Este artículo está basado en un metaanálisis sobre la producción bibliográfica, nacionale internacional, referida al clima institucional en los institutos educativos y surelación con el desempeño laboral de los docentes, en los últimos años (2015-2022).Se ha llevado a cabo una revisión sistemática según las directrices PRISMA. La búsquedase llevó a cabo en las bases de datos Web of Science, EBSCO, Scopus y en el sitioweb Scholar Google. Los análisis metaanalíticos se realizaron a través del softwaregratuito JAMOVI y los complementos del (...) programa MAJOR y ESCI. (shrink)

To verify the occurrence of a singular instance of testimonial injustice three facts must be established. The first is whether the hearer in fact has an identity prejudice of which she may or may not be aware; the second is whether that prejudice was in fact the cause of the unjustified credibility deficit; and the third is whether there was in fact a credibility deficit in the testimonial exchange. These three elements constitute the facts of the matter of testimonial injustice. (...) In this essay we argue that none of these facts can be established with any degree of confidence, and therefore that testimonial injustice is an undetectable phenomenon in singular instances. Our intention is not to undermine the idea of testimonial injustice, but rather to set limits to what can be justifiably asserted about it. According to our argument, although there are insufficient reasons to identify individual acts of testimonial injustice, it is possible to recognize recurrent patterns of epistemic responses to speakers who belong to specific social groups. General testimonial injustice can thus be characterized as a behavioral tendency of a prejudiced hearer. (shrink)

We describe the informed consent procedures in a research clinic in Santiago, Chile, and a qualitative study that evaluated these procedures. The recruitment process involves information, counseling and screening of volunteers, and three or four visits to the clinic. The study explored the decision‐making process of women participating in contraceptive trials through 36 interviews. Women understood the research as experimentation or progress. The decision to participate was facilitated by the information provided; time to consider it and to discuss it with (...) partners or relatives; and perceived benefits such as quality of care, non‐cost provision of methods and medical care. For some women, participation was an opportunity to express altruism. The main obstacles for participation were perceived side effects or risks. The final risk‐benefit balance was strongly influenced by women’s needs. Women perceived that the consent form benefited the clinic, proving that participants had made a free decision, and benefited the volunteers by warranting their right to free medical care. The most important problem detected was occasional misunderstanding of the information given on the form. We concluded that a full decision‐making process enhances women’s ability to exercise their right to choose, and assures research institutions that trials are conducted without coercion and that the participants are committed to the study. Researchers have the responsibility of conducting this process. (shrink)

Psychologists, as well as other mental health professionals, face unique demands in the workplace that create increased risk for burnout. This article discusses burnout prevalence and detection, including issues of complexity regarding diagnosis and assessment. An ethical lens is utilized to explore problems that may arise due to burnout, and the ethical responsibility of practicing self-care. Recommendations for graduate clinical training programs as well as practicing professionals are suggested, including strategies for monitoring self and others for warning signs of burnout (...) and implementing self-care. (shrink)

In the present study, we investigated the effects of selective attention at encoding on conceptual object priming (Experiment 1) and old-new recognition memory (Experiment 2) tasks in young and older adults. The procedures of both experiments included encoding and memory test phases separated by a short delay. At encoding, the picture outlines of two familiar objects, one in blue and the other in green, were presented to the left and to the right of fixation. In Experiment 1, participants were instructed (...) to attend to the picture outline of a certain color and to classify the object as natural or artificial. After a short delay, participants performed a natural/ artificial speeded conceptual classification task with repeated attended, repeated unattended and new pictures. In Experiment 2, participants at encoding memorized the attended pictures and classified them as natural or artificial. After the encoding phase, they performed an old-new recognition memory task. Consistent with previous findings with perceptual priming tasks, we found that conceptual object priming, like explicit memory, required attention at encoding. Significant priming was obtained in both age groups, but only for those pictures that were attended at encoding. Although older adults were slower than young adults, both groups showed facilitation for attended pictures. In line with previous studies, young adults had better recognition memory than older adults. (shrink)

Elizabeth Anker y Bernardette Meyler, profesoras de literatura y de derecho respectivamente, involucradas ambas en los últimos años con el movimiento “derecho y literatura”, editan en 2017 New Directions in Law and Literature.

