommer. The research method was, within the qualitative paradigm, through case studies, given the interest in describing the phenomenon in a specific scenario. The results show the epistemological beliefs of teachers and students, the events that make them evident and its relationship with (...) the behaviors shown in the classroom. The role of pedagogical beliefs as mediation between personal epistemology of educational actors and their practice are described and, finally, the relation between beliefs and educational practice is illustrated by analyzing specific class events and the justification expressed by teachers and students about their actions in the classroom. (shrink)

At this time when the development of synthetic biology and artificial intelligence are changing the world around us, philosophers and scientists, first of all, must converge to analyze the present and predict the ethical-social consequences and biological dangers associated with new “living entities” that are not the result of the natural evolutionary process. As synthetic/artificial life forms (xenobots, robots, transgenic organisms, etc.) become more and more abundant and sophisticated, it seems first of all necessary to bring some order to all (...) this new biodiversity, establishing what is alive and what is not, and analyzing the consequences of this incessant creative activity. Here I intend to organize all these human-made entities and clarify their status as living beings or artificial elements, leaving the door open to an uncertain future in which we will be able to see how “the artificial” and “the natural” could merge to originate something different from everything known. Accordingly, I propose the creation of a new domain, Lithbea, which includes all synthetic and artificial entities within a new kingdom called Humade (derived from human-made). I have also included viruses in a new realm, the Viral kingdom, because they were excluded from the classical three-domain tree of life despite playing a fundamental role in the evolution of biodiversity on Earth. Finally, I make a brief comment on the unpredictability of the unknown, the implications of this new landscape of biodiversity, and the uncertain future of all these advances. (shrink)

En este artículo describiremos la vitalidad del sistema fonológico del mapudungun hablado por escolares pewenches de la Provincia del Biobío, VIII Región. Específicamente, nos hemos propuesto: a) Determinar los fonos/fonemas, y su fonotaxis, que se relevan como indicadores de vitalidad, b) Identificar las transferencias fonético-fonológicas presentes en la fonología del pewenche hablado por estos escolares y c) Interpretar las transferencias encontradas en términos del grado de vitalidad de la fonología de la lengua. La muestra está conformada por un grupo de (...) 20 escolares bilingües de entre 12 y 15 años de edad, que se encuentran cursando 7° y 8° año básico en escuelas rurales pertenecientes a dos comunidades pewenches del valle del Queuco, en la comuna de Alto Biobío. Para la recolección del material fonológico, se aplicó a los participantes una lista léxica de 65 ítems, material que se complementó con la narración oral en mapudungun de un cuento. Según nuestros datos, hemos podido constatar la existencia de una serie de rasgos fónicos en el mapudungun hablado por los escolares pewenches que obedece a la influencia de las estructuras fonológicas del castellano. Sin embargo, el grado y la difusión de los fenómenos de transferencia se desarrollan de manera heterogénea en ambas comunidades en estudio, debido, entre otros factores, a la intensidad del contacto. In this article we will describe the vitality of the phonological system Mapudungun spoken by Pewenche schoolchildren from the Biobío province, VIII Region. We intend: a) To determine the phones/phonemes, and their phonotactics, which are revealed as vitality markers. b) To identify the phonetic-phonological transferences which are present in the Pewenche spoken by these schoolchildren, and, c) To interpret the transferences found in terms of the degree of the language phonological vitality. The sample is composed of 20 bilingual schoolchildren from 12 to 15 years old, who are in 7th and 8th grade in rural primary schools belonging to two Pehuenche comunities from Valle del Queuco, in the city of Alto Biobío. To collect the phonological material, we applied a 64-item lexical list, which was complemented with the oral narration of a tale in Mapudungun. According to our data, we have been able to verify the existence of a series of phonic features in the Mapudungun spoken by Pewenche schoolchildren, which originate because of the influence of the Spanish phonological structure. However, the degree and spread of the transference phenomena develop in a heterogeneous way in both of the studied communities. due to the contact intensity, among other possible factors. (shrink)

