Propósito: la adecuación del esfuerzo terapéutico es una decisión clínica basada en la evidencia que pretende evitar la futilidad médica. Se han señalado diferentes factores que pueden influir en esta toma de decisiones los cuales se relacionan con el paciente, el profesional médico que toma de las decisiones, barreras del sistema, cultura y economía, entre otros. El presente estudio pretende identificar aquellos factores que influyen en los médicos especialistas que laboran en la institución referente del cáncer en Colombia, a fin (...) de planear acciones que mejoren el abordaje de la toma de decisiones con respecto a la adecuación del esfuerzo terapéutico en pacientes con cáncer. Metodología: diseño cualitativo basado en 13 entrevistas en profundidad a médicos especialistas del Instituto Nacional de Cancerología de Colombia. Resultados: participaron 3 mujeres y 10 hombres, con un promedio de edad de 36 años, 7 pertenecientes a la especialidad de oncología de adultos, 2 a oncohematología pediátrica, 1 a cuidados intensivos de adultos y 3 a cuidados intensivos pediátricos. Los factores hallados se agruparon en cuatro categorías: 1) conocimiento, 2) aspectos relacionados con la toma de decisiones, 3) quién decide, 4) tipo de decisión que se toma; a su vez, estas categorías se agruparon en temas que hacen alusión a los factores que influyen en la toma de decisiones de los especialistas para adecuar los esfuerzos terapéuticos. Conclusión: la adecuación de los esfuerzos terapéuticos es importante para evitar procedimientos médicos fútiles que prolonguen el sufrimiento. Se evidenciaron algunos factores que influyen en la toma de decisiones de los especialistas: falta de preparación de los profesionales de salud en el tema de toma de decisiones al final de la vida, uso reducido de escalas que permitan mejorar la información del pronóstico y desconocimiento sobre voluntades anticipadas; estos son algunos de aquellos factores que deben fortalecerse para generar acciones que mejoren el abordaje de esta temática. (shrink)

El objetivo de esta investigación es determinar si existe influencia en los alumnos al elegir una carrera profesional por parte de los padres al manifestar estos un deseo diferido por obtener un título profesional y establecer el grado de satisfacción de los alumnos con su carrera elegida. La investigación se realizó dos etapas, la primera detecta si existe el deseo diferido de los padres por obtener un título profesional y la influencia de este sobre los alumnos. La segunda midió la (...) satisfacción de los alumnos con la carrera y el grado de influencia de los padres. El 79.31% de los padres presentan el deseo diferido por obtener un título profesional, de los cuales el 67% de ellos a influenciado alguno de sus hijos con su deseo, la satisfacción de los alumnos con su carrera está directamente relacionada con la influencia de los padres y con el semestre que cursa. Se concluye que el deseo diferido de los padres por obtener un título profesional existe en la mayoría de ellos y este se refleja en sus consejos para la selección de la carrera por parte del alumno y su grado de satisfacción. (shrink)

La práctica profesional es el medio que permite a los estudiantes aplicar los conocimientos aprendidos durante su proceso de formación y fortalecer las competencias del saber, saber hacer y ser/convivir. El articulo sintetiza las características y procesos desarrollados desde el curso práctica profesional en la Corporación Universitaria del Caribe en pandemia. En tanto, el proceso de práctica se adaptó a la contingencia adoptando nuevas modalidades de realización de práctica a nivel institucional (telepráctica, trabajo en casa, práctica asesor/tutor, investigación, emprendimiento y (...) telepsicología) para garantizarle a los estudiantes el espacio pedagógico que permitiera poner en práctica sus conocimientos y competencias disciplinares. (shrink)

