1.Teilhard de Chardin dans l'Église de son temps.-- 2.Teilhard de Chardin et l'avenir de la pensée chrétienne.

Caring for critically ill and dying patients often triggers both professional and personal growth for physician trainees. In pediatrics, the neonatal intensive care unit is among the most distressing settings for trainees. We used longitudinal narrative writing to gain insight into how physician trainees are challenged by and make sense of repetitive, ongoing conflicts experienced as part of caring for very sick and dying babies. The study took place in a 45-bed, university-based NICU in an urban setting in the United (...) States. From November 2009 to June 2010 we enrolled pediatric residents and neonatology fellows at the beginning of their NICU rotations. Participants were asked to engage in individual, longitudinal narrative writing about their “experience in the NICU.” Thematic narrative analysis was performed. Thirty-seven physician trainees participated in the study. The mean number of narratives per trainee was 12; a total of 441 narratives were available for analysis. Conflict was the most pervasive theme in the narratives. Trainees experienced conflicts with families and conflicts with other clinicians. Trainees also described multiple conflicts of identity as members of the neonatology team, as members of the medical profession, as members of their own families, and as members of society. Physician trainees experience significant conflict and distress while learning to care for critically ill and dying infants. These conflicts often led them to question their own morals and their role in the medical profession. Physician trainees should be educated to expect various types of distress during intensive care rotations, encouraged to identify their own sources of distress, and supported in mitigating their effects. (shrink)

Approximately one in 10 children in foster care are medically complex and require intensive medical supervision, frequent hospitalization, and difficult medical decision making. Some of these children are in foster care because their parents cannot care for their medical needs; other parents are responsible for their child’s medical needs due to abuse or neglect. In either case, there can be uncertainty about the role that a child’s biological parents should play in making serious medical decisions. Here we highlight some of (...) the ethical challenges inherent in making these decisions for children in foster care, as seen through the lenses of a child welfare provider, an inpatient care physician, and a primary care pediatrician. (shrink)

Children in foster care are considered a “vulnerable population” in clinical care and research, with good reason. These children face multiple medical, psychological, and social risks that obligate the child welfare and healthcare systems to protect them from further harms. An unintended consequence of the “vulnerable population” designation for children in foster care is that it may impose barriers on tracking and studying their health that creates gaps in knowledge that are key to their receipt of medical care and good (...) outcomes. These gaps in knowledge have implications for justice, beneficence, and maleficence and serve to undermine “protection” of this population. Here we review the challenges of research regarding children in foster care, particularly medically complex children, and offer specific recommendations to include children in foster care in medical research. (shrink)

The number of children with chronic critical illness (CCI) is a growing population in the United States. A defining characteristic of this population is a prolonged hospital stay. Our study assessed the proportion of pediatric patients with chronic critical illness in U.S. hospitals at a specific point in time, and identified a subset of children whose hospital stay lasted for months to years. The potential harms of a prolonged hospitalization for children with CCI, which include over treatment, infection, disruption of (...) family life, and the intensive utilization of resources—combined with the moral distress experienced by the clinicians who care for the children, suggest the need for ethical analysis of this growing issue to identify actions that could be taken at the clinical and health systems levels to reduce the harms associated with prolonged hospital stay.In this article we present three real cases from our study that involved a very long hospital stay. We applied a framework developed by Mackenzie, Rogers, and Dodds to analyze inherent, situational, and pathogenic vulnerabilities to examine the ways that interventions intended to remedy one source of harm for the children in our cohort inadvertently created other harms. We examined the complex ways that children with protracted hospitalization are vulnerable to the choices made by their family and clinicians, as well as by healthcare systems and communities. Finally, we used this analysis to summarize actions and ethical responses to this growing patient population. Such an understanding is essential to making clinical and ethical decisions that arise for children who are at risk for a very long stay in the hospital. (shrink)

