I. El destino del normativismo en la ciencia jurídica contemporanea.--II. El fundamento de la seguridad social.

A cross-sectional study to ascertain what the Singapore population would regard as material risk in the anaesthesia consent-taking process and identify demographic factors that predict patient preferences in medical decision-making to tailor a more patient-centered informed consent. A survey was performed involving patients 21 years old and above who attended the pre-operative evaluation clinic over a 1-month period in Singapore General Hospital. Questionnaires were administered to assess patients’ perception of material risks, by trained interviewers. Patients’ demographics were obtained. Mann–Whitney U (...) test and Kruskal-Wallis one-way analysis of variance was used. Statistical significance was taken at p < 0.05. Four hundred fourteen patients were eligible of which 26 refused to participate and 24 were excluded due to language barrier. 364 patients were recruited. A higher level of education, being employed and younger age group are factors identified in patients who wanted greater participation in medical decisions. Gender, marital status, type of surgery, and previous surgical history did not affect their level of participation. The complications most patients knew about were Nausea, Drowsiness and Surgical Wound Pain. Patients ranked Heart Attack, Death and Stroke as the most significant risks that they wanted to be informed about in greater detail. Most patients wanted to make a joint decision with the anaesthetist, instead of letting the doctor decide or deciding for themselves. Discussion with the anaesthetist is the preferred medium of communication compared to reading a pamphlet or watching a video. Age and educational level can influence medical decision-making. Despite the digital age, most patients still prefer a clinic consult instead of audio-visual multimedia for pre-operative anaesthetic counselling. The local population appears to place greater importance on rare but serious complications compared to common complications. This illustrates the need to contextualize information provided during informed consent to strengthen the doctor-patient relationship. (shrink)

Introduction Tourette Syndrome is a childhood onset disorder characterized by vocal and motor tics and often remits spontaneously during adolescence. For treatment refractory patients, Deep Brain Stimulation may be considered. Methods and Results We discuss ethical problems encountered in two adolescent TS patients treated with DBS and systematically review the literature on the topic. Following surgery one patient experienced side effects without sufficient therapeutic effects and the stimulator was turned off. After a second series of behavioural treatment, he experienced a (...) tic reduction of more than 50%. The second patient went through a period of behavioural disturbances that interfered with optimal programming, but eventually experienced a 70% tic reduction. Sixteen DBS surgeries in adolescent TS patients have been reported, none of which pays attention to ethical aspects. Discussion Specific ethical issues arise in adolescent TS patients undergoing DBS relating both to clinical practice as well as to research. Attention should be paid to selecting patients fairly, thorough examination and weighing of risks and benefits, protecting the health of children and adolescents receiving DBS, special issues concerning patient’s autonomy, and the normative impact of quality of life. In research, registration of all TS cases in a central database covering a range of standardized information will facilitate further development of DBS for this indication. Conclusion Clinical practice should be accompanied by ongoing ethical reflection, preferably covering not only theoretical thought but providing also insights in the views and perspectives of those concerned, that is patients, family members and professionals. (shrink)

The interconnections, common interests, and other linkages between the Jewish and Islamic traditions have long been a matter of interest to academics. Today the need to understand these relationships, and to emphasize commonalities rather than conflicts, is of the greatest public interest. The present volume of studies, likely the first such collection in the scholarly literature, explores the full range of interconnections between Jews and Muslims in all fields (intellectual history, religion, philosophy, social history, etc.) and in all periods, from (...) the Middle Ages till today. The essays have been written by some twenty distinguished scholars from North America, Europe, and Israel. The volume is dedicated to our esteemed colleague Joel L. Kraemer, John Barrows Professor Emeritus in the Divinity School and on the Committee on Social Thought of the University of Chicago. In the course of his distinguished career Professor Kraemer has made major contributions to our understanding of the intellectual and cultural history of the Jews in the Arabic world, Islamic and Jewish philosophy and their sources in ancient philosophy, the humanistic renaissance in Islam (on which he published two seminal monographs), and Maimonides (on which he has published many important papers and is completing a biography and a translation of Maimonides' letters, to appear in the Yale Judaica Series). (shrink)

