Objective: To measure the stability of life-sustaining treatment preferences amongst older people and analyse the factors that influence stability. Design: Longitudinal cohort study. Setting: Primary care centres, Granada (Spain). Eighty-five persons age 65 years or older. Participants filled out a questionnaire with six contexts of illness (LSPQ-e). They had to decide whether or not to receive treatment. Participants completed the questionnaire at baseline and 18 months later. Results: 86 percent of the patients did not change preferences. Sex, age, marital status, (...) hospitalisation, and self-perception of health and pain did not affect preferences. Morbidity and the death of a relative did. Conclusion: Stability of preferences of older persons in relation to end-of-life decisions seems to be more probable than instability. Some factors, such as the death of a relative or the increase in morbidity, can change preferences. These findings have implications for advance directives (ADs) and advance care planning. (shrink)

Remedios ÁVILA CRESPO Trotta 2018, 213 pp. Madrid ISBN: 978-84-9879-758-9.

Tumor progression involves the transition from normal to malignant cells, through a series of cumulative alterations. During this process, invasive and migratory properties are acquired, enabling cells to metastasize (reach and grow in tissues far from their origin). Numerous cellular changes take place during epithelial malignancy, and disruption of E‐cadherin based cell‐cell adhesion is a major event. The small Rho GTPases (Rho, Rac and Cdc42) have been implicated in multiple steps during cellular transformation, including alterations on the adhesion status of (...) the tumor cells. This review focuses on recent in vivo evidence that implicates RhoGTPases in epithelial tumor progression. In addition, we discuss different hypotheses to explain disruption of cadherin‐mediated cell–cell adhesion, directly or indirectly, through activation of Rho GTPases. Understanding the molecular mechanism of how cadherin adhesion and RhoGTPases interplay in normal cells and how this balance is altered during cellular transformation will provide clues as to how to interfere with tumor progression. © 2003 Wiley Periodicals, Inc. BioEssays 25:452–463, 2003. © 2003 Wiley Periodicals, Inc. (shrink)

Drawing on Husserl, Ingarden and Levinas’ works, this article explores Ibsen’s Rosmersholm from a phenomenological perspective, aiming to shed light both on this play and on the phenomenology of hunger and theatre, as well as on the larger meaning of alimentary enjoyment.

The Uniform Determination of Death Act (UDDA) provides that “an individual who has sustained either (1) irreversible cessation of circulatory and respiratory functions or (2) irreversible cessation of all functions of the entire brain, including the brain stem, is dead.” We show that the UDDA contains two conflicting interpretations of the phrase “cessation of functions.” By one interpretation, what matters for the determination of death is the cessation of spontaneous functions only, regardless of their generation by artificial means. By the (...) other, what matters is the cessation of both spontaneous and artificially supported functions. Because each UDDA criterion uses a different interpretation, the law is conceptually inconsistent. A single consistent interpretation would lead to the conclusion that conscious individuals whose respiratory and circulatory functions are artificially supported are actually dead, or that individuals whose brain is entirely and irreversibly destroyed may be alive. We explore solutions to mitigate the inconsistency. (shrink)

This two country study examines the effect of corporate ethical values and enforcement of a code of ethics on perceptions of the role of ethics in the overall success of the firm. Additionally, the impact of organizational commitment and of individual variables such as ethical idealism and relativism was examined. The rationale for examining the perceived importance of the role of ethics in this manner is to determine the extent to which the organization itself can influence employee perceptions regarding ethics (...) and social responsibility. Results indicate that all of the variables tested, except relativism, impacted upon one’s perceptions of the importance of ethics and social responsibility. Perceptions of the importance of ethics and social responsibility also varied depending upon country of residence with the U.S. sample having somewhat higher perceptions concerning the importance of ethics and social responsibility than their counterparts in Spain. Furthermore, when comparing the two samples, the U.S. sample had significantly higher corporate ethical values, greater enforcement of ethical codes, less organizational commitment and both lower idealism and relativism. (shrink)

El artículo contextualiza e investiga los detalles del «Mes de Reflexión Episcopal» organizado por el Departamento de Pastoral de Conjunto del Celam en julio de 1971, que reunió providencialmente varios obispos, algunos de los cuales no estuvieron en la II Conferencia General tres años antes, y que darían testimonio del espíritu de Medellín hasta el martirio o hasta una muerte trágica en cumplimiento de su misión: Oscar Arnulfo Romero, Juan Gerardi Conedera, Gerardo Valencia Cano y Raúl Zambrano Camader. El encuentro (...) se describe a partir de la revisión documental de las actas y de los pocos informes impresos. La tesis central del artículo es que el diálogo informal entre obispos, teólogos y otros expertos en el «Mes de Reflexión Episcopal» es fuente de propuestas novedosas para una Pastoral de Conjunto, contra la clericalización y el autoritarismo en la Iglesia latinoamericana. Desafortunadamente, no hay una reunión posterior similar debido a una controversia con la Congregación romana para los obispos. (shrink)