El propósito de este estudio es analizar las estrategias discursivas utilizadas por la escritora argentina Luisa Valenzuela para denunciar el abuso y las violaciones a los derechos humanos perpetrados por las tiranías del cono sur americano entre 1970 y 1980. Mediante el análisis de Cambio de armas y Cola de Lagartija dentro del marco teórico de la dialogización del discurso, propuesto por Mikhail Bakhtin, se discute el uso de la polifonía y el silencio como estrategias para denunciar la dictadura como (...) fenómeno social y político en Argentina entre 1966 y 1982. The purpose of this study is to analyze the strategies used by, the Argentinian writer, Luisa Valenzuela to denounce the abuse and human rights violations by dictatorships in the Southern Cone. Through the analysis of Cambio de armas and Cola de lagartija, from a Bakhtinean dialogical discourse perspective, we discuss the use of polyphony and silence as discursive strategies used by Valenzuela to condemn Argentinian dictatorship and to portray the social and political impact of Argentinian dictatorship between 1966 and 1982. (shrink)

Social reality is configured and permanently re-configured from the meaning societies give to the world. From these meanings, people shape their social order; their ways of being, doing, represent in the world, organizing in this framework their daily lives. It is established as a social practice as far as it acquires enough roots, significance and objectification to give a transformative sense to its social actors and their environment. The purpose of this article is to question some perspectives from which social (...) practice has been set up, departing decisively from the functional dimension, showing the power of the concept of social practice in the human configuration as an expression of humanity from the social imaginary. The article analyses some trends in social practice, seeking to establish a synthesis as an expression of humanity; it confronts theories and support its proposal in the logic of social imaginary to overcome the practice as mere activity and place it as socio-historical and psychosomatic stage. La realidad social se configura y re-configura permanentemente a partir del sentido que las sociedades dan al mundo. Desde estas significaciones las personas configuran su orden social; sus formas de ser, hacer, representar en el mundo, organizando en este marco su vida cotidiana. Ella se establece como práctica social en la medida que adquiere el suficiente arraigo, significación y objetivación que les da un sentido transformador a sus actores sociales y su entorno. El objeto del presente artículo es abordar algunas perspectivas desde las cuales se ha configurado la práctica social, que se salen decididamente de la dimensión meramente funcional, y que evidencian la potencia de este concepto en la configuración de seres humanos como expresión de humanidad desde los imaginarios sociales. En el texto se propone un análisis de algunas tendencias de la práctica social buscando establecer una síntesis de consideraciones por las cuales esta adquiere una dimensión como expresión de humanidad; confronta teorías que la apoyan y soporta su propuesta en la lógica de los imaginarios sociales para superar la práctica como mera actividad y situarla como escenario socio-histórico y psicosomático. (shrink)

The INBIOSA project brings together a group of experts across many disciplines who believe that science requires a revolutionary transformative step in order to address many of the vexing challenges presented by the world. It is INBIOSA’s purpose to enable the focused collaboration of an interdisciplinary community of original thinkers. This paper sets out the case for support for this effort. The focus of the transformative research program proposal is biology-centric. We admit that biology to date has been more fact-oriented (...) and less theoretical than physics. However, the key leverageable idea is that careful extension of the science of living systems can be more effectively applied to some of our most vexing modern problems than the prevailing scheme, derived from abstractions in physics. While these have some universal application and demonstrate computational advantages, they are not theoretically mandated for the living. A new set of mathematical abstractions derived from biology can now be similarly extended. This is made possible by leveraging new formal tools to understand abstraction and enable computability. [The latter has a much expanded meaning in our context from the one known and used in computer science and biology today, that is "by rote algorithmic means", since it is not known if a living system is computable in this sense (Mossio et al., 2009).] Two major challenges constitute the effort. The first challenge is to design an original general system of abstractions within the biological domain. The initial issue is descriptive leading to the explanatory. There has not yet been a serious formal examination of the abstractions of the biological domain. What is used today is an amalgam; much is inherited from physics (via the bridging abstractions of chemistry) and there are many new abstractions from advances in mathematics (incentivized by the need for more capable computational analyses). Interspersed are abstractions, concepts and underlying assumptions “native” to biology and distinct from the mechanical language of physics and computation as we know them. A pressing agenda should be to single out the most concrete and at the same time the most fundamental process-units in biology and to recruit them into the descriptive domain. Therefore, the first challenge is to build a coherent formal system of abstractions and operations that is truly native to living systems. Nothing will be thrown away, but many common methods will be philosophically recast, just as in physics relativity subsumed and reinterpreted Newtonian mechanics. -/- This step is required because we need a comprehensible, formal system to apply in many domains. Emphasis should be placed on the distinction between multi-perspective analysis and synthesis and on what could be the basic terms or tools needed. The second challenge is relatively simple: the actual application of this set of biology-centric ways and means to cross-disciplinary problems. In its early stages, this will seem to be a “new science”. This White Paper sets out the case of continuing support of Information and Communication Technology (ICT) for transformative research in biology and information processing centered on paradigm changes in the epistemological, ontological, mathematical and computational bases of the science of living systems. Today, curiously, living systems cannot be said to be anything more than dissipative structures organized internally by genetic information. There is not anything substantially different from abiotic systems other than the empirical nature of their robustness. We believe that there are other new and unique properties and patterns comprehensible at this bio-logical level. The report lays out a fundamental set of approaches to articulate these properties and patterns, and is composed as follows. -/- Sections 1 through 4 (preamble, introduction, motivation and major biomathematical problems) are incipient. Section 5 describes the issues affecting Integral Biomathics and Section 6 -- the aspects of the Grand Challenge we face with this project. Section 7 contemplates the effort to formalize a General Theory of Living Systems (GTLS) from what we have today. The goal is to have a formal system, equivalent to that which exists in the physics community. Here we define how to perceive the role of time in biology. Section 8 describes the initial efforts to apply this general theory of living systems in many domains, with special emphasis on crossdisciplinary problems and multiple domains spanning both “hard” and “soft” sciences. The expected result is a coherent collection of integrated mathematical techniques. Section 9 discusses the first two test cases, project proposals, of our approach. They are designed to demonstrate the ability of our approach to address “wicked problems” which span across physics, chemistry, biology, societies and societal dynamics. The solutions require integrated measurable results at multiple levels known as “grand challenges” to existing methods. Finally, Section 10 adheres to an appeal for action, advocating the necessity for further long-term support of the INBIOSA program. -/- The report is concluded with preliminary non-exclusive list of challenging research themes to address, as well as required administrative actions. The efforts described in the ten sections of this White Paper will proceed concurrently. Collectively, they describe a program that can be managed and measured as it progresses. (shrink)

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)

Resumen Debido a la polisemia que la complejidad exhibe, se pretenden exponer las distintas posturas, definiciones, descripciones y debates acerca de esta, a la luz de lo descrito por Carlos Maldonado, Edgar Morin, Ilya Progogine, Murray Gell-Mann, Leonardo Rodríguez y Julio Aguirre, quienes comportan un principio dialógico y translúcido, que integraría la lógica clásica teniendo en cuenta sus límites de facto y de jure, que además llevaría en sí el principio de la Unitas Multiplex, que escapa a la unidad abstracta (...) por lo alto y por lo bajo. Luego de la presentación de las posturas de los autores mencionados se pasa a describir los encuentros y desencuentros que de estos aparecen sobre este concepto; y finalizar al proponer una definición y caracterización personal de la complejidad.Due to the polysemy of Complexity, it is intended to expose different postures, definitions, descriptions and debates about It, in the light of what was described by Carlos Maldonado, Edgar Morin, Ilya Prigogine, Murray Gell-Mann, Leonardo Rodríguez and Julio Aguirre. For them it implies a dialogical and translucent principle that would integrate classical logic considering its de facto and de jure limits, and that in addition would take in himself the principle of Unitas Multiplex that escapes to the abstract unity by the high and by the low. After the presentation of the positions of the mentioned authors the paper goes on to describe encounters and disagreements about this concept finally proposing a definition and characterization of complexity. (shrink)

Resumen Debido a la polisemia que la complejidad exhibe, se pretenden exponer las distintas posturas, definiciones, descripciones y debates acerca de esta, a la luz de lo descrito por Carlos Maldonado, Edgar Morin, Ilya Progogine, Murray Gell-Mann, Leonardo Rodríguez y Julio Aguirre, quienes comportan un principio dialógico y translúcido, que integraría la lógica clásica teniendo en cuenta sus límites de facto y de jure, que además llevaría en sí el principio de la Unitas Multiplex, que escapa a la unidad abstracta (...) por lo alto y por lo bajo. Luego de la presentación de las posturas de los autores mencionados se pasa a describir los encuentros y desencuentros que de estos aparecen sobre este concepto; y finalizar al proponer una definición y caracterización personal de la complejidad.Due to the polysemy of Complexity, it is intended to expose different postures, definitions, descriptions and debates about It, in the light of what was described by Carlos Maldonado, Edgar Morin, Ilya Prigogine, Murray Gell-Mann, Leonardo Rodríguez and Julio Aguirre. For them it implies a dialogical and translucent principle that would integrate classical logic considering its de facto and de jure limits, and that in addition would take in himself the principle of Unitas Multiplex that escapes to the abstract unity by the high and by the low. After the presentation of the positions of the mentioned authors the paper goes on to describe encounters and disagreements about this concept finally proposing a definition and characterization of complexity. (shrink)

Resumen Debido a la polisemia que la complejidad exhibe, se pretenden exponer las distintas posturas, definiciones, descripciones y debates acerca de esta, a la luz de lo descrito por Carlos Maldonado, Edgar Morin, Ilya Progogine, Murray Gell-Mann, Leonardo Rodríguez y Julio Aguirre, quienes comportan un principio dialógico y translúcido, que integraría la lógica clásica teniendo en cuenta sus límites de facto y de jure, que además llevaría en sí el principio de la Unitas Multiplex, que escapa a la unidad abstracta (...) por lo alto y por lo bajo. Luego de la presentación de las posturas de los autores mencionados se pasa a describir los encuentros y desencuentros que de estos aparecen sobre este concepto; y finalizar al proponer una definición y caracterización personal de la complejidad.Due to the polysemy of Complexity, it is intended to expose different postures, definitions, descriptions and debates about It, in the light of what was described by Carlos Maldonado, Edgar Morin, Ilya Prigogine, Murray Gell-Mann, Leonardo Rodríguez and Julio Aguirre. For them it implies a dialogical and translucent principle that would integrate classical logic considering its de facto and de jure limits, and that in addition would take in himself the principle of Unitas Multiplex that escapes to the abstract unity by the high and by the low. After the presentation of the positions of the mentioned authors the paper goes on to describe encounters and disagreements about this concept finally proposing a definition and characterization of complexity. (shrink)

Resumen Debido a la polisemia que la complejidad exhibe, se pretenden exponer las distintas posturas, definiciones, descripciones y debates acerca de esta, a la luz de lo descrito por Carlos Maldonado, Edgar Morin, Ilya Progogine, Murray Gell-Mann, Leonardo Rodríguez y Julio Aguirre, quienes comportan un principio dialógico y translúcido, que integraría la lógica clásica teniendo en cuenta sus límites de facto y de jure, que además llevaría en sí el principio de la Unitas Multiplex, que escapa a la unidad abstracta (...) por lo alto y por lo bajo. Luego de la presentación de las posturas de los autores mencionados se pasa a describir los encuentros y desencuentros que de estos aparecen sobre este concepto; y finalizar al proponer una definición y caracterización personal de la complejidad.Due to the polysemy of Complexity, it is intended to expose different postures, definitions, descriptions and debates about It, in the light of what was described by Carlos Maldonado, Edgar Morin, Ilya Prigogine, Murray Gell-Mann, Leonardo Rodríguez and Julio Aguirre. For them it implies a dialogical and translucent principle that would integrate classical logic considering its de facto and de jure limits, and that in addition would take in himself the principle of Unitas Multiplex that escapes to the abstract unity by the high and by the low. After the presentation of the positions of the mentioned authors the paper goes on to describe encounters and disagreements about this concept finally proposing a definition and characterization of complexity. (shrink)

Building upon the insights of scholars attuned to story, narrative, and myth, this article explores the relationship between myth, science, and religion. After clarifying the interplay of the three terms—story, narrative, and myth—and the preference for the term myth, this article will argue that myth can serve as a medium through which religion, neuroscience, and mental well‐being interact. Such an exploration will cover the role of myths in religion, the neurological basis of myth, and the practices of narrative psychology and (...) bibliotherapy. The article will conclude with suggestions for understanding and utilizing the relationship between myth and the scholarly study of the relationship between science and religion. This article ultimately suggests that myth can operate as a methodological aid to the science‐and‐religion field. (shrink)

This article is a response to Josh Reeves's recent book Against Methodology in Science and Religion: Recent Debates on Rationality and Theology that welcomes Reeves's proposal for an anti‐essentialist future for the field of science‐and‐religion, particularly because it has the potential to move the field beyond current, well‐worn methods: the dominance of Christian theology and doctrine, the importance of credibility strategies, and the dependence upon philosophical discourses. Reeves’ proposal has the potential to open the science‐and‐religion field to other topics, problems, (...) and methods, such as studying lived science‐and‐religion. One way of doing this is to study popular culture and its artifacts such as literature, which portrays a co‐mingling of religion and science at the level of day‐to‐day experiences and practices of characters. For at the level of lived experience, religion and science are not well‐defined disciplines neatly compartmentalized into separate academic departments. (shrink)

Climate change exacts a devastating toll on health that is rarely incorporated into the economic calculus of climate action. By aligning health and environmental policy and collaborating across borders, governments and industries can develop powerful initiatives to promote both environmental and human health.

BackgroundThis article aims to contribute to a better conceptualization of pain and suffering by providing non-essential and non-naturalistic definitions of both phenomena. Contributions of classical evidence-based medicine, the humanistic turn in medicine, as well as the phenomenology and narrative theories of suffering and pain, together with certain conceptions of the person beyond them are critically discussed with such purpose.MethodsA philosophical methodology is used, based on the review of existent literature on the topic and the argumentation in favor of what are (...) found as better definitions of suffering and pain.ResultsPain can be described in neurological terms but cognitive awareness, interpretation, behavioral dispositions, as well as cultural and educational factors have a decisive influence on pain perception. Suffering is proposed to be defined as an unpleasant or even anguishing experience, severely affecting a person at a psychophysical and existential level. Pain and suffering are considered unpleasant. However, the provided definitions neither include the idea that pain and suffering can attack and even destroy the self nor the idea that they can constructively expand the self; both perspectives can b e equally useful for managing pain and suffering, but they are not defining features of the same. Including the existential dimension in the definition of suffering highlights the relevance of suffering in life and its effect on one’s own attachment to the world. An understanding of pain and suffering life experiences is proposed, meaning that they are considered aspects of a person’s life, and the self is the ever-changing sum of these experiences.ConclusionsThe provided definitions will be useful to the identification of pain and suffering, to the discussion of how to relieve them, and to a better understanding of how they are expressed and experienced. They lay the groundwork for further research in all these areas, with the twofold aim of a) avoiding epistemological mistakes and moral injustices, and b) highlighting the limitations of medicine in the treatment of suffering and pain. (shrink)

Current methods of obtaining an informed consent leave much to be desired. Patients rarely read consent forms or understand all of the risks, benefits, or alternatives associated with their treatment. Evaluating the advantages and disadvantages of treatment options often presents a more significant challenge for patients with lower levels of health literacy. This article reviews the evidence of shortcomings in our informed consent system and then explores the potential for a new approach to engage patients at all levels of health (...) literacy in their treatment decisions. Specifically, the article will examine the potential of shared decision-making to bridge gaps in knowledge, increase patient adherence to treatment, and improve health outcomes in low health literacy patient populations. Leveling barriers to treatment information for disadvantaged populations should be a public health imperative, especially if it can be shown to improve health outcomes and reduce health disparities. (shrink)

Current methods of obtaining an informed consent leave much to be desired. Patients rarely read consent forms or understand all of the risks, benefits, or alternatives associated with their treatment. Evaluating the advantages and disadvantages of treatment options often presents a more significant challenge for patients with lower levels of health literacy. This article reviews the evidence of shortcomings in our informed consent system and then explores the potential for a new approach to engage patients at all levels of health (...) literacy in their treatment decisions. Specifically, the article will examine the potential of shared decision-making to bridge gaps in knowledge, increase patient adherence to treatment, and improve health outcomes in low health literacy patient populations. Leveling barriers to treatment information for disadvantaged populations should be a public health imperative, especially if it can be shown to improve health outcomes and reduce health disparities. (shrink)

The present study focuses on a grammatical category called evidentiality. The primary meaning of evidentiality is concerned with information source. That is, it expresses whether something has been seen, heard or inferred. The aim here is to conduct a conceptual study of evidentiality in which use is made of formal tools. The fundamental intuition is that the distinction between ‘evidence’as ‘proof’and ‘evidentiality’as ‘to do with proof’is a crucial one. Evidentiality is a dynamic notion to be analysed through the use of (...) knowledge by the agents, a knowledge in action, which involves an in-coming state and an out-coming state that is typical of the transmission of information. We propose our own approach in which the dynamics of knowledge in action is grasped in the context of a dynamic epistemic logic. (shrink)

Several aspects of the personality, thought and work of Don Vasco de Quiroga are known today, but a deeper awareness of his legal thinking would enable us to understand better the motives for his actions in New Spain and the Michoacán region. In order to do this we need to place him in the conceptual, institutional and legal context in which he was educated and where he developed throughout his life. Well versed in the different legal systems in use at (...) the time, he absorbed Roman laws, which he respected as the work of esteemed scholars, while at the same time basing his evangelical mission in Mexico on the canons of the Church. And the legal system that was to govern the villages he created according to a new model would be based on custom coming from the grassroots. (shrink)

The American Journal of Bioethics, Volume 12, Issue 7, Page 32-33, July 2012.

Quadruple Helix Collaborations (QHCs) is a cooperation model in which industry, government, academia, and the public interact to innovate. This paper analyses the impact of a training intervention to provide specific knowledge, skills, and attitudes to deal with barriers commonly found in the progress of QHCs. We designed, implemented, and evaluated three training programs in Austrian, Colombian, Danish, and Spanish institutions. We analysed trainees’ (n = 66) and trainers’ (n = 9) perceptions to identify the competencies acquired with the intervention (...) and the approach’s limitations. We used online questionnaires (35 trainees; 9 trainers), semi-structured interviews (10 trainees), and a focus group (6 trainers). Trainees answered positively regarding their self-perception about the impact of the course and highlighted the acquisition of inspiration for their practice (score 4.1 out of 5.0) and knowledge (3.7). In contrast, they perceived that a deeper interaction with other participants (2.7) was challenging. After the courses, 74% of respondents indicated that they know more about how QHCs work in practice, and 86% about collaboration or engagement methods. Moreover, participants plan to be more sensitive towards setting common goals (71%) and power imbalances (63%). Trainers’ perceptions align with those expressed by participants, except that they considered that the interaction amongst participants during the course was higher. Qualitative analysis of interviews with participants and the focus group with trainers provides more detail about the strengths and weaknesses of the intervention. Our study shows that the collaborative design and implementation of training impact the participant’s learning competencies, with potential implications in their medium- to long-term practice. (shrink)

Mirativity is a grammatical category or a linguistic strategy that makes explicit the surprising aspect of a piece of information. Different mirativity strategies appear in different languages. Evidentiality is a grammatical category that explicitly expresses the source of information, i.e. if something has been seen, heard or inferred. Whether mirativity forms part of evidentiality is an open question. An agent makes use of a mirativity marker when she or he expresses something about a surprising fact with respect to her or (...) his background knowledge. But there are different kinds of mirativity markers. Some of them are simple and direct and others, more complex, involve inferential processes. Here, we focus on complex mirativity and we compare it with inferred evidentials and deferred realizations. Our proposal goes beyond the purely linguistic analysis, since we try to interpret mirativity, and its role in interaction, as forming part of or involving a particular kind of inference, namely abduction. Mirativity can be used to express the surprising state that triggers an abductive reasoning but it can also encapsulate its result in such a way that it can be understood in relation to evidentiality. Thus, at least in some cases of complex mirativity, mirativity may convey indication about the source of information. Interesting for studies on dialogue is that they also indicate the degree of commitment of the speakers with the content of their own utterances. (shrink)

The role of academic satisfaction on persistence and successful academic behavior has been the focus of research for decades. Nevertheless, driven by positive educational psychology, subjective well-being has been highlighted as another central feature in the academic path of students. Studies aimed at identifying the variables that contribute to explain different aspects of academic performance have been widely investigated, although studies aimed at identifying the determinants of subjective well-being are still limited. The present paper examined the contribution of AS judgments (...) on subjective well-being. To this end, it was hypothesized that SWB levels depend on the balance between positive/negative emotions and life satisfaction judgments. Furthermore, it was stipulated that AS has an indirect contribution on SWB, through life satisfaction, whereas the balance of emotions influences both AS judgments and life satisfaction. Using an analysis strategy based on structural equation modeling, the results indicated that the model fitted satisfactorily, explaining 32% of the variance of SWB. Particularly, it was observed that AS judgments contributed to life satisfaction judgments. Although no direct contribution of AS on SWB was reported, a total contribution partially mediated by life satisfaction judgments was revealed. These findings support the importance of academic satisfaction judgments, not only because of their importance in academic terms, but also because of their impact on university students’ subjective well-being and health. (shrink)

Ciencias sociales : saberes coloniales y eurocéntricos / Edgardo Lander / - Europa modernidad y eurocentrismo / Enrique Dussel / - La colonialidad a lo largo y a lo ancho : el hemisferio occidental en el horizonte colonial de la modernidad / Walter D. Mignolo / - Naturaleza del poscolonialismo : del eurocentrismo al globocentrismo / Fernando Coronil / - El lugar de la naturaleza y la naturaleza del lugar : ¿globalización o postdesarrollo? / Arturo Escobar / - Ciencias sociales, (...) violencia epistémica y el problema de la invención del otro / Santiago Castro-Gómez / - Superar la exclusión, conquistar la equidad : reformas, políticas y capacidades en el ámbito social / Alejandro Moreno / - Abrir, impensar, y redimesionar las ciencias sociales en América Latina y el Caribe. ¿Es posible una ciencia social no eurocéntrica en nuestra región? / Francisco López Segrera / - Colonialidad del poder, eurocentrismo y América Latina / Aníbal Quijano. (shrink)

In a recent opinion paper, it was argued that individuals with multiple retractions or a record of academic misconduct should not serve as editors, including as editors-in-chief, on the editorial boards of scholarly or academic journals. As a first step towards appreciating how such a policy could be applied in practice, the presence of 30 individuals listed on the Retraction Watch Leaderboard on editorial boards was screened. Six cases are highlighted to gain an appreciation of the potential reputational risks that (...) journals and publishers might incur by including individuals with a tainted academic record on editorial boards. Given the reputational, legal and other risks associated with this type of assessment and decision, more formal positioning and guidance are needed by global ethics policy-related bodies such as COPE, the ICMJE, and the CSE, even more so in journals that claim to follow these organizations’ ethical guidelines. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:To Nurse BetterJaime HenselWhen things were quiet again I asked him what training he’d had to become the director of hospital security. “I worked for 20 years in corrections,” he answered proudly, and I was saddened but not surprised.In September 2010 I started an accelerated graduate entry nurse practitioner program to become a family nurse practitioner. Accelerated programs leave little time for preamble, since the idea is to take (...) a total novice and turn her first into a nurse and then into a nurse practitioner in just three years. While the classroom information was vital, it was our clinical experiences that really initiated us into the profession. In just the second week of school, we were divided into small groups and assigned to clinical preceptors—hands–on teachers who introduced us to our first patients, curbed our mistakes, quelled our fears, and pushed and pulled and cajoled us into being nascent healthcare providers. In showing us how to give bed baths, suction secretions, insert Foley catheters, and hang IV bags, our preceptors really began showing us how to use our hands as healers.In that first semester my patients also proved to be invaluable instructors. Talking to them, administering their medication, washing their bodies made me keenly aware of the delicate balance of vulnerability and power and trust and respect and intimacy that underlies all healthcare relationships. I hope, wherever those patients are now, they know how deeply I appreciate their patience and good humor and their collusion in my education.In December, the first semester and the first clinical rotations ended. Four months into nursing school I had a basic understanding of what it means to be a nurse. Frankly, most days I still felt like an impostor in blue pajamas sporting a stethoscope I didn’t really know how to use and new Dansko clogs that squeaked with every step. But in an accelerated program, fast and furious is the name of the game. We went away for winter break—a much needed breather—and came back to something completely different: psychiatric nursing.In preparation for these new clinicals, we were taught in class that we should not wear dangly jewelry or stethoscopes. That we should never let the patient get between us and the door. That psychiatric (psych) patients could escalate quickly; psych patients could have surprising triggers; psych patients could be very unpredictable. And psych patients could be violent. We were taught about physical and chemical restraints, and about show of force. We were cautioned, as students, to stay out of the way if things got tense on the floor. In stark contrast to medical patients, psych patients were made to sound less like people who had diseases and more like adversaries. I drove to my first day on the floor with trepidation.My new preceptor had spent her entire career in psych. She loved her job, loved the care of psychiatric patients. She set up a rotation because she wanted our entire clinical group to get full exposure to the breadth of psychiatric services offered by this medium–sized community hospital. We would each get to spend shifts on the locked psych floor, observing outpatient group therapy sessions, and in the psych emergency department (ED).I rotated to the psych ED for the first time on a Friday night. The first couple hours of the shift were very slow. I started talking to the mustachioed guard on duty, who looked as bored as I felt. He told me about his kids, I told him about nursing school. He seemed nice.When our conversation flagged, I explored the psych ED. It didn’t take long—just a short hallway with a bathroom, the social workers’ office, and two patient rooms without doors. The majority of the designated psych beds were actually around the corner in the main room of the medical ED—stretchers lined against the wall, without curtains or any [End Page 98] other attempt at privacy. I noticed that from where the guard stood at the corner of the psych hall he had a pretty good view of all the beds. Then again, so did most of the other patients... (shrink)

Recognizing that GLBTI individuals are often barred from visiting their partners in hospitals or from acting as health care surrogates for incapacitated partners, President Obama directed the Department of Health and Human Services to address these issues. In response, the department amended its rules to prohibit hospitals from restricting, limiting, or denying visitation privileges on the basis of gender identity or sexual orientation. But the changes do not affect the designation of a health care surrogate, a matter largely governed by (...) state law. Therefore, subject to state law, same-sex partners can still be legally barred from making health care decisions for their incapacitated partners, and it remains essential that they execute advance directives and appoint one another as their health care proxies. (shrink)

Desde la antigüedad la reflexión sobre la imagen del arte se ha erigido como una de las tareas de la filosofía, más aun, desde el arte la filosofía ha tratado temas de gran relevancia para sí misma, como la imitación y el conocimiento, luego la imaginación, el juicio, la verdad, la interpretación. La fotografía surgió como un medio de hacer imágenes que cuestionó los principios fundamentales del arte, su relación con la naturaleza, la tradicional forma de hacer imágenes hasta entonces (...) conocida; puso además en tela de juicio los temas de la representación o géneros establecidos, pero también el arte cuestionó la incursión del nuevo medio en su dominio. (shrink)