Background: Treating medication-refractory freezing of gait in Parkinson’s disease remains challenging despite several trials reporting improvements in motor symptoms using subthalamic nucleus or globus pallidus internus deep brain stimulation. Pedunculopontine nucleus region DBS has been used for medication-refractory FoG, with mixed findings. FoG, as a paroxysmal phenomenon, provides an ideal framework for the possibility of closed-loop DBS.Methods: In this clinical trial, five subjects with medication-refractory FoG underwent bilateral GPi DBS implantation to address levodopa-responsive PD symptoms with open-loop stimulation. Additionally, PPN (...) DBS leads were implanted for CL-DBS to treat FoG. The primary outcome of the study was a 40% improvement in medication-refractory FoG in 60% of subjects at 6 months when “on” PPN CL-DBS. Secondary outcomes included device feasibility to gauge the recruitment potential of this four-lead DBS approach for a potentially larger clinical trial. Safety was judged based on adverse events and explantation rate.Findings: The feasibility of this approach was demonstrated as we recruited five subjects with both “on” and “off” medication freezing. The safety for this population of patients receiving four DBS leads was suboptimal and associated with a high explantation rate of 40%. The primary clinical outcome in three of the five subjects was achieved at 6 months. However, the group analysis of the primary clinical outcome did not reveal any benefit.Interpretation: This study of a human PPN CL-DBS trial in medication-refractory FoG showed feasibility in recruitment, suboptimal safety, and a heterogeneous clinical effect in FoG outcomes. (shrink)

Bringing together the expertise of rhetoricians in English and communication as well as media studies scholars, Arguments about Animal Ethics delves into the rhetorical and discursive practices of participants in controversies over the use of nonhuman animals for meat, entertainment, fur, and vivisection. Both sides of the debate are carefully analyzed, as the contributors examine how stakeholders persuade or fail to persuade audiences about the ethics of animal rights or the value of using animals.

Biodiversity informatics produces global biodiversity knowledge through the collection and analysis of biodiversity data using informatics techniques. To do so, biodiversity informatics relies upon data accrual, standardization, transferability, openness, and “invisible” infrastructure. What biodiversity informatics mean to society, however, cannot be adequately understood without recognizing what organizes biodiversity data. Using insights from science and technology studies, we story the organizing “visions” behind the growth of biodiversity informatics infrastructures in Sweden—an early adopter of digital technologies and significant contributor to global biodiversity (...) data—through interviews, scientific literature, governmental reports and popular publications. This case story discloses the organizational formation of Swedish biodiversity informatics infrastructures from the 1970s to the present day, illustrating how situated perspectives or “visions” shaped the philosophies, directions and infrastructures of its biodiversity informatics communities. Specifically, visions related to scientific progress and species loss, their institutionalization, and the need to negotiate external interests from governmental organizations led to unequal development across multiple infrastructures that contribute differently to biodiversity knowledge. We argue that such difference highlights that the social and organizational hurdles for combining biodiversity data are just as significant as the technological challenges and that the seemingly inconsequential organizational aspects of its infrastructure shape what biodiversity data can be brought together, modelled and visualised. (shrink)

This study aimed to investigate the relationships between physical fitness and academic performance in youth handball players of different BMI classifications. Thirty-three male handball players were recruited from the Qatar handball first league and were assigned to their BMI age-adjusted groups. Measurements included anthropometric data and body fat percentage, and physical performance tests: agility T-half test; squat jump, and countermovement jump, 10 and 15 m sprint; medicine ball throw. Aerobic capacity was evaluated using the Yo-Yo Intermittent Recovery Test level 1. (...) Academic achievement was assessed through school records of grades point average of Mathematics, Science and Arabic. None academic performance parameter and four physical performance parameters were different between BMI related groups. In 43% of performance parameters and all academic parameters, the normal weight group showed the highest performance level, whereas the overweight group had the best performance in both sprint tests. The obese group was only superior in the medicine ball throw, but not at the p 0.5) between academic and physical performance parameters was only found between Yo-Yo IR 1 and science. A relevant correlation were found between CMJ and BMI. The agility T-half test was correlated with CMJ and 10 m sprint. These findings suggest being overweight or obese are related to science academic performance among schoolchildren athletes in Qatar. Possibly, a normal BMI could positively influence academic performance. Physical education teachers, staff, and administrators should be cognizant that health promotion interventions improving composition may have the additional potential to improve dimensions of academic performance. (shrink)

This study examined the differences in the level of physical fitness and academic performance among male middle-school children based on different body status categories. A total of 69 male children [age: 12.4 ± 0.7 years; body mass: 58.5 ± 7.2 kg; height: 1.62 ± 0.09 m; and body mass index : 22.4 ± 3.3 kg/m2] participated and were divided into BMI age-adjusted groups. Height, mass, BMI, stork test of static balance, 10 and 15 m sprint as an indicator for speed, (...) hand-grip strength test, agility T-half test, medicine ball throw, and the Yo-Yo Intermittent Recovery Test level 1 were assessed. School records were retrieved for grade point averages of mathematics, science, and Arabic. We found significant group differences regarding anthropometric, physical, and academic performance parameters. The largest difference correlation between parameters of different dimensions was found. In conclusion, the highest BMI group exhibited similar physical and academic performances than the lowest group. Thus, these data emphasize the importance and appropriateness to engage young Qatari schoolchildren in physical activity as it associates with superior academic performance. (shrink)

