IntroductionCardiology is characterized by its state-of-the-art biomedical technology and the predominance of Evidence-Based Medicine. This predominance makes it difficult for healthcare professionals to deal with the ethical dilemmas that emerge in this subspecialty. This paper is a first endeavor to empirically investigate the axiological foundations of the healthcare professionals in a cardiology hospital. Our pilot study selected, as the target population, cardiology personnel not only because of their difficult ethical deliberations but also because of the stringent conditions in which they (...) have to make them. Therefore, there is an urgent need to reconsider clinical ethics and Value-Based Medicine. This study proposes a qualitative analysis of the values and the virtues of healthcare professionals in a cardiology hospital in order to establish how the former impact upon the medical and ethical decisions made by the latter.ResultsWe point out the need for strengthening the roles of healthcare personnel as educators and guidance counselors in order to meet the ends of medicine, as well as the need for an ethical discernment that is compatible with our results, namely, that the ethical values developed by healthcare professionals stem from their life history as well as their professional education.ConclusionWe establish the kind of actions, communication skills and empathy that are required to build a stronger patient-healthcare professional relationship, which at the same time improves prognosis, treatment efficiency and therapeutic adhesion. (shrink)

La presencia del orden se nos impone con singular insistencia. La reflexión sobre el orden, las posibilidades de su emergencia y las condiciones de su articulación y de su crítica, al igual que de su transgresión o transformación, ha constituido un eje central en el pensamiento filosófico y social continental a lo largo del siglo XX. Los trabajos que aparecen en este libro proceden de pensadores provenientes de Alemania, Francia y México y se proponen contribuir a una reflexión amplia, sistemática (...) y a la vez interdisciplinaria sobre este problema a la vez inquietante e inescapable. (shrink)

En este trabajo, se propone una clasificación epistemológica teórica para el discurso astrológico a partir de evidencia empírica a fin de abordar el problema de cómo determinar específicamente qué es lo que lo hace ilegítimo. A partir de esta clasificación, se diseñó una intervención didáctica, enmarcada en el enfoque de Enseñanza de las Ciencias Naturales en Contexto (ECNC), con el objetivo de fomentar, en estudiantes de nivel secundario, la capacidad de distinguir enunciados cognoscitivamente ilegítimos -por infalsables o por falsos- respecto (...) de aquellos que pueden constituir genuino conocimiento científico. La secuencia didáctica se implementó con un grupo de 51 estudiantes de 14 a 17 años. Se evaluó su impacto por comparación entre un pretest y un postest. Los resultados mostraron que su capacidad de discernimiento entre enunciados falsables y no falsables se incrementó apreciablemente. (shrink)

Adaptive optics are techniques used for processing the spatial resolution of astronomical images taken from large ground-based telescopes. In this work, computational results are presented for a modified curvature sensor, the tomographic pupil image wavefront sensor, which measures the turbulence of the atmosphere, expressed in terms of an expansion over Zernike polynomials. Convolutional neural networks are presented as an alternative to the TPI-WFS reconstruction. This technique is a machine learning model of the family of artificial neural networks, which are widely (...) known for its performance as modeling and prediction technique in complex systems. Results obtained from the reconstruction of the networks are compared with the TPI-WFS reconstruction by estimating errors and optical measurements. The reconstructed wavefronts from both techniques are compared for wavefronts of 153 Zernike modes. For this case, a detailed comparison and grid search to find the most suitable neural network is performed, searching between multi-layer perceptron, CNN and recurrent networks topologies. In general, the best network was a CNN trained for TPI-WFS reconstruction, achieving better performance than the reconstruction software from TPI-WFS in most of the turbulent profiles, but the most significant improvements were found for higher turbulent profiles that have the lowest r0 values. (shrink)

