Background One of the biggest challenges of practicing medicine in the age of informational technology is how to conciliate the overwhelming amount of medical-scientific information with the multiple patients’ values of modern pluralistic societies. To organize and optimize the the Decision-Making Process of seriously ill patient care, we present a framework to be used by Healthcare Providers. The objective is to align Bioethics, Evidence-based Practice and Person-centered Care. Main body The framework divides the DMP into four steps, each with a (...) different but complementary focus, goal and ethical principle. Step 1 focuses exclusively on the disease, having accuracy is its ethical principle. It aims at an accurate and probabilistic estimation of prognosis, absolute risk reduction, relative risk reduction and treatments’ burdens. Step 2 focuses on the person, using empathic communication to learn about patient values and what suffering means for the patient. Emphasis is given to learning and active listening, not taking action. Thus, instead beneficence, we trust comprehension and understanding with the suffering of others and respect for others as autonomous moral agents as the ethical principles of Step 2. Step 3 focuses on the healthcare team, having the ethics of situational awareness guiding this step. The goal is, through effective teamwork, to contextualize and link rates and probabilities related to the disease to the learned patient’s values, presenting a summary of which treatments the team considers as acceptable, recommended, potentially inappropriate and futile. Finally, Step 4 focuses on provider-patient relationship, seeking shared Goals of Care, for the best and worst scenario. Through an ethics of deliberation, it aims for a consensus that could ensure that the patient’s values will be respected as well as a scientifically acceptable medical practice will be provided. In summary: accuracy, comprehension, understanding, situational awareness and deliberation would be the ethical principles guiding each step. Conclusion Hopefully, by highlighting and naming the different perspectives of knowledge needed in clinical practice, this framework will be valuable as a practical and educational tool, guiding modern medical professionals through the many challenges of providing high quality person-centered care that is both ethical and evidence based. (shrink)

G. A. Cohen (2000) provided us with a challenging “paradox of conviction” by means of pointing out the fact that, even when we realize that we hold certain beliefs (for example, political or religious ones) only because we have been raised to have them, this discovery does not modify what we believe. This seems to be irrational, but acknowledging that fact would entail that irrationality is much more widespread than we are, in principle, willing to accept. In this article (...) we will focus on the solution proposed by Federico Penelas (2007), according to which the paradox can be dissolved by appealing to Rorty’s “ethnocentrism”. We will try to argue that this solution can work insofar as what supports our choice to retain our “convictions” is not theoretical in character, but practical. The reason why we can continue to support certain positions that lack neutral evidence in their favour is that it would be too costly not to do it—a condition which does not, nonetheless, make it any more probable that the positions in question are theoretically acceptable. (shrink)

Near-death experiences (NDEs) have been defined as any conscious perceptual experience occurring in individuals pronounced clinically dead or who came very close to physical death. They are frequently reported by patients surviving a critical injury and, intriguingly, they show common features across different populations. The tool traditionally used to assess NDEs is the NDE Scale, which is available in the original English version. The aim of this study was to develop the Italian version of the NDE Scale and to assess (...) its reliability in a specific clinical setting. A process of translation of the original scale was performed in different stages in order to obtain a fully comprehensible and accurate Italian translation. Later, the scale was administered to a convenience sample of patients who had experienced a condition of coma and were, at the time of assessment, fully conscious and able to provide information as requested by the scale. Inter-rater and test–retest reliability, assessed by the weighted Cohen’s kappa ( K w ), were estimated. A convenience sample of 20 subjects [mean age ± standard deviation (SD) 51.6 ± 17.1, median time from injury 3.5 months, interquartile range (IQR) 2–10] was included in the study. Inter-rater [ K w 0.77 (95% CI 0.67–0.87)] and test–retest reliability [ K w 0.96 (95% CI 0.91–1.00)] showed good to excellent values for the total scores of the Italian NDE Scale and for subanalyses of each single cluster of the scale. An Italian Version of the NDE Scale is now available to investigate the frequency of NDE, the causes for NDE heterogeneity across different life-threatening conditions, and the possible neural mechanisms underlying NDE phenomenology. (shrink)

