En este ensayo se reflexiona sobre el sentido de la interpretación nietzscheana de Grecia, que aunque problemática y filosófica, se inserta en la tradición clasicista de Occidente. Ubicando el clima intelectual en el que surgió El nacimiento de la tragedia, se postula que el pensador alemán no puede..

Background:Nurses and nursing students appear vulnerable to moral distress when faced with ethical dilemmas or decision-making in clinical practice. As a result, they may experience professional dissatisfaction and their relationships with patients, families, and colleagues may be compromised. The impact of moral distress may manifest as anger, feelings of guilt and frustration, a desire to give up the profession, loss of self-esteem, depression, and anxiety.Objectives:The purpose of this review was to describe how dilemmas and environmental, relational, and organizational factors contribute (...) to moral distress in undergraduate student nurses during their clinical experience and professional education.Research design:The research design was a systematic literature review.Method:The search produced a total of 157 articles published between 2004 and 2014. These were screened with the assessment sheet designed by Hawker and colleagues. Four articles matched the search criteria (one quantitative study and three qualitative), and these were separately read and analyzed by the researchers. The process of review and analysis of the data was supervised by a colleague experienced in moral distress who provided an independent quality check.Ethical consideration:Since this was a systematic review, no ethical approval was required.Findings:From the analysis, it emerged that inequalities and healthcare disparities, the relationship with the mentor, and students’ individual characteristics can all impact negatively on the decisions taken and the nursing care provided, generating moral distress. All these factors condition both the clinical experience and learning process, in addition to the professional development and the possible care choices of future nurses.Conclusion:Few studies dealt with moral distress in the setting of nurse education, and there is a knowledge gap related to this phenomenon. The results of this review underline the need for further research regarding interventions that can minimize moral distress in undergraduate nursing students. (shrink)

The time marked by the clock hands, the so-called “objective time,” is deeply different from the one perceived by the individual. Starting from this hypothesis, directly connected to the subjective modality of “living” the time and defined as time perspective, we will try to understand how much it affects the various domains of people's lives, attitudes, and experiences. Therefore, the research investigates whether all our decisions can be influenced by one or more time perspectives beyond our awareness. Last, but not (...) least, we will try to understand if some time perspectives in specific contexts are more functional and adaptive than others. (shrink)

Background:Nurse managers are expected to continuously ensure that ethical standards are met and to support healthcare workers’ ethical competence. Several studies have concluded that nurses across various healthcare settings lack the support needed to provide safe, compassionate and competent ethical care.Objective:The aim of this study was to explore and understand how nurse managers perceive their role in supporting their staff in conducting ethically sound care in nursing homes and home nursing care.Design and participants:Qualitative individual interviews were performed with 10 nurse (...) managers with human resources responsibilities for healthcare workers in four nursing home wards and six home nursing care districts. Content analysis was used to analyse the data.Ethical considerations:The Norwegian Centre for Research Data granted permission for this study.Findings:The analysis resulted in seven subcategories that were grouped into three main categories: managers’ perception of the importance of the role, managers’ experiences of exercising the role and managers’ opportunities to fulfil the role. Challenges with conceptualizing ethics were highlighted, as well as lack of applicable tools or time and varying motivation among employees.Discussion:The leaders tended to perceive ethics as a ‘personal matter’ and that the need for and benefit of ethical support (e.g., ethics reflection) depended on individuals’ vulnerability, attitudes, commitment and previous experiences. The managers did not seem to distinguish between their own responsibility to support ethical competence and the responsibility of the individual employee to provide ethical care.Conclusions:Our findings suggest that nurse managers need support themselves, both to understand and to carry out their responsibilities to foster their staffs’ ethical conduct. Supporting staff in conducting ethically sound care requires more than organizing meeting places for ethical reflection; it also requires greater awareness and understanding of what ethical leadership means. (shrink)

Cognitive Science, Volume 45, Issue 11, November 2021.

