This paper presents a systematic account of ethical issues actualised in different areas, as well as at different levels and stages of health care, by introducing organisational and other procedures that embody a shift towards person centred care and shared decision-making (PCC/SDM). The analysis builds on general ethical theory and earlier work on aspects of PCC/SDM relevant from an ethics perspective. This account leads up to a number of theoretical as well as empirical and practice oriented issues that, in view (...) of broad advancements towards PCC/SDM, need to be considered by health care ethics researchers. Given a PCC/SDM-based reorientation of health care practice, such ethics research is essential from a quality assurance perspective. (shrink)

Background: Ethical and legal issues are increasingly being reported by health caregivers; however, little is known about the nature of these issues in geriatric care. These issues can improve work and care conditions in healthcare, and consequently, the health and welfare of older people. Aim: This literature review aims to identify research focusing on ethical and legal issues in geriatric care, in order to give nurses and other health care workers an overview of existing grievances and possible solutions to take (...) care of old patients in a both ethical and legally correct way. Methods: Using a systematic approach based on Aveyard, a search of the PubMed, CINAHL, and Ethicshare databases was conducted to find out the articles published on ethical and legal issues in geriatric care. Ethical considerations: The approval for the study was obtained from UMIT-The Health and Life Sciences University, Austria. Results: Only 50 articles were included for systematic analysis reporting ethical and legal issues in the geriatric care. The results presented in this article showed that the main ethical issues were related to the older people’s autonomy, respect for their needs, wishes and values, and respect for their decision-making. The main legal issues were related to patients’ rights, advance directives, elderly rights, treatment nutrition dilemma, and autonomy. Conclusion: Further education for professional caregivers, elderly people, and their families is needed on following topics: care planning, directive and living wills, and caregiver-family member relationships to guide and support the elderly people within their decision-making processes and during the end-of-life care. (shrink)

The remember/know procedure is the most widely used method to investigate recollection and familiarity. It uses trial-by-trial reports to determine how much recollection and familiarity contribute to different kinds of recognition. Few other methods provide information about individual memory judgements and no alternative allows such direct indications of recollection and familiarity influences. Here we review how the RK procedure has been and should be used to help resolve theoretical disagreements about the processing and neural bases of components of recognition memory. (...) Emphasis is placed on procedural weaknesses and a possible confound of recollection and familiarity with recognition memory strength. Recommendations are made about how to minimise these problems including using modified versions of the procedure. The proposals here are important for improving behavioural and lesion research, and vital for brain imaging work. (shrink)

The COVID-19 outbreak has placed extraordinary demands upon healthcare systems worldwide. Italy's hospitals have been among the most severely overwhelmed, and as a result, Italian healthcare workers' well-being has been at risk. The aim of this study is to explore the relationships between dimensions of burnout and various psychological features among Italian healthcare workers during the COVID-19 emergency. A group of 267 HCWs from a hospital in the Lazio Region completed self-administered questionnaires online through Google Forms, including the Maslach Burnout (...) Inventory, Resilience Scale, and Intolerance of Uncertainty Scale Short Form. Cluster analysis highlighted two opposite burnout risk profiles: low burnout and high-risk burnout. The high-risk group had lower resilience and greater difficulties in tolerating the uncertainty than the low-burnout group. A set of general linear models confirmed that both IU subscales, prospective and inhibition, moderated the relationship between resilience and burnout. In conclusion, the results showed that individual levels of resilience and one's ability to tolerate uncertainty have been significant factors in determining the impact of the COVID-19 emergency on HCWs. The use of emotional strategies that allow individuals to stay in a critical situation without the need to control it appears to protect against burnout in these circumstances. (shrink)

