Este estudio analiza el artículo 146 del Código Orgánico Integral Penal (COIP) de Ecuador, esta trata sobre el homicidio culposo por práctica profesional equivocada. La mala praxis médica es un problema grave en el sistema de salud de Ecuador, y la interpretación inadecuada de este artículo ha generado confusión en los procesos legales relacionados. El objeto de la investigación es analizar la normativa del artículo 146 del COIP y las lagunas de interpretación jurídica para determinar la culpabilidad o inocencia de (...) los profesionales de la salud. Para ello, se emplearán métodos comparativos e históricos, que incluyen revisión bibliográfica, análisis de contenido del artículo 146. Los resultados esperados son demostrar las dudas razonables en la prueba del delito de mala praxis, resaltar la importancia de la bioética en los procedimientos legales. Este estudio busca contribuir a una mejor comprensión del marco legal y brindar ideas para la resolución de casos de mala praxis y homicidio culposo en Ecuador. (shrink)

Este trabajo se centra en el análisis de la percepción del alumnado universitario acerca de la utilización de la metodología Flipped Classroom. Se analizarán los resultados obtenidos de una experiencia docente basada en su uso, centrándose entre otros aspectos, en la satisfacción del alumnado, la comprensión de conocimientos y adquisición de competencias, el grado de implicación de profesores/as y alumnos/as, así como las ventajas e inconvenientes percibidos. Los resultados obtenidos muestran, entre otros beneficios, la percepción de una mejora en el (...) proceso de enseñanza-aprendizaje y un aumento en la calidad de la formación, así como en la satisfacción del alumnado. (shrink)

Existe gran consenso dentro de la academia en relación a la necesidad de tener en cuenta un gran número de variables para poder conceptualizar y medir la inclusión o, por ende, la exclusión social que viven ciertos colectivos. A través de un estudio en profundidad de la bibliografía, casos piloto y proyectos similares, se ha creado un sistema de indicadores con la finalidad de medir el impacto socioeconómico de una actividad sociodeportiva vinculada a la inclusión de personas con diversidad funcional. (...) El sistema resultante, se aplicarán en el caso piloto VARIED, un proyecto europeo realizado en cinco países de la propia Unión Europea. (shrink)

Histamine is a multifunctional biogenic amine with relevant roles in intercellular communication, inflammatory processes and highly prevalent pathologies. Histamine biosynthesis depends on a single decarboxylation step, carried out by a PLP-dependent histidine decarboxylase activity (EC 4.1.1.22), an enzyme that still remains to be fully characterized. Nevertheless, during the last few years, important advances have been made in this field, including the generation and validation of the first three-dimensional model of the enzyme, which allows us to revisit previous results and conclusions. (...) This essay provides a comprehensive review of the current knowledge of the structural and functional characteristics of mammalian histidine decarboxylase. BioEssays 27:57–63, 2005. © 2004 Wiley Periodicals, Inc. (shrink)

Particularly in his work Representative Government, J. S. Mill tries to shape the government of social order according to the rules that served as a pattern for the constitution of the literary salons and clubs of the 17 th and 18th centuries. On these rules the Enlightened legal-rational model of society was built, whose demands as well as its differences from reality are enormous. However, this model, which remained in existence, although often broken, during the 19 th and 20 th (...) centuries, does not seem able to survive, even as a regulative ideal. The characteristics that now define the society of the masses in which we live make the fundamentals of Mill’s theory totally inadequate for an understanding of that society. (shrink)

Los centros penitenciarios poseen módulos educativos donde se procura dotar de enseñanza reglada a los internos para favorecer su reinserción, como se recoge en la Constitución Española de 1978 así como en los decretos de Enseñanza Secundaria para personas adultas. En este marco, se ofrece aquí una propuesta educativa para desarrollar un tema controvertido, como es el del Holocausto, en un ámbito educativo especialmente sensible a procesos educativos en situaciones de confinamiento, un aula de 4º de ESPA en un centro (...) penitenciario, a través del conocimiento de las responsabilidades criminales consideradas en los Juicios de Núremberg. Utilizando la representación dramática como recurso didáctico, ya que los internos tendrían que reproducir los distintos roles de los participantes en los juicios, se pretende, en las diferentes sesiones en las que está estructurada esta propuesta, tratar de las responsabilidades morales, entender la necesaria existencia de unas instituciones fuertes con códigos de convivencia adecuados y desarrollar la empatía con las víctimas del régimen nazi, con el objetivo de que sean desarrollados valores cívicos entre los internos. (shrink)