The radical changes deriving from the COVID-19 emergency have heavily upset some of the most familiar routines of daily work life. Abruptly, many workers have been forced to face the difficulties that come with switching to remote working. Basing on the theoretical framework proposed by the Job Demands-Resources model, the purpose of this paper was to explore the effect of work overload, on behavioral stress, meant as an outcome linked to the health impairment process. Furthermore, the aim of the study (...) was to explore the mediating role of job crafting, considered as a second-order construct consisting of two dimensions in the abovementioned relation. Participants were 530 workers experiencing remote working or work-from-home during the first COVID-19 lockdown in Italy. Hypotheses were explored by using three different latent variables, measured reflexively through indicators on a 5-point scale, extracted from validated questionnaires. Data analysis was performed through Structural Equation Modeling; to test the mediation, bootstrap validation was computed. Results showed that the mediation of job crafting was partial. More specifically, the direct effect between work overload and behavioral stress was positive; moreover, the indirect, negative effect through the mediation of job crafting was also significant. Therefore, results showed that job crafting can play a crucial role as a protective factor supporting the activation and adjustment of suitable resources; these resources can be useful to deal with the negative effects of work overload, particularly under the condition of heavy remote working and use of technologies, on individual outcomes. Starting from the current global scenario of the pandemic that has not yet ceased its effects, the study suggested decisive theoretical and practical implications. Accordingly, findings extended the current trends in occupational health psychology research, with special reference to the mainstream topic “work and COVID-19” in the Italian context. Finally, results can give suggestions to companies engaged in managing change, recommending that they build a collaborative workplace at the individual and collective level to implement job crafting interventions and enrich the personal and organizational resources of workers, which is useful cope with the current demands. (shrink)

Despite the lack of invariance problem (the many‐to‐many mapping between acoustics and percepts), human listeners experience phonetic constancy and typically perceive what a speaker intends. Most models of human speech recognition (HSR) have side‐stepped this problem, working with abstract, idealized inputs and deferring the challenge of working with real speech. In contrast, carefully engineered deep learning networks allow robust, real‐world automatic speech recognition (ASR). However, the complexities of deep learning architectures and training regimens make it difficult to use them to (...) provide direct insights into mechanisms that may support HSR. In this brief article, we report preliminary results from a two‐layer network that borrows one element from ASR, long short‐term memory nodes, which provide dynamic memory for a range of temporal spans. This allows the model to learn to map real speech from multiple talkers to semantic targets with high accuracy, with human‐like timecourse of lexical access and phonological competition. Internal representations emerge that resemble phonetically organized responses in human superior temporal gyrus, suggesting that the model develops a distributed phonological code despite no explicit training on phonetic or phonemic targets. The ability to work with real speech is a major advance for cognitive models of HSR. (shrink)

Grossberg and VanDieren have started a program to develop a stability theory for tame classes. We name some variants of tameness and prove the following. Let K be an AEC with Löwenheim-Skolem number ≤κ. Assume that K satisfies the amalgamation property and is κ-weakly tame and Galois-stable in κ. Then K is Galois-stable in κ⁺ⁿ for all n<ω. With one further hypothesis we get a very strong conclusion in the countable case. Let K be an AEC satisfying the amalgamation property (...) and with Löwenheim-Skolem number ℵ₀ that is ω-local and ℵ₀-tame. If K is ℵ₀-Galois-stable then K is Galois-stable in all cardinalities. (shrink)

In his 1676 text De Quadratura Arithmetica, Leibniz distinguished infinita terminata from infinita interminata. The text also deals with the notion, originating with Desargues, of the point of intersection at infinite distance for parallel lines. We examine contrasting interpretations of these notions in the context of Leibniz’s analysis of asymptotes for logarithmic curves and hyperbolas. We point out difficulties that arise due to conflating these notions of infinity. As noted by Rodríguez Hurtado et al., a significant difference exists between the (...) Cartesian model of magnitudes and Leibniz’s search for a qualitative model for studying perspective, including ideal points at infinity. We show how respecting the distinction between these notions enables a consistent interpretation thereof. (shrink)

La decisión de Angela Merkel de abrir sin reservas las fronteras de su país en 2015 a cientos de miles de refugiados representa uno de los acontecimientos más relevantes de la historia de Alemania en el siglo xxi. Tanto la determinación de la canciller como la actitud manifestada por la mayoría de los ciudadanos han de ser interpretadas en el contexto de una historia caracterizada tanto por el sufrimiento infligido por Alemania como por el sufrimiento propio derivado de los conflictos (...) bélicos en los que se vieron inmersos. A este respecto, el humanitarismoalemán posterior a 1990 se debe en parte a una deudacon el pasado: bien como restitución del daño causado, bien como recordatorio del dolor sufrido. Ámbitos tan diversos como el discurso político o la literatura contribuyeron durante décadas a conformar una memoria cultural que prestaba especial atención al traumático siglo xx y a las responsabilidades nacionales que aún no habían prescrito. (shrink)