Los canales de YouTube, Alanna y WITCHYSOFFIE, enseñan al espectador sobre hechicería y tradiciones paganas. Estas se oponen a la estigmatización, el tótem patriarcal y los tabúes religiosos generados por la Inquisición los cuales aún son mantenidos por una parte de la sociedad actual. La magia de varios grupos wiccanos se encamina hacia la espiritualidad y alabanza de un Dios creador, algo semejante con la filosofía católica. De igual forma, su estudio por la naturaleza y su aplicación en rituales se (...) enfocan en el autoconocimiento y la conexión con el universo. Los factores como la globalización y modernización actúan de manera crucial en las impresiones colectivas que se tiene sobre la brujería. (shrink)

Background: Frailty is a common syndrome among older adults and patients with several comorbidities. Grip strength is a representative parameter of frailty because it is a valid indicator of current and long-term physical conditions in the general population and patients with severe mental illnesses. Physical and cognitive capacities of people with SMIs are usually impaired; however, their relationship with frailty or social functioning have not been studied to date. The current study aimed to determine if GS is a valid predictor (...) of changes in cognitive performance and social functioning in patients with type-2 diabetes mellitus and SMIs. Methods: Assessments of social functioning, cognitive performance, and GS were conducted in 30 outpatients with type 2 diabetes mellitus, 35 with major depressive disorder, 42 with bipolar disorder, 30 with schizophrenia, and 28 healthy controls, twice during 1-year, follow-up period. Descriptive analyses were conducted using a one-way analysis of variance for continuous variables and the chi-squared test for categorical variables. Differences between groups for the motor, cognitive, and social variables at T1 and T2 were assessed using a one-way analysis of covariance, with sex and age as co-variates. To test the predictive capacity of GS at baseline to explain the variance in cognitive performance and social functioning at T2, a linear regression analysis was performed. Results: Predictive relationships were found among GS when implicated with clinical, cognitive, and social variables. These relationships explained changes in cognitive performance after one year of follow-up; the variability percentage was 67.7%, in patients with type-2 diabetes mellitus and 89.1% in patients with schizophrenia. Baseline GS along with other variables, also predicted changes in social functioning in major depressive disorder, bipolar disorder, and schizophrenia, with variability percentages of 67.3, 36, and 59%, respectively. Conclusion: GS combined with other variables significantly predicted changes in cognitive performance and social functioning in people with SMIs or type-2 diabetes mellitus. Interventions aimed to improve the overall physical conditions of patients who have poor GS could be a therapeutic option that confers positive effects on cognitive performance and social functioning. (shrink)

This paper focuses on the description and analysis of three codices from Biblioteca Nacional in Madrid with the aim of redefining their origin, dating, authorship, and content. Connecting their production to the environment of the Sacromonte affair and identifying Pedro de Castro’s hand allows to expand what was known so far about his attempts to learn Arabic and delve into the most controversial aspects of the Lead Books. The grammatical and religious contents, in addition to the copious marginal notes linked (...) to the sources he used, provide valuable information on his selection of works. Grammatical materials such as al-Āŷurrūmiyya, of which different versions are preserved in these codices, were being published in Rome and Leiden and would be widely disseminated. The building up of his library, to which these codices must have belonged, runs in parallel to the construction of an orientalist knowledge in modern Europe. (shrink)

This research aims to fill a major gap in the relevant literature on small businesses in developing countries, specifically concerning the development of models to better explain economic and environmental performance as a result of environmental compliance, thus moving toward an explanation of the sustainable behavior of these businesses. Data from 186 pottery craft businesses located in three Mexican states (Oaxaca, Puebla and Tlaxcala) reveal that environmental compliance significantly influences economic and environmental performance, with the mediating role of environmental innovation, (...) confirming the Porter hypothesis in the context of small businesses in an emerging economy. Environmental compliance is an important factor in improving the economic and environmental performance of small businesses in emerging economies. (shrink)

Parent and preschool teacher ratings of the 10 noun categories of MacArthur-Bates Communication Development Inventory were used to study expressive language in 2–4-year-old children with autism spectrum disorder across the home and preschool context. There was no significant difference in the total number of words the children said in the two contexts, but the children said significantly more words in the noun categories “Furniture and rooms” and “People” at home. Only one third of the words the children said were said (...) both at home and in the preschool, while the other two thirds were said only at home or only in preschool. This suggests that what words the children use across contexts differ substantially and that their vocabulary is larger than it seems when measured only in one context. This novel study highlights the importance of assessing the language in children with ASD in multiple contexts in order to better measure their vocabulary and to design appropriate language interventions. (shrink)