La perception à travers l’imaginationDans le présent travail, je mets en relation les lectures de Wittgensteil et de Gadamer avec les manuscrits de Merleau-Ponty avec l’intention de traverser la construction du « concept de représentation » et de réfléchir sur les questions suivantes : quel lieu occupe la dimension esthétique dans l’expérience humaine? Dans l’expérience esthétique, faut-il retrouver autant le profil émotionnel que le profil cognitif? Le point de départ est que l’esthétique ne doit pas être comprise comme une simple (...) perception par les sens; ce qu’aucun discours sur l’esthétique ne peut occulter est sa nécessaire implication de l’horizon problématique de la perception, à partir de l’étymologie même du terme, dérivé du grec aisthesis.Un tel terme porte en lui autant le champ subjectif instable des sensation que le champ stable et tendanciellement structuré des discriminations perceptives.L’affirmation théorique est que l’expérience de la rencontre d’une oeuvre d’art dévoile un monde et à peine cessons-nous de voir une oeuvre d’art comme objet pour la voir comme un monde que nous nous rendons compte que l’art se révèle être l’expédient pour clarifier le sens de notre rapport perceptif avec le monde, cette syntonie perceptive entre l’essence du monde et le sentir des sujets, cette processualité expressive dans laquelle activité et passivité sont les horizons, qu’on peut certes distinguer dans la description, mais qui coopèrent à l’intérieur d’elle-même.Perception Through ImaginationIn the present work, I bring the lectures of Wittgenstein and Gadamer into contact with the manuscripts of Merleau-Ponty with the intention of going over the construction of the “concept of representation” and of reflecting on the following questions: what place does the aesthetic dimension occupy in human experience? In aesthetic experience, is just as necessary to recognize the emotional profile as the cognitive profile? The point of the departure is that aesthetics must not be understood as a simple perception by the senses. That which no discourse of aesthetics may conceal is its necessary implication of the problematic horizon of perception, following the actual etymology of the term, derived from the Greek aisthēsis.This term contains just as much the subjective and unstable field of sensation as it does the stable field of perceptual discriminations that tend to be structured. The theoretical affirmation is that the experience of the encounter with a work of art unveils a world. No sooner do we stop seeing the work of art as an object and start seeing as a world, then we realize that art reveals itself to be the expedient that clarifies the meaning of our perceptual relationship with the world, this perceptual syntony between the essence of the world and the sensing of subjects, this expressive processuality in which activity and passivity are horizons that can certainly be distinguished in description, but that cooperate internally. (shrink)

Background:Smart Aging is a serious game (SG) platform that generates a 3D virtual reality environment in which users perform a set of screening tasks designed to allow evaluation of global cognition. Each task replicates activities of daily living performed in a familiar environment. The main goal of the present study was to ascertain whether Smart Aging could differentiate between different types and levels of cognitive impairment in patients with neurodegenerative disease.Methods:Ninety-one subjects (mean age = 70.29 ± 7.70 years)—healthy older adults (...) (HCs,n= 23), patients with single-domain amnesic mild cognitive impairment (aMCI,n= 23), patients with single-domain executive Parkinson's disease MCI (PD-MCI,n= 20), and patients with mild Alzheimer's disease (mild AD,n= 25)—were enrolled in the study. All participants underwent cognitive evaluations performed using both traditional neuropsychological assessment tools, including the Mini-Mental State Examination (MMSE), Montreal Overall Cognitive Assessment (MoCA), and the Smart Aging platform. We analyzed global scores on Smart Aging indices (i.e., accuracy, time, distance) as well as the Smart Aging total score, looking for differences between the four groups.Results:The findings revealed significant between-group differences in all the Smart Aging indices: accuracy (p< 0.001), time (p< 0.001), distance (p< 0.001), and total Smart Aging score (p< 0.001). The HCs outperformed the mild AD, aMCI, and PD-MCI patients in terms of accuracy, time, distance, and Smart Aging total score. In addition, the mild AD group was outperformed both by the HCs and by the aMCI and PD-MCI patients on accuracy and distance. No significant differences were found between aMCI and PD-MCI patients. Finally, the Smart Aging scores significantly correlated with the results of the neuropsychological assessments used.Conclusion:These findings, although preliminary due to the small sample size, suggest the validity of Smart Aging as a screening tool for the detection of cognitive impairment in patients with neurodegenerative diseases. (shrink)