Manifeste de la philosophie cartésienne, le Discours de la méthode (1637) est tout à la fois le récit d'un cheminement intellectuel et l'illustration magistrale d'un projet : fonder l'unité des sciences et constituer une science universelle. Foyer d'une oeuvre foisonnante, le Discours revendique les droits de la raison contre toute tradition et toute autorité. C'est pourquoi il assigne à la philosophie une tâche : s'élever à 1a certitude. La présente édition, augmentée d'un dossier, entend mettre en évidence le jeu de (...) résonances qui relie le Discours aux autres textes de Descartes. (shrink)

Volume 20, Issue 7, July 2020, Page 77-80.

Measuring neuronal activity with electrophysiological methods may be useful in detecting neurological dysfunctions, such as mild traumatic brain injury (mTBI). This approach may be particularly valuable for rapid detection in at-risk populations including military service members and athletes. Electrophysiological methods, such as quantitative electroencephalography (qEEG) and recording event-related potentials (ERPs) may be promising; however, the field is nascent and significant controversy exists on the efficacy and accuracy of the approaches as diagnostic tools. For example, the specific measures derived from an (...) electroencephalogram (EEG) that are most suitable as markers of dysfunction have not been clearly established. A study was conducted to summarize and evaluate the statistical rigor of evidence on the overall utility of qEEG as an mTBI detection tool. The analysis evaluated qEEG measures/parameters that may be most suitable as fieldable diagnostic tools, identified other types of EEG measures and analysis methods of promise, recommended specific measures and analysis methods for further development as mTBI detection tools, identified research gaps in the field, and recommended future research and development thrust areas. The qEEG study group formed the following conclusions: 1. Individual qEEG measures provide limited diagnostic utility for mTBI. However, many measures can be important features of qEEG discriminant functions, which do show significant promise as mTBI detection tools. 2. ERPs offer utility in mTBI detection. In fact, evidence indicates that ERPs can identify abnormalities in cases where EEGs alone are nondisclosing. 3. The standard mathematical procedures used in the characterization of mTBI EEGs should be expanded to incorporate newer methods of analysis including nonlinear dynamical analysis, complexity measures, analysis of causal interactions, graph theory and information dynamics. 4. and 5. are too long to include here. (shrink)

Philosophie et théologie chez Maurice Blondel étudie les relations complexes qu'entretiennent la philosophie et la théologie dans l'œuvre de Maurice Blondel. Pour celui-ci, il s'agit de passer d'une foi vécue à une réflexion philosophique autonome qui refuse tout préjugé. L'inspiration théologique transparaît dans de nombreux thèmes qui font l'objet d'une transposition proprement philosophique. Si philosophie et théologie interfèrent par une partie de leur contenu, elles se distinguent par leur méthode. Distinction toujours maintenue, alors même que la conception blondélienne de la (...) philosophie évolue à partir d'une phénoménologie vers un réalisme intégral. Philosophiquement cohérente à partir de sources dont elle n'intègre pas d'élément sans vérification critique, la pensée blondélienne a déployé une remarquable fécondité théologique dans des questions telles que la foi, le surnaturel, le rapport de l'histoire et du dogme, la mystique. Elle a divisé les théologiens de son temps. D'abord suspectée de modernisme, elle n'en a pas moins exercé une profonde influence, contribuant à ouvrir le catholicisme à la pensée contemporaine. Il lui reste à être mieux reconnue pour sa valeur philosophique. Ce livre voudrait y contribuer pour sa part en montrant que d'étroites relations avec la théologie, loin de dénaturer la philosophie, élargissent son champ et confortent sa consistance rationnelle. (shrink)

Plusieurs auteurs se sont inspirés des thèses du deuxième Wittgenstein pour proposer une nouvelle approche en sciences sociales qui viserait la justification plutôt que l'explication de l'action. Sur la base d'une étude de trois types d'énoncés formulés grâce au langage de l'action (factuels, normatifs et attributifs d'états mentaux), cet article évalue les difficultés et possibilités d'une telle suggestion.