This study was conducted with the purpose of analyzing the combined and mediating effect of actor’s withdrawal–partner’s demand conflict resolution strategies between avoidance attachment dimension and relationship satisfaction. We conducted a dyadic study with 175 heterosexual couples who filled in the questionnaires. Six hypotheses were tested using the actor–partner interdependence model with mediation analysis. Results showed that the avoidance dimension of attachment was more strongly associated with actor’s withdrawal strategy than with demand/aggression strategy. Furthermore, avoidance attachment was negatively associated with (...) both actor’s and partner’s relationship satisfaction, the actor effect being higher. Withdrawal strategy was a mediator between actor’s avoidance and actor’s relationship satisfaction, but it was not a mediator for partner’s relationship satisfaction. The interactive pattern of actor’s withdrawal–partner’s demand/aggression was associated with low levels of both actor’s and partner’s relationship satisfaction. These results point out to the need of discerning the interactive pattern of conflict-solving strategies as well as their intertwined effect on relationship satisfaction. (shrink)

¿El conflicto armado ha transformado los roles de la mujer en Colombia? En este artículo se quiere evaluar la diversidad de escenarios y roles que las mujeres adquirieron durante el conflicto armado en Colombia. Para dirigir el rumbo de esta investigación y la posibilidad de evaluar alguno escenarios de posacuerdo, este texto se propone: realizar una consideración epistemológica por parte del feminismo latinoamericano que tenga en cuenta la pluralidad de relatos violentos en Latinoamérica analizar relatos de mujeres partícipes en la (...) guerra que permitan evaluar el rol de la mujer más allá de su simple victimización; examinar la situación de la mujer dentro de los conflictos bélicos colombianos y presentar cómo se diferencia de las situaciones de guerra ocurridas en Europa. Todos estos puntos permiten evaluar cómo la guerra en Colombia ha sido fundamental para contemplar los roles de las mujeres más allá del de víctima, como, por ejemplo, las mujeres activistas que han participado en la reconciliación y el ejercicio de memoria histórica durante el acuerdo de paz y el posacuerdo. Dicho logro promueve un porvenir del feminismo que abre nuevos espacios de acción para la mujer, los cuales, debido a la limitación de este trabajo, quedan aún por explorar. (shrink)

Tuberculosis en América Latina y el Caribe: reflexiones desde la bioética Tuberculose na América Latina e no Caribe: reflexões da bioética The objective of this article is to analyze the conditions of access to health services by people with tuberculosis in Latin America and the Caribbean, reflecting on the public health aspects involved from a bioethical perspective. A literature review of the context of tuberculosis in LAC based on epidemiological data was performed. The results were analyzed from its relationship with (...) the social determinants of health and the ethical principles that guide medical practice. Tuberculosis is a pressing public health problem in the region because of its family, social, economic and health impact. It mainly affects vulnerable individuals and populations. Health services violate ethical principles. Tuberculosis is a serious ethics and public health problem in the region that causes death, disability and increased poverty. It is imperative to ensure the right to health services and to understand the individual and public health consequences of non-adherence to treatment. It is important that national tuberculosis control strategies include principles of dignity and non-discrimination of the sick, changes in the social determinants of the disease, and respect for the ethnicity, language culture and identity of patients. Para citar este artículo / To reference this article / Para citar este artigo Muñoz del Carpio-Toia A, Sánchez-Pérez HJ, Verges de López C, López-Dávila LM, Sotomayor-Saavedra MA, Sorokin P. Tuberculosis en América Latina y el Caribe: reflexiones desde la bioética. pers. bioét. 2018; 22: 331-357. DOI: 10.5294/pebi.2018.22.2.10. (shrink)