This article aims to study the simulation and design of automobile automatic clutch under mechatronics. A new control strategy for the automatic clutch of the electromagnetic transmission is proposed. The clutch mechanism model, clutch drive model, clutch system model, and internal combustion engine model are constructed. The fuzzy logic control performance of the automatic clutch was verified in different operating modes, including starting on flat roads and mountain roads. The method provides a reasonable reference for the design of an automatic (...) clutch of electromagnetic continuously variable transmission. (shrink)

In 2016, Béziau introduces a restricted notion of paraconsistency, the so-called genuine paraconsistency. A logic is genuine paraconsistent if it rejects the laws $\varphi,\neg \varphi \vdash \psi$ and $\vdash \neg (\varphi \wedge \neg \varphi)$. In that paper, the author analyzes, among the three-valued logics, which of them satisfy this property. If we consider multiple-conclusion consequence relations, the dual properties of those above-mentioned are $\vdash \varphi, \neg \varphi$ and $\neg (\varphi \vee \neg \varphi) \vdash$. We call genuine paracomplete logics those rejecting (...) the mentioned properties. We present here an analysis of the three-valued genuine paracomplete logics. A very natural twist structures semantics for these logics is also found in a systematic way. This semantics produces automatically a simple and elegant Hilbert-style characterization for all these logics. Finally, we introduce the logic LGP which is genuine paracomplete is not genuine paraconsistent, not even paraconsistent and cannot be characterized by a single finite logical matrix. (shrink)

Objective: Quality of Life is an important predictor of patient's recovery and survival in lung cancer patients. The aim of the present study is to identify 1-year trends of lung cancer patients' QoL after robot-assisted or traditional lobectomy and investigate whether clinical and sociodemographic variables may predict these trends.Methods: An Italian sample of 176 lung cancer patients undergoing lobectomy completed the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire—Core 30 at the pre-hospitalization, 30 days, 4 months, (...) 8 months, and 12 months after surgery. Sociodemographic and clinical characteristics were also collected. The individual change over time of the 15 dimensions of the EORTC QLQ-C30 and the effects of pre-surgery scores of QoL dimensions, type of surgery, perioperative complications, and age on patients' QoL after surgery were studied with the individual growth curve models.Results: Patients had a good recovery after lobectomy: functioning subscales improved over time, while most of the symptoms became less severe over the care process. Perioperative complications, type of surgery, pre-surgery status, and age significantly affected these trends, thus becoming predictors of patients' QoL.Conclusion: This study highlights different 1-year trends of lung cancer patients' QoL. The measurement of pre- and post-surgery QoL and its clinical and sociodemographic covariables would be necessary to better investigate patients' care process and implement personalized medicine in lung cancer hospital divisions. (shrink)

The increasing use of cluster randomised trials in low-resource settings raises unique ethical issues. The Ottawa Statement on the Ethical Design and Conduct of Cluster Randomised Trials is the first international ethical guidance document specific to cluster trials, but it is unknown if it adequately addresses issues in low-resource settings. In this paper, we seek to identify any gaps in the Ottawa Statement relevant to cluster trials conducted in low-resource settings. Our method is to analyse a prototypical cluster trial conducted (...) in a low-resource setting with the Ottawa Statement; to identify ethical issues in the design or conduct of the trial not captured adequately and to make recommendations for issues needing attention in forthcoming revisions to the Ottawa Statement. Our analysis identified six ethical aspects of cluster randomised trials in low-resource settings that require further guidance. The forthcoming revision of the Ottawa Statement should provide additional guidance on these issues: streamlining research ethics committee review for collaborating investigators who are affiliated with other institutions; the classification of lay health workers who deliver study interventions as health providers or research participants; the dilemma experienced by investigators when national standards seem to prohibit waivers of consent; the timing of gatekeeper engagement, particularly when researchers face funding constraints; providing ancillary care in health services or implementation trials when a routine care control arm is known to fall below national standards and defining vulnerable participants needing protection in low-resource settings. (shrink)

The human being can be divided into body and mind, two inextricably linked aspects influencing each other. From birth, the body is the site of emotional experiences thanks to cellular memory. The t...

