L’interrogation en Italie du Nord : ce que les corpus nous disent et les questions qu’ils laissent ouvertesCet article traite de l’interrogation dans les variétés de l’Italie du Nord, plus précisément celles du ladin dolomitique. Une discussion sur les corpus disponibles, leurs avantages et leurs inconvénients est complétée par la présentation de mes enquêtes dialectales : méthodologie et données recueillies. Ainsi, on verra comment la recherche basée sur des corpus déjà existants et l’enquête de terrain peuvent se compléter, (...) les données des atlas linguistiques offrant un point de départ indispensable à des investigations plus spécifiques et nécessaires. (shrink)

Transplantation programs commonly rely on clinicians’ judgments about patients’ social support (care from friends or family) when deciding whether to list them for organ transplantation. We examine whether using social support to make listing decisions for adults seeking transplantation is morally legitimate, drawing on recent data about the evidence-base, implementation, and potential impacts of the criterion on underserved and diverse populations. We demonstrate that the rationale for the social support criterion, based in the principle of utility, is undermined by its (...) reliance on tenuous evidence. Moreover, social support requirements may reinforce transplant inequities, interfere in patients’ personal relationships, and contribute to biased and inconsistent listing procedures. As such, accommodating the needs of patients with limited social support would better balance ethical commitments to equity, utility, and respect for persons in transplantation. We suggest steps for researchers, transplantation programs, and policymakers to improve fair use of social support in transplantation. (shrink)

BackgroundNational guidelines require programmes use subjective assessments of social support when determining transplant suitability, despite limited evidence linking it to outcomes. We examined how transplant providers weigh the importance of social support for kidney transplantation compared with other factors, and variation by clinical role and personal beliefs.MethodsThe National survey of the American Society of Transplant Surgeons and the Society of Transplant Social Work in 2016. Using a discrete choice approach, respondents compared two hypothetical patient profiles and selected one for transplantation. (...) Conditional logistic regression estimated the relative importance of each factor; results were stratified by clinical role and beliefs.ResultsFive hundred and eighy-four transplant providers completed the survey. Social support was the second most influential factor among transplant providers. Providers were most likely to choose a candidate who had social support, always adhered to a medical regimen, and had a 15 years life expectancy with transplant. Psychosocial providers were more influenced by adherence and quality of life compared with medical/surgical providers, who were more influenced by candidates' life expectancy with transplant. For providers concerned with avoiding organ waste, social support was the most influential factor, while it was the least influential for clinicians concerned with fairness.ConclusionsSocial support is highly influential in listing decisions and may exacerbate transplant disparities. Providers’ beliefs and reliance on social support in determining suitability vary considerably, raising concerns about transparency and justice. (shrink)

Normothermic Regional Perfusion (NRP) is increasingly being adopted as an intervention designed to improve organ utilization from donors after circulatory death because of the efficiency with which...

The transplant community has faced unprecedented challenges balancing risks of performing living donor transplants during the COVID-19 pandemic with harms of temporarily suspending these procedures. Decisions regarding postponement of living donation stem from its designation as an elective procedure, this despite that the Centers for Medicare and Medicaid Services categorise transplant procedures as tier 3b (high medical urgency—do not postpone). In times of severe resource constraints, health systems may be operating under crisis or contingency standards of care. In this manuscript, (...) the United Network for Organ Sharing Ethics Workgroup explores prioritisation of living donation where health systems operate under contingency standards of care and provide a framework with recommendations to the transplant community on how to approach living donation in these circumstances.To guide the transplant community in future decisions, this analysis suggests that: (1) living donor transplants represent an important option for individuals with end-stage liver and kidney disease and should not be suspended uniformly under contingency standards, (2) exposure risk to SARS-CoV-2 should be balanced with other risks, such as exposure risks at dialysis centres. Because many of these risks are not quantifiable, donors and recipients should be included in discussions on what constitutes acceptable risk, (3) transplant hospitals should strive to maintain a critical transplant workforce and avoid diverting expertise, which could negatively impact patient preparedness for transplant, (4) transplant hospitals should consider implementing protocols to ensure early detection of SARS-CoV-2 infections and discuss these measures with donors and recipients in a process of shared decision-making. (shrink)