Purpose. The dynamics and pace of social and economic transformations that are characteristic of modern society, lead to an increase in tension and the destruction of habitual stereotypes – ideals, values, norms, patterns of behaviour that unite people. These moments encourage us to rethink the understanding of "security" essence, in particular, psychological, which emphasizes the urgency of its study in the philosophical and sociocultural coordinates. Theoretical basis of the research is based on the philosophical methodology of K. Jaspers, E. Fromm (...) and the A. Maslow’s psychological approach to understanding of a person. Originality. Psychological security is considered at different levels: first and foremost, society is a characteristic of social security, that is an analysis of how today’s social technologies, social changes affect the quality of life of the country’s population; secondly, the social environment – the family, the immediate environment, reference groups, training teams; thirdly, a person is an experience of his own security-insecurity, when it is possible to talk about the manifestations of psychological violence, when certain behavioral acts contribute to the violation of the security of the other or to self-destruction. It is found out that the knowledge of psychological security is closely connected with the socio-historical conditions of being, with the level of development of material and spiritual culture, with the interests and values prevailing in society, which determines its ontological, epistemological and axiological features. The presented issue is considered in the correlation of psychological security with types of scientific rationality – classical, nonclassical and post-nonclassical approaches, within the framework of which various perspectives, aspects, forms and types of psychological security are studied. Conclusions. The concept of security requires a systematic description of its manifestations, types, levels, concepts: security as the absence of dangers ; security as a certain activity to ensure or to prevent any threats or dangers ; security as a conscious necessity, the value of the individual. The study systematizes various ideas about psychological security in accordance with the logic of scientific knowledge: in the mainstream of classical, non-classical and post-nonclassical approaches. (shrink)

This paper provides insights into the pedagogy in practice of non-mainstream education through a qualitative case study of an alternative school in the context of the Israeli school system. The school’s alternative agenda is based on being isolated from mainstream education. We explore the negotiations between the school’s pedagogy and mainstream educational standards. We point to the tensions stemming from the intersections between the school’s ideals and the external context. This issue is significant for understanding the voices that affect alternative (...) education, in relation to its aspiration for autonomous practices, and the ways in which secluded practices are permeated by mainstream influences. Our findings reveal that these negotiations centre on issues relating to learning, knowledge, and assessment. Mainstream standards pass into the alternative educational schemes, creating challenges leading not to a rejection of mainstream demands but to a need to balance between the different educational approaches. The act of balancing does not negate the significance of the alternative school. On the contrary, the ability to suspend educational isolation by interacting with the surrounding educational context enables this type of alternative education to stay in touch with its radical educational agenda. (shrink)

Introduction While quizzing during informed consent for research to ensure understanding has become commonplace, it is unclear whether the quizzing itself is problematic for potential participants. In this study, we address this issue in a multinational HIV prevention research trial enrolling injection drug users in China and Thailand. Methods Enrolment procedures included an informed consent comprehension quiz. An informed consent survey followed. Results 525 participants completed the informed consent survey (Heng County, China=255, Xinjiang, China=229, Chiang Mai, Thailand=41). Mean age was (...) 33 and mean educational level was 8 yrs. While quizzing was felt to be a good way to determine if a person understands the nature of clinical trial participation (97%) and participants did not generally find the quiz to be problematic, minorities of respondents felt pressured (6%); anxious (5%); bored (5%); minded (5%); and did not find the questions easy (13%). In multivariate analysis, lower educational level was associated with not minding the quizzing (6–10 yrs vs 0–5 yrs: OR=0.27, p=0.03; more than 11 yrs vs 0–5 yrs: OR=0.18, p=0.03). There were also site differences (Heng County vs Xinjiang) in feeling anxious (OR=0.07; p=<0.01), not minding (OR=0.26; p=0.03), being bored (OR=0.25; p=0.01) and not finding the questions easy (OR=0.10; p=<0.01). Conclusions Quizzing during the informed consent process can be problematic for a minority of participants. These problems may be associated with the setting in which research takes place and educational level. Further research is needed to develop, test and implement alternative methods of ensuring comprehension of informed consent. Trial Registration clinicaltrials.gov number NCT00270257. (shrink)

Social media applications such as Twitter, YouTube and Facebook have attained huge popularity, with more than three billion people and organizations predicted to have a social networking account by 2015. Social media offers a rapid avenue of communication with the public and has potential benefits for communicable disease control and surveillance. However, its application in everyday public health practice raises a number of important issues around confidentiality and autonomy. We report here a case from local level health protection where the (...) friend of an individual with meningococcal septicaemia used a social networking site to notify potential contacts. (shrink)

The article is devoted to the problems of introducing the SMART-education technology in the training and development of personnel of hotel complexes and business activities in the field of hotel business. The methodological and organizational bases for the application of SMART-education in staff training were identified; the leading qualitative features and development trends of this type of entrepreneurial educational activity were outlined. The principles of SMART-education of staff in the field of hotel business and its applied features in the service (...) sector were developed. A model of SMART- education of hotel complex staff was developed based on solving case problems and practical mastering of professional content. (shrink)