The first European settlements in the new world faced technical issues with the help of the XVI century scientific advances. Besides briefly exposing the scientific and technological situation, this paper explores, with the help of reverse engineering, two singular mechanical wits representative of the technological advances introduced in America to overcome different problems. Firstly, a pump, based on an alternative movement system through crankshafts and pistons used against the continuous flooding suffered in the Ciudad de México valley. Although flooding remained (...) a problem (it was solved in the XX century), hydraulic pumps were essential for continuous soil drainage. Secondly, a port crane for handling cannons, military devices, and construction materials during the Lima fortification in the XVII century. For both cases, reverse engineering, through engineering methods, Computer-Aided Design CAD programs, and additive manufacturing, provides virtual and/or tangible mockups that help to analyze and improve our knowledge about the dimensions, materials, and functions of used (and currently lost) mechanical systems during the American colonization. (shrink)

RESUMEN. Aunque pocos comentarios repararan en ella, la pregunta por la conciencia y su relación con el mundo moral está presente en Murdoch desde sus primeros escritos y reaparece con fuerza en Metaphysics as a guide to morals. La crítica moderna de la metafísica, y de la idea cartesiana de alma como sustancia, nos deja sin imágenes metafísicas para la concepción de sentido común del yo individual como un centro moral. ¿Cómo pensarla e imaginarla ahora? El existencialismo francés y el (...) conductismo lingüístico británico, Sartre y Hare, comparten una imagen del hombre y de la moral que resitúa ese centro en una voluntad que se ejerce discontinuamente, a saltos, dejando en la sombra tanto el campo de los pensamientos como el de los valores. Murdoch se enfrenta a tales posiciones con una trama de conceptos alternativa: el mundo que habitamos los agentes morales contiene ya siempre los valores que introduce en ellos el sujeto moral a través de una conversación interna continua que depende de la atención que prestamos a unas cosas u otras, al ego o a la realidad que lo trasciende. Proponemos finalmente una fusión de horizontes entre Heidegger, Weil y Murdoch que incluye también los conceptos de amor y bien. (shrink)

Behavioral interventions have shown promising neuroprotective effects, but the cascade of molecular, brain and behavioral changes involved in these benefits remains poorly understood. Projecte Moviment is a 12-week multi-domain, single-blind, proof-of-concept randomized controlled trial examining the cognitive effect and underlying mechanisms of an aerobic exercise, computerized cognitive training and a combined groups compared to a waitlist control group. Adherence was > 80% for 82/109 participants recruited. In this study we report intervention-related changes in plasma biomarkers and structural-MRI and how they (...) related to changes in physical activity and individual variables and their potential role as mediators in the cognitive changes. Our results show that although there were no significant changes in molecular biomarker concentrations in any intervention group, changes in ICAM-1 and SDF1-α were negatively associated with changes in physical activity outcomes in AE and COMB groups. Brain volume changes were found in the CCT showing a significant increase in precuneus volume. Sex moderated the brain volume change in the AE and COMB groups, suggesting that men may benefit more than women. Changes in molecular biomarkers and brain volumes did not significantly mediate the cognitive-related benefits found previously for any group. This study shows crucial initial molecular and brain volume changes related to lifestyle interventions at early stages and highlights the value of examining activity parameters, individual difference characteristics and using a multi-level analysis approach to address these questions. (shrink)

Tras la pandemia de la COVID-19 se empezó a potenciar el proceso de virtualización de contenidos de aprendizaje, que ha dado lugar al desarrollo de materiales audiovisuales de apoyo a la docencia. Estos materiales son a menudo vídeos de duración variable diseñados para complementar las estrategias tradicionales de formación y facilitar la adquisición de algunos contenidos de la materia curricular. El presente trabajo presenta una experiencia colaborativa entre docentes para la introducción de materiales audiovisuales como recursos para la educación universitaria (...) de asignaturas de matemáticas básicas en cinco Grados de distintas ingenierías de la Universidad de Cantabria. (shrink)

This text focuses on the grounding of the legal and political structure of the modern state and starts from the Hobbesian conception of power as absolute and unlimited power. For their part, Spinoza and Bentham argue, against Hobbes, for the need to set certain limits to power, although they each based it on radically different grounds. Spinoza's political ontology makes it easy to carry out to the end what was permitted by a factual conception of power, which opens up the (...) possibility of thinking about power in a different way, namely, normatively. The difference between the utilitarian approach and that of Spinoza is his special conception of natural law, which leads him to maintain that it can only be defended where men have rights in common, that is, where there is civil order, making the preservation of our being the justification and limit of the institutionalization of the civil order. Bentham, however, remains true to his empiricist conception and a prisoner of its shortcomings, so that he cannot conceive of the limit of power except as self-limitation. The reason is that he does not have a sufficiently consistent concept of natural rights. Bentham's conception of them as “nonsense upon stilts” makes it impossible. (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)