« Aucun autre écrit de Descartes, même le Discours de la méthode, ne nous fournit une meilleure approche et une meilleure introduction à son univers de pensée. » Ernst Cassirer.La Recherche de la Vérité par la lumière naturelle nous fait découvrir un Descartes méconnu, désireux de transmettre sa pensée, non seulement par la méditation mais aussi par le dialogue. Dans cette philosophie, ce qui est le plus individuel et le plus intime, la conscience, est en même temps ce dont chacun (...) d’entre nous peut faire l’expérience. ainsi le dialogue cartésien se donne pour ambition de conduire le lecteur jusqu’à cette expérience partagée de la conscience qui est au fondement de la philosophie moderne. (shrink)

Je me propose d'examiner la solution davidsonnienne au problème de la duperie de soi afin de clarifier en quel sens il s'agit d'un acte intentionnel. Après une étude de quelques difficultés liées au concept même de duperie de soi, mon analyse met en lumière que la notion de partition de l'esprit que Davidson emprunte à son traitement de la faiblesse de la volonté ne peut être appliquée de manière satisfaisante à ce nouveau problème. J'indique ensuite que non seulement Davidson mais (...) la majorité des philosophes qui étudient le phénomène ont négligé de donner un traitement adéquat du rôle qui est dévolu aux pro-attitudes dans la formation des croyances. Je reviens finalement à la question fondamentale, celle de savoir s'il est approprié de considérer que la duperie de soi est un acte intentionnel, afin de mettre en évidence le caractère paradoxal de tout raisonnement pratique qui prétendrait rationaliser un tel état ou processus. (shrink)

According to the standard view on the issue, the habit of marking questions with a particular typographical sign in Greek and Latin script does not arise prior to the eighth or ninth century. This period is generally credited with the ‘invention’ of the question mark (excepting Syriac evidence, which points to the fifth and sixth centuries). The purpose of the present article is to correct this view. It argues that the first indication for the use of a typographical sign that (...) marks questions can actually be detected no later than during the reign of Emperor Hadrian (a.d. 117–38), that is, more than half a millennium before the traditional date of the invention. The chief witness is Nicanor of Alexandria, who does not seem to have used question marks himself, but criticizes the misappropriation of another punctuation mark to that purpose. He thus indirectly testifies to the existence of question marks. Comparable traces can also be found later in the exegetical works of some Christian commentators. (shrink)

Les résultats quantitatifs que la psychologie et la physiologie n'ont cessé d'accumuler depuis le début du siecle à propos du sens tactile laissent apparaître aujourd'hui une certaine ambiguïteé. D'un côté en effet, la préoccupation de connaître les sensibilities cutanées spécifiques telles qu'elles se présentent de manière isolée à l'analyse objective des récepteurs stimulés: les sensations de chaud et de froid, de pression et de contact, de douleur, de vibration. D'un autre côté, le désir de sauvegarder l'unité fonctionnelle du sens tactile (...) c.a.d. sa spécificité propre par rapport aux quatre autres sens traditionnels. Ainsi, par exemple, une analyse neurophysiologique des récepteurs tactiles5 ne manque pas de mentionner plusieurs catégories fonctionnelles de la sensibilité cutanée: la douleur, comme signal d'un danger qui peut menacer l'existence de l'organisme; la perception des qualités d'un objet, comme intégration du toucher et de la kinesthésie au cours d'une exploration active de la main; les expériences somatiques complexes telles que le chatouillement et les sensations sexuelles. Pour le phénoménologue, un tel compromis s'apparente à une confusion et provient des positions épistémologiques qui ont animé l'orientation méthodologique des recherches, depuis la psychophysiologie mécaniste jusqu'à la psychologie cybernétique de l'information sensorielle. En cela, la domaine de la sensation tactile reste l'apanage de la psychophysique, et nous tenterons de clarifier pourquoi cette position ne peut aboutir qu'à des résultats problématiques. A partir d'une psychologie anthropologique du sens tactile,14 nous défendrons l'idée d'une psychologie comparée qui permettrait une investigation empirique, objective des comportements animaux, sur la base de prolégomènes phénoménologiques. (shrink)

Ce texte propose une analyse des mécanismes argumentatifs mis en œuvre dans les lettres que Hernán Cortés, conquistador du Mexique, a adressées à Charles V (Cartas de Relación) pour légitimer sa conquête du territoire qui deviendra la Nouvelle Espagne et, par ce biais, le Nouveau Monde. Il s’agit en particulier de montrer l’emploi du concept rhétorique d’inventio dans le passage d’une appropriation conceptuelle du « Nouveau Monde » (par l’élaboration de ce concept) à sa domination territoriale (la fondation de Veracruz (...) et la création de la Nouvelle Espagne). (shrink)