The nature of the relationship between language and thought has been quite elusive. We believe that its understanding is crucially dependent on the available notions of language and thought. Foundations of Language offers an unusually clear and complete account of both, providing a fruitful and much needed framework for future research. No doubt it will help us think better about these elusive complexities.

This study analysed the effects a values education programme can have on the feelings of self‐realisation, self‐concept and self‐esteem of Romany adolescents in southern Spain. To do this, an experimental group received a values education intervention but a control group did not. The intervention programme was adapted to the Romany culture. The self‐realisation, self‐concept and self‐esteem of both groups were evaluated using the Self‐Concept and Realisation Questionnaire. Statistical analyses showed the existence of significant differences between the experimental and control groups (...) on the variables studied. Based on the results, we suggest that a values education programme like this, that has been culturally adapted, can make a positive impact on the self‐realisation of young people from a marginalised community. (shrink)

Laura Specker Sullivan (2022) makes a fairly compelling case for the value of the perspectives of Buddhist practitioners in neuroethics. In this study, Tibetan Buddhist monks have been asked, among other things, whether consciousness, in brain-injured patients in a minimally conscious state, entails a duty to preserve life. In our view, some of the participants’ responses could be used to inform the bioethical debate on death determination.

En este texto se trata de pensar el proyecto que Foucault inició con el análisis de la parrhesía. Se aborda ese problema en relación a otros dos elementos de su obra: la reflexión sobre la función de los intelectuales y sus escritos sobre la noción de crítica. Desde esa perspectiva trataré de mostrar que las investigaciones sobre la parrhesía reflejan el intento de pensar una nueva política de la verdad.

The past decade has seen a flurry of social scientific research on the use of racial categories in human genetics research. This literature has critically analyzed how U.S. race relations are being shaped by and themselves shaping research on human biological difference and disease. Recent work, however, suggests that the particular configurations of science and ethnoracial politics in the US are not exportable. Instead, research on human biology in other contexts reveals the importance of not just racial categories, but national, (...) ethnic, regional and linguistic classifications of bodies and communities... (shrink)

Este trabajo tiene como objeto fundamental llevar a cabo una reconstrucción de la teoría trascendental del conocimiento en las experiencias filosóficas de Kant y Habermas. En ambas se produce un peculiar tránsito de la subjetividad a la intersubjetividad, gracias al cual se rompe el paradigma de la filosofía de la conciencia y emerge una específica experiencia comunicativa a través del sensus communis y de la razón comunicativa. A lo largo de esta investigación se intenta poner de manifiesto el paralelismo entre (...) ambos proyectos filosóficos, cuyo fundamento es la ilustración o la autonomía de la razón. Subjetividad trascendental, sensus communis, intereses del conocimiento y razón comunicativa representan distintas soluciones al problema de la comunicabilidad de los juicios mediante los que declaramos la posibilidad, realidad y necesidad de los estados de cosas. (shrink)

Dilthey es uno de los autores que introducen el tema de la historia en el ámbito de la filosofía. Lo cual es un acierto, aunque haya encontrado multitud de problemas. Leonardo Polo procura encontrarles solución.

In ‘Normative Facts and Reasons’, Fabienne Peter proposes that there are two different types of practical warrant, which she terms ‘entitlement warrant’ and ‘reason-based justification’. This thesis relies fundamentally on her distinction between normative facts and normative reasons. I will raise two general critical observations. First, I will claim that Peter advocates a representation-dependent conception of reasons that is at odds with an intuitive and accepted understanding of them. Second, I will contend that reasons need not be the entities we (...) directly handle in our deliberations, which undermines the idea that reasons are propositions. In this way, her distinction fails: normative reasons are just normative facts. This implies that the existence of two types of practical warrant, based either on normative facts or reasons, is unfounded. (shrink)

Based on a narrative of the recent history of postcolonial feminism within and outside the Swedish academic world, this article discusses the controversial relationship between feminism and politics. Installing a socialist inspired perspective on intersectionality in Swedish feminist debates and in gender research has been a hard task for postcolonial feminists in a society whose self-imagination excludes the recognition of racism as a fundamental component of the national identity. Moreover, as the country moves rapidly towards a neoliberalization of the former (...) Keynesian Swedish welfare state, racism and homo-nationalism spreads out and permeates the political sphere and state institutions. The author emphasizes the importance for postcolonial feminists to continuously highlight the chasm that exists between neoliberal understandings of gender equality, which are not meant to eradicate structural class, gender, racial or other social inequalities, and those emanating from socialist and anti-racist feministic ontologies. (shrink)

SIMONDON, Gilbert. Comunicación e información: cursos y conferencias. Buenos Aires, Cactus, 2016.

