IntroductionThe objectives of this study are to assess and compare differences in the intensity, frequency, and overall severity of moral distress among a diverse group of healthcare professionals.MethodsParticipants from within Baylor Health Care System completed an online seven-point Likert scale (range, 0 to 6) moral distress survey containing nine core clinical scenarios and additional scenarios specific to each participant’s discipline. Higher scores reflected greater intensity and/or frequency of moral distress.ResultsMore than 2,700 healthcare professionals responded to the survey (response rate 18.14 (...) percent); survey respondents represented multiple healthcare disciplines across a variety of settings in a single healthcare system. Intensity of moral distress was high in all disciplines, although the causes of highest intensity varied by discipline. Mean moral distress intensity for the nine core scenarios was higher among physicians than nurses, but the mean moral distress frequency was higher among nurses. Taking into account both intensity and frequency, the difference in mean moral distress score was statistically significant among the various disciplines. Using post hoc analysis, differences were greatest between nurses and therapists.ConclusionsMoral distress has previously been described as a phenomenon predominantly among nursing professionals. This first-of-its-kind multidisciplinary study of moral distress suggests the phenomenon is significant across multiple professional healthcare disciplines. Healthcare professionals should be sensitive to situations that create moral distress for colleagues from other disciplines. Policy makers and administrators should explore options to lessen moral distress and professional burnout that frequently accompanies it. (shrink)

_Global Religious and Secular Dynamics_ integrates European theories of modern secularization and theories of global religious revival as interrelated dynamics. Casanova contrasts the internal European road of secularization with the external colonial road of global interreligious encounters and the globalization of the secular immanent frame with the expansion of global religious denominationalism.

Ernst Bloch formulated problems of enormous philosophical and human relevance. He held that in our contemporary situation we have but two questions concerning the fundamental direction of our lives and history: we must choose, first, between hopeless nihilism and transcendent hope; and, second, between transcendent hope with transcendence and transcendent hope without transcendence. Bloch opted for the transcendent hope without transcendence and formulated a hard critique of hope with transcendence. Josef Pieper and Bernard Schumacher have offered a competent response to (...) Bloch from the Catholic perspective. However, we offer here a little explored aspect of the problem by demonstrating that Bloch’s metaphysical arguments do not consider that (a) a material reality necessarily has the concrete potentiality of dissolving, and (b) therefore, left to itself, it will dissolve necessarily in infinite time; and that (c) no effect can have a reality disproportionate to its cause, which is the reason why (d) no immortal reality can proceed from mortal reality without the intervention of a higher cause. (shrink)

University program dropout is a problem that has important consequences not only for the student that leaves but also for the institution in which the withdrawal occurs. Therefore, higher education institutions must study the problem in greater depth to establish appropriate prevention measures in the future. However, most research papers currently focus primarily on the characteristics of students who leave university, rather than on those who choose to pursue alternative courses of study and therefore fail to take into account the (...) different kinds of abandonment. The aim of this paper is to identify the different types of dropout to define their characteristics and propose some recommendations. Thus, an ex post facto study was carried out on a sample of 1,311 freshmen from a university in the north of Spain using data gathered using an ad-hoc designed questionnaire, applied by telephone or an online survey, and completed with data available in the university data warehouse. A descriptive analysis was performed to characterize the sample and identify five different groups, including 1. Students persisting in their initiated degree 2. Students who change of program (within the same university) 3. Students transferring to a different university 4. Students enrolling in non-higher-education studies 5. Students that quit studying. Also, data mining techniques (decision trees) were applied to classify the cases and generate predictive models to aid in the design of differentiated intervention strategies for each of the corresponding groups. (shrink)

