Objectives The use of empathy during clinical practice is paramount to delivering quality patient care and is important for understanding patient concerns at both the cognitive and affective levels. This study sought to determine how and when physicians self-report the use of empathy when interacting with their patients. Methods A cross-sectional survey of 76 physicians working in a large urban hospital was conducted in August of 2017. Physicians were asked a series of questions with Likert scale responses as well as (...) asked to respond to open-ended questions. Results All physicians self-report that they always (69%) or usually (29.3%) use empathic statements when engaging with patients. 93.1% of physicians believe that their colleagues always (20.7%) or usually (69%) use empathic statements when communicating with patients. Nearly one-third of physicians (33%) indicated that using the words “I understand” denotes an empathic statement. Although 36% of physicians reported that they would like to receive more training or assistance about how and when to use empathy during clinical practice. Significance of Results Despite the self-reported prevalent use of empathic statements, one-third of physicians indicate a desire for more training in what empathy means and when it should be used in a clinical setting. Additionally, nearly one-third of physicians in this study reported using responses that patients may not perceive as being empathic, even when intended to be empathic. This suggests that many physicians feel uncertain about a clinical skill they believe should be used in most, if not all, encounters. (shrink)

Gutenbergs tryckteknik ledde till en medierevolution som förändrades Europa. I 1500-talets början spreds litteratur, grafik och vetenskap, men också nyhetsblad om katastrofer, pamfletter om invaderande turkar och religiösa stridsskrifter. Medan mycket ännu vägde blommade renässanshumanismen genom Erasmus av Rotterdam. Han stod bakom en femtedel av Europas böcker, och skulle ge framtiden ett viktigt arv. Nina Burton skriver om Erasmus och hans tid så att man känner sig vara med när han träffar konstnärerna och de intellektuella? Albrecht Dürer, Holbein d.y., (...) Paracelsus, Thomas More och Luther? lika väl som påvar, kejsare, pedagoger och rebeller. Genom honom möter man en hel epok. Vilken var Erasmus hemlighet? I sina brev klottrade han självporträtt med dubbla ansikten, och hans förmåga att se två sidor födde ett samtal bortom all fanatism? en dröm om ett gränslöst Europa, där kultur och vetenskap knöt nya samband. Men då religiösa strider började skaka världen fick han mäktiga fiender. Erasmus visade vilken roll litteraturen kan spela i en dramatisk tid som har många likheter med vår egen. (shrink)

Background: Although convolutional neural networks (CNNs) achieve high diagnostic accuracy for detecting Alzheimer’s disease (AD) dementia based on magnetic resonance imaging (MRI) scans, they are not yet applied in clinical routine. One important reason for this is a lack of model comprehensibility. Recently developed visualization methods for deriving CNN relevance maps may help to fill this gap as they allow the visualization of key input image features that drive the decision of the model. We investigated whether models with higher accuracy (...) also rely more on discriminative brain regions predefined by prior knowledge. Methods: We trained a CNN for the detection of AD in N = 663 T1-weighted MRI scans of patients with dementia and amnestic mild cognitive impairment (MCI) and verified the accuracy of the models via cross-validation and in three independent samples including in total N = 1655 cases. We evaluated the association of relevance scores and hippocampus volume to validate the clinical utility of this approach. To improve model comprehensibility, we implemented an interactive visualization of 3D CNN relevance maps, thereby allowing intuitive model inspection. Results: Across the three independent datasets, group separation showed high accuracy for AD dementia versus controls (AUC ≥ 0.91) and moderate accuracy for amnestic MCI versus controls (AUC ≈ 0.74). Relevance maps indicated that hippocampal atrophy was considered the most informative factor for AD detection, with additional contributions from atrophy in other cortical and subcortical regions. Relevance scores within the hippocampus were highly correlated with hippocampal volumes (Pearson’s r ≈ −0.86, p < 0.001). Conclusion: The relevance maps highlighted atrophy in regions that we had hypothesized a priori. This strengthens the comprehensibility of the CNN models, which were trained in a purely data-driven manner based on the scans and diagnosis labels. The high hippocampus relevance scores as well as the high performance achieved in independent samples support the validity of the CNN models in the detection of AD-related MRI abnormalities. The presented data-driven and hypothesis-free CNN modeling approach might provide a useful tool to automatically derive discriminative features for complex diagnostic tasks where clear clinical criteria are still missing, for instance for the differential diagnosis between various types of dementia. (shrink)