Parental substance use is a major risk factor for child development, heightening the risk of drug problems in adolescence and young adulthood, and exposing offspring to several types of traumatic event. First, prenatal drug exposure can be considered a form of trauma itself, with subtle but long-lasting sequalae at the neuro-behavioural level. Second, parents’ addiction often entails a childrearing environment characterised by poor parenting skills, disadvantaged contexts and adverse childhood experiences, leading to dysfunctional outcomes. Young adults born from/raised by parents (...) with drug problems and who develop a Substance Used Disorder (SUD) themselves might display a particularly severe condition in terms of cognitive deficits and impaired personality function. This preliminary study aims to investigate the role of early exposure to drugs as a traumatic event, capable of affecting the psychological status of young drug addicts. In particular, it intends to examine the neuropsychological functioning and personality profile of young adults with severe SUDs who were exposed to drugs early in their family context. The research involved 3 groups each consisting of 15 young adults (aged 18-24): a group of inpatients diagnosed with SUDs and exposed to drugs early, a comparison group of non-exposed inpatients and a group of non-exposed youth without SUDs. A neuropsychological battery (Esame Neuropsicologico Breve-2), an assessment procedure for personality disorders (Shedler-Westen Assessment Procedure-200) and the Symptom CheckList-90-Revised were administered. According to present preliminary results, young drug addicts exposed to drugs during their developmental age were characterised by elevated rates of neuropsychological impairments, especially at the expense of attentive and executive functions; personality disorders were also common but did not differentiate them from non-exposed young people with SUDs. Alternative multi-focused prevention and intervention programs are needed for children of drug-misusing parents, addressing executive functions and adopting a trauma-focused approach. (shrink)

In theCompanion to Heidegger's Contributions to Philosophyan international group of fourteen Heidegger scholars shares strategies for reading and understanding this challenging work.

El presente artículo ahonda en la vulnerabilidad de las y los migrantes en México, ya sean en tránsito o de destino, haciendo énfasis en la falta de políticas públicas al respecto, las cuales si las hay, no contemplan la perspectiva de género, categoría de análisis imprescindible. La llamada “feminización de las migraciones” está aumentando, adquiriendo especial importancia en la Frontera Sur. La violación sistemática de los derechos humanos hacia las mujeres migrantes y su situación de indefensión, hace que sean objeto (...) de vejaciones que ni si quiera pueden denunciar por su condición irregular, así como por sus factores sociales y culturales (género, clase, etnia…), lo que les hace estar desprovistas de los recursos necesarios de empoderamiento y acción. Se analiza la desprotección de las migrantes centroamericanas en Chiapas así como los Convenios nacionales e internacionales en defensa de sus derechos, acabando el artículo con propuestas específicas, relativas a las políticas públicas para el caso estudiado. (shrink)

The development of neuropsychological assessment methods using virtual reality (VR) is a valid and promising option for the detection of cognitive impairment in the older people, focusing on activities composed of tasks of multiple demands. This study verified the association of age, schooling, and general cognitive status on the performance of neurologically healthy older adults in ECO-VR, a virtual reality task of multiple demands for neuropsychological assessment. A total of 111 older adults answered a sociodemographic questionnaire, the Mini Mental State (...) Examination, the Vocabulary subtest of the Wechsler Intelligence Scale for Adults (third edition), and the ECO-VR. Correlation analyses, multiple linear regression, and comparisons between groups (effects by age and schooling groups) were used to evaluate the results. The ECO-VR total score was significantly associated with age, years of education, MMSE, and Vocabulary subtest. The linear regression models identified that age was the main predictor for total score and rule breaking of ECO-VR. According to the univariate analysis, it was identified the main effect of age group and schooling group in the total ECO-VR score, but there was no interaction effect. The results are discussed in order to understand the role of sociodemographic characteristics in the performance of older adults in a virtual reality task of multiple demands. It was also verified the possibility use of virtual reality for neuropsychological assessment of older adults. (shrink)

Legal information retrieval is in need of the provision of legal knowledge for the improvement of search strategies. For this purpose, the LOIS project is concerned with the construction of a multilingual WordNet for cross-lingual information retrieval in the legal domain. In this article, we set out how a hybrid approach, featuring lexically and legally grounded conceptual representations, can fit the cross-lingual information retrieval needs of both legal professionals and laymen.