En este artículo queremos realizar una propuesta de abordaje bioético para la toma de decisiones médicas. Los siguientes tres argumentos son los que sostienen esta propuesta. En primer lugar, creemos que el concepto de cuidado es una herramienta necesaria para alcanzar la excelencia profesional y ver que en este hay un compromiso moral para con el paciente. En segundo lugar, defendemos que el principialismo es una buena opción para dar una mayor comprensión al abordaje de los casos. En tercer lugar, (...) consideramos que la ética dialógica puede servir como fundamentación ética a dichos principios. (shrink)

The aim of this paper is both to present the model of shared decision making and to review if it is possible and positive to apply it to mental illness like schizophrenia. First, we show the main features of that clinic relationship. Second, we expose both some medical and some ethical aspects that endorse its applicability. Finally, we annotate some essential characteristics that a medical team should have to do that kind of care relationship.

El presente artículo está centrado en el análisis y reformulación de la ética del cuidado. En primer lugar se define qué es la ética del cuidado y se desarrollan algunas ideas clave del pensamiento de Carol Gilligan y Nel Noddings. En segundo lugar realizamos una valoración crítica de la ética del cuidado, señalando algunos aspectos positivos y negativos de la misma. Por último, se sostiene que es necesaria una reformulación de esta teoría dado que tiene carencias e insuficiencias.

Adela Cortina, doctora Honoris Causa, es un referente indiscutible en el ámbito de la ética. En sus primeras obras ya se indicaba la necesidad de encontrar unos mínimos cívicos, un conjunto de valores y principios para una convivencia pacífica entre ciudadanos con distintas morales, gracias a los cuales construir modos ideales particulares de vida buena. Para descubrir esos mínimos optó por el procedimentalismo dialógico. Ahora bien, durante los años ha ido reflexionando sobre ese procedimentalismo para hacer un análisis más completo (...) del vínculo comunicativo. Y eso fue lo que pretendió con sus obras centradas en desarrollar una ética cordis. Como bien sostiene, «quien tenga voluntad de justicia, voluntad de descubrir mediante el diálogo qué es lo justo, está obligado a trabajar activamente por la defensa de los derechos humanos y las capacidades básicas de los afectados». (shrink)

Cardiology is characterized by its state-of-the-art biomedical technology and the predominance of Evidence-Based Medicine. This predominance makes it difficult for healthcare professionals to deal with the ethical dilemmas that emerge in this subspecialty. This paper is a first endeavor to empirically investigate the axiological foundations of the healthcare professionals in a cardiology hospital. Our pilot study selected, as the target population, cardiology personnel not only because of their difficult ethical deliberations but also because of the stringent conditions in which they (...) have to make them. Therefore, there is an urgent need to reconsider clinical ethics and Value-Based Medicine. This study proposes a qualitative analysis of the values and the virtues of healthcare professionals in a cardiology hospital in order to establish how the former impact upon the medical and ethical decisions made by the latter. (shrink)

IntroductionCardiology is characterized by its state-of-the-art biomedical technology and the predominance of Evidence-Based Medicine. This predominance makes it difficult for healthcare professionals to deal with the ethical dilemmas that emerge in this subspecialty. This paper is a first endeavor to empirically investigate the axiological foundations of the healthcare professionals in a cardiology hospital. Our pilot study selected, as the target population, cardiology personnel not only because of their difficult ethical deliberations but also because of the stringent conditions in which they (...) have to make them. Therefore, there is an urgent need to reconsider clinical ethics and Value-Based Medicine. This study proposes a qualitative analysis of the values and the virtues of healthcare professionals in a cardiology hospital in order to establish how the former impact upon the medical and ethical decisions made by the latter.ResultsWe point out the need for strengthening the roles of healthcare personnel as educators and guidance counselors in order to meet the ends of medicine, as well as the need for an ethical discernment that is compatible with our results, namely, that the ethical values developed by healthcare professionals stem from their life history as well as their professional education.ConclusionWe establish the kind of actions, communication skills and empathy that are required to build a stronger patient-healthcare professional relationship, which at the same time improves prognosis, treatment efficiency and therapeutic adhesion. (shrink)