Customer orientation and the development of long-term relationships with customers are known conditions for growth and profit sustainability. Businesses use special treatments, inducements, and personal gestures to show their appreciation to customers. However, there are concerns about whether these inducements really create the right perceptions in customer’s mind. This study suggests that when customers believe that the firm is ethical, the inducements and special treatments received are seen in a positive light and can help develop loyalty. The hypotheses were tested (...) with responses from 299 customers of financial institutions in Chile. Results support the hypotheses that firm’s ethical reputation helps in retaining customers. Managerial implications are provided. (shrink)

A 50 años del golpe de Estado: reflexiones sobre la revolución y la historia reciente desde la militancia.

Resumen: El artículo busca observar el hecho religioso mapuche, a partir de la reflexión de Rudolf Otto respecto de lo numinoso y lo santo. Para ello se utiliza su metodología de análisis fenomenológico aplicada a los conceptos de mysterium, tremendum y fascinans o las dimensiones del temor, incorporadas en la cultura mapuche. Se concluye que el análisis de estos diversos momentos de la experiencia santo-numinoso en la vida religiosa del mapuche, permite constatar el dinamismo existente en la idea religiosa del (...) mapuche, lo que a su vez representa adecuadamente la relación entre el hombre religioso y lo santo.: This article seeks to observe the Mapuche religious fact, starting from Rudolf Otto’s reflection on the numinous and the holy. For this, it uses its methodology of phenomenological analysis applied to the concepts of mysterium, tremendum and fascinans or the dimensions of fear, incorporated in the Mapuche culture. It is concluded that the analysis of these different moments of the saint-numinous experience in the religious life of the mapuche, allows to verify the dynamism existing in the religious idea of ​​the mapuche, which in turn represents adequately the relationship between religious man and the Holy. (shrink)

Context: Despite the fact that pain and body awareness are by definition subjective experiences, most studies assessing these phenomena and the relationship between them have done so from a “third-person” perspective, meaning that they have used methods whose aim is to try to objectify the phenomena under study. Problem: This article assesses the question of what is the impact of a widespread chronic pain condition in the bodily experience of persons suffering from fibromyalgia. Method: I used an interview methodology stemming (...) from a phenomenological approach called the “elicitation interview.” Results: The results indicate that the intensification of fibromyalgia pain does in fact affect different aspects of body awareness: in particular, experienced body size, weight and localization, as well as the experience of owning one’s own body. In addition, these disruptions in patient’s body awareness have as a result, a modification of the experience of pain, leading to the apparently paradoxical experience of being in pain while not feeling it. Implications: The elicitation interview approach made it possible to gather and analyze descriptions of the bodily experience of persons suffering from fibromyalgia. This approach allowed the consideration of the hypothesis that the disruption of implicit knowledge of the topography of patients’ bodies prevents them from referring to the pain sensation in terms of its localization and intensity, transforming the sensation in a way that is experienced as paradoxical. Further studies should be conducted that focus on the interplay between attention, pain and body perception. Constructivist content: The study presented in this article is framed within the perspective that the study of conscious phenomena should consider a first-person perspective, which is in line with constructivist approaches. (shrink)

Most decision-making research in economics focuses on individual decisions. Yet, we know, from psychological research in particular, that individual preferences can be sensitive to social pressures. In this paper, we study the impact of a group environment on individual preferences for risky and ambiguous prospects. In our experiment, each participant was invited to make a series of lottery-choice decisions in two different conditions. In the Alone condition, individuals made private choices, whereas in the Group condition, individuals belonged to a three-person (...) group and group members’ choices were aggregated according to either a majority or unanimity rule. This design allows us to study the impact of a group environment on individuals’ attitude towards both risky and ambiguous prospects, while controlling for the decision rule used in the group. Our experimental results show that when individuals are in the Group condition, they tend to be less risk averse and more ambiguity averse than when they are not part of a group. Our experiment also suggests that the decision rule matters as it shows that these two trends tend to be stronger when the group implements a unanimity rule. Specifically, we found that individuals who belong to a group implementing a unanimity rule are significantly less risk averse than individuals who belong to a group that relies on the majority rule. We obtained a similar—but non-significant—result under ambiguity. (shrink)

Decentralized biobanking “de-bi” applies blockchain technology and web3 values to embed the procedural principles of transparency, accountability, and inclusion into the biomedical research ecosyst...

El artículo analiza el rol que cumple la confianza en la construcción de la realidad social, argumentando que constituye uno de sus componentes esenciales. Lo es porque hace posible el nacimiento, permanencia y reconocimiento colectivo de las instituciones, así como su iteración y organización en subsistemas.

En este artículo, nos preguntamos si es pertinente un análisis del personaje de Medea de Eurípides, y más concretamente, de su filicidio, a la luz de la doctrina aristotélica de la acción. Resulta dudoso, y quizás equívoco, hablar de "responsabilidad" (en sentido aristotélico) en el caso de la heroína, ya que sus motivaciones, como las de todo héroe trágico, tienen un doble signo: enfrentado a una ἀνάγκη superior, también desea lo que está forzado a hacer. Además, Medea no es una (...) mujer común: es un personaje ontológicamente complejo que participa, más de lo que frecuentemente se ha enfatizado, del plano divino. In this article we wonder if it is pertinent to analyse the character of Euripides' Medea and, more precisely, her filicide, in the light of Aristotle's doctrine of action. With regard to the heroine, it is doubtful and perhaps confusing to talk about "responsibility" (in Aristotelian terms) because her motivations, as all tragic heroes', are two-sided: faced to a superior ἀνάγκη he wants what he is forced to do as well. In addition, Medea is not an ordinary woman: she is an ontologically complex character that has a share in the divine level, a share which is more crucial than what has usually been emphasized. (shrink)

Conscience – a catholic anthropological vision In the catholic tradition conscience always played an important role as visible in the ‘clausula Petri’ (Ac 5,30-33) or in Paul’s belief in its wisdom (Rm 2,14-16). Conscience can break rules (‘epikeia’), but should not stand up against the church as such. Luther’s historical deed left behind a distrust in conscience in the Catholic Church; it took 400 years to restore Paul’s vision of the conscience as the highest authority – if it is formed (...) and reaches the state of maturity. By his conscience, man is called to be as God created him; he is called by others to develop and to respect their dignity. He is also called by the world to form it according to its higher possibilities which cannot be realized but by man. Conscience is God’s voice in the person where his promises can be heard. Though conscience is free, it is the place where responsibility is formed according to what someone can and should do. This is why the conscience will keep its unavoidable and undeniable role – even in a postmodern context. (shrink)

Se ha tratado de desprestigiar al postmodernismo y no se ha valorado su gran contribución a la cultura universal. El postmodernismo empieza a desarrollarse cuando el ser humano se da cuenta que no tan solo sus órganos de los sentidos pueden engañarlo, sino que también su intelecto, razón y sus facultades superiores más preciadas. Las caídas del positivismo y del racionalismo le abrieron la puerta, apoyado por la insuficiencia de la ciencia y la filosofía para entender el universo. La nomología (...) (legalidad) ha tenido que resignarse frente a la ideografía (procesos irrepetibles e irreversibles) para entender el desarrollo universal. La antinomia del mentiroso, el teorema de Gödel, los procesos caóticos, la impredecibilidad, la incertidumbre, son parte de sus elementos sustantivos. El postmodernismo ha condenado a los ideologismos nomológicos o raciales que terminaron en las masacres de la Revolución Francesa, el Nazismo y las dos Guerras Mundiales, entre otros. (shrink)

La denominada “crisis ambiental” que advierte sobre los límites materiales del planeta ha dado lugar a una extensa producción teórica durante décadas. Producción que, como regla general, ha relegado la relectura de los textos clásicos de las ciencias sociales. El presente artículo rescata algunos debates contemporáneos relacionados con la lectura en clave ecológica de la obra de Marx. Obra que adquiere especial importancia al momento de comprender las formas que toma la explotación de la naturaleza bajo el sistema capitalista, problemática (...) resignificada en el marco de las discusiones actuales sobre sustentabilidad ambiental. (shrink)

El campo de las ciencias de la salud se encuentra actualmente en constante cambio y esta condición ha sido más acentuada en la última década ya que nuevas enfermedades, como el SARS-CoV-2, forzaron a la ciencia a evolucionar y pusieron a prueba el componente ético del personal de la salud, despertando un interés especial en la bioética y la ética médica.