This article takes Viviana Zelizer’s (1985) Pricing the Priceless Child to the new millennium. Zelizer documented the transformation between the 19th and 20th century from an “economically useful” to an “emotionally priceless” child. She observed that by the 1930s, American children were practically economically worthless but invested with significant emotional value. What has happened to this emotionally priceless child at the dawn of the new millennium? Has there been a new transformation in the social value of children, and, if so, (...) what might have such a transformation entailed? To address these questions, we examine overtime trends that point to increasing devotion of resources and time to children’s education, a key input in the exceedingly influential human capital theory, which connects investment into children’s human capital with their future market value. Therefore, we argue that the priceless child 2.0 is a useful-to-be human capital investment child. We use four empirical examples of overtime growth in children’s human capital investment: (a) enrollments in early childhood education, (b) federal spending on early education, (c) federal spending on K-12 programs, and (d) parental spending on child care, education and extracurricular activities. In the conclusion, we discuss some potential consequences and concerns about raising children as human capital investment. (shrink)

Dans Capitale de l’amour. Filles et lieux de plaisir à Paris au xixe siècle, l’historienne Lola Gonzalez-Quijano aborde l’histoire de la prostitution dans le Paris du xixe siècle. L’œuvre incontournable avec laquelle toutes les études sur le sujet sont en dialogue est le travail magistral d’Alain Corbin, Filles de Noce. L’argument de ce dernier, que la structure de la prostitution variait en fonction des contours modulables de la demande sexuelle masculine, a révolutionné le champ de recherch...

Cet ouvrage présente le résultat des réflexions engagées depuis 2015 par le réseau d'écoles doctorales Création, Art & Médias (Rescam) sur le doctorat de recherche en création, et concrétisées lors de deux colloques: le premier organisé à l'université Toulouse-Jean Jaurès en 2016, le second à la Sorbonne Nouvelle en 2017. 0Afin de s'interroger sur cette pratique de recherche si particulière que constitue la recherche en création et sur les formats possibles des doctorats qui en résultent, les différents acteurs français et (...) étrangers de la recherche en art, côté université et côté école d'art ont été sollicités. (shrink)

Type D personality in Poland: Validity and application of the Polish DS14 Type D personality is an emerging risk indicator in cardiovascular disease, associated with poor patient-centered outcomes, mortality and morbidity. Little is known about the cross-cultural utility of the construct, as it has primarily been used in the Western European setting. We applied the Type D Scale to a large sample of healthy and CVD patients to validate the DS14 in Poland. DS14 was used in the sample comprised 1154 (...) persons, healthy and CVD. The internal consistency of the Polish version of the DS14 was good with Cronbach's alpha of 0.86 for negative affectivity and 0.84 for social inhibition. The 2-factor structure of the DS14 was confirmed both with exploratory and confirmatory factor analysis. Both of the DS14 subscales were internally consistent and stable over time. Using the standardized cut-off ≥10 for both NA and SI to identify those with a Type D personality, the prevalence was 72.1% in CVD patients and 34.8% in healthy. The Type D personality construct, as assessed with the DS14, seems to be applicable to the Polish setting, as the Polish DS14 was shown to be a psychometrically sound instrument. (shrink)

Cette étude vise à identifier les facteurs associés à l’insatisfaction des jeunes adultes finlandais qui présentent une incapacité physique majeure, avec ou sans déficience intellectuelle concomitante, à la suite de leur transition des services santé pour enfants aux services pour adultes. Les pédiatres neurologues ont utilisé la grille d’évaluation clinique du Système de classification de la fonction motrice globale (étendu et révisé) de niveau IV ou V afin de diagnostiquer l’incapacité physique majeure spécifique à chacun des 74 participants (âge moyen (...) : 20,2 ans). Trente-neuf (53%) participants présentaient une déficience intellectuelle concomitante, selon la CIM-10 (QI inférieur à 70). Les pédiatres neurologues ont développé l’instrument Severely Disabled Youths’ Life Situation and the Functioning of the Service Systems in Finland afin de recueillir et traiter les données. Enfin, les tests de Fisher examinaient les corrélations entre l’insatisfaction des facteurs de soins et les soins de santé. Des régressions logistiques binaires ont permis d’associer l’insatisfaction à l’égard des services santé à la nécessité d’utiliser de nouveaux appareils d’assistance, à la difficulté accrue d’accéder à des rendez-vous médicaux et à l’ignorance des médecins à l’égard des problématiques du handicap. L’étude recommande la création de cliniques neurologiques multi-professionnelles qui accueilleraient les jeunes adultes qui présentent des incapacités physiques majeures, avec ou sans déficience intellectuelle, et qui initieraient les médecins aux caractéristiques de ces catégories de patients et à leurs enjeux spécifiques. (shrink)