The purpose of this study is to determine empirically the state of the art of the medical care, when healthcare personal is confronted with ethical dilemmas related with the care they give to the geriatric population. An observational, longitudinal, prospective and qualitative study was conducted by analyzing the correlation between healthcare personnel–patient relationship, and ethical judgments regarding dilemmas that arise in daily clinical practice with geriatric patients. Mexican healthcare personnel with current active practices were asked to write up an ethical (...) dilemma that arose frequently or that had impacted their medical practice. From the narrative input, we were able to draw up a database with 421 dilemmas, and those corresponding to patients 60 years and older were selected. The axiological analysis of the narrative dilemmas of geriatric patients was made using dialectical empiricism. The axiological analysis values found most frequently were classified into three groups: the impact of healthcare, the roles of the physician, and refusal of therapy; the healthcare role of educator, caring for the patients’ life and the risk of imminent death where the values found more often. The persistence and universality of certain dilemmas in geriatrics calls for awareness and requires a good training in the ethical discernment of these dilemmas. This would help to improve substantially the care and the life quality of this population. (shrink)

Critical thinking is a complex, dynamic process formed by attitudes and strategic skills, with the aim of achieving a specific goal or objective. The attitudes, including the critical thinking attitudes, constitute an important part of the idea of good care, of the good professional. It could be said that they become a virtue of the nursing profession. In this context, the ethics of virtue is a theoretical framework that becomes essential for analyse the critical thinking concept in nursing care and (...) nursing science. Because the ethics of virtue consider how cultivating virtues are necessary to understand and justify the decisions and guide the actions. Based on selective analysis of the descriptive and empirical literature that addresses conceptual review of critical thinking, we conducted an analysis of this topic in the settings of clinical practice, training and research from the virtue ethical framework. Following JBI critical appraisal checklist for text and opinion papers, we argue the need for critical thinking as an essential element for true excellence in care and that it should be encouraged among professionals. The importance of developing critical thinking skills in education is well substantiated; however, greater efforts are required to implement educational strategies directed at developing critical thinking in students and professionals undergoing training, along with measures that demonstrate their success. Lastly, we show that critical thinking constitutes a fundamental component in the research process, and can improve research competencies in nursing. We conclude that future research and actions must go further in the search for new evidence and open new horizons, to ensure a positive effect on clinical practice, patient health, student education and the growth of nursing science. (shrink)

We aimed to characterize the age of onset of training, age at menarche, menstrual periodicity, and performance perception during the menstrual cycle and examined the impact of these reproductive variables on body composition, morphology, and body weight satisfaction in Brazilian elite futsal players. The study consisted of 115 female Brazilian elite futsal players from the top national teams. Data were collected during the twentieth Women’s Brazil Futsal Cup. Players were interviewed and self-reported their age of onset of training, age at (...) menarche, menstrual periodicity, and the menstrual period, where they performed best. We also asked for what they considered to be their ideal body weight as well as information related to their training. Subsequently, anthropometric measurements were performed to estimate the body composition and determine morphological characteristics. Fifty-nine players were postmenarche-trained and 52 were premenarche-trained. Eighteen, 65, and 28 were classified as early, normal, and late menarche, respectively. Only 11 and 1 had irregular menstrual cycles and were amenorrheic, respectively. Seventy-three, 23, and 9 reported that their game performance was the best at the follicular phase, menses, and luteal phase of the menstrual cycle, respectively. No associations between the four reproductive-related variables were found. Postmenarche-trained players had significant lower age at menarche and higher percentage body fat. The somatotype profile registered lower ectomorphy rate for the postmenarche-trained participants after controlling for covariates. Early menarche group presented higher sum of six skinfold thickness and endomorphy rate compared to normal and late menarche groups. No differences were found when menstrual periodicity groups and best performance groups were compared, except for higher femur width in the regular menstrual cycle group compared to the irregular one. The association between body weight satisfaction and the four reproductive-related variables were not observed. Premenarche-trained Brazilian elite futsal players had the menarche later than the postmenarche-trained athletes. Most of the participants had menarche age classified as “normal,” presented “regular” menstrual cycles and perceived to perform better during the follicular phase of the menstrual cycle. (shrink)