Mexico's southeastern Maya movement offers one of the most advanced proposals in the construction of a theoretical and practical world alternative. It comes from the rain forest people's deepest convictions, simultaneously synthesizing western beliefs and ideas with those characteristic of the long struggles of resistance by the poor, discriminated and excluded of the earth. The many voices that spoke out at the Intercontinental Meeting for Humanity and against Neoliberalism, held in Chiapas from 27 July to 3 August 1996, reinforced the (...) Zapatista Army of National Liberation's (EZLN) blueprint for universal democracy with justice, freedom, pluralism and dignity for all human beings, and joined in the emergence of a new way of thinking, feeling and acting. The originality of the theory of the Rain Forest is to be found in linking utopia, as a construct of the possible based on reality, with the construction of power derived from civil society. It is also a creative and historic movement that responds to the challenges of the 21st century with hope for the survival of humanity in dignity and justice. (shrink)

BackgroundIn the Canadian Alliance for Healthy Hearts and Minds (CAHHM) cohort, participants underwent magnetic resonance imaging (MRI) of the brain, heart, and abdomen, that generated incidental findings (IFs). The approach to managing these unexpected results remain a complex issue. Our objectives were to describe the CAHHM policy for the management of IFs, to understand the impact of disclosing IFs to healthy research participants, and to reflect on the ethical obligations of researchers in future MRI studies.MethodsBetween 2013 and 2019, 8252 participants (...) (mean age 58 ± 9 years, 54% women) were recruited with a follow-up questionnaire administered to 909 participants (40% response rate) at 1-year. The CAHHM policy followed a restricted approach, whereby routine feedback on IFs was not provided. Only IFs of severe structural abnormalities were reported.ResultsSevere structural abnormalities occurred in 8.3% (95% confidence interval 7.7–8.9%) of participants, with the highest proportions found in the brain (4.2%) and abdomen (3.1%). The majority of participants (97%) informed of an IF reported no change in quality of life, with 3% of participants reporting that the knowledge of an IF negatively impacted their quality of life. Furthermore, 50% reported increased stress in learning about an IF, and in 95%, the discovery of an IF did not adversely impact his/her life insurance policy. Most participants (90%) would enrol in the study again and perceived the MRI scan to be beneficial, regardless of whether they were informed of IFs. While the implications of a restricted approach to IF management was perceived to be mostly positive, a degree of diagnostic misconception was present amongst participants, indicating the importance of a more thorough consent process to support participant autonomy.ConclusionThe management of IFs from research MRI scans remain a challenging issue, as participants may experience stress and a reduced quality of life when IFs are disclosed. The restricted approach to IF management in CAHHM demonstrated a fair fulfillment of the overarching ethical principles of respect for autonomy, concern for wellbeing, and justice. The approach outlined in the CAHHM policy may serve as a framework for future research studies.Clinical trial registrationhttps://clinicaltrials.gov/ct2/show/nct02220582. (shrink)

Resumen Este artículo analiza, en discusión con Joaquín García-Huidobro y Alejandro Miranda, la conveniencia de utilizar en moral sexual el argumento de la facultad pervertida, conforme al cual sería inmoral frustrar el fin natural de las facultades reproductivas. Según García-Huidobro y Miranda este argumento sólo puede utilizarse desde el “principio de totalidad”, pues su uso aislado llevaría a los absurdos denunciados por la New Natural Law Theory. Con vistas a una reconsideración de este argumento, se demuestra la importancia de considerar (...) la ética en su carácter tópico o contextual. Así, es en el ámbito de la templanza y de las inclinaciones sexuales donde el AFP cobra un papel normativo; en cambio, el “principio de totalidad” entra en juego cuando se está considerando el problema del límite de las intervenciones médicas.This paper focuses on the adequacy of using the so-called perverted faculty argument within the context of sexual morality. According to this argument, frustrating the reproductive faculty would be immoral. Professors García-Huidobro and Miranda think that this argument can be appropriately used only within the framework of the principle of totality. They argue that an unqualified use of the PFA would lead to the absurdities pointed out by the New Natural Law Theory. In order to see the PFA in a new light we demonstrate the importance of respecting the dialectical or contextual nature of Ethics. Thus, regarding temperance, and especially sexual inclinations, the PFA has a clear normative role. The principle of totality, instead, must be used when considering the problem of the moral limits of medical interventions. (shrink)