In this paper we study the presence of elements related to Roman games in the work of the bishop Paulinus of Nola (355-431 AD). References to shows inhis work are not as abundant as they occurs among his contemporaries. Nevertheless, many of these references possess a great importance for us. Certainly, they are similar to other allusions made by his contemporaries; however they express the opinion of one of the most famous and prestigious bishops of the Late Antiquity about these (...) popular exhibitions. In his writings we can see his criticism of the waste of wealth in the organization of the Roman games, and also the use of a metaphorical language with ludical reminiscences whose origins go back to Paul of Tarsus. (shrink)

Reconocida la función creadora del juez y especialmente la del juez constitucional, que puede poner en cuestión mediante sus decisiones la capacidad normativa del propio poder legislativo, hasta el extremo de llegar a anular la ley adoptada por éste, se plantean dos cuestiones. La primera consiste en establecer los antecedentes de por qué el poder judicial es poder. En la segunda se aborda de manera específica el poder de la justicia constitucional con la finalidad de adentrarse en el problema central (...) de todo poder, el de su legitimidad enfrentada, en este último caso de manera evidente, a la legitimidad democrática del legislador. (shrink)

Ante las dificultades que presenta el camino que hace ya algún tiempo se decidió emprender en este país, un camino lúgubre en el que proliferan como hongos diversas reivindicaciones del derecho de autodeterminación, esto es, de la soberanía, por parte de distintos pueblos o naciones, se hace evidente la necesidad de reflexionar sobre el mismo concepto del poder soberano. En este texto se aborda tal problema desde tres perspectivas, fáctica, normativa y racional. Al mismo tiempo que se ponen de manifiesto (...) las insuficiencias de las dos primeras, se defiende una comprensión racional del poder soberano, que quizá podría contribuir a la disolución de los malos augurios que se ciernen sobre nuestro futuro. (shrink)

En este artículo se presenta una revisión bibliográfica de la novela Terra nostra, de Carlos Fuentes, y propicia diálogos que evidencian su actualidad y su relación interdisciplinar con la filosofía, la historia, el arte, la sociedad y la cultura. En los criterios estructurales se distinguen estas temáticas: mito e identidad, relaciones con el otro, imagen y memoria, y la reconstrucción de lo que somos y seremos. Se tuvieron en cuenta franjas temporales de ocho años, desde el momento de su publicación, (...) 1975, hasta el año 2015. Los estudios destacan los problemas de la identidad latinoamericana, la intertextualidad, la multiculturalidad y la conquista; revelan su actualidad en el siglo XXI a través del mestizaje, las tradiciones culturales del Viejo y el Nuevo Mundo, y los otros mundos; y expresan, así, la necesidad de reconstruir un nuevo humanismo. (shrink)

This paper does resemble a philosophical-juridical perspective that reflects on the possibility to reconstruct the constitutional democracy through a Hegelian focus. Its aim is to tackle the current crisis of our liberal democracy, as well as to determine its causes. These causes are not only found in a deficient praxis of its purposes, but fundamentally in an insufficient understanding of the principles of that type of democracy. At the end, this democracy, if we mind to deter its ruin, has to (...) last on the idea of universal will and its determination through the individual rights and liberties. In this context, political liberties obtain a key role, especially the right of political participation and the freedom of expression, whose final purpose lays in the construction of a rational political will. (shrink)

No deja de llamar la atención que un autor considerado como subversivo y expulsado de su comunidad, sea después de todo el creador de los límites del estado político. Pareciera que debía haber sido el destructor de todo orden, cuando es precisamente el inspirador de un orden y además limitado. Su concepción del estado político no supone, como en Hobbes, el abandono del estado de naturaleza, sino la metamorfosis de este último en el primero, ya que aquello que se modifica, (...) el estado natural, permanece en lo modificado, el estado político. Reconoce que únicamente en la medida en que no es posible asegurar nuestra pervivencia en el estado natural por sí solo, es por lo que se requiere la institucionalización del estado político, aunque éste no puede construirse rompiendo con la razón de su creación que no es sino el aseguramiento de nuestra pervivencia física, el incremento de nuestra riqueza y la generación de las condiciones que hagan posible el cultivo de la razón. Las ideas de un autor como Spinoza fueron relevantes para resolver el problema de la fundamentación del Estado desde los inicios de la modernidad. Su presencia en la reflexión jurídico-política occidental impresiona, está desde el comienzo, con Hobbes, pero contra Hobbes, y además destacando la insuficiencia del núcleo central de la argumentación hobbesiana, en la medida en que la libertad de pensamiento exigirá para Spinoza la libertad de expresión. Desde entonces no dejará de acompañarnos, si bien de manera larvada, pues cada vez que se acercaron a justificar de una u otra manera el orden jurídico-político, la sombra de Spinoza puede entreverse. Spinoza pergeña el orden moderno, lo traza, aunque también es verdad que a partir de ese momento intentaron olvidarlo, en el sentido en que la mayor parte de los grandes autores, Kant y Hegel por ejemplo, si bien no frenaron sus propuestas, aunque a veces uno piensa que sí que lo hicieron, lo que es cierto es que no desarrollaron aquello que Spinoza dejó en ciernes. (shrink)