A teoria da Motricidade Humana criada na década de 1980 pelo português Manuel Sérgio é uma presunção que tenta dar bases epistemológicas para criar um novo paradigma a fim de pautar as práxis da Educação Física. As bases da teoria se assentam numa perspectiva de corpo centrada na filosofia e ciências humanas para contrapor e somar as bases históricas das práxis da Educação Física historicamente fundadas no corpo anatomo-biológico. Neste sentido, o presente artigo tem como objetivo discutir a centralidade do (...) corpo para a construção de uma base ética na teoria da Motricidade Humana. Para argumentar tal centralidade os autores estabelecem fundamentalmente um diálogo tensivo entre Nietzsche e Merleau-Ponty para fazer um paralelo de como Manuel Sérgio se apropria da filosofia de ambos para conceber o corpo enquanto dimensão ética na sua teoria. La teoría de la motricidad humana criada en la década de 1980 por el portugués Manuel Sérgio trata de elaborar las bases epistemológicas de la creación de un nuevo paradigma que tiene como objetivo fundamentar la praxis de la Educación Física. Las bases de esta teoría se apoyan, principalmente, en una perspectiva del cuerpo de la filosofía y ciencias humanas para se contraponer y sumar a las bases históricas de la praxis de la Educación Física históricamente fundamentada en el cuerpo anatómico-biológico. El artículo tiene como objetivo discutir el carácter central de cuerpo en la construcción de una base ética de la teoría de la Motricidad Humana. Pretendiendo argumentar ese carácter central en el artículo se realiza un diálogo entre Nietzsche y MerleauPonty buscando colocar que Manuel Sérgio se apropria de la filosofía de ambos con el objetivo de concebir el cuerpo como dimensión ética en su teoría. (shrink)

This article investigates the existence of an original Brazilian legal culture. It parts from a critical examination of the key moments in the history of Brazil through the accounts of its most important scholars, such as Caio Prado Júnior, Darcy Ribeiro, Sérgio Buarque de Holanda, Wilson Martins, Oliveira Viana, Roberto Damatta, José Murilo de Carvalho, among others. It identifies in the Brazilian legal culture something one might call tradition of exception, which can be found in many of its most prominent (...) aspects, such as the persistent denial of any general or abstract regulatory standards, the uncritical introduction of foreign doctrines and legal patterns, the maintenance of aristocratic traditions in social life and the historical disregard of the Brazilian people as political subject. The article also offers a reflection on the problems and potentials of the current historic moment, in which for the first time Brazilians face the possibility of a genuine cultural emancipation. (shrink)

Drawing from ethnographic research in the Research Triangle of North Carolina and Williamsburg, Virginia, the authors build on Anzaldúa's conceptualization of “borderlands” to analyze how borders of social membership are constructed and enforced in “el Nuevo South.” Our gender analysis reveals that intersecting structural conditions—the labor market, the organization of public space, and the institutional organization of health care and other public services—combine with gendered processes in the home and family to regulate women's participation in community life. Enforcers of borders (...) include institutional actors, mostly women, in social services and clinics who occupy institutional locations that enable them to define who is entitled to public goods and to categorize migrants as undeserving “others.” We reveal how a particularly configured matrix of domination transcends the spheres of home, work, and community to constrain women migrants' physical and economic mobility and personal autonomy and to inhibit their participation in their societies of reception. (shrink)

Universal jurisdiction and the existence of an International Criminal Court (ICC) under the Rome Statute provide a framework through which true reconciliation can be achieved simultaneously with truth and justice. The ICC and universal jurisdiction can be viewed as laying out objective limits on the power of domestic and international actors to seek peace at any cost.This paper argues that those objective limits are not necessarily inimical to a just peace, nor are an undue burden on peacemakers. On the contrary, (...) they can set parameters whereby a just and lasting peace can be differentiated from impunity achieved through blackmail.The first step is to take a hard look at whether international standards of accountability for gross abuses have been met. At the same time, the examination of any specific scheme of domestic accountability cannot be done on a blanket basis. It will require a close look at conditions prevailing in the country, both at the time the scheme was adopted and later; at the policies adopted and how they were meant to advance the process of national reconciliation; at who adopted those measures and how; and at concrete applications of the scheme to individual cases.Even applying this exacting standard, there will be cases in which the best course of action for the ICC and for third country courts will be to defer to the greater wisdom of local actors operating in good faith, and to decline to prosecute. (shrink)