Conley and colleagues (2023) explore how calls for broad public engagement (PE) in the case of heritable human genome editing are being put into action, reviewing the activities of five different i...

Focusing on the new theories of human motivation that emerged during the transition from feudalism to the modern period, this is the first book of new essays on the relationship between politics and the passions from Machiavelli to Bentham. Contributors address the crisis of moral and philosophical discourse in the early modern period; the necessity of inventing a new way of describing the relation between reflection and action, and private and public selves; the disciplinary regulation of the body; and the (...) ideological constitution of identity. The collection as a whole asks whether a discourse of the passions might provide a critical perspective on the politics of subjectivity. Whatever their specific approach to the question of ideology, all the essays reconsider the legacy of the passions in modern political theory and the importance of the history of politics and the passions for modern political debates. Contributors, in addition to the editors, are Nancy Armstrong, Judith Butler, Riccardo Caporali, Howard Caygill, Patrick Coleman, Frances Ferguson, John Guillory, Timothy Hampton, John P. McCormick, and Leonard Tennenhouse. (shrink)

This study examines the impact of government divestiture on corporate environmental investment (EI) and investigates how regional development moderates this relationship. Using a sample of Chinese listed firms from 2012 to 2022, we employ a fixed-effect model to analyze the data. Our findings reveal a negative effect of government divestiture on EI. Furthermore, we observe that regional development mitigates this negative impact, indicating that firms operating in developed environments are more inclined to prioritize environmental concerns, likely due to increased stakeholder (...) monitoring. To address concerns regarding endogeneity, we utilize propensity score matching (PSM), Heckman tests, and the generalized method of moments (GMM). Overall, our results carry significant policy implications, particularly regarding the environmental consequences of privatization in emerging markets like China. (shrink)

The aim of the present study was to investigate the association between attachment dimensions and neural correlates in response to the Rorschach inkblots. Twenty-seven healthy volunteers were recruited for the electroencephalographic registration during a visual presentation of the Rorschach inkblots and polygonal shapes. The Attachment Style Questionnaire was administered to participants. Correlations between the ASQ scores and standardized low-resolution brain electromagnetic tomography intensities were performed. The Rorschach inkblots elicited several projective responses greater than the polygonal shapes. Only during the Rorschach (...) inkblots presentation, discomfort with closeness and relationships as secondary subscales were negatively correlated with the activation of right hippocampus, parahippocampus, amygdala, and insula; need for approval subscale was negatively correlated with the activation of orbital and prefrontal cortex and left hippocampus. Moreover, the correlations between attachment dimensions and neural activation during the Rorschach inkblots were significantly higher compared to the same correlations in response to polygonal shapes. These findings suggest that attachment style can modulate brain activation during the projective activity of the Rorschach inkblots. (shrink)