Introduction: Publications arguing against the null hypothesis significance testing (NHST) procedure and in favor of good statistical practices have increased. The most frequently mentioned alternatives to NHST are effect size statistics (ES), confidence intervals (CIs), and meta-analyses. A recent survey conducted in Spain found that academic psychologists have poor knowledge about effect size statistics, confidence intervals, and graphic displays for meta-analyses, which might lead to a misinterpretation of the results. In addition, it also found that, although the use of ES (...) is becoming generalized, the same thing is not true for CIs. Finally, academics with greater knowledge about ES statistics presented a profile closer to good statistical practice and research design. Our main purpose was to analyze the extension of these results to a different geographical area through a replication study. Method: For this purpose, we elaborated an on-line survey that included the same items as the original research, and we asked academic psychologists to indicate their level of knowledge about ES, their CIs, and meta-analyses, and how they use them. The sample consisted of 159 Italian academic psychologists (54.09% women, mean age of 47.65 years). The mean number of years in the position of professor was 12.90 (SD = 10.21). Results: As in the original research, the results showed that, although the use of effect size estimates is becoming generalized, an under-reporting of CIs for ES persists. The most frequent ES statistics mentioned were Cohen’s d and R2/η2, which can have outliers or show non-normality or violate statistical assumptions. In addition, academics showed poor knowledge about meta-analytic displays (e.g., forest plot and funnel plot) and quality checklists for studies. Finally, academics with higher-level knowledge about ES statistics seem to have a profile closer to good statistical practices. Conclusions: Changing statistical practice is not easy. This change requires statistical training programs for academics, both graduate and undergraduate. (shrink)

Is socialism desirable? Is it even possible? In this concise book, one of the world's leading political philosophers presents with clarity and wit a compelling moral case for socialism and argues that the obstacles in its way are exaggerated. There are times, G. A. Cohen notes, when we all behave like socialists. On a camping trip, for example, campers wouldn't dream of charging each other to use a soccer ball or for fish that they happened to catch. Campers do (...) not give merely to get, but relate to each other in a spirit of equality and community. Would such socialist norms be desirable across society as a whole? Why not? Whole societies may differ from camping trips, but it is still attractive when people treat each other with the equal regard that such trips exhibit. But, however desirable it may be, many claim that socialism is impossible. Cohen writes that the biggest obstacle to socialism isn't, as often argued, intractable human selfishness--it's rather the lack of obvious means to harness the human generosity that is there. Lacking those means, we rely on the market. But there are many ways of confining the sway of the market: there are desirable changes that can move us toward a socialist society in which, to quote Albert Einstein, humanity has "overcome and advanced beyond the predatory stage of human development.". (shrink)

In this paper I question the primacy of argumentation relying solely on logic by showing how the body and mind are deeply connected and as a result how communication and argumentation are a product of this mind/body connection. In particular, I explore the physicality of argumentation through the research and writings on gestures and the embodied mind. Michael Gilbert’s theory of multi-modal argumentation provides the general approach for this elaboration.

This two-wave study investigated the temporal interplay between motivation and the intensity and reported impact of athletes’ emotions in training settings. In total, 217 athletes completed self-report measures of motivational climate, motivation regulations, emotional states (i.e., pleasant states, anger, and anxiety) experienced before practice at two time points during a 3-month period. Latent change score modeling revealed significantly negative paths from task-involving climate at time 1 to the latent change in the intensity of dysfunctional anxiety and anger, and significantly positive (...) paths from ego-involving climate at time 1 to the latent change in dysfunctional anger (i.e., intensity and reported impact). The paths from controlled motivation at time 1 to the latent change in the intensity of dysfunctional anxiety and vice versa were significantly positive. The path from controlled motivation at time 1 to the latent change in the intensity of functional anger was significantly positive, but not vice versa. In addition, the paths from dysfunctional anger (i.e., intensity and reported impact) at time 1 to the latent change in motivation regulations were significant, but not vice versa. Overall, evidence provided suggested that the temporal interplay of motivation and emotions is contingent on the specific emotions. The findings highlight the role of coach-created motivational climate and the importance of identifying high levels of controlled motivation to help athletes better adapt to psychological stress. (shrink)

In this paper a new trajectory-based representation to non-relativistic quantum mechanics is formulated. This is ahieved by generalizing the notion of Lagrangian path which lies at the heart of the deBroglie-Bohm “ pilot-wave” interpretation. In particular, it is shown that each LP can be replaced with a statistical ensemble formed by an infinite family of stochastic curves, referred to as generalized Lagrangian paths. This permits the introduction of a new parametric representation of the Schrödinger equation, denoted as GLP-parametrization, and of (...) the associated quantum hydrodynamic equations. The remarkable aspect of the GLP approach presented here is that it realizes at the same time also a new solution method for the N-body Schrödinger equation. As an application, Gaussian-like particular solutions for the quantum probability density function are considered, which are proved to be dynamically consistent. For them, the Schrödinger equation is reduced to a single Hamilton–Jacobi evolution equation. Particular solutions of this type are explicitly constructed, which include the case of free particles occurring in 1- or N-body quantum systems as well as the dynamics in the presence of suitable potential forces. In all these cases the initial Gaussian PDFs are shown to be free of the spreading behavior usually ascribed to quantum wave-packets, in that they exhibit the characteristic feature of remaining at all times spatially-localized. (shrink)