The present article investigates some consequences from the rapport ofthe creative and the sedimented language in Maurice Merleau-Ponty's works. It aims at analyzing the different positions adopted by the philosopher on that rapport by considering the image of a boiling liquid as the guide for such analysis. The heuristic power of this image will help, on one side, to comprehend the different standpoints used to interpret the phenomenon of language; on the other side, it will serve as an index to (...) follow the rectification and the radicalization of his philosophy. (shrink)

Nuvens baixas, pesadas, sombrias vestem o dia de melancolia... mas nem sempre está no céu que nos cobre a iminência de um temporal - por vezes está numa sensação, num presságio, numa angústia sem nome - ou que traz todos os nomes: inquietação, esgotamento, ansiedade, impotência, desolação, saudades que se enredam no poente do inesquecimento.

Propomos, neste artigo, tomar a encruzilhada enquanto gesto metodológico, político, epistemológico e de análise de processos e produtos comunicacionais relacionados à música. A encruzilhada permite que analisemos temporalidades e territorialidades de modo distinto às concepções dominantes modernas de tempo e território, ao enfatizar as multiplicidades e demandar a articulação e rearticulação de saberes não conformados pela colonialidade. Para isso, realizamos um breve exercício analítico colocando o álbum visual Bom Mesmo É Estar Debaixo D’Água da cantora e compositora baiana Luedji Luna (...) na encruza, invocando temporalidades e territorialidades em diálogo com o produto. Ao convocar a encruzilhada, colocamos ainda as nossas subjetividades enquanto autores no ebó, problematizando o fazer científico estabelecido na modernidade. (shrink)

Like many ethics debates surrounding emerging technologies, neuroethics is increasingly concerned with the private sector. Here, entrepreneurial visions and claims of how neurotechnology innovation will revolutionize society—from brain-computer-interfaces to neural enhancement and cognitive phenotyping—are confronted with public and policy concerns about the risks and ethical challenges related to such innovations. But while neuroethics frameworks have a longer track record in public sector research such as the U.S. BRAIN Initiative, much less is known about how businesses—and especially start-ups—address ethics in tech (...) development. In this paper, we investigate how actors in the field frame and enact ethics as part of their innovative R&D processes and business models. Drawing on an empirical case study on direct-to-consumer (DTC) neurotechnology start-ups, we find that actors engage in careful boundary-work to anticipate and address public critique of their technologies, which allows them to delineate a manageable scope of their ethics integration. In particular, boundaries are drawn around four areas: the technology’s actual capability, purpose, safety and evidence-base. By drawing such lines of demarcation, we suggest that start-ups make their visions of ethical neurotechnology in society more acceptable, plausible and desirable, favoring their innovations while at the same time assigning discrete responsibilities for ethics. These visions establish a link from the present into the future, mobilizing the latter as promissory place where a technology’s benefits will materialize and to which certain ethical issues can be deferred. In turn, the present is constructed as a moment in which ethical engagement could be delegated to permissive regulatory standards and scientific authority. Our empirical tracing of the construction of ‘ethical realities’ in and by start-ups offers new inroads for ethics research and governance in tech industries beyond neurotechnology. (shrink)

Um aspecto poucas vezes (se é que alguma vez) referido a propósito deste livro de José Gil é o modo como sintetiza tantos aspectos da sua obra anterior. O que é tanto mais interessan­te quanto o faz recorrendo quer a noções centrais dela como a aspectos quase desconhecidos, e isto através de uma reflexão sobre mentalidades que não é muito frequente destacar-se nos seus trabalhos. Mais ainda do que «a intensidade que uma relação com este país supõe» (p. 142), que (...) José Gil refere ao terminar, e... (shrink)