IntroductionAfter three decades of the absolute prohibition of abortion, Chile enacted Law 21,030, which decriminalizes voluntary pregnancy termination when the person is at vital risk, when the embryo or fetus suffers from a congenital or genetic lethal pathology, and in pregnancy due to rape. The law incorporates conscientious objection as a broad right at the individual and institutional levels.ObjectivesThe aim of the study was to explore the exercise of conscientious objection in public health institutions, describing and analyzing its consequences and (...) proposals to prevent it from operating as structural violence.Materials and methodsThis study uses a qualitative, post-positivist design. At the national level, according to the chain technique, people who were identified as key actors due to their direct participation in implementing the law were included. Grounded theory was used to analyze the information obtained through a semi-structured interview. The methodological rigor criteria of transferability or applicability, dependability, credibility, auditability, and theoretical-methodological adequacy were met.ResultsData from 17 physicians, 5 midwives, 6 psychologists, 8 social workers, 2 nursing technicians, and 1 lawyer are included. From an inductive process through open coding, conscientious objection as structural violence and strategies to minimize the impact of objection emerge as meta-categories. The first meta-category emerges from the barriers linked to the implementation of the law, the infringement of the rights of the pregnant person, and pseudo conscientious objection, affecting timely and effective access to pregnancy termination. The second meta-category emerges as a response from the participants, proposing strategies to prevent conscientious objection from operating as structural violence.ConclusionConscientious objection acts as structural violence by infringing the exercise of sexual and reproductive rights. The State must fulfill its role as guarantor in implementing public policies, preventing conscientious objection from becoming hegemonic and institutionalized violence. (shrink)

Residências Integradas Multiprofissionais em Saúde são programas de pós-graduação caracterizados por ensino em serviço. A ULBRA oferece o programa com ênfase em Saúde do Adulto e do Idoso e Saúde Comunitária. Objetiva-se descrever as atividades realizadas em ambiente hospitalar por enfermeiras. Trata-se de um relato de experiência de enfermeiras residentes em relação ao primeiro ano de formação especializada. O primeiro ano de residência abrangeu atividades em unidades de internação, centro cirúrgico e unidade de tratamento intensivo. Diversas foram as atividades desenvolvidas (...) pelas residentes, abrangendo aperfeiçoamento técnico, produção de conhecimento científico e atuação em gestão e gerenciamento. A presença de tutores e preceptores é fundamental no sentido de discutir, orientar e facilitar a inserção e o desenvolvimento profissional do residente. O programa de residência permitiu aperfeiçoar habilidades nos três campos de atuação da categoria: assistência, gerenciamento e pesquisa. (shrink)

Soccer players inescapably live under stress during the sportive career, and many real-life aspects of soccer situations operate in the ongoing performance. This study’s main objective was to elaborate the List of Stressors in Professional Indoor and Field Soccer, a self-report instrument designed to measure the impact of 77 soccer situations upon the sport performance. Participants were 138 indoor and field soccer players from the Brazilian Premier League. Each situation was evaluated on a 7-point scale, ranging from the most negative (...) to the most positive. Data were analyzed according to the players’ perception of the items: distress or eustress and its intensity, and after that, situations perceived as plus −1 and +1 were compared by time in which they were experienced and distributed among five categories established by the literature: Expectations about the Performance, Personal Factors, Competition Aspects, Training Demands, and Relationship with Significant People. Narratives of athletes’ experiences were also used to discuss the results. An Exploratory Structural Equation Modeling using Bi-factorial was employed to assess the factor structure. For the total participants, 49 situations were perceived as distress and 28 as eustress. Using the criteria established a priori, the distribution was among the five categories in the remaining 32 situations. Differences in perception between less and more experienced players were found in 11 situations. The results revealed that Brazilian professional soccer players experience various stressful situations. These events are important representations of environmental demands and could predict the performance as they are perceived as eustress or distress. Some of these stressful situations are inherent in sport and others adjacent to the sports system or environment. Coach pressure to win and conflicts with teammates are examples of stressors in-sport, family problems and disputes with press or fans are examples of stressors external to the team, also called peripheral opponents, and showed the relative social influence of significant others in soccer performance. We can conclude that the knowledge of the direction of a given stress situation has important practical implications in preparing athletes and helping them face the performance stressors that are part of soccer daily life. (shrink)