In his final notebook, published posthumously as On Certainty , Wittgenstein offers a sustained and, at least apparently, fragmentary treatment of skeptical issues. Given the ambiguity and obscurity of some of its remarks, in the recent literature on the subject we can find a number of competing interpretations of OC, particularly of the elusive concept of ‘hinges’, central to Wittgenstein’s last work. In this paper, I will discuss the dominant interpretations of OC in order to show how they fail to (...) represent plausible renderings of his anti-skeptical thought. Finally, I will argue that the analogy between ‘hinges’ and ‘rules of grammar’, correctly understood and developed, can represent a plausible interpretation of Wittgenstein’s thought and, more importantly, a viable anti-skeptical strategy. (shrink)

Numbers are vital to so many areas of life: in science, economics, sports, education, and many aspects of everyday life from infancy onwards. This handbook brings together the different research areas that make up the vibrant field of numerical cognition in one comprehensive and authoritative volume.

En busca de un arte hispanoamericano.--El cine es arte?--La imagen y la obra de arte.--Velázquez, cumbre y mediodía.

La justicia social internacional.--La participación política en América Latina.--Apuntes acerca de la dialéctica democracia-autoritarismo en América Latina.

Comparing estimates of the cost-effectiveness of human immunodeficiency virus (HIV) interventions can help communities select an HIV prevention portfolio to meet local needs efficiently. The authors developed a spreadsheet tool to estimate the relative cost-effectiveness of 26 HIV prevention interventions. HIV prevalence of the population at risk and the cost per person reached were the two most important factors determining cost-effectiveness. In low-prevalence populations, the most cost-effective interventions had a low per-person cost. Among the most cost-effective interventions overall were showing (...) videos in sexually transmitted disease clinics and raising alcohol taxes. (shrink)

This study examines the impact of the level of religious observance on the attitudes toward end‐of‐life (EOL) decisions and euthanasia of Jews in Israel—where euthanasia is illegal—as compared to Jews living in the USA, in the states where euthanasia is legal. A self‐reporting questionnaire on religiosity and personal beliefs and attitudes regarding EOL care and euthanasia was distributed, using a convenience sample of 271 participants from Israel and the USA. Findings show that significant differences were found in attitudes between Jews (...) of different levels of religious observance with respect to patient autonomy, right to die with dignity, and dying in familiar and supportive surroundings. The USA and Israeli Jews have similar knowledge regarding EOL care and expressed similar attitudes and perceptions toward the issues of authority of medical staff and religious figures and patient's autonomy. Findings indicate that the level of religious observance has more potency in shaping their attitudes and perceptions of EOL decisions than the state law. We conclude by discussing the implications of our findings with regard to multicultural health systems and providing practical recommendations. (shrink)

L. Jonathan Cohen; XI*—Guessing, Proceedings of the Aristotelian Society, Volume 74, Issue 1, 1 June 1974, Pages 189–210, https://doi.org/10.1093/aristotelian/7.

El presente trabajo analiza el debate reciente sobre operatividad, técnica y cultura en la Teoría de los medios alemana, en el cual se enfrentan, por un lado, el enfoque tecnicista radical, y por el otro, el giro antropológico de los Estudios de las técnicas culturales. Asimismo, analiza la manera en que Simondon fue recientemente incorporado a la discusión y propone, en distancia crítica con ello, un nuevo modo de considerar los posibles aportes simondonianos al debate. Uno de los principales aportes (...) que el presente trabajo destaca es el siguiente: la noción simondoniana de operación técnica ofrece un enfoque no antropológico sobre la técnica y a la vez una consideración no tecno-céntrica de la dimensión técnica de la cultura. (shrink)

Este trabalho discute a formação da mentalidade individual, por meio de uma reflexão comparativa entre Democracia e educação, de John Dewey, e Admirável mundo novo, de Aldous Huxley. O texto literário permite um diálogo e uma leitura em face do texto filosófico, que o caracteriza como campo para a realização de um experimento de pensamento. Esse experimento é a discussão do valor atribuído por Dewey ao crescimento individual e ao social, em contraposição ao valor encontrado na narrativa de Huxley, da (...) estabilidade. Confrontando as leituras dessas duas obras, se pode compreender mais profundamente e, em uma perspectiva diferenciada, a relevância das condições do crescimento na formação plena da mentalidade individual. (shrink)

