Background:The decision whether to initiate cardiopulmonary resuscitation may sometimes be ethically complex. While studies have addressed some of these issues, along with the role of nurses in cardiopulmonary resuscitation, most have not considered the importance of nurses acting as advocates for their patients with respect to cardiopulmonary resuscitation.Research objective:To explore what the nurse’s advocacy role is in cardiopulmonary resuscitation from the perspective of patients, relatives, and health professionals in the Basque Country (Spain).Research design:An exploratory critical qualitative study was conducted from (...) October 2015 to March 2016. Thematic analysis was used to analyse the data.Participants:Four discussion groups were held: one with patients and relatives (n = 8), two with nurses (n = 7 and n = 6, respectively), and one with physicians (n = 5).Ethical considerations:Approval was obtained from the Basque Country Clinical Research Ethics Committee.Findings:Three significant themes were identified: (a) accompanying patients during end of life in a context of medical dominance, (b) maintaining the pact of silence, and (c) yielding to legal uncertainty and concerns.Discussion:The values and beliefs of the actors involved, as well as pre-established social and institutional rules reduced nurses’ advocacy to that of intermediaries between the physician and the family within the hospital environment. On the contrary, in primary health care, nurses participated more actively within the interdisciplinary team.Conclusion:This study provides key information for the improvement and empowerment for ethical nursing practice in a cardiac arrest, and provides the perspective of patients and relatives, nurses and physicians. (shrink)

BackgroundComorbidity between diabetes mellitus and depression is highly prevalent. The risk of depression in a person with diabetes is approximately twice that of a person without this disease. Depression has a major impact on patient well-being and control of diabetes. However, despite the availability of effective and specific therapeutic interventions for the treatment of depression in people with diabetes, 50% of patients do not receive psychological treatment due to insufficient and difficult accessibility to psychological therapies in health systems. The use (...) of information and communication technologies has therefore been proposed as a useful tool for the delivery of psychological interventions, but it continues to be a field in which scientific evidence is recent and controversial. This systematic review aims to update the available information on the efficacy of psychological interventions delivered through ICTs to improve depressive symptomatology in patients with diabetes.MethodsA systematic review of the literature was performed following the PRISMA guidelines and using MEDLINE, Embase, PubMed, Web of Science, PsycINFO, Scopus, and Cochrane Library databases to search for randomized clinical trials of eHealth treatments for patients with diabetes and comorbid depression from 1995 through 2020. In addition, studies related to follow-up appointments were identified. Inclusion criteria were as follows: randomized clinical trials ; patients with type 1 and type 2 diabetes; adult population over 18 years of age; presence of depressive symptomatology assessed with standardized instruments; treatments for depression based on established psychotherapeutic techniques and principles; delivered through eHealth technologies. We did not limit severity of depressive symptomatology, delivery setting or comparison group. Two coauthors independently reviewed the publications identified for inclusion and extracted data from the included studies. A third reviewer was involved to discuss discrepancies found. The PEDro scale was used to assess the quality of the RCTs. No meta-analysis of the results was performed. The protocol used for this review is available in PROSPERO.ResultsThe initial search identified 427 relevant scientific publications. After removing duplicates and ineligible citations, a total of 201 articles were analyzed in full text. Ten articles met the criteria of this review and were included, obtaining very good scientific quality after evaluation with the PEDro scale. The main results show that the eHealth psychological intervention for depression in patients with diabetes showed beneficial effects both at the end of treatment and in the short and long term for the improvement of depressive symptomatology. The methodology used was very heterogeneous. However, all studies were based on cognitive-behavioral tools and used standardized assessment instruments to evaluate depressive symptomatology or diagnosis of MDD. Glycemic control was assessed by glycosylated hemoglobin, but no benefits were found in improving glycemic control. Only four studies included psychoeducational content on diabetes and depression, but none used tools to improve or enhance adherence to medical prescriptions or diabetes self-care.ConclusionsICT-based psychological interventions for the treatment of depression in people with diabetes appear to be effective in reducing depressive symptomatology but do not appear to provide significant results with regard to glycemic control. Nonetheless, the scientific evidence reported to date is still very limited and the methodology very diverse. In addition, no studies have implemented these systems in routine clinical practice, and no studies are available on the economic analysis of these interventions. Future research should focus on studying and including new tools to ensure improvements in diabetes outcomes and not only on psychological well-being in order to advance knowledge about these treatments. Economic evaluations should also be undertaken to analyze whether these treatment programs implemented using eHealth technologies are cost-effective. (shrink)