The distribution of cultural variants in a population is shaped by both neutral evolutionary dynamics and by selection pressures. The temporal dynamics of social network connectivity, that is, the order in which individuals in a population interact with each other, has been largely unexplored. In this paper, we investigate how, in a fully connected social network, connectivity dynamics, alone and in interaction with different cognitive biases, affect the evolution of cultural variants. Using agent‐based computer simulations, we manipulate population connectivity dynamics (...) (early, mid, and late full‐population connectivity); content bias, or a preference for high‐quality variants; coordination bias, or whether agents tend to use self‐produced variants (egocentric bias), or to switch to variants observed in others (allocentric bias); and memory size, or the number of items that agents can store in their memory. We show that connectivity dynamics affect the time‐course of variant spread, with lower connectivity slowing down convergence of the population onto a single cultural variant. We also show that, compared to a neutral evolutionary model, content bias accelerates convergence and amplifies the effects of connectivity dynamics, while larger memory size and coordination bias, especially egocentric bias, slow down convergence. Furthermore, connectivity dynamics affect the frequency of high‐quality variants (adaptiveness), with late connectivity populations showing bursts of rapid change in adaptiveness followed by periods of relatively slower change, and early connectivity populations following a single‐peak evolutionary dynamic. We evaluate our simulations against existing data collected from previous experiments and show how our model reproduces the empirical patterns of convergence. (shrink)

Randomized controlled trial trial designs exist on an explanatory-pragmatic spectrum, depending on the degree to which a study aims to address a question of efficacy or effectiveness. As conceptualized by Schwartz and Lellouch in 1967, an explanatory approach to trial design emphasizes hypothesis testing about the mechanisms of action of treatments under ideal conditions, whereas a pragmatic approach emphasizes testing effectiveness of two or more available treatments in real-world conditions. Interest in, and the number of, pragmatic trials has grown substantially (...) in recent years, with increased recognition by funders and stakeholders worldwide of the need for credible evidence to inform clinical decision-making. This increase has been accompanied by the onset of learning healthcare systems, as well as an increasing focus on patient-oriented research. However, pragmatic trials have ethical challenges that have not yet been identified or adequately characterized. The present study aims to explore the views of key stakeholders with respect to ethical issues raised by the design and conduct of pragmatic trials. It is embedded within a large, four-year project that seeks to develop guidance for the ethical design and conduct of pragmatic trials. As a first step, this study will address important gaps in the current empirical literature with respect to identifying a comprehensive range of ethical issues arising from the design and conduct of pragmatic trials. By opening up a broad range of topics for consideration within our parallel ethical analysis, we will extend the current debate, which has largely emphasized issues of consent, to the range of ethical considerations that may flow from specific design choices. Semi-structured interviews with key stakeholders, across multiple jurisdictions, identified based on their known experience and/or expertise with pragmatic trials. We expect that the study outputs will be of interest to a wide range of knowledge users including trialists, ethicists, research ethics committees, journal editors, regulators, healthcare policymakers, research funders and patient groups. All publications will adhere to the Tri-Agency Open Access Policy on Publications. (shrink)

In the context of the current heated debate surrounding the pervasive influence of the English language and Anglo-American culture on other languages, as well as the widespread purist attitude towards some contact-induced language change phenomena, both abroad and in Romania, our article discusses the situation of English lexical borrowings in present-day Romanian, focusing on the perception and processing of the so-calledluxury Anglicisms(Sections 2and3) by young Romanian native speakers, in an attempt to see whether such an analysis can help clarify their (...) acceptability and diffusion across our target population. We propose an alternative cognitive, psycholinguistic approach to the study of contact-induced lexical borrowings, aiming to show that there is no difference in the young Romanian native speakers’ processing of sentences containing luxury Anglicisms and their established Romanian counterparts. Such findings may support our claim that the acceptability and diffusion of such Anglicisms are pervasive across our target population, even if the official position generally condemns such uses, considering them gratuitous and a burden in communication, even making it unintelligible sometimes.Our analysis starts from the observation that most (but not all) Romanian academics, whether linguists or not, tend to embrace a purist attitude, while on the other hand young Romanians accept such Anglicisms and tend to use them extensively. In fact, such uses are not limited to young people, who have been the subjects of our research, but are the ‘norm’ in daily conversations and elsewhere across the general population (Stoichițoiu Ichim 2006). Thus, there seems to be a gap between the actual acceptability and diffusion of luxury Anglicisms among Romanians and the ‘official’ recommendations. Based on the results of a sensicality task, meant to show how 188 Romanians, aged 18–22, process and perceive sentences with or without luxury Anglicisms (seeSection 6), we will try to show that luxury Anglicisms are accepted and, by recurrent use, diffused among the Romanian community. For a more accurate picture of their diffusion, the findings will be further correlated with data fromCoRoLa, the only official corpus ofpresent-day Romanian (beginning 1989) made available under the auspices of the Romanian Academy, as well as a corpus currently in the making, and the Internet (seeSection 7).Besides showing that luxury Anglicisms cannot really be blamed for burdening or impairing processing, and thus communication, and explaining why such uses should not be censured or disapproved, we hope that our study of acceptability and diffusion will demonstrate that we are dealing with a complex, multi-layered phenomenon that can be better understood by going beyond a diachronic and synchronic analysis of particular words and a frequency count, and should incorporate more experimental data.Last but not least, we suggest that, on the practical side, such experimental studies as the one described here could be used as an additional criterion for the lexicographic inclusion of lexical borrowings. (shrink)