Aunque se ha caracterizado el pensamiento liberal-democrático como la última ideología propia del fin de la historia, en este texto se considera que tal apreciación no es correcta pues ese pensamiento se apoya fundamentalmente en dos pilares, la democracia y la defensa de unos derechos humanos, que se encuentran en una tensión, que lejos de mostrar signos de agotamiento ideológico, constituye el núcleo teórico de la reflexión jurídico-política a lo largo del siglo veinte. La prueba más evidente de tal afirmación (...) la constituye el pensamiento de autores como Kelsen, Hart y Habermas, desde el que se ha intentado lograr la armonización entre el principio de la soberanía popular y el reconocimiento de una serie de límites al ejercicio del principio de las mayorías. (shrink)

This text considers the results of the western powers’ recognition of Kososvo’s independence from three perspectives: firstly, the possible consequences (of which what is happening in Georgia already gives us some proof) of this independence proclaimed and recognised outside the provisions of international law, and which can be considered a precedent in other territories with similar problems; secondly, it proposes, following Hegel, a rational conception of the state, far removed from ideas of ethnicity based on race, language, and so on, (...) in which nationalism finds its inspiration. Finally, it analyses and criticises from the Hegelian perspective, as updated by the reasoning of authors such as Habermas, the foundations of nationalism, especially its mistaken defence of the pre-eminence of collective over individual rights. (shrink)

The Historia monachorum Syriae, written by Theodoret of Cyrrhus in 444 AD, contains a large quantity of sports metaphors in which the ascetic was presented as the “athlete of God”. The origin of this metaphor goes back to the epistles of Paul of Tarsus. Afterwards, there were many Christian writers who included it in their writings, although Theodoret undoubtedly exploited it in a much more intense way than other authors. His abundant use of this metaphor was due to the great (...) popularity enjoyed by athletic contests in the eastern Mediterranean well into the fifth century. Moreover, the partially profane education of Theodoret allowed him to give a specific terminology to his sports metaphors hardly documentable in other writers of Christian antiquity. (shrink)

Abstract“The Book of Secrets in the Results of Ideas”, usually called “The Book of Secrets” is a codex containing drawings and descriptions of thirty-one artifacts attributed to the engineer Alī Ibn Khalaf al-Murādī, who lived in Andalusia in southern Spain at the beginning of the 11th century. This manuscript is one of the first written testimonies that describe medieval mechanisms with complex precision. The aim of this work is to reconstruct and study from a historical and technological point of view (...) two of the ancient artifacts contained in the “Book of Secrets”, the “Fortress Demolisher” and the “Magic Well”. The “Fortress Demolisher” is a war machine designed to demolish the upper part of the walls or towers and consists of a battering ram mounted on a platform that can be raised several meters above the ground using a scissor mechanism. The “Magic Well” is a mechanism with several pulleys whose purpose is to raise water several meters from the bottom of a well by collecting a small portion of rope. To reconstruct the two artifacts, a digital model and a detailed study of the geometry and operation of the mechanisms, were first carried out. 3D printing, using the Fused Deposition Modelling technology, made the physical reproduction. The digitization and physical reproduction by 3D printing of the mechanisms represent an update of the traditional ways of transmitting knowledge. The use of these new technologies makes the knowledge more accessible, understandable and attractive. (shrink)

Este artículo realiza un análisis léxico-semántico de la terminología irreligiosa en la literatura griega. Se ha seleccionado un término clave y un autor relevante a fin de ilustrar la importancia del fenómeno irreligioso en la sociedad de Época Clásica. El adjetivo ὅσιος describe el respeto religioso en acciones y actitudes hacia las divinidades y también hacia otros seres humanos. Sófocles usa la forma privativa ἀνόσιος en contextos donde falta ese respeto religioso, con consecuencias negativas para la polis.