There is a growing recognition within cognitive enhancement and neuroethics debates of the need for greater emphasis on cognitive artefacts. This paper aims to contribute to this broadening and expansion of the cognitive-enhancement and neuroethics debates by focusing on a particular form of relation or coupling between humans and cognitive artefacts: interaction-dominance. We argue that interaction-dominance as an emergent property of some human-cognitive artefact relations has important implications for understanding the attribution and distribution of causal and other forms of responsibility (...) as well as agency relating to the actions of human-cognitive artefact couplings. Interaction-dominance is both indicated and constituted by the phenomenon of “pink noise”. Understanding the role of noise in this regard will establish a necessary theoretical groundwork for approaching the ethical and political dimensions of relations between human cognition and digital cognitive artefacts. We argue that pink noise in this context plays a salient role in the practical, ethical, and political evaluation of coupling relations between humans and cognitive artefacts, and subsequently in the responsible innovation of cognitive artefacts and human-artefact interfaces. (shrink)

Research on bodies and work relies on theoretical perspectives that see the working body as a resource and/or symbol. This study bridges these complementary theories, incorporating two concepts that extend and synthesize them into a more holistic model of embodied inequality. Drawing primarily on the accounts of women domestic workers in Ecuador’s largest city, I explore the embodied dimensions of domestic work and show how unequal relations between workers and employers manifest in and on bodies, specifically through interactions around health, (...) food, and appearance/clothing. I argue that paid domestic workers’ bodies are simultaneously resources that can be used for work, and symbols interpreted according to local hierarchies of gender and class. (shrink)

O artigo tem o propósito de problematizar a designação de “realismo fantástico” geralmenteatribuída ao estilo literário de Franz Kafka. Isto se faz de modo a questionar a presença docomponente fantástico na própria realidade, interrogando pelos pressupostos fundamentais em jogona composição de realidade e fantasia. O presente problema, e outros que dele derivam, pretendeser respondido não apenas diante da consideração dos escritos do autor tcheco, especialmente noconto A Metamorfose, mas na interface da filosofia de Martin Heidegger. O filósofo alemão nosoferece, em (...) sua obra Ser e tempo, elementos para darmos os seguintes passos: delimitar o lugar dohomem a partir da constituição singular do espaço de transcendência que o mundo é; considerar asexperiências de singularidade e aversão em face da noção de poder-ser; abordar as assim chamadas“metamorfoses do corpo” e como tais transformações físicas do personagem impõem-lheconcomitantemente uma mudança do seu próprio modo de ser. (shrink)

Ancient monism matters today because it reveals an alternative answer to a problem faced by ontology “after the death of god,” namely, how to distinguish between good and bad actions after the disappearance of transcendence. The modern answer in Continental philosophy was systematized by Heidegger and consists in positing that the everyday is permeated by instrumentality whereas there is a different kind of action that is noninstrumental, such as art or the thinking of being. By contrast, ancient monism holds that (...) all actions are instrumental and employs on a typology of action that relies on the distinction between techne and phronesis. Recognizing a different answer from the dominant Heideggerian one has the potential to renew the conception of the ethical and the political in Continental philosophy. (shrink)

O objetivo do presente texto é investigar as articulações essenciais de três noções decisivas para a constituição do pensamento heideggeriano posterior à assim chamada virada : acontecimento apropriativo , seer e linguagem. Para tanto, deter-nos-emos fundamentalmente na análise de algumas passagens importantes do escrito Beiträge zur Philosophie . Através desta análise, procuraremos, ao mesmo tempo, revelar em que medida o conceito de acontecimento apropriativo possui uma relação direta com o acontecimento de uma apropriação de si mesmo por parte do homem (...) enquanto ser-aí.The central goal of this paper is investigating the essential liaison between three decisive concepts for Martin Heidegger's thought after the so-called "turn" : Event , Being and Language. In order to do this we will mainly analyse certain important passages of the book Contributions to Philosophy . Through this analysis we will try to show at the same time in which measure the enowning is in a fundamental relationship with the occurrence of a self-appropriation of the man as Dasein. (shrink)

Gracias a la documentación conservada en la Real Academia de la Historia y a una cuidada revisión bibliográfica, se aportan nuevos datos para el conocimiento del descubrimiento y primeros estudios del epitafio del monarca aftasí, Abd Allah al-Mansur I de Badajoz.