As a continuation of the work of the third author in [5], we make further observations on the features of Galois cohomology in the general model theoretic context. We make explicit the connection between forms of definable groups and first cohomology sets with coefficients in a suitable automorphism group. We then use a method of twisting cohomology (inspired by Serre’s algebraic twisting) to describe arbitrary fibres in cohomology sequences—yielding a useful “finiteness” result on cohomology sets. Applied to the special case (...) of differential fields and Kolchin’s constrained cohomology, we complete results from [3] by proving that the first constrained cohomology set of a differential algebraic group over a bounded, differentially large, field is countable. (shrink)

Introduction to the Institutional Logics Perspective -- Precursors to the Institutional Logics Perspective -- Defining the Inter-institutional System -- The Emergence, Stability and Change of the Inter-institutional System -- Micro-Foundations of Institutional Logics -- The Dynamics of Organizational Practices and Identities -- The Emergence and Evolution of Field-Level Logics -- Implications for Future Research.

Overview -- Locke's internal sense and Kant's changing views -- Personal identity amd its problems -- Rationalist metaphysics of mind -- Consciousness, self-consciousness, and cognition -- Strands of Argument in the Duisburg Nachlass -- A transcendental deduction for a priori concepts -- Synthesis : why and how? -- Arguing for apperception -- The power of apperception -- "I-think" as the destroyer of rational psychology -- Is Kant's theory consistent? -- The normativity objection -- Is Kant's thinker (as such) a free (...) and responsible agent? -- Kant our contemporary. (shrink)

El presente artículo trata de hacer un breve recorrido alrededor de las distintas posturas que han sostenido la idea de la verdad como elaboración interpretativa. Para ello, se revisarán textos de autores tales como Nietzsche o Deleuze, junto con otros más contemporáneos como López Petit. Así, se pretende descifrar el papel que tienen las colectividades en los mecanismos de generación del sentido, planteando la performatividad como vía de acceso a las certezas y entendiendo la verdad no como aquello que tan (...) solo es verificable a través del discurso, sino como evento encarnado inmerso en la dimensión estética. (shrink)

Abstract:During recent years, the principle and practice of employment-at-will have been under attack. While progress has been made in eroding the practice, the principle still governs the philosophical assumptions underlying employment practices in the United States, and, indeed, EAW has been promulgated as one of the ways to address economic ills in other countries. This paper will briefly review the major critiques of EAW. Given the failure of these arguments to erode the underpinnings of EAW, we shall suggest new avenues (...) for approaching employment issues to achieve the desirable goal of employee dignity and respect. (shrink)

In Frege's Conception of Logic Patricia A. Blanchette explores the relationship between Gottlob Frege's understanding of conceptual analysis and his understanding of logic.

Let ‘semantic relevance’ be the thesis that the wide semantic properties of representational mental states (like beliefs and desires) are causally relevant to behavior. A popular way of arguing for semantic relevance runs as follows: start with a sufficient counterfactual condition for causal or explanatory relevance, and show that wide semantic properties meet it with respect to behavior (e.g., Loewer & Lepore (1987,1989), Rescorla (2014), Yablo (2003)).This paper discusses an in‐principle limitation of this strategy: even the most sophisticated counterfactual criteria (...) systematically misclassify irrelevant properties as relevant when they stand in certain kinds of modal co‐variation or ‘entanglement’ relations to genuinely relevant properties. This entanglement problem, I argue, is more general and more serious than proponents of the counterfactual strategy have recognized: it threatens recent interventionist arguments for semantic relevance, and is not easily solved by appeal to proportionality or naturalness. I end by suggesting that proponents of semantic relevance may need to shift their attention from patterns of counterfactuals to the lawful psychological generalizations that explain them. (shrink)

The present paper tries to answer the question Is religious education compatible with the purposes of liberal education? This work argues that it is possible, and desirable, that democratic states built on liberal ideals include religious education in all schools since increasing the number of options among which the future citizen may choose the conception of the good with which he or she wishes to live is a condition for autonomy as one of its educational purposes. However, the proposal is (...) not based on religious confessional education, which by itself does not satisfy the liberal educational goals, but is redefined from the common principles compatible both religious confessions and non-religious views of morality and citizenship. (shrink)