Requiring family authorization for apnea testing subtracts health professionals control over death determination, a procedure that has traditionally been considered a matter of clinical expertise alone. In this commentary, we first provide evidence showing that health professionals’ (HPs) disposition to act on death determination without family’s prior consent could be much lower than that referred to by Berkowitz and Garrett (2020). We hypothesize that HPs may have reservations about their own expertise as regards death, and may thus hesitate to impose (...) their views on patients’ families. We then address the theoretical question of clinical expertise in death determination by distinguishing judgments about facts (e.g., the presence or absence of spontaneous breathing) from interpretations given of these facts (i.e., their meaning for the vital status of an individual). We argue that, while clinicians may claim some expert authority on the former, they hold no particular authority on the latter. (shrink)

According to kin selection theory, indirect reproductive advantages may induce individuals to care for others with whom they share genes by common descent, and the amount of care, including self-sacrifice, will increase with the proportion of genes shared. Twins represent a natural situation in which this hypothesis can be tested. Twin pairs experience the same early environment because they were born and raised at the same time and in the same family but their genetic relatedness differs depending on zygosity. We (...) compared the degree of willingness to fight and sacrifice for the co-twin among monozygotic and dizygotic pairs in a sample of 1443 same-sex and opposite-sex twins. We also analyzed the effect of the subject’s gender and that of the co-twin on those altruistic behaviors. Results partly supported the postulated explanation. MZ twins were significantly more likely than DZ twins to self-sacrifice for their co-twins, but zygosity did not affect willingness to fight for him/her. The genders of the subject and of the co-twin, not genetic relatedness, were the best predictors of aggressive altruistic intentions. (shrink)

A principios de los años 80 se desató en Francia una polémica conocida como «el silencio de los intelectuales». En este texto abordaremos la singular postura de Michel Foucault al respecto. Para ello realizaremos una doble operación. Por un lado, planteamos la hipótesis siguiente: se pueden encontrar los fundamentos que sostienen su posición en los análisis que realizó sobre la parrhesía a partir de los años 80. En segundo lugar, realizaremos un recorrido por autores como Lyotard y Blanchot, quienes intervinieron (...) en dicha polémica con conocidos escritos, para mostrar las particularidades de la apuesta de Foucault. De esta manera, pretendemos, no solamente mostrar su original aportación al problema, sino señalar los desplazamientos respecto a la crítica del intelectual que había elaborado durante los años 70. (shrink)

The thesis that I develop in this paper is that there is a way of affirmation of the existence and the world in Schopenhauer, assuming no foundation, an aesthetic justification of existence or a way of life either as a tragic pessimism or pessimism of strength. This is an additional path to his basic position stated in The World as Will and Representation and is clearly in Parerga and Paralipomena, especially in «On Religion» and in «Aphorisms on the wisdom of (...) life». To develop that thesis, I analyze the concept of «need for metaphysics» and its relationship to art and to the author’s project of philosophy. (shrink)

En este artículo analizo la novela de Nayib Mahfuz, Hijos de nuestro barrio, desde la perspectiva de los personajes femeninos, especialmente en referencia a dos elementos centrales del barrio de las religiones monoteístas: la tierra prometida y el pueblo elegido.Através de los personajes femeninos Mahfuz recupera una memoria más comprensiva de la civilización humana.