Accidie, depression, and dejection seem to be psychological phenomena that are best characterized as cases in which an agent has no motivation to pursue what he or she judges to be good or valuable. The phenomena thus seem to present a challenge to any view that draws a close connection between motivation and evaluation. ‘Accidie, Evaluation, and Motivation’ aims to show that the phenomena are actually best explained by a theory that postulates a conceptual connection between motivation and evaluation.

Ce livre résume une recherche que l'auteur a menée pendant de très longues années, et qu'il a voulu exposer comme élargissement de l'œuvre de William James, fondateur de la philosophie et de la psychologie américaines.

En el escenario actual de Cuba y el mundo la migración al software libre constituye una necesidad para el desarrollo para garantizar la independencia tecnológica. Los procedimientos para realizar dicho proceso son fundamentales en la estrategia definida por el país que incluye la "Guía cubana de migración al software libre", sin embargo, su aplicación práctica enfrenta dificultades que han motivado a los autores a la elaboración de una estrategia específica para la migración al software libre en el sector de la (...) Salud Pública de la provincia de Camagüey, Cuba. En esta estrategia se proponen las acciones concretas, los programas docentes que permitirán la recalificación del capital humano y las acciones que posibiliten garantizar la sostenibilidad de la migración al concluir el proceso. In the present Cuban and world scenarios the migration to free software constitutes a need for the development to guarantee technological independence. The procedures to carry out that process are vital in the strategy defined by the country that includes “Cuban guidelines for the migration to free software” however its practical implementation is facing difficulties that have motivated the authors to elaborate a specific strategy form the migration to free software in the Public health sector in the province of Camagüey, Cuba. In this strategy actions are suggested, like teaching programs that will allow the recertification of the capital human resources and steps that will make possible to guarantee the sustainability of the migration at the end of the process. (shrink)

An effective method to increase the number of potential cadaveric organ donors is to make people donors by default with the option to opt out. This non-coercive public policy tool to influence people’s choices is often justified on the basis of the as-judged-by-themselves principle: people are nudged into choosing what they themselves truly want. We review three often hypothesized reasons for why defaults work and argue that the as-judged-by-themselves principle may hold only in two of these cases. We specify further (...) conditions for when the principle can hold in these cases and show that whether those conditions are met is often unclear. We recommend ways to expand nationwide surveys to identify the actual reasons for why defaults work and discuss mandated choice policy as a viable solution to many arising conundrums. (shrink)

Resumen Como toda actividad social, la investigación en el campo de las ciencias sociales se institucionaliza por la acción de los individuos, instaurando ciertos mecanismos que regulan -a través de pautas organizacionales definidas- su quehacer social e institucional. Es así que la investigación social desarrollada en las instituciones de educación superior es experimentada por sus actores como una realidad establecida y objetiva que antecede al individuo actual, una realidad sujeta a una clara definición de roles, situaciones y comportamientos. Desde una (...) perspectiva sociológica, y ante a la injerencia de las actuales tecnologías de la información y la comunicación, en este trabajo se exploran los obstáculos y las posibilidades que enfrenta la condición institucionalizada de la investigación social y la de sus actores en sociedades con distintos tipos de desarrollo. Con tal propósito nos detenemos en el enlace de cuatro dimensiones del problema: la expansión y dispersión de las ciencias humanas y sociales; la institución como marco normativo de la organización de la actividad de investigación; el académico-investigador como principal actor y, por último, la función del "par académico" como árbitro de una competencia más institucional que cognitiva.As any social activity, research in social sciences is institutionalized by the action of individuals, establishing certain mechanisms that regulate -through defined organizational patterns- its social and institutional activities. In this way, the social research developed in higher education institutions is experienced by their actors as an established and objective reality that precedes the actual individual; a reality attached to a clear definition of roles, situations and behaviors. From a sociological perspective, and confronting the interference of the current information and communications technologies, in this paper are explored the obstacles and opportunities facing the institutionalized condition of social research, and their actors in societies with different types of development. For that purpose, we look into the connection of four dimensions of the problem: the expansion and dispersion of human and social sciences; the institution as a regulatory structure for the organization of the research activity; the academic researcher as the main actor, and finally, the role of "academic peer" as an arbiter of a competition more institutional than cognitive. (shrink)