Contexte : L’ensemble des troubles causés par l’alcoolisation fœtale (ETCAF), un diagnostic complexe qui comprend une vaste gamme de troubles neurodéveloppementaux, résulte de l’exposition à l’alcool dans l’utérus. L’ETCAF demeure mal compris par les Canadiens, ce qui pourrait contribuer à la stigmatisation dont souffrent les personnes atteintes d’ETCAF et les femmes qui consomment de l’alcool pendant leur grossesse. Méthodes : Pour mieux comprendre comment l’information sur l’ETCAF est présentée dans la sphère publique, nous avons analysé le contenu de 286 articles (...) tirés de dix grands journaux canadiens de langue anglaise (2002-2015). Nous avons utilisé le codage inductif pour établir une grille de codage à partir des données, puis nous avons appliqué de façon itérative des codes identifiés sur l’échantillon, en vérifiant la fiabilité intercodeurs. Résultats : Nous avons identifié six grands thèmes liés au contenu cliniques et scientifiques des médias : 1) prévalence de l‘ETCAF et de la consommation d’alcool chez les femmes ; 2) recherche en lien avec l’ETCAF ; 3) diagnostic d’ETCAF ; 4) traitement de l’ETCAF et de l’abus de substances par les mères ; 5) incapacités primaires associés à l’ETCAF ; et 6) effets de l’alcool pendant la grossesse. Discussion : Dans le cadre de ces six thèmes, nous examinons trois types d’exagération et de fausse représentation qui ont des conséquences sur le plan éthique : 1) l’exagération des taux d’ETCAF dans les communautés autochtones ; 2) la contradiction entre les articles sur les effets de l’exposition prénatale à l’alcool ; et 3) l’information scientifiquement exacte qui néglige le contexte social de la consommation et de l’abus d’alcool par les femmes. Respectivement, ces représentations pourraient mener à des croyances stéréotypées préjudiciables au sujet des peuples autochtones, pourraient créer de la confusion quant aux choix sains pendant la grossesse et risqueraient d’enflammer inutilement les débats sur des questions délicates concernant les choix des femmes. (shrink)

Infantologies is a collective writing project designed to express and summarise important ideas, approaches and forms of advocacy in a short and condensed method, in order to present a network of d...

This broad and insightful book presents current scholarship in important subfields of philosophy of science and addresses an interdisciplinary and multidisciplinary readership. It groups carefully selected contributions into the four fields of I) philosophy of physics, II) philosophy of life sciences, III) philosophy of social sciences and values in science, and IV) philosophy of mathematics and formal modeling. Readers will discover research papers by Paul Hoyningen-Huene, Keizo Matsubara, Kian Salimkhani, Andrea Reichenberger, Anne Sophie Meincke, Javier Suárez, Roger Deulofeu, Ludger Jansen, (...) Peter Hucklenbroich, Martin Carrier, Elizaveta Kostrova, Lara Huber, Jens Harbecke, Antonio Piccolomini d'Aragona and Axel Gelfert. This collection fosters dialogue between philosophers of science working in different subfields, and brings readers the finest and latest work across the breadth of the field,illustrating that contemporary philosophy of science has successfully broadened its scope of reflection. It will interest and inspire a wide audience of philosophers as well as scholars of the natural sciences, social sciences and the humanities. The volume shares selected contributions from the prestigious second triennial conference of the German Society for Philosophy of Science/ Gesellschaft für Wissenschaftsphilosophie (GWP.2016, March 8, 2016 - March 11, 2016). (shrink)

Resenha da tradução da Ética, de Baruch de Espinosa, da Editora Relógio d'Água.

A presente nota de pesquisa foi produzida na Universidade do Estado da Bahia pelo Grupo de Pesquisa Olhos D’água que investiga a significação do espaço público a partir do enfoque da ética e dos direitos humanos procurando apontar soluções para os desafios brasileiros.Lo presente artículo ha sido producido en la Universidad del Estado de Bahia por el grupo de investigación Ojos Delagua e indaga la resignificación del espacio público desde el foco de la ética e de los derechos humanos buscando (...) apuntar soluciones para los desafíos brasileños. (shrink)

Francisco Suárez (1548-1617) publicou em 1597 sua obra-prima em metafísica, as Disputationes metaphysicae. Na trigésima terceira Disputa – o objeto deste artigo – Suárez defende primeiramente a substância sobtrês aspectos: como “ens per se” (uma entidade independente), como o que permanece no tempo, e como o suporte fundamental de acidentes. Secundariamente, ele utiliza três distinções com o objetivo de articular a noção de substância: substâncias completas e incompletas, substâncias perfeitas e imperfeitas, e a distinção entre substância primeira e substância segunda. (...) Uma gota d’água, por exemplo, é uma primeira substância completa, mas relativamente imperfeita. Em comparação com ela, a alma humana é uma primeira substância incompleta, mas mais perfeita. A regra é: quanