Women account for 70% of healthcare workers, so their role has been – and still is – fundamental in addressing and managing the current pandemic event caused by the SARS-CoV-2 coronavirus. Far from being an opportunity to highlight the importance of women in the field, the healthcare crisis, together with lockdown policies and care responsibilities, have contributed to increase the gender gap. To study the depiction of women healthcare professionals, this paper analyses 401 cartoons on the COVID-19 pandemic that depict (...) healthcare workers. Most represent doctors as men and nurses as women, in roles subordinate to men. The representation of women is also impacted by stereotypes that do not contribute to better reflect the roles and professional skills of women in the healthcare field today. (shrink)

The objective of the study is to verify the reliability and validity of the Factors Influencing Teaching Choice, as well as to determine the teaching of Early childhood and Primary education students’ motivations and perceptions for the choice of this degree. The sample consisted of 262 student teachers aged between 18 and 27. According to degree, 54.2% of the participants were enrolled in Early Childhood Education and 45.8% in Primary Education. The instrument used in the study was the Factors Influencing (...) Teaching Choice, FIT-Choice Scale, adapted to Spanish by Gratacós and López-Jurado. Results evidenced the high reliability and validity of the scale that is similar to the original model, presenting 12 motivational factors and 6 perceptions. The main reasons that lead to choose teaching profession, despite gender differences, are: having influence in the educational children’s process, the intrinsic value of the qualification, the fact that this profession contributes socially, or working with children. Also, students consider that teaching is a demanding profession and they are satisfied with the degree choice. The most important factors influencing the choice of education degree are intrinsic motivations and perceptions as the vocation, in contrast to external reasons such as economic incentives or social recognition. (shrink)

This paper deals with the interrelation between mystique and prophecy in the Christian spirituality. It intends to face dualisms, observed in the past and also in the current Christianity, between these terms. It presents Saint Teresa of Avila’s testimony as a way for overcoming the dichotomy between mystique and prophecy by means of a procedural integration. The foundation for the needed relation between the terms concerned is the existence of Jesus of Nazareth itself, which may be regarded as prophetic-mystic. It (...) means that there’s an interrelation between prayer and action, contemplation and mission. However, the modern and postmodern subject has difficulties in this integration, such as letting himself be transformed by prayer, overcoming the tendency to control and effectiveness. Saint Teresa of Jesus, in this context, is a testimony to mystique and prophecy, mediated by a discretion which goes through daily perceptions. The book Foundations contributes to illustrate this discretion. Keywords : Mystique. Prophecy. Discretion. Saint Teresa of Jesus. Resumo Este artigo trata da inter-relação entre mística e profecia na espiritualidade cristã. Pretende enfrentar dualismos, observados no passado e também no presente do cristianismo, entre esses termos. Apresenta o testemunho de Santa Teresa de Ávila como caminho de superação da dicotomia entre mística e profecia através de uma integração processual. O fundamento da necessária relação entre os termos em questão é a própria existência de Jesus de Nazaré, que pode ser considerada profético-mística. Isso significa que há uma inter-relação entre oração e ação, contemplação e missão. No entanto, o sujeito moderno e pós-moderno apresenta dificuldades nessa integração, como o deixar-se transformar pela oração, superando a tendência ao controle e à eficácia. Santa Teresa de Jesus, nesse contexto, é testemunho de mística e profecia, mediadas por um discernimento que passa por percepções cotidianas. O livro Fundações contribui para ilustrar esse discernimento. Palavras-chave : Mística. Profecia. Discernimento. Santa Teresa de Jesus. (shrink)

Drawing on many areas of expertise, from paleontology to psychology, Tomasello offers a plausible, evolutionary story abouthow our ancestors are likely to have developed cooperative behaviors and collaborative lifeways in order to survive and thrive.He also claims that this narrative explains why they would have begun to think in characteristically cooperative and moral ways,developing a “we is greater than me” [we>me] psychological orientation. Do the arguments offered support this extra claim? Thisarticle suggests that they do not. It seeks to alleviate (...) this shortcoming by drawing upon some conceptual resources offered bySartre’s Theory of Practical Ensembles. The centerpiece of the article consists of a detailed analysis of Sartre’s account of the genesisof the “group-in-fusion,” seeking to show that the genesis of a we-way of thinking in a group made up of many requires themediation of what Sartre calls a “third party” (le tiers). After closely examining Sartre’s treatment of the “third party” in theapocalyptic genesis of the “group-in-fusion,” I evaluate the success of this notion in resolving those questions that Tomasello’saccount raises while, at the same time, addressing the ontological question concerning the nature of the individual-grouprelation, in a way that suggests new and significant alternatives to standard dilemmas in contemporary social philosophy. (shrink)