Background: Serious games have shown positive results in increasing motivation, adherence to treatment and strengthening the therapeutic alliance in multiple psychiatric disorders. In particular, patients with impulse control disorders and other disorders in which the patient suffers from inhibitory control deficits have been shown to benefit from serious games.Aim: The aim of this study was to describe the characteristics and to evaluate the usability of a new serious videogame, e-Estesia. This serious videogame was designed to improve emotion regulation in patients (...) with gambling disorder. Preliminary results from a pilot sample are also reported.Method: A pilot sample of 26 patients undergoing treatment for GD was recruited. Participants used e-Estesia on a tablet, which was connected to a thoracic band that sent heart rate and heart rate variability data to the videogame platform in order to provide biofeedback. The System Usability Scale was completed by patients to determine the usability of e-Estesia.Results and Discussion: e-Estesia performed comparatively well for all the explored groups. Around 84.6% of the patients endorsed that it was easy to use. Female patients with GD presented higher HRV during the use of the serious videogame compared to men. (shrink)

The main implication of the scientific consensus on human causality of climate change is the need to implement urgent and transformative policies. However, inaction remains. Much of the academic research has concentrated on discourses that question the evidence of climate science under the umbrella term "climate change denial", but the focus has recently started to shift to the arguments of those who, while accepting the evidence, criticize the processes by which it is obtained and, especially, oppose ambitious measures, in many (...) cases using misinformation. In this article, we will present a taxonomy of such arguments, categorized under the concept of "climate action obstructionism", and we will analyze how this discourse is "amplified" through the Internet; specifically, as an example, we will examine a YouTube video posted on Dalas Review’s channel. (shrink)

A growing body of research has suggested that high levels of family functioning—often measured as positive parent–child communication and low levels of parental stress—are associated with stronger cognitive development, higher levels of school engagement, and more successful peer relations as youth age. The COVID-19 pandemic has brought tremendous disruption to various aspects of daily life, especially for parents of young children, ages 3–5, who face isolation, disconnection, and unprecedented changes to how they engage and socialize. Fortunately, both youth and parent (...) brains are plastic and receptive to change. Resilience research shows that factors such as engaging in acts of kindness, developing trusting relationships, and responding compassionately to the feelings of others can help lay new neural pathways and improve quality of life. Yet, little research has investigated the effects of brain healthy parental practices of kindness with pre-school aged children. The current study examines whether an interactive, parent–child kindness curriculum can serve as a potentiator for brain health as measured by resilience and child empathy levels. During a peak of the pandemic, mother participants between the ages of 26–46 completed questionnaires on parental resilience levels and parent-reported child empathic pro-social behaviors before and after engaging in a 4 weeks online, self-paced, kindness curriculum. Half of the group received additional brain health education explaining the principles of neuroplasticity, empathy, perspective taking, and resiliency. Mothers in both groups showed increased resilience and reported higher levels of empathic behavior in their child after completing the curriculum. There was no significant difference between groups. Comparison of mean resilience levels during COVID-19 to pre-pandemic general means indicated that mothers are reporting significantly lower levels of resilience as well as decreased empathetic behaviors in their children. These results support the notion that kindness is a powerful brain health booster that can increase resilience and empathy. This research study was timely and relevant for parents in light of the myriad of stresses brought about by the ongoing COVID-19 pandemic. There are broader public health implications for equipping individuals with tools to take a proactive and preventative approach to their brain health. (shrink)

Ante ciertos modelos causales del agente libre inspirados en Tomás de Aquino, resulta interesante atender al modelo causal presentado por Tomás mismo, especialmente en un texto a partir del cual se puede rastrear la exposición de la acción libre como el efecto de los cuatro sentidos causales aristotélicos. Se trata de la cuestión sobre los actos imperados (ST I–II, q. 17); en cuyos primeros cuatro artículos –y en sus textos paralelos– determina que la voluntad es causa agente; la razón práctica, (...) causa ordenadora; y el imperium de ambas (razón y voluntad) se relaciona con el acto imperado como lo formal con lo material. (shrink)

Presentación del libro de Nicolás Rosa Relatos críticos. Cosas animales discursos.

Este artículo está motivado por el problema de la responsabilidad colectiva frente a las acciones cometidas por nuestros antepasados y por la pregunta acerca de la legitimidad de las demandas de perdón. Acudiendo al universo conceptual heredado de Hannah Arendt, en este texto se aboga por el ejercicio de la capacidad de juicio como detonante tanto de la demanda de perdón como de la responsabilidad colectiva. El perdón se presenta así no solo como una categoría moral sino fundamentalmente política, imprescindible (...) para reconciliarse con lo acontecido y mirar al futuro con esperanza. (shrink)