'We desire all and only those things we conceive to be good; we avoid what we conceive to be bad.' This slogan was once the standard view of the relationship between desire or motivation and rational evaluation. Many critics have rejected this scholastic formula as either trivial or wrong. It appears to be trivial if we just define the good as 'what we want', and wrong if we consider apparent conflicts between what we seem to want and what we seem (...) to think is good. In Appearances of the Good, Sergio Tenenbaum argues that the old slogan is both significant and right, even in cases of apparent conflict between our desires and our evaluative judgements. Maintaining that the good is the formal end of practical inquiry in much the same way as truth is the formal end of theoretical inquiry, he provides a fully unified account of motivation and evaluation. (shrink)

This paper offers a particular intuitionistic negation completion of Urquhart's system C resulting in a super-intuitionistic contractionless propositional logic equivalent to Dummett's LC without contraction.

Though it is held that some models in science have explanatory value, there is no conclusive agreement on what provides them with this value. One common view is that models have explanatory value vis-à-vis some target systems because they are developed using an abstraction process. Though I think this is correct, I believe it is not the whole picture. In this paper, I argue that, in addition to the well-known process of abstraction understood as an omission of features or information, (...) there is also a family of abstraction processes that involve aggregation of features or information and that these processes play an important role in endowing the models they are used to build with explanatory value. After offering a taxonomy of abstraction processes involving aggregation, I show by considering in detail several models drawn from different sciences that the abstraction processes involving aggregation that are used to build these models are responsible for their having explanatory value. (shrink)

El pluralismo ontológico depende estrechamente de la doctrina de las relaciones externas. Los términos son singularidades materiales y las relaciones son singularidades virtuales, no menos reales que las primeras y que responden a una lógica propia. En su «empirismo trascendental» Deleuze retoma de modo implícito la discusión tradicional acerca de las relaciones (Bradley, Russell, Whitehead y James), aunque reconduciéndola hacia la ontología de lo virtual que actúa en el plano de inmanencia. Si nuestro análisis es correcto, la ontología misma podría (...) ser definida como una ecología de las relaciones externas que se establecen entre los diversos planos de organización (especies, individuaciones, actualidades) y el plano de inmanencia (medio ecológico o virtual). (shrink)

Equality policies in Spain have increasingly developed since the creation of the National Women’s Agency (1983). Over a ten‐year period Spain has achieved European standards in equality policies in terms of institutions, budget and legitimization. In a short time Spain moved from a dictatorship to European Union membership, which has brought about enormous changes regarding women’s roles and rights. Other relevant changes concern the political organization of the state: the 1978 Constitution sets a model of regional administrative autonomy, neither centralized (...) nor federal, in which each region has developed gender institutions. Gender‐equality policies constituted the framework for the development of gay and lesbian policies. Both gender equality and gay and lesbian policies have evolved differently at the national and regional levels, with a trend of inclusiveness, more creative policies and institutions at the regional and local levels. In the meantime, the national debate has concentrated on same‐sex marriage, while sexuality is not a topic within gender equality policies. This paper argues that the progressive inclusiveness of lesbians within the equality agenda and the new intersectional perspectives, alongside gay marriage shows an evolution of Spanish citizenship models, largely influenced by the European Union context. (shrink)