Teens live in a complicated world. They are constantly bombarded by messages from their friends, parents, teachers, the internet, and their churches, and not all of these messages agree or line up with each other. How do students figure out who to listen to? How do they figure out what is true? Inklings on Philosophy and Worldview will show teens practical ways to filter out the wrong messages and focus on what is real. Using teachings from highly respected, loved, and (...) well-known writers, teacher Matthew Dominguez will show teens the power of story as he guides them through a study of world religions, philosophies, and worldview, and gives them a firm foundation to stand on as they prepare to face the world. (shrink)

Este artículo plantea que ciertas situaciones en las que nos vemos obligados a prestar atención a los riesgos que tomamos al confiar, como la amenaza de violencia o la ruptura de la confianza, motivan una forma particular de confianza en la cual nos interesa tomar consciencia de las creencias, valoraciones e intenciones prácticas implicadas al confiar. Tras describir fenomenológicamente, desde una perspectiva husserliana, la estructura de esta forma de confianza, denominada confianza reflexiva o racional, se expone por qué su análisis (...) filosófico puede contruibuir a aclarar problemáticas epistemológicas y éticas que se desprenden del carácter social de nuestra existencia. En la parte final del artículo se sugiere que el concepto de confianza reflexiva o racional puede servir para entender problemáticas relacionadas con la posverdad y para discernir algunas formas básicas de dominación y de complicidad con la dominación. (shrink)

The multiobjective optimization on the basis of ratio analysis method captures diverse features such as the criteria and alternatives of appraising a multiple criteria decision-making problem. At the same time, the multiple criteria problem includes a set of decision makers with diverse expertise and preferences. In fact, the literature lists numerous approaches to aid in this problematic task of choosing the best alternative. Nevertheless, in the MCDM field, there is a challenge regarding intangible information which is commonly involved in multiple (...) criteria decision-making problem; hence, it is substantial in order to advance beyond the research related to this field. Thus, the objective of this paper is to present a fused method between multiobjective optimization on the basis of ratio analysis and Pythagorean fuzzy sets for the choice of an alternative. Besides, multiobjective optimization on the basis of ratio analysis is utilized to choose the best alternatives. Finally, two decision-making problems are applied to illustrate the feasibility and practicality of the proposed method. (shrink)

Las cinco investigaciones que se incluyen en este libro se relacionan con la variacion lexica y conceptual de diferentes estratos sociales de Mexico. Sin duda, un mayor acervo conceptual de mayores posibilidades de comprender y modificar el mundo. A pesar de su importancia, este tipo de diferencias ha sido muy poco estudiado, mas especificamente, la semantica social puede considerarse como un campo nuevo en la linguistica. Mexico es un pais con diferencias economicas bastante notables, y los intereses de la gente (...) se relacionan con este hecho. Mientras unos se preocupan por la educacion y la cultura, los valores y las ideas, otros piensan fundamentalmente en el alimento y en el vestido. Las diferencias que encuentra el autor lo llevan a proponer que, en Mexico al parecer, la riqueza lexica y conceptual esta tan mal distribuida como la economica. (shrink)

En el contexto de la ética fenomenológica de Dietrich von Hildebrand, indagamos sobre las vivencias implicadas en la acción moral y en las condiciones, tanto formales como materiales, que la constituyen en una acción moralmente buena o valiosa. En este análisis planteamos que en toda acción humana están presentes tres vivencias intencionales, a saber, la aprehensión cognoscitiva del valor, la respuesta al valor y la realización de la acción; y que el valor moral de una acción depende, principalmente, de la (...) respuesta volitiva a un grupo especial de valores, los valores moralmente relevantes. Junto con ello, recuperamos el rol central del modelo o ejemplo moral en la educación valórica de las personas y la importancia de la imitación en el desarrollo moral de estas. Para ello, contraponemos la ética de Hildebrand a la ética kantiana. Además, reflexionamos sobre el sentido y alcance de la teoría de Hildebrand sobre las acciones inmorales, concluyendo que una acción formalmente moral (correcta) puede ser materialmente inmoral. (shrink)