Knowledge brokers are among the main channels of communication between scientists and the public and a key element to establishing a relation of trust between the two. But translating knowledge from the scientific community to a wider audience presents several difficulties, which can be accentuated in times of crisis. In this paper we study some of the problems that knowledge brokers face when communicating in times of crisis. During the first wave of the COVID-19 pandemic, we collected interviews with Italian (...) experts that played a major role as knowledge brokers in the local media. We asked them questions about five main topics: the features and role of science communicators; the use of language in communicating science; the importance of the relation of trust with the public; the peculiarity of communicating in a context of emergency; the problem of disagreement among experts, and its public perception and communication. The goal of this paper is to understand, through the words of knowledge brokers themselves, what they consider as best practices (and obstacles) to create trust between scientists and the public. Our empirical work can inform normative accounts of what knowledge brokering should be about. (shrink)

The deep comprehension of a text is tantamount to the construction of an articulated mental model of that text. The number of correct recollections is an index of a learner's mental model of a text. We assume that another index of comprehension is the timing of the gestures produced during text recall; gestures are simultaneous with speech when the learner has built an articulated mental model of the text, whereas they anticipate the speech when the learner has built a less (...) articulated mental model. The results of four experiments confirm the predictions deriving from our assumptions for both children and adults. Provided that the recollections are correct, the timing of gestures can differ and can be considered a further measure of the quality of the mental model, beyond the number of correct recollections. (shrink)

ABSTRACT Despite journalism’s commitment to ethical principles such as accuracy, humanity and diversity, compliance with the gender perspective in content is still minimal in approximately one hundred countries. This inequality reinforces misperceptions, imbalances, and perceived differences between men and women. To address this situation, from 2010 to 2021, eight Spanish media companies appointed a new editorial position responsible for self-regulating gender equality. This qualitative study focused on 10 journalists who currently exercise or have exercised that job, to detect, describe and (...) propose the implementation of this new professional role. This study suggests that gender editing has advanced equality in parity of sourcing and the presence of women in the opinion sections, but implementation of equality in overall content is more difficult. Gender editors’ daily work is hampered by a lack of management support and an absence of independence in editorial decisions. (shrink)

Two-dimensional semantics is a framework that helps us better understand some of the most fundamental issues in philosophy: those having to do with the relationship between the meaning of words, the way the world is, and our knowledge of the meaning of words. This selection of new essays by some of the world's leading authorities in this field sheds fresh light both on foundational issues regarding two-dimensional semantics and on its specific applications. Contributors: Richard Breheny, Alex Byrne, David Chalmers, Martin (...) Davies, Gareth Evans, Manuel Garcia-Carpintero, Josep Maci`, Martine Nida-Rumelin, Christopher Peacocke, James Pryor, Francois Recanati, Scott Soames, Cara Spencer, Robert Stalnaker, Kai-Yee Wong, Stephen Yablo. (shrink)

Josefa Amar y Borbón, une intellectuelle espagnole du XVIIIe siècle, défendit dans ses ouvrages et dans sa vie la raison des femmes, à partir de sa propre tradition culturelle mais simultanément avec d’autres intellectuelles européennes de son temps. Elle se forgea un prestige intellectuel et intervint publiquement dans le débat sur l’admission des femmes dans les sociétés réformistes, contre l’opinion négative d’une partie des hommes des élites éclairées espagnoles. La lecture de ses textes et leur comparaison avec la pensée de (...) sa contemporaine Mme d’Épinay montre que, dans des contextes sociaux et culturels différents, ces deux femmes avait des idées concordantes sur la raison, l’éducation et la condition social des femmes, loin des opinions plus répandues, celles des auteurs comme Thomas, Rousseau et d’autres contemporains espagnols. Elles avaient aussi des stratégies vitales communes, qui visaient à occuper et à revendiquer pour les femmes des possibilités et des espaces dans l’activité culturelle et la sociabilité des Lumières. (shrink)