This paper deals with one of the first attempts to measure simple reactions in humans. The Swiss astronomer Adolph Hirsch investigated personal differences in the speed of sensory transmission in order to achieve accuracy in astronomy. His controversial results, however, started an intense debate among both physiologists and astronomers who disagreed on the nature of these differences. Were they due to different eyes or brains, or to differences in skill and education? Furthermore, they debated how to eliminate them. Some, for (...) example, wanted to eliminate the observer, and prescribed the use of new technologies like the electro-chronograph or photography, while others believed in discipline and education. By debating the nature of these differences, astronomers and physiologists sketched both different conceptions of ‘man’ and different paths to objectivity. These diverse conceptions, moreover, were tied to current nineteenth-century debates, such as the benefits or disadvantages of railroads, telegraphy and the standardization of time and longitudes. By focusing on the debates surrounding the speed of sensory transmission, this paper reevaluates the history of astronomy, physiology and experimental psychology. Furthermore, in investigating astronomy's relation to the human sciences, it uncovers profound connections in the traditionally separate histories of objectivity and the body.L'heure sera distribuée dans les maisons,comme l'eau ou le gaz.Adolph Hirsch. (shrink)

ArgumentIn 1895 when the Lumière brothers unveiled their cinematographic camera, many scientists were elated. Scientists hoped that the machine would fulfill a desire that had driven research for nearly half a century: that of capturing the world in its own image. But their elation was surprisingly short-lived, and many researchers quickly distanced themselves from the new medium. The cinematographic camera was soon split into two machines, one for recording and one for projecting, enabling it to further escape from the laboratory. (...) The philosopher Henri Bergson joined scientists, such as Etienne-Jules Marey, who found problems with the new cinematographic order. Those who had worked to make the dream come true found that their efforts had been subverted. This essay focuses on the desire to build a cinematographic camera, with the purpose of elucidating how dreams and reality mix in the development of science and technology. It is about desired machines and their often unexpected results. The interplay between what “is” (the technical), what “ought” (the ethical), and what “could” be (the fantastical) drives scientific research. (shrink)

This paper seeks to find possibilities forreconciliation of the implementation of theprecautionary principle and the promotion ofinternational trade of genetically modified organisms,based on the assumption that a sustainabledevelopment is a right objective to strive for. Itstarts with an explanation of the background and therole of the precautionary principle, and describes inwhat way measures based on the precautionary principlecan easily lead to the creation of trade barriers. Thearticle then examines to what extent the WTO (WorldTrade Organisation) Agreements allow theimplementation of the (...) precautionary principle. Inaddition, structural conflicts between the perceptionof the precautionary principle and the concept oftrade liberalisation will be evoked. The last sectionof the paper analyses to what extent the WTO rulesprovide possibilities to avoid or solve theseconflicts in order to attempt to answer the mainquestion: are the precautionary principle and theinternational trade of genetically modified organismsreconcilable? (shrink)

This article analyzes the migrant caravans as a strategy of resistance to the war against migrants in transit to the United States, exacerbated during the pandemic. This is the edited transcript of an interview conducted with Honduran journalist Inmer Gerardo Chevez, correspondent of Radio Progreso. Having travelled the Central American and Mexican routes accompanying on foot the transit of thousands of migrants since 2018, Chevez is a notable eyewitness and expert in situ of the Caravans. The interview confirms that the (...) caravan has become one of the premier forms in which Latin American migrants, including agricultural workers, struggle and their spatial dispute with the heterogeneous border control regime of the Americas are materialized. The text also reflects on the role that photography and critical journalism can play in the face of the contemporary anti-migrant policy turn. We conclude with an interpretation of the effects that the militarized violence against Latin American migrants in transit to the United States is having across the region. (shrink)

Academics are confronted with multiple and conflicting narratives as to what it is to be an academic. Their identities, however, are not entirely of their own making. Through a qualitative study, and deploying a social realist perspective, this paper analyses academic identities in Chile and attempts to locate the patterns of identity in the context of a marketised higher education system. The data were collected in both a state and a private university. The results suggest that distinct kinds of fragilities (...) may be emerging among Chilean academics (ontological and contractual fragilities). These two fragilities can be traced to the attendant structures of the university system at an institutional level (reputational fragility in the public sector and a branding fragility in the private sector). The paper concludes by observing that, although the power of the structures is considerable, there are still spaces for agentic responses. (shrink)

Disparities in maternal morbidity and mortality for Latinx populations are a paradigmatic example of the now widely acknowledged structural racism in U.S. health care that predisposed minorities to...

In lieu of an abstract, here is a brief excerpt of the content:Respire, Con-spireMarielle Macé (bio)Translated by Alexis Ann StanleyA rather suffocating atmosphere is becoming our customary environment, ecologically, politically, and socially. It is time to affirm "a universal right to breathe"–what Achille Mbembe called the essential demand for justice that escalated during the age of the Anthropocene and is now crudely reemerging in the current pandemic's attack on the respiratory system.But the right to breathe is not "merely" the right (...) to live, to breathe in unpolluted spaces, or to share clean air; it is also the right to a breathable life, a life worth caring for. It is the right to love life, life with and among one another: the right to fraternize in and through breath, the right to detoxify our relationships and breathe with others. To respire with: to con-spire.Because in order to breathe, one needs air, but one especially needs other living beings, a world and landscapes with which to breathe, in which to breathe, and which can breathe through us. To breathe is not only to maintain one's own breath or nourish one's own organic system as if it lived an unconnected life; it is to acquiesce to the world, to the fact that there is a world—this one, precisely—and to participate in it. A person who breathes, in fact, partakes both in and of the world. Moreover, they make a gift to it, contributing to the way of the world in its entirety by a breath that tightly holds the ties binding each of our bodies to the current state of the living._______The lack of air, the feeling of a stifling age, even the fear of overwhelming suffocation—such is our current "natural" condition, the primary characteristic not only of our virtually toxic living environment, but also of our smothering, asphyxiating political condition wrought with violence and discrimination. Such also is the state of our social condition—the way we (rather poorly) create community—or rather, of our distinct social conditions. For there is a very inequitable distribution of the right to air or to breathe determined by which lives "count" and which do not.The Anthropocene is perhaps the age of a new respiratory 'condition.' Toxic fumes, pestilential odors, extensive carbon consumption, agro-chemical [End Page 177] discharge, microparticles, deforestation and soil asphyxiation, radioactive clouds with phantom trajectories and invisible powers of penetration… the history of industrial modernity is that of "the continuous and large-scale alteration of life's atmospheric conditions" (Zimmer 25). Recently, wildfires affecting America and Europe have been adding their horrifying fumes to century-old pollution. Even clouds ("the clouds up there, the marvelous clouds" of Baudelaire) are being targeted: China recently announced the country's intention to accelerate its cloud seeding program1 (in 2008, over one thousand shells loaded with silver iodide were dispersed in order to clear the skies of Beijing and prevent rain from ruining the opening ceremony of the Olympic games. This technique is also used more and more frequently to generate rainfall and avoid agricultural droughts. This type of 'sky colonization' or climate militarization is a profanation of language as much as of nature: to "sow the clouds" (or "grow meat")—even language tells us something is wrong…)It took a great amount of time and much denial before widespread bodily infection and industrial pollution's public health effects could be recognized. Industrialists may object (at times with doctors), but in the most working-class regions, bodies know: "lungs and our sense of smell protest in their own way against any conclusive evidence which would exonerate factories" (Zimmer 23).The history of pollution is, in fact, also a question of exploitation as well as a social history: that of the unequal distribution of air and the inequitable exposure (depending on one's living milieux) to what is oppressive, stifling—in a word, unbreathable. Unsanitary housing, proximity to mines or factories, and lack of access to healthcare are always factors; respiratory diseases are the most prevalent of occupational illnesses2; and the staggering surge in childhood lead poisoning in the very heart of our capitals—the weakest of bodies have... (shrink)

Por supuesto se expresa como quien conoce muy bien los términos jurídicos pero con la habilidad de no abrumar al interlocutor. Inspira confianza. Es una mujer grande que mira directamente a los ojos y sonríe casi siempre. Escucha con atención y acierta a comunicar desde la propia experiencia no ya de brillante profesional de la judicatura, sino de mujer, madre, compañera� Enseguida hemos pasado del usted al tú�.

Resumen: Durante la Reconquista de Alberto Blest Gana puede ser leída como una novela en donde el secreto y el poder se entrelazan de manera profundamente significativa. Esta interrelación se constituye en el soporte de la narración, en cuyo desarrollo se entretejen los acontecimientos históricos, las intrigas amorosas y la descripción de costumbres sociales. En el despliegue de la novela hallamos inscritas las preocupaciones políticas y éticas de su autor.: Durante la Reconquista by Alberto Blest Gana can be read as (...) a novel in which a secret and power are intertwined in a profoundly significant manner. This interrelationship is constituted in the narrative support, in which the development of historical events, amorous intrigues and social customs are all interwoven. In the unfolding of the novel we can find the inscription of the political and ethical concerns of the author. (shrink)

Durante la Reconquista de Alberto Blest Gana puede ser leída como una novela en donde el secreto y el poder se entrelazan de manera profundamente significativa. Esta interrelación se constituye en el soporte de la narración, en cuyo desarrollo se entretejen los acontecimientos históricos, las intrigas amorosas y la descripción de costumbres sociales. En el despliegue de la novela hallamos inscritas las preocupaciones políticas y éticas de su autor.

Dice Kant que la locura no consiste en un desarreglo de la razón. No es que el loco razone incorrectamente, sino que su razonamiento opera desde otros presupuestos diferentes y se aplica a otros datos, pero sus principios siguen siendo los mismos. La oposición de Kant a todo innatismo le lleva, entre otras cosas, a hablar de usos más que de contenidos de la razón. Y entre esos usos están los de la razón científica, los del entusiasmo revolucionario, los del (...) fanatismo y también los de la locura. La psicología moderna ha dejado de lado toda la reflexión kantiana acerca de la psicopatología que, aunque fragmentaria y asistemática, aún puede proporcionar consecuencias interesantes en este terreno. Vamos, pues, a analizar alguno de los rasgos de este uso de la razón que genéricamente se ha llamado locura y que cobran una especial relevancia desde las críticas que desde hace ya unos 50 años se le han venido haciendo a una cierta medicalización de la psicología. Este análisis habrá de remitirnos irremediablemente al problema de la constitución de la subjetividad y tendremos que enfrentarnos al nuevo concepto de sujeto que Kant propone a la filosofía y que todavía, en mi opinión, dos siglos y medio después, no hemos acabado de entender. Sean, pues, estas reflexiones una modesta contribución también a este entendimiento. (shrink)

The objective of this study is to determine the contribution made by knowledge of letters, phonological awareness, phonological memory, and alphanumeric and non-alphanumeric rapid automatized naming at the ages of six and seven to the ability of Spanish children to read words at 7 years of age. A total of 116 Spanish-speaking school children took part in the study, from schools located in an average socio-cultural setting, without special educational needs. The reading ability of these pupils was evaluated at the (...) age of seven, and cognitive variables were assessed at 6 and 7 years of age. Descriptive-exploratory analyses, bivariate analyses, and multivariate regressions were performed. The results show that cognitive variables measured at these ages contribute differently to the ability to read words at 7 years of age. Rapid naming does not seem to influence word reading; knowledge of letters no longer influences word reading as children grow older; and phonological awareness and phonological memory maintain their contribution to the explanation of word reading. These results indicate that reading in Spanish depends on different cognitive variables and that this relationship varies according to age. The findings have key educational implications in terms of teaching reading skills and the prevention of specific learning difficulties in Spanish Primary Education. (shrink)

Common hospital and surgical center responses to the Covid‐19 pandemic included curtailing “elective” procedures, which are typically determined based on implications for physical health and survival. However, in the focus solely on physical health and survival, procedures whose main benefits advance components of well‐being beyond health, including self‐determination, personal security, economic stability, equal respect, and creation of meaningful social relationships, have been disproportionately deprioritized. We describe how female reproduction‐related procedures, including abortion, surgical sterilization, reversible contraception devices and in vitro fertilization, (...) have been broadly categorized as “elective,” a designation that fails to capture the value of these procedures or their impact on women's overall well‐being. We argue that corresponding restrictions and delays of these procedures are problematically reflective of underlying structural views that marginalize women's rights and interests and therefore threaten to propagate gender injustice during the pandemic and beyond. Finally, we propose a framework for triaging reproduction‐related procedures during Covid‐19 that is more individualized, accounts for their significance for comprehensive well‐being, and can be used to inform resumption of operations as well as subsequent restriction phases. (shrink)