As a result of recent corporate scandals, several rules have focused on the role played by Boards of Directors on the planning and monitoring of corporate codes of ethics. In theory, outside directors are in a better position than insiders to protect and further the interests of all stakeholders because of their experience and their sense of moral and legal obligations. Female directors also tend to be more sensitive to ethics according to several past studies which explain this affirmation by (...) early gender socialization, the fact that women are thought to place a greater emphasis on harmonious relations and the fact that men and women use different ethical frameworks in their judgments. The goal of this paper is to determine the influence of these characteristics of the Board in terms of promoting and hindering the creation of a code of ethics. Our findings show that a greater number of female directors does not necessarily lead to more ethical companies. Moreover, within Europe as a continent, board ownership leads to an entrenchment of upper-level management, generating a divergence between the ethical interests of owners and managers. In light of this situation, the presence of independent directors is necessary to reduce such conflicts. (shrink)

RESUMEN Se analiza la relación entre las memorias inscritas en el cuerpo, el trauma y los recursos corporizados subjetivos y colectivos con los que cuentan las mujeres víctimas de violencia para reconstruir y resignificarse como personas dignas de credibilidad y agentes de cambio. Se refieren casos específicos de violencia sexual en Colombia y se expone la importancia de la creación de comunidades de confianza que propicien espaclos para la narración y escucha de los testimonlos de víctimas, la tramitación de conflictos (...) y nuevas vías de afrontamiento, a partir de los recursos que brinda la reinvención de hábitos corporizados en el arte. ABSTRACT The article analyzes the relation among memories inscribed in the body, trauma, and the subjective and collective embodied resources available to women victims of violence in order to reconstruct and resignify themselves as persons worthy of credibility and as agents of change. It discusses specific cases of sexual violence in Colombia and the importance of creating communities of trust that foster spaces for narrating and listening to the testimonies of victims, as well as for handling conflicts and exploring new ways of coping, on the basis of the resources provided by the reinvention of habits embodied in art. (shrink)

Este trabajo toma como punto de partida el hecho de que la corrección política se extendió por los países occidentales en la misma década (1960-1970) en que el eslogan «Il est interdit d’interdire» se puso de moda también. Y, puesto que las prohibiciones explícitas parecen ser políticamente incorrectas, el lenguaje políticamente correcto recurrió a la ambigüedad y a la indeterminación del significado para prohibir indirectamente así como a otros métodos tales como la reescritura y/o la reinterpretación de algunos textos del (...) pasado. (shrink)

Las personas portadoras o enfermas del virus de inmunodeficiencia humana han experimentado consecuencias devastadoras en el plano personal, familiar y social desde la aparición de los primeros casos. El objetivo del presente trabajo es analizar el cumplimiento de los principios bioéticos, así como la repercusión derivada de las implicaciones éticas del actuar profesional con estos pacientes, lo cual demuestra la necesidad de vencer los tabúes y la discriminación que han sido objeto desde los inicios de la epidemia. Persons who are (...) carrier of the Acquired Immunodeficiency Syndrome or persons who are sick have experienced destructive consequences in the personal, familiar and social spheres since the appearance of the first cases. The objective of this work is to analyze the fulfilment of the bioethical principles, as well as the repercussion derived from the ethics dilemma of the professional behaviour with these patients, what demonstrate the necessity of overcoming taboos and the discrimination they have suffered from since the beginnings of the disease. (shrink)