SummaryThe aim of this study was to investigate marriage behaviour from 1825 to 1924 in an Alpine valley inhabited by Ladin speakers, where the particular geographic, linguistic and economic characteristics may have influenced the level of reproductive isolation. A total of 2183 marriage acts from the two main parishes of Santa Cristina and Ortisei were examined. Birth and residence endogamy, inbreeding coefficients from dispensations and from isonymy, birth place distribution of the spouses and isonymic relationships were analysed in four (...) 25-year sub-periods. All the indicators considered point to a lower level of reproductive isolation at Ortisei, a main centre for the woodcarving industry, which appeared to be experiencing an early and effective breakdown of isolation. Marriage behaviour in the Gardena Valley between 1825 and 1924 seems to have been mostly influenced by socioeconomic factors rather than linguistic and cultural ones. (shrink)

Berry, Daniels, and Ladin make a strong argument for discontinuing the use of, “lack of social support,” as an organ transplantation listing criterion. This argument, however, actually leads to conclusions much stronger than those that the authors’ propose: The argument works equally well against using, (1) any “psychosocial” factors at all as a listing criterion, and, (2) any criteria other than factors that directly relate to empirically established medical need, and/or empirically established survival rate. Moreover, while the authors rightly (...) point to a lack of empirical evidence connecting social support to survivability, they neglect mentioning that the empirical literature on social support provides grounds to favor listing persons who seem to, sadly, lack a social support system. (shrink)

Sur le versant Sud d'une colline appelée Sténokorifi, non loin de Drama, de nombreux filons de marbre dolomitique, gris clair et de petite granulométrie, affleurent sur une étendue d'environ 19 000 m2 entre une végétation dense. Excepté le front de taille vertical d'une exploitation marbrière des années 1950 qui a fait des essais d'extraction en profondeur à l'aide du marteau-piqueur, il n'y a que des fronts de taille obliques (selon la pente) et les extractions sont superficielles. Dès lors que (...) les filons présentent une masse homogène et compacte, des traces d'extraction sont visibles ; certaines d'entre elles (canaux, emboîtures, entailles pour coins, négatifs de blocs extraits) sont conformes à celles des techniques d'extraction de l'époque romaine, alors que d'autres «enfonçures » sont les témoins de la technique d'extraction à l'époque proto-byzantine. Deux fours à chaux ont été identifiés, l'un d'époque byzantine et l'autre contemporain de l'exploitation moderne, d'où la rareté des blocs abandonnés. (shrink)

In their essay arguing for ethical review of social research, Sheehan et al write: > Inquiry and human life are intertwined and interdependent. To be human is to be curious, to ask questions about yourself, the world, and your place in the world. This process of inquiry is undertaken individually, but is a social activity.1 As researchers in medical ethics, all the authors in this issue have chosen to ask a particular type of question about the world: questions about ethical (...) complexity and justification. Their inquiries are rich and diverse. We can see each as an individual piece of scholarship, contributing to our knowledge of a specific topic. But we can also see medical ethics as a social activity—one undertaken by a community of authors and readers, debating and reasoning together. What is striking when we think of medical ethics in this second way is the diversity of approaches to research that are useful in our discussions. Understanding ethics in healthcare is furthered by very different types of research, and this issue of the journal clearly illustrates this breadth of approaches to scholarship in medical ethics. The three articles on transplant ethics provide an excellent example of this diversity of scholarship in medical ethics. All explore ethical aspects of transplantation but using different approaches. Ladin and colleagues2 identify an ethical problem through empirical inquiry. Their research examines the requirement that a patient have adequate social support in …. (shrink)

Partant du substrat intellectuel et scientifique sur lequel repose, en dernière analyse, l’Atlas linguistique de la France (ALF : 1902-1910) de Jules Gilliéron (1854-1926), cet article envisage l’évolution ultérieure de la géographie linguistique « atlantiste », surtout sous l’égide de Karl Jaberg (1877-1958) et Jakob Jud (1882-1952), auteurs de l’atlas italo-suisse AIS, et des promoteurs des Nouveaux atlas linguistiques de la France (NALFs) à partir de 1950. Il en appert que l’orientation théorique de base et la recherche inconditionnée de l’intercomparabilité (...) des données d’atlas collectées ont fini par céder devant une « faim empirique » générale qui risque de saper la raison d’être de la géographie linguistique à proprement parler. A la fin, il est fait mention des deux parties de l’atlas linguistique ladin ALD, publiées – chaque fois en 7 volumes – en 1998 et en 2012, qui ont été élaborées dans le plus strict respect des principes « atlantistes » de Jules Gilliéron. (shrink)