Background: This study investigated the factors affecting the acceptability in France of abortions. Method: 80 study participants from Toulouse and 124 from Metz judged the acceptability of abortion in 64 vignettes composed of five factors: 1) the adolescent's age (15 or 17.5 years), 2) the adolescent's plans to continue schooling or not, 3) the fetus' age (1, 2, 3, or 4 months), 4) the adolescent's parents' agreement or not, and 5) the agreement or not of baby's father. Results: Three clusters (...) were noted: 1) abortion is never acceptable (8% of participants), 2) abortion is always acceptable (23%), and 3) acceptability of abortion depends on the circumstances (63%). In the majority cluster (3), all five factors had significant effects, but the fetus's age accounted for most of the variance (78%). Conclusion: Most subjects in this study judged, in accordance with French law, that the acceptability of induced abortion in minors depends on the circumstances and, in particular, on the fetus' age. (shrink)

The aim of this article is to explore the concept of “courtliness” in Castiglione and Gracián. The hero of Gracián learns the art of the “courtliness” from Castiglione, but he is not a “courtier”. Gracián uses the word “courtier” in a much broader sense. The courtliness in Castiglione is a sort of meta-discipline that contains in itself all the arts and is founded on the universal rule of «grace». The article shows how the theory of the grace of Castiglione, through (...) which the count would have been able to reconcile two requirements, achieved success in Court and a life governed by the sign of elegance, loses its intensity in Gracián, who insists more on the strategic behavior, based more on prudence and discretion than on grace. The courtesan philosophy of Gracián is understood as a discourse on the life. If we understand the court as the enclosed space in which the courtier of Castiglione lives, it is not a philosophy of court but a philosophy of human life. Gracián court is the square in the world. (shrink)

This book is a multi-faceted attempt to understand the psychological mysteries of land, space, native cultures, changing eras, and geographical dislocation. It shows us that many remote and seemingly peaceful areas of the world have their own dark and silent pasts in which their original inhabitants were often brutally wiped out. Weaving history, geography, myth, philosophy, and psychoanalysis together, this book tries to understand why such atrocities were committed, how those subjected to these 'crimes' might have perceived them, and what (...) are the long-term, trans-generational consequences of these historical events. (shrink)

Se reflexiona sobre la posible autoría del documento que se conserva en la Biblioteca Nacional de Madrid, “_Censura_ sobre los Anales de Tácito…”, ms. 13086. El colector de la miscelánea lo catalogó como anónimo a pesar del nombre que figura en una hoja adjunta al documento: Pedro Ponce de León. En este artículo se plantea una hipótesis sobre su posible autoría: Pedro Ponce de León podría ser el seudónimo con el que ocultó su identidad don Diego de Saavedra Fajardo.

In his main work, The Science of Legislation , the Neapolitan Gaetano Filangieri proposed a set of extensive political and cultural reforms. These reforms were necessary to free eighteenth-century societies from the remnants of feudal institutions that obstructed international peace and economic growth. Filangieri's ideas were shaped by the international political climate between the seven Years’ War and the eve of the French Revolution. Reinterpreting Montesquieu and Genovesi through the influences of French radical and Enlightenment thought , as well as (...) the economics of Hume, Verri and the Physiocrats, he concluded that European modernity was inherently contradictory.From this perspective Filangieri set out to force a clean break between the technical horizons of mercantilism and enlightened absolutism and a society based on civil rights, a fair distribution of wealth and resources, and free trade. Proper ‘scientific’ knowledge of the rules and principles of legislation would allow governments to balance out the natural and cultural factors that characterise individual states, and to identify the appropriate model for social and economic development. If all states acted on their proper interest, international free trade and peaceful competition between states would emerge and the potential for general economic growth be materialised. Thus, the natural equilibrium and ‘universal consensus’ among nations could be restored. (shrink)

Examining the ethics of the church as an institution necessarily asks what can serve as criteria or ultimate aims for the functioning of institutions responsible for nourishing and supporting Christian witness in society. For liberation theology and ethics, orthopraxis—righteousness in the practices both within and outside the church for the sake of becoming the church of the poor—becomes such criteria. Becoming a church of liberation, the church of the poor, allows us to evaluate the church as an institution or polis (...) with a particular common good that ought to be shaped for and put at the service of prophetic Christian witness. Recent crises and challenges in the life of the Christian churches in the United States help ground this proposal in the author’s specific context. (shrink)

This article offers a review of the chapter dedicated by Strawson to the concept of a person in Individuals. Characteristics given to the concept of person by Strawson are criticized by Bernard Williams. What I set out to show is that this criticism can be answered by reviewing: a) how Strawson understands that the concept of a person is primitive, b) what are the implications of affirming the primitiveness of such concept, and, mainly c) what this philosopher understands by referring.

En este artículo se defiende la siguiente tesis: Wittgenstein “exorciza” los argumentos escépticos mostrando una concepción alternativa del lenguaje y del conocimiento que ha dado en caracterizarse como naturalismo y quietismo. Y se ofrece un deslinde entre los planteamientos quietistas y naturalistas wittgensteinianos y el naturalismo propio del empirismo mínimo de McDowell. A diferencia de este último, la propuesta wittgensteiniana nos ofrece la posibilidad de rechazar el reto escéptico.