Fichte wie auch später Sartre gewinnen vergleichbare Resultate auf der theoretischen Ebene hinsichtlich der ethischen Fundierung der Intersubjektivität im Selbstbewusstsein. Die Rolle der Ästhetik wird von beiden Denkern aufgrund ethischer Implikationen so bestimmt, dass sie die durch sie bestimmte Intersubjektivität auf praktischer Ebene zum Vorschein bringt. Die Ästhetik stellt bei beiden Autoren nicht einen Selbstzweck dar, sondern spielt eine herausragende Rolle für die Bildung der Menschen. Sartre wie auch Fichte brauchen die Ästhetik, um die Ethik zu fundieren. Während Sartre ein (...) unmittelbar lebensbezogenes ästhetisches Denken hat, in dem er ethische Aspekte in seiner Literatur anhand konkreter Beispiele verarbeitet, geht es Fichte in seinen Ausführungen zur Ästhetik vornehmlich um die Frage nach der Bedingung der Möglichkeit des ästhetischen Bewusstseins und darum, dieses als Voraussetzung des ethischen Bewusstseins zu bestimmen. Sartres Ethik offenbart sich vor allem in seinem ästhetischen Schaffen. Dem ästhetischen Moment in Sartres Ethik kommt die zentrale Aufgabe für die Entwicklung des ethischen Individualismus des Menschen und der gesamten Menschheit zu. Die Analogie zu Fichtes transzendentalkritischem Idealismus liegt in der Fundierungsrolle der Ästhetik für die Ethik in beiden philosophischen Konzeptionen, woraus eine aussagefähige Ethik in Sartres Existenzphilosophie resultiert. So zeigt sich In Sartres Literatur der direkte Wechselbezug zwischen praktischer Ethik und produktiver Ästhetik. Die Funktion der Ästhetik wird von Sartre dadurch bestimmt, dass in seinem Konzept mittels der Ästhetik die Vermittlung zwischen theoretischer und praktischer Vernunft geleistet wird. (shrink)

La Educación Sensible es ayuda para que el “yo” habite en su “hogar interior” y crezca hacia su “apoteosis original” en el “nosotros”, donde se hace cocreador de belleza con libertad, sabiduría y amor. La educación sensible es pedagogía no invasiva pero radicalmente exigente para que la persona acepte desplegar su versión original y vivir con gozo en un “nosotros-maduro”. No es una pedagogía que protege a los sensibles; es una educación que atiende a todas las personas, independientemente de su (...) grado de sensibilidad: alta, media o baja (como intervalos comunes que se manejan en las ciencias de la sensibilidad). La sensibilidad personal es capaz de captar la propia originalidad y disponerse para interpretarla en los dos sentidos: comprenderla y actuarla. La sensibilidad humana necesita la educación sensible para que sea punto de partida de un desarrollo personal auténtico y pleno de la propia originalidad que es alterada y altera la de los “yoes” con quien habita la existencia formando “nosotros”, que a su vez, se impactan con interdependencia. Además de al “yo”, la educación sensible se orienta al “nosotros”, que será tanto más “sensible” en la medida que altera la intimidad de la persona con “amor-maduro” que es fuente de gozo, a pesar de los pesares. Sin educación sensible la vida daña y cuanta mayor es la sensibilidad de la persona, mayor es el daño, pero también es mayor la capacidad para detectarlo cicatrizarlo y ayudar a otros con educación sensible. Así, la educación sensible se manifiesta de tres maneras: como acción sanadora de la persona, destrucción creadora para evolucionar en el tiempo, como la crisálida se transforma en mariposa, y acción desarrollante del propio potencial con originalidad. (shrink)

En un contexto de transformaciones profundas en la sociedad boliviana, el autor plantea que más que una nueva teoría de la sociedad boliviana se requiere desarrollar otra mirada. En esta dirección, el presente artículo busca plantear un esquema renovado sobre las referencias desde las cuales deben encuadrar el debate los bolivianos y bolivianas. El texto aborda la construcción de matrices culturales, explicitando la moderna y la andina, y conecta matriz cultural con institucionalidad, para proponer una institucionalidad andina.

Los Congresos y Semanas de Estudios reflejan la vitalidad de las disciplinas académicas. Son numerosos los Congresos mariológicos y marianos promovidos por distintas instituciones o por iniciativa privada y celebrados a lo largo de los ss. XX y XXI. Este artículo explora únicamente los organizados por la Pontificia Academia Mariana Internacional, que coordina a los estudiosos de la teología mariana en el mundo, y por varias Sociedades Mariológicas nacionales. Ofrece un breve informe sobre el origen y perfil de cada institución (...) y señala los temas tratados en sus Congresos y publicados en las respectivas Actas. Presta atención sobre todo a los organizados por la PAMI, especialmente a los celebrados en lo que va de siglo. (shrink)