This paper presents a pilot study that explores instances of objectless awareness during sleep: conscious experiences had during sleep that prima facie lack an object of awareness. This state of objectless awareness during sleep has been widely described by Indian contemplative traditions and has been characterised as a state of consciousness-as-such; while in it, there is nothing to be aware of, one is _merely_ conscious (cf. Evans-Wentz, 1960 ; Fremantle, 2001 ; Ponlop, 2006 ). While this phenomenon has received different (...) names in the literature, such as ‘witnessing-sleep’ and ‘clear light sleep’ among others, the specific phenomenological profile of this state has not yet been rigorously studied. This paper aims at presenting a preliminary investigation of objectless consciousness during sleep using a novel tool in qualitative research that can guide future research. Five participants experiencing objectless consciousness during sleep were interviewed following the _Micro-phenomenological Interview_ technique (MPI; Petitmengin, 2005, 2006 ). All participants reported an experience they had during sleep in which there was no scenery and no dream. This period labelled as ‘No Scenery/Void’ was either preceded by the dissolution of a lucid dream or by other forms of conscious mentation. The analysis of the results advances four experiential dimensions during this state of void, namely (1) Perception of absence, (2) Self-perception, (3) Perception of emotions, and (4) Perception of awareness. While the results are primarily explorative, they refer to themes found in the literature to describe objectless sleep and point at potential avenues of research. The results from this study are taken as indications to guide future operationalisations of this phenomenon. (shrink)

Progress in the neurosciences is profoundly changing our conception of ourselves. Contrary to time-honored intuition, the mind turns out to be a complex of brain functions. And contrary to the wishful thinking of some philosophers, there is no stemming the revolutionary impact that brain research will have on our understanding of how the mind works. Brain-Wise is the sequel to Patricia Smith Churchland's Neurophilosophy, the book that launched a subfield. In a clear, conversational manner, this book examines old questions (...) about the nature of the mind within the new framework of the brain sciences. What, it asks, is the neurobiological basis of consciousness, the self, and free choice? How does the brain learn about the external world and about its own introspective world? What can neurophilosophy tell us about the basis and significance of religious and moral experiences? Drawing on results from research at the neuronal, neurochemical, system, and whole-brain levels, the book gives an up-to-date perspective on the state of neurophilosophy—what we know, what we do not know, and where things may go from here. (shrink)

Obras escogidas/M. Sánchez-Mazas. - v.1.

What is morality? Where does it come from? And why do most of us heed its call most of the time? In Braintrust, neurophilosophy pioneer Patricia Churchland argues that morality originates in the biology of the brain. She describes the "neurobiological platform of bonding" that, modified by evolutionary pressures and cultural values, has led to human styles of moral behavior. The result is a provocative genealogy of morals that asks us to reevaluate the priority given to religion, absolute rules, (...) and pure reason in accounting for the basis of morality. Moral values, Churchland argues, are rooted in a behavior common to all mammals--the caring for offspring. The evolved structure, processes, and chemistry of the brain incline humans to strive not only for self-preservation but for the well-being of allied selves--first offspring, then mates, kin, and so on, in wider and wider "caring" circles. Separation and exclusion cause pain, and the company of loved ones causes pleasure; responding to feelings of social pain and pleasure, brains adjust their circuitry to local customs. In this way, caring is apportioned, conscience molded, and moral intuitions instilled. A key part of the story is oxytocin, an ancient body-and-brain molecule that, by decreasing the stress response, allows humans to develop the trust in one another necessary for the development of close-knit ties, social institutions, and morality. A major new account of what really makes us moral, Braintrust challenges us to reconsider the origins of some of our most cherished values. (shrink)