RESUMOO presente artigo tem como objetivo analisar os meandros da composição e suas intertextualidades na polêmica do samba entre Noel Rosa e Wilson Batista, observando o dialogismo na interação verbal e musical entre os autores e os diversos textos da década de 1930. Ao apurar os ouvidos sobre a "polêmica do samba" observa-se que as composições revelam tensões inexoráveis entre um mundo festivo do "malandro" e os limites da realidade da época. Desse modo, com suporte em estudos que tratam deste (...) tema, busca-se trazer à tona um insight sobre este "duelo" musical que está, certamente, muito mais disseminado na sociedade que restrito a questões puramente estéticas.ABSTRACTThe purpose of this paper is to analyze the meanders of composition and their intertextuality in the samba controversy between Noel Rosa and Wilson Batista. We observe dialogism in the verbal and musical interaction between the samba writers and several texts of the 1930s. When ears are in tune with the "samba controversy," one observes that the compositions reveal inexorable tensions between the festive world of the "malandro" and the limits of the reality of the time. Accordingly, based on studies that address this theme, we aim to present an insight into this musical "duel," which is not restricted to purely aesthetics issues, but certainly disseminated in society. (shrink)

Public health agencies undertake a broad range of health promotion and injury and disease prevention activities in collaboration with an array of actors, such as the community, businesses, and non-profit organizations. These activities are “multisectoral” in nature and centered on public health agencies that oversee and engage with the other actors. Public health agencies can influence the hazardous activities in the private sector in a variety of ways, “ranging from prohibition and regulation to volunteerism, and from cooperation to cooption.” Hence, (...) a public health agency that possesses the necessary administrative resources and authority is vital to the effective implementation of health policies and regulations.In the developing world, however, many state health agencies lack these basic capacities in dealing with critical health threats, including their ability to avert epidemics of communicable diseases arising from poor sanitary conditions. A serious constraint is the shortage of public health funding for health agencies in the developing world for typical agency functions. This is often aggravated by the transaction-intensive demands entailed in enforcing regulations among an array of private and public sector actors including individuals, businesses, and local bodies responsible for providing civic services. (shrink)

The centromere is a specialized chromosomal structure that dictates kinetochore assembly and, thus, is essential for accurate chromosome segregation. Centromere identity is determined epigenetically by the presence of a centromere‐specific histone H3 variant, CENP‐A, that replaces canonical H3 in centromeric chromatin. Here, we discuss recent work by Roulland et al. that identifies structural elements of the nucleosome as essential determinants of centromere function. In particular, CENP‐A nucleosomes have flexible DNA ends due to the short αN helix of CENP‐A. The higher (...) flexibility of the DNA ends of centromeric nucleosomes impairs binding of linker histones H1, while it facilitates binding of other essential centromeric proteins, such as CENP‐C, and is required for mitotic fidelity. This work extends previous observations indicating that the differential structural properties of CENP‐A nucleosomes are on the basis of its contribution to centromere identity and function. Here, we discuss the implications of this work and the questions arising from it. (shrink)

Estudos indicam que o estresse altera o sistema imune e pode influir na etiologia, progressão e severidade de doenças. A resiliência pode ser definida como a capacidade que algumas pessoas desenvolvem e as ajudam a passar por situações adversas na vida, a superá-las, e ainda a saírem fortalecidas ou..

Newborn bloodspot screening programs are some of the longest running population screening programs internationally. Debate continues regarding the need for parents to give consent to having their child screened. Little attention has been paid to how meanings of consent-related terminology vary among stakeholders and the implications of this for practice. We undertook semi-structured interviews with parents, healthcare professionals and policy decision makers in two Canadian provinces. Conceptions of consent-related terms revolved around seven factors within two broad domains, decision-making and information (...) attainment. Decision-making comprised: parent decision authority; voluntariness; parent engagement with decision-making; and the process of enacting choice. Information ascertainment comprised: professional responsibilities ; parent responsibilities; and the need for discussion and understanding prior to a decision. Our findings indicate that consent-related terms are variously understood, with substantive implications for practice. We suggest that consent procedures should be explained descriptively, regardless of approach, so there are clear indications of what is expected of parents and healthcare professionals. Support systems are required both to meet the educational needs of parents and families and to support healthcare professionals in delivering information in a manner in keeping with parent needs. (shrink)