En este texto defendemos que todo lo que adquiere sentido, significado, es afectivo. Nuestras operaciones mentales y acciones en el mundo están orientadas afectivamente. En la primera sección discutimos la forma en que sentido y afecto han sido entendidos bajo las concepciones de mente y cuerpo en el debate tradicional. En la segunda, proponemos una concepción de sentido público, corporizado y constituido por el afecto. Para ello, nos apoyamos en la sintonía en torno a la concepción de sentido y afecto (...) que puede encontrarse en las propuestas filosóficas de L. Wittgenstein y M. Merleau-Ponty. Finalmente, en la tercera sección discutimos las implicaciones de nuestra propuesta; señalamos allí algunas diferencias importantes con propuestas cercanas a la nuestra, así como algunas objeciones a las mismas. (shrink)

This edited volume, aimed at both students and researchers in philosophy, mathematics and history of science, highlights leading developments in the overlapping areas of philosophy and the history of modern mathematics. It is a coherent, wide ranging account of how a number of topics in the philosophy of mathematics must be reconsidered in the light of the latest historical research and how a number of historical accounts can be deepened by embracing philosophical questions.

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

Latina immigrant women who work as nannies or housekeepers and reside in Los Angeles while their children remain in their countries of origin constitute one variation in the organizational arrangements of motherhood. The authors call this arrangement “transnational motherhood.” On the basis of a survey, in-depth interviews, and ethnographic materials gathered in Los Angeles, they examine how Latina immigrant domestic workers transform the meanings of motherhood to accommodate these spatial and temporal separations. The article examines the emergent meanings of motherhood (...) and alternative child-rearing arrangements. It also discusses how the women view motherhood in relation to their employment, as well as their strategies for selectively developing emotional ties with their employers' children and for creating new rhetorics of mothering standards on the basis of what they view in their employers' homes. (shrink)

In the predominant pedagogical frameworks of our days, rationalist, voluntarist or sentimentalist reductionisms are seen, from which it is about educating people regardless of their Origin and the singular and unrepeatable originality with which they have been given to existence. Faced with this anthropocentric confinement, Sensitive Education arises so that every person, regardless of their culture and creed, remains sensitive to their Origin and captures their own originality, which in the end is what they must accept and try to manifest (...) with education. When educational systems are not sensitive to the original, they develop falsehood. With the aim of consolidating the validity of the pedagogical-anthropological foundation of Sensitive Education, this study seeks to show how Edith Stein’s argument explains Sensitive Education, although Stein, after her conversion, uses explicitly Christian terminology. Stein’s direct terms serve to describe Education Sensitive to the Holy Spirit, but for those who do not start from a Christian worldview, Education Sensitive to Origin can be a more non-denominational way of approaching the Original. To achieve this objective, an analytical-synthetic methodology has been followed in which essential features of Sensitive Education are proposed and in a hermeneutic manner, arguments are extracted from the writings of Edith Stein that offer support for these essential features. In conclusion, it is sufficiently shown that Edith Stein’s thought provides a pedagogical foundation to Sensitive Education. (shrink)

Biological naturalism’s mental ontology decisively depends on the notion of causality. However, Searle does not embed this notion in his ontology in dialogue with the relevant scientific and philosophical literature, but rather guided by a certain sort of intuitive verisimilitude. Taking Bunge’s general ontology as a background, we discuss two important problems rooted in this shallow treatment of causality: the first one has to do with the fact that Searlean emergentism builds upon a categorical error between properties and processes; the (...) second one with the fact that Searle’s only argument for anti-reductionism contradicts the rest of his ontology of the mental. La ontología de lo mental del naturalismo biológico depende decisivamente de la noción de causalidad. No obstante, Searle no incardina dicha noción en su ontología en diálogo con la literatura científica y filosófica relevante, sino antes bien orientado por cierta suerte de verosimilitud intuitiva. Sobre el trasfondo de la ontología general de Mario Bunge, discutimos dos importantes problemas derivados de este somero tratamiento de la causalidad: por una parte, que el emergentismo searleano se alza sobre la base de un error categorial entre propiedades y procesos; por otra, que el único argumento de Searle en favor del antirreduccionismo se encuentra en contradicción con el resto de su ontología de lo mental. (shrink)