The most recent work by Jürgen Habermas tries to revalue religion in today's society. For this he tries to find genealogical connections between secular content and the worldviews that emerged in the Axial Age, including Jewish monotheism. In this article we try to propose that a genealogical approach to monotheism from the perspective of those involved would have to start from the context of undetected origin that constitutes the ethical universalism of Judaism: the Noahide code. To do this, we analyze (...) narrative and conceptual elements of axial and non-axial cultures and show their parallels with the seven laws of the children of Noah as the moral core of humanity. (shrink)

Parmenides of Elea was the most important and influential philosopher before Plato. He rejected as impossible the scientific inquiry practiced by the earlier Presocratic philosophers and held that generation, destruction, and change are unreal and that only one thing exists. In this book, Patricia Curd argues that Parmenides sought to reform rather than to reject scientific inquiry, and she offers a more coherent account of his influence on later philosophers._ _The Legacy of Parmenides_ examines Parmenides' arguments, considering his connection (...) to earlier Greek thought and how his account of what-is could have served as a model for later philosophers. Curd also explores the theories of his successors, including the Pluralists, the Atomists, the later Eleatics, and the later Presocratics. She concludes with a discussion of the importance of Parmenides' work to Plato's _Theory of Forms._ _The Legacy of Parmenides_ challenges traditional views of early Greek philosophy and provides new insights into the work of Parmenides. "_The Legacy of Parmenides_ represents a milestone... of Parmenides' interpretation. It is full of ideas and tells a coherent story about Parmenides and early Greek thought." --_ Alexander Nehamas, Princeton University___ "Professor Curd offers a genuinely original and possibly correct interpretation of the core thesis of the poem of Parmenides in a field so well worked over that saying something both new and true is profoundly difficult, this is a notable achievement." --_ Thomas M. Robinson, University of Toronto___ "This will be a substantial book in the story of early Greek philosophy, and future writers on the tradition from Thales through Plato will not be able to ignore it without missing an important interpretive alternative. It will be of value to students of Presocratic philosophy or the Greek tradition, as well as to students of the scientific revolution, cosmology, the origins of logic, or comparative mysticism." --_ Scott W. Austin, Texas A&M University___ PATRICIA CURD_ is professor at Purdue University where she works primarily in Ancient Philosophy. She is a co-editor of _Readings in Ancient Greek Philosophy_, and is the editor of _A Presocratics Reader._. (shrink)

According to selective, retentive, scientific realism, past empirical success may be explained only by the parts of past theories that are responsible of their successful predictions being approximately true, and thus theoretically retained, or approximated, by the parts of posterior theories responsible of the same successful predictions. In this article, we present as case study the transit from Ptolemy’s to Kepler’s astronomy, and their successful predictions for Mars’ orbit. We present an account of Ptolemy’s successful prediction of Mars’ orbit from (...) Kepler’s perspective, and scrutinize whether the theoretical elements responsible for Ptolemy’s empirical success are approximately retained in Kepler. In order to give to the realist the best chances, we try different strategies. We conclude that all fail and thereby this case constitutes a prima facie strong anomaly for selective retentive realism. Structural realists may call preservation of structure to the rescue, but the existing notions of structure do not work. In absence of a new notion that works, the burden of the proof lies on the realist side. (shrink)

Vaesen infers unique properties of mind from the appearance of specific cultural innovation – a correlation without causal direction. Shifts in habitat, population density, and group dynamics are the only independently verifiable incentives for changes in cultural practices. The transition from Acheulean to Late Stone Age technologies requires that we consider how population and social dynamics affect cultural innovation and mental function.

Science-engaged theology has emerged as a new way of conducting research within the vast field of science and religion, with the aim of, at least in one way of understanding it today, solving theological puzzles. In this article we suggest that an analysis of the diversity of approaches in which thirteenth-century philosopher and theologian Thomas Aquinas engaged theological questions with the best knowledge of the natural world available at the time allows twenty-first century science-engaged theologians to move forward the discussion (...) about the different ways of engaging theology with the contemporary natural sciences. (shrink)