Cet article expose le problème de l’identité personnelle chez Paul Ricoeur, à partir de Temps et récit et Soi-même comme un autre , en abordant, succinctement, des positions philosophiques qui affirment ce que Ricoeur caracterise comme identité en tant que permanence dans le temps (mêmeté), au contraire de l’identité en tant que mutable et diverse dans le temps (ipséité), qui va à la rencontre de sa thèse de l’identité narrative. Ensuite, nous indiquons la limitation de la narrative pour rendre compte (...) du problème de l’identité personnelle devant le possible effacement de soi-même dans le cadre narratif et persévérance dans le cadre éthique avec le concepte de promesse. Enfin, l’article est conclu avec l’exposition de l’approximation que Ricoeur réalise du concept de promesse en tant que speech act et comme pouvoir de promettre , et le rapport avec le concept de responsabilité qui découle de cela. (shrink)

Este artículo analiza el proceso de integración del Mercosur en el que participan Argentina, Brasil, Paraguay y Uruguay y sus efectos sobre la ciudadanía política y social. En la primera parte del mismo los autores examinan los rasgos, el contexto de nacimiento y la filosofía del proceso de integración mercosureño. La segunda parte analiza la evolución de la democracia y de la justicia social durante el proceso de integración. Los autores llegan a la conclusión de que el modelo de integración (...) mercosureño no puede contrarrestar la crisis de la democracia y de la justicia social que tienen lugar especialmente en Argentina y Brasil. (shrink)

The new normal has made social distancing a new way of experiencing sociality. Social neuroscience has for a long time been concerned with studying the beneficial effects of social relationships, of physical contact. It is known that physical contact activates neurophysiological processes that reduce the perception of discomfort and even physical pain. So in the absence of physical contact, our social brain may be modulated differently when we are with others. But what could be the long-term effects of this normality? (...) This mini-review focuses on highlighting with the support of social neuroscience evidence such as isolation, distancing can affect people’s health. (shrink)

The present article is devoted to a logical inquiry on the notions of permanence and termination, which play a central role in many areas of temporal reasoning. In the first part, we introduce a bimodal framework to represent these notions and provide a syntactic and semantic comparison with a monomodal framework representing the notion of future necessity. In the second part, we focus on the problem of defining synonymous logical systems over the two frameworks; as an example, we provide an (...) extended analysis of two systems, the monomodal K4 and the bimodal S4X. The third part of the article indicates possible developments of the proposed line of inquiry, such as finding a simple representation in the bimodal language of some interesting properties of time and identifying further pairs of synonymous systems. (shrink)

The problem is posed of the prescription of the so-called Boltzmann–Grad limit operator ) for the N-body system of smooth hard-spheres which undergo unary, binary as well as multiple elastic instantaneous collisions. It is proved, that, despite the non-commutative property of the operator \, the Boltzmann equation can nevertheless be uniquely determined. In particular, consistent with the claim of Uffink and Valente that there is “no time-asymmetric ingredient” in its derivation, the Boltzmann equation is shown to be time-reversal symmetric. The (...) proof is couched on the “ab initio” axiomatic approach to the classical statistical mechanics recently developed. Implications relevant for the physical interpretation of the Boltzmann H-theorem and the phenomenon of decay to kinetic equilibrium are pointed out. (shrink)

The present study investigated the mediating role of conceptions of learning in the relationship between metacognition and academic outcomes among middle school students. The self-report ‘Learning Conceptions Questionnaire’ (LCQ) and ‘Metacognitive questionnaire on the method of study’ (QMS) were administered to 136 middle school students and their academic outcomes were collected. Correlation analyses revealed that within metacognition only self-assessment was positively correlated with academic outcomes. Mediation analysis indicated that a conception of learning as internal attribution of success and failure was (...) significantly involved as mediator in the relationship between metacognition and academic achievements. The present study permitted to advance our knowledge about the relationship between metacognition and academic achievements and it opened the way to practical implications. (shrink)

En este artículo intento mostrar que la desigualdad económica, la militarización de los Estados así como el odio y la violencia son las causas de gran parte de los conflictos bélicos. Ante lo cual, apoyándome en una línea que se genera en Oriente pero que no es ajena al pensamiento occidental, propongo seguir investigando en torno al pacifismo gandhiano, así como acerca de valores que el budismo cultiva conscientemente, como es el valor de la compasión universal, y que poseen una (...) gran importancia para consolidar una cultura de la paz. (shrink)