Marxian class theory has been unable to account for the most significant historical developments of the 20th century. The rise of fascism not only belied the hopes put in the revolutionary proletariat, it also brought into the center of the political stage those social strata which the class theory had relegated to, at best, secondary supporting roles. The triumph of the Bolshevik, revolution and the institutionalization and expansion of Soviet socialism has not only failed to issue into the anticipated free, (...) classless society, but has led to the creation of a new system of stratification and domination which is simply unthinkable within the classical Marxian framework. Late or advanced capitalism continues advancing in spite of all its crises and contradictions. (shrink)

CASANOVA: In the “Foreword” to your book Religion and Social Conflicts, Luis Ogade begins with a series of texts from the Latin American Anticommunist Federation, the Rockefeller Report, the Rand Study for the State Department and the like denouncing the Church as “subversive” and “revolutionary. “Hepoints out that the Right has begun to appreciate the revolutionary and subversive potential of religion, while the Left seems to continue the old stereotypes, such as religion being “the opium of the people,” or a (...) traditional residuum likely to disappear with the advance of science and modernity. Why do you think the Left has not been able to appreciate the alleged subversive and revolutionary potential of religion? (shrink)

El artículo contiene una exposición general del De Motu Animalium que se ordena a mostrar que no puede usarse esta obra como fundamento de la la opinión según la cual el silogismo práctico culmina en una acción y no en un juicio. Se refuta, además, la tesis contraria, del modo como la defienden diversos autores, tales como Martha Nussbaum, Elizabeth Anscombe y Alejandro Vigo. This paper contains a general exposition of De Motu Animalium , particularly chapters 6-11. The goal is (...) to prove that this Aristotelian work cannot be used to ground the opinion according to which practical syllogism concludes in an action and not in a judgment. The contrary thesis, as it is held by several authors such as Elizabeth Anscombe, Martha Nussbaum, and Alejandro Vigo, is refuted. (shrink)

Este artículo constituye una investigación sobre el estatuto ontológico de las categorías. Examina cuatro tesis: que las categorías son lingüísticas, que son meramente lógicas, que son reales todas y que algunas son reales y otras lógicas con fundamento en la realidad. Prueba que la cuarta tesis es la correcta y muestra algunos de sus presupuestos más importantes, desarrollos e implicaciones.

Este artículo presenta primero las objeciones que John Crosby y Josef Seifert han opuesto a la noción boeciana de persona. Responde después a dichas objeciones mediante (a) una crítica a la metafísica que esas objeciones presuponen, (b) un mostrar cómo se puede atender a las principales preocupaciones de los fenomenólogos sin abandonar la noción boeciana, (c) un señalar algunos problemas teológicos que podría suscitar la metafísica fenomenológica y que, sin duda, esos dos autores desearían evitar.

Este escrito considera y distingue dos objeciones que de ordinario se piensa que se dirigen contra una concepción ética realista: la falacia naturalista de G. E. Moore y la ley de Hume. Después de haber expuesto ambas objeciones, desplegado sus supuestos y consecuencias y respondido a todos ellos, concluye que es posible hoy sostener una ética realista. Se estructura a la manera de una cuestión disputada, dividida en seis artículos.

This paper first expounds the Aristotelian conception of universals. Afterwards, it determines (a) that in the metaphysics of the Stagirite there is place for divine Ideas as archetypes, and (b) which are the relations that exist between things and Ideas. It concludes, in the light of the above, with a reconsideration of the Aristotelian critique of Plato’s theory of anamnesis.