In the USA, there are missed opportunities to diagnose hepatitis C virus in pregnancy because screening is currently risk-stratified and thus primarily limited to individuals who disclose history of injection drug use or sexually transmitted infection risks. Over the past decade, the opioid epidemic has dramatically increased incidence of HCV and a feasible, well-tolerated cure was introduced. Considering these developments, recent evidence suggests universal HCV screening in pregnancy would be cost-effective and several professional organisations have called for updated national policy. (...) Historically, universal screening has been financially disincentivised on the healthcare system level, particularly since new diagnoses may generate an obligation to provide expensive treatments to a population largely reliant on public health resources. Here, we provide ethical arguments supporting universal HCV screening in pregnancy grounded in obligations to respect for persons, beneficence and justice. First, universal prenatal HCV screening respects pregnant women as persons by promoting their long-term health outside of pregnancy. Additionally, universal screening would optimise health outcomes within current treatment guidelines and may support research on treatment during pregnancy. Finally, universal screening would avoid potential harms of risk-stratifying pregnant women by highly stigmatised substance use and sexual behaviours. (shrink)

Background: Little is known about U.S. healthcare provider views and practices regarding evidence, counseling, and shared decision-making about in-hospital versus out-of-hospital birth settings. Methods: We conducted 19 in-depth, semistructured, qualitative interviews of eight obstetricians, eight midwives, and three pediatricians from across the United States. Interviews explored healthcare providers’ interpretation of the current evidence and their personal and professional experiences with childbirth within the existing medical, ethical, and legal context in the United States. Results: Themes emerged concerning risks and benefits, decision-making, (...) and patient-provider power dynamics. Collectively, the narratives illuminated fundamental ideological tensions between in- and out-of-hospital providers arising from divergent assignment of value to described risks and benefits. The majority of physicians focused on U.S.-specific data demonstrating increased neonatal morbidity and mortality associated with delayed access to hospital-based interventions, thereby justifying hospital birth as the standard of care. By contrast, midwives emphasized data demonstrating fewer interventions and superior maternal and neonatal outcomes in high-income European countries, where out-of-hospital birth is more common for low-risk birthing people. A key gap in counseling was revealed, as no interviewees offered anticipatory counseling regarding birth setting options. Providers directly and indirectly illustrated the propensity for asymmetric power relations between birth providers and pregnant people, especially in hospital settings. Conclusions: The narratives highlight the common goal of optimizing maternal and neonatal outcomes despite tensions arising from divergent prioritization of specific maternal and neonatal risks. Our findings suggest opportunities to foster collaboration and optimize outcomes via mutual respect and improved integration of care. (shrink)

Occupy Wall Street, Indignés, Nuit Debout - plus que jamais la question est posée de définir la vie que nous souhaitons choisir et vivre. Une vie vécue est inséparable de ses formes, de ses modalités, de ses régimes, de ses gestes, de ses façons, de ses allures... qui sont déjà des idées. Le monde, tel que nous le partageons et lui donnons sens, ne se découpe pas seulement en individus, en classes ou en groupes, mais aussi en "styles", qui sont (...) autant de phrasés du vivre, animé de formes attirantes ou repoussantes, habitables ou inhabitables, c'est-à-dire de formes qualifiées : des formes qui comptent, investies de valeurs et de raisons d'y tenir, de s'y tenir, et aussi bien de les combattre. C'est sur ce plan des formes de la vie que se formulent aujourd'hui beaucoup de nos attentes, de nos revendications, et surtout de nos jugements. C'est toujours d'elles que l'on débat, et avec elles ce sont des idées complètes du vivre que l'on défend ou que l'on accuse. Une forme de vie ne s'éprouve que sous l'espèce de l'engagement, là où toute existence, personnelle ou collective, risque son idée. Vouloir défendre sa forme de vie, sans tapage, en la vivant, mais aussi savoir en douter et en exiger de tout autres, voilà à quoi l'histoire la plus contemporaine redonne de la gravité. Bien au-delà du champ de l'art, Marielle Macé propose la construction critique d'une véritable stylistique de l'existence. Cela suppose de s'intéresser sans préjugé à tout ce qu'engagent les variations formelles de la vie sur elle-même - styles, manières, façons - et de ne pas traiter forcément de vies éclatantes, triomphantes, d'apparences prisées ou de corps élégants. Ce n'est pas seulement la littérature mais bien toutes les sciences humaines qui, pour comprendre le monde immédiat, sous nos yeux, doivent s'y rendre vraiment attentives. (shrink)