El presente trabajo se propone describir e interpretar, en una primera etapa, los mecanismos de canonización literaria de obra y autor en una comunidad cultural específica, la latinoamericana. El caso estudiado es el del escritor argentino Manuel Puig y su obra. La relación interactiva entre contexto cultural, institucionalidad y sistemas de significado social y valoración permite modelar una descripción e intento de explicación de las relaciones de significado entrañadas en la constitución de los repertorios literarios canonizados, sus criterios de selección, (...) su naturaleza ideológica y la manera en que las prácticas sociales asociadas a este proceso se constituyen por un número variable de prácticas discursivas. Para ello se analiza un conjunto ilustrativo de eventos comunicativos y sus instancias textuales, donde se articulan los cánones literarios y sus efectos culturales: posicionamiento, valoración estética, iconización de autor y de discurso, influencia profesional, tematización crítica y académica, entre otros. Se estudia, por tanto, un caso de integración canónica: la del escritor argentino Manuel Puig en el canon literario de habla hispana y el canon literario universal de fines de siglo y se establece un plano de interacción con los parámetros de construcción canónica de la generación previa, la del llamado “boom literario latinoamericano”. This paper aims to initially describe and interpret the mechanisms of work and author’s literary canonization in a specific cultural community, Latin America. The case studied is that of Argentine writer Manuel Puig and his work. The interactive relationship among cultural context, social institutions and systems of social and evaluation meaning allows a description and attempted explanation of the imbued meaning relations in the constitution of the canonized literary repertoires, their selection criteria, ideological nature and the way in which social practices associated with this process are formed by a variable number of discursive practices. To do this, we analyze an illustrative set of communicative events and their textual instances, through which the literary canon and cultural effects are articulated: positioning, aesthetic appreciation, author and discourse iconisation, and professional influence, critical and academic thematization, among others. Thus, we study a case of canonical integration by the Argentine writer Manuel Puig into Hispanic and universal literary canon at the end of the century, and set up an interaction with the parameters of canonical construction from the previous generation, the so-called “Latin American literary boom”. (shrink)

Primary progressive multiple sclerosis (PPMS) shows a highly variable disease progression with poor prognosis and a characteristic accumulation of disabilities in patients. These hallmarks of PPMS make it difficult to diagnose and currently impossible to efficiently treat. This study aimed to identify plasma metabolite profiles that allow diagnosis of PPMS and its differentiation from the relapsing-remitting subtype (RRMS), primary neurodegenerative disease (Parkinson’s disease, PD), and healthy controls (HCs) and that significantly change during the disease course and could serve as surrogate (...) markers of multiple sclerosis (MS)-associated neurodegeneration over time. We applied untargeted high-resolution metabolomics to plasma samples to identify PPMS-specific signatures, validated our findings in independent sex- and age-matched PPMS and HC cohorts and built discriminatory models by partial least square discriminant analysis (PLS-DA). This signature was compared to sex- and age-matched RRMS patients, to patients with PD and HC. Finally, we investigated these metabolites in a longitudinal cohort of PPMS patients over a 24-month period. PLS-DA yielded predictive models for classification along with a set of 20 PPMS-specific informative metabolite markers. These metabolites suggest disease-specific alterations in glycerophospholipid and linoleic acid pathways. Notably, the glycerophospholipid LysoPC(20:0) significantly decreased during the observation period. These findings show potential for diagnosis and disease course monitoring, and might serve as biomarkers to assess treatment efficacy in future clinical trials for neuroprotective MS therapies. (shrink)

The main aim of the present research is to analyze the predictive value of individual characteristics such as online self-efficacy, adaptability to uncertainty, and sources of stress during online learning on learning engagement. We also aimed to highlight if these relationships could be mediated by the online self-regulated learning strategies, during the COVID-19 pandemic. The participants were 529 university students and the design was cross-sectional. The results showed significant associations of the sources of stress in online learning with self-efficacy, leaning (...) engagement and self-regulated learning strategies. Self-regulated strategies—task strategies and goal setting represent mediators of stressors perceived by the students under the conditions of the sudden shift to online activity and online learning engagement. The most relevant self-regulation strategies seemed to be goal setting and task strategies, which confirm the need for a clear structure of learning in the context of online activities. The implications of this study reside in the increased awareness regarding how learning engagement in online learning can be predicted by individual characteristics. (shrink)