The rise of mathematical developments in the theories of consciousness has led to new measures to detect consciousness in a system. The Integrated Information Theory is one of the best mathematical rooted attempts to quantify the level of consciousness in a system with Φ as the effective information generated in a system above its parts. Recently, the IIT has inspired the Perturbational Complexity Index to detect conscious states in patients with disorders of consciousness, and it has shown to have almost (...) perfect classification accuracy. In this study, we explore the statistical correspondence between the theoretical Φ and the experimental PCI through a neurocomputational model of coupled oscillators that can be artificially perturbed, which mainly focuses on the dynamics of collective synchronization between subsets of brain areas. Our results reveal that both measures are statistically related but, in principle, this relationship is far to be perfect. These results are discussed in the context of the model of coupled oscillators, which mainly focuses on the dynamics of collective synchronization between subsets of brain areas. (shrink)

In this article, I explore the role of the body in Indian thought through the lens of Lilian Silburn’s works, focusing on the idea of carving the cosmos, namely of somatic performances that have cosmological relevance. First, I delve into her biography, to study, subsequently, her analysis of ancient Vedic philosophy, the Brāhmaṇa, the Upanişad, and Buddhism. In this manner, I touch upon a series of conceptual developments, trying to understand the constant tensions between the discontinuous and the continuous, the (...) non-arranged and the arranged, the multiple and the One, and finally between eternalism and nihilism. I conclude by examining the way Buddhism has of resolving these tensions in the non-substantial theory of Karman. (shrink)

Objectives To increase postmortem organ donation rates, several countries are adopting an opt-out (presumed consent) policy, meaning that individuals are deemed donors unless they expressly refused so. Although opt-out countries tend to have higher donation rates, there is no conclusive evidence that this is caused by the policy itself. The main objective of this study is to better assess the direct impact of consent policy defaults per se on deceased organ recovery rates when considering the role of the family in (...) the decision-making process. This study does not take into account any indirect effects of defaults, such as potential psychological and behavioural effects on individuals and their relatives. -/- Design Based on previous work regarding consent policies, we created a conceptual model of the decision-making process for deceased organ recovery that included any scenario that could be directly influenced by opt-in or opt-out policies. We then applied this model to internationally published data of the consent process to determine how frequently policy defaults could apply. -/- Main outcome measures We measure the direct impact that opt-in and opt-out policies have per se on deceased organ recovery. -/- Results Our analysis shows that opt-in and opt-out have strictly identical outcomes in eight out of nine situations. They only differ when neither the deceased nor the family have expressed a preference and defaults therefore apply. The direct impact of consent policy defaults is typically circumscribed to a range of 0%–5% of all opportunities for organ recovery. Our study also shows that the intervention of the family improves organ retrieval under opt-in but hinders it under opt-out. -/- Conclusions This study may warn policy makers that, by emphasising the need to introduce presumed consent to increase organ recovery rates, they might be overestimating the influence of the default and underestimating the power granted to families. (shrink)

La renovación metodológica que impulsa el EEES implica un nuevo enfoque didáctico, dándole mayor importancia al aprendizaje motivacional que a la enseñanza. En este contexto, las metas vitales del alumnado y su actitud ante el aprendizaje son determinantes clave en su motivación. El objetivo de este trabajo es analizar las orientaciones motivacionales y de aprendizaje de los estudiantes de la Facultad de Ciencias Sociales y Jurídicas de la Universidad de Jaén para proponer al profesorado actuaciones, procedimientos, tácticas, y recursos que (...) influyan favorablemente en la motivación del alumnado, impulsen la participación y asistencia a clase y contribuyan a un aprendizaje activo. (shrink)

Background: Treating medication-refractory freezing of gait in Parkinson’s disease remains challenging despite several trials reporting improvements in motor symptoms using subthalamic nucleus or globus pallidus internus deep brain stimulation. Pedunculopontine nucleus region DBS has been used for medication-refractory FoG, with mixed findings. FoG, as a paroxysmal phenomenon, provides an ideal framework for the possibility of closed-loop DBS.Methods: In this clinical trial, five subjects with medication-refractory FoG underwent bilateral GPi DBS implantation to address levodopa-responsive PD symptoms with open-loop stimulation. Additionally, PPN (...) DBS leads were implanted for CL-DBS to treat FoG. The primary outcome of the study was a 40% improvement in medication-refractory FoG in 60% of subjects at 6 months when “on” PPN CL-DBS. Secondary outcomes included device feasibility to gauge the recruitment potential of this four-lead DBS approach for a potentially larger clinical trial. Safety was judged based on adverse events and explantation rate.Findings: The feasibility of this approach was demonstrated as we recruited five subjects with both “on” and “off” medication freezing. The safety for this population of patients receiving four DBS leads was suboptimal and associated with a high explantation rate of 40%. The primary clinical outcome in three of the five subjects was achieved at 6 months. However, the group analysis of the primary clinical outcome did not reveal any benefit.Interpretation: This study of a human PPN CL-DBS trial in medication-refractory FoG showed feasibility in recruitment, suboptimal safety, and a heterogeneous clinical effect in FoG outcomes. (shrink)