In spite of the advances in our knowledge of cancer biology, most cancers remain not curable with present therapies. Current treatments consider cancer as resulting from uncontrolled proliferation and are non‐specific. Although they can reduce tumour burden, relapse occurs in most cases. This was long attributed to incomplete tumour elimination, but recent developments indicate that different types of cells contribute to the tumour structure, and that the tumour's cellular organization would be analogous to that of a normal tissue, with a (...) main mass of differentiating cells sensitive to anti proliferative agents, together with a small percentage of quiescent, resistant stem cells responsible for replenishing the tumour: the Cancer Stem Cells (CSCs). Anti‐CSCs targeted therapeutic agents would prevent tumour regeneration. New mouse models tailored to exploit this novel concept will be critical to develop CSC‐based anti‐cancer therapies. Here we review the biological basis and the therapeutic implications of the stem‐cell model of cancer. BioEssays 29:1269–1280, 2007. © 2007 Wiley Periodicals, Inc. (shrink)

(1982). Latin America's prospects and alternatives vis‐a‐vis world problems. World Futures: Vol. 18, Alternatives for Humankind: The Role of Latin America, pp. 41-70.

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)

The city of Puebla was put on the UNESCO list of Cultural Heritage of Humanity in 1987; its history dates back to the sixteenth century allowing for the preservation of various important buildings, such as churches with baroque and neoclassical facades, buildings from the period known as Novo Hispanics, when some of its historic neighbourhoods were founded, including the Barrio el Refugio, hereinafter referred to as BR, where indigenous people employed in the lime manufacture used to live. Since those times, (...) however, the neighbourhood has become a place with bad reputation, “a den of thieves”. The traditional, religious commemoration, the “Fiesta Patronal de la Virgen del Refugio,” is the most important celebration in the neighbourhood. In the Church of La Virgen del Refugio, built in the seventeenth century after an inhabitant painted a mural with the image of the virgin, the “mañanitas” are sung with the Mariachi. During the patronal feast, the “El Refugio Cultural Festival” is held with more than a hundred artists taking part and creating about a thousand murals according to the organiser’s estimation. This happens in the city where a project “Puebla Ciudad Mural” was started, as an initiative of the “Colectivo Tomate,” which sought to regenerate the neighbourhood through art, in alliance with the government and private companies. However, these policies are more tourist oriented rather than benefit the neighbourhood. For this reason, the graffiti movement “Festival Cultural el Refugio” is becoming a meeting point for urban artists from Mexico and Puebla, accustomed to taking up public or private space, as they demand space where they can live and express themselves. For ten years the festival has realised more than one thousand pieces of urban art, including Wild Style graffiti, bombs, stickers, stencil, and murals. All this is done under the patronage of the artists themselves, as three hundred of them come from all over the country to take part in every edition of the festival that does not receive any government support or other form of sponsorship. (shrink)

BackgroundImplementing the routine consultation of patient advance directives in hospital emergency departments and emergency medical services has become essential, given that advance directives constitute the frame of reference for care personalisation and respect for patients’ values and preferences related to healthcare. The aim of this study was to assess the levels and relationship of knowledge and attitudes of nursing and medical professionals towards advance directives in hospital emergency departments and emergency medical services, and to determine the correlated and predictor variables (...) of favourable attitudes towards advance directives.MethodsObservational, descriptive, and cross-sectional study. The study was conducted in the emergency department of a second-level hospital and in the emergency medical service. Data collection was performed from January 2019 to February 2020. The STROBE guidelines were followed for the preparation of the study.ResultsA total of 173 healthcare professionals responded to the questionnaire. Among them, 91.3% considered that they were not sufficiently informed about advance directives, and 74% acknowledged not having incorporated them into their usual practice. Multinomial analysis indicated a statistically significant relationship between the variable emergency medical service and having more favourable attitudes towards consulting the advance directives in their practical application (OR 2.49 [95% CI 1.06–5.88]; p = 0.037) and compliance in complex scenarios (OR 3.65 [95% CI 1.58 − 8.41]; p = 0.002). Working the afternoon and night shift was a predictor variable for obtaining a higher score with respect to attitudes in complex scenarios.ConclusionThere is an association between the level of knowledge that nursing and medical professionals have about advance directives and the scores obtained on the attitude scales at the time of practical implementation and in complex scenarios. This shows that the more knowledge professionals have, the more likely they are to consult patients' advance directives and to respect their wishes and preferences for care and/or treatment. (shrink)