In post-Revolutionary Mexico, the Indian was conceptualized as a problem that needed to be solved. Indians were believed to be weighing down the nation and thought to constitute an obstacle for fulfilling its promised modern future. Thus, the scientific study of indigenous peoples in Mexico became, in the 1930s, a focus of anthropologists, physicians, and other experts, who sought to learn more about indigenous populations in order to solve this "problem." In this paper I explore how this "problem-solving" was practiced, (...) how and why particular groups of people were used as subjects of inquiry and intervention, how they were selected, and how they enabled the production of knowledge deemed useful to... (shrink)

We offer an analysis of the disciplinary transformations underwent by mathematical or symbolic logic since its emergence in the late 19th century. Examined are its origins as a hybrid of philosophy and mathematics, the maturity and institutionalisation attained under the label �logic and foundations,� a second wave of institutionalisation in the Postwar period, and the institutional developments since 1975 in connection with computer science and with the study of language and informatics. Although some �internal history� is discussed, the main focus (...) is on the emergence, consolidation and convolutions of logic as a discipline, through various professional associations and journals, in centers such as Torino, Göttingen, Warsaw, Berkeley, Princeton, Carnegie Mellon, Stanford, and Amsterdam. (shrink)

El presente artículo hace una lectura de la obra dramatúrgica Bandada de pájaros: segundo ensayo sobre la memoria (2016) de Jorgelina Cerritos (San Salvador, 1974) desde una perspectiva tanatopolítica. Se indaga acerca del poder que ejerce el Estado salvadoreño en la vida de la ciudadanía, representada por personajes que, desprovistos de su categoría de persona, ven interrumpidos todos sus derechos. Estos sujetos son miembros de una comunidad que se convierten en una amenaza potencial a suprimir por parte del Estado. Además, (...) se analiza la vulnerabilidad de la mujer ante el aparato bélico heteropatriarcal y las posibilidades del teatro como espacio para la construcción de una memoria que restituya el recuerdo y la identidad de los miles de desaparecidos durante la guerra civil salvadoreña. (shrink)

El presente artículo indaga en la construcción de las estéticas y las subjetividades emergentes en jóvenes urbanos mexicanos a través del tatuaje. La pregunta de investigación que articula el trabajo tiene relación con ¿por qué ciertos jóvenes urbanos, hombres como mujeres, se están tatuando los cuerpos? El método utilizado para la reconstrucción de los significados (las subjetividades emergentes) fue interpretativo. La investigación fue exploratoria y de corte etnográfico, debido a la casi inexistencia de investigaciones en México que consideren a la (...) oferta (tatuadores) y a la demanda (los tatuados) en el propio contexto histórico-social de los significados asociados a la práctica del tatuaje como expresión estética en la alteración de los cuerpos. Los instrumentos que se emplearon en la construcción de los datos fueron los diarios de campo, para la observación de contextos; y una guía de entrevista en profundidad, para conocer los significados que dieron los propios actores sociales a sus prácticas. (shrink)

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

Formal models of argumentation have been investigated in several areas, from multi-agent systems and artificial intelligence (AI) to decision making, philosophy and law. In artificial intelligence, logic-based models have been the standard for the representation of argumentative reasoning. More recently, the standard logic-based models have been shown equivalent to standard connectionist models. This has created a new line of research where (i) neural networks can be used as a parallel computational model for argumentation and (ii) neural networks can be used (...) to combine argumentation, quantitative reasoning and statistical learning. At the same time, non-standard logic models of argumentation started to emerge. In this paper, we propose a connectionist cognitive model of argumentation that accounts for both standard and non-standard forms of argumentation. The model is shown to be an adequate framework for dealing with standard and non-standard argumentation, including joint-attacks, argument support, ordered attacks, disjunctive attacks, meta-level attacks, self-defeating attacks, argument accrual and uncertainty. We show that the neural cognitive approach offers an adequate way of modelling all of these different aspects of argumentation. We have applied the framework to the modelling of a public prosecution charging decision as part of a real legal decision making case study containing many of the above aspects of argumentation. The results show that the model can be a useful tool in the analysis of legal decision making, including the analysis of what-if questions and the analysis of alternative conclusions. The approach opens up two new perspectives in the short-term: the use of neural networks for computing prevailing arguments efficiently through the propagation in parallel of neuronal activations, and the use of the same networks to evolve the structure of the argumentation network through learning (e.g. to learn the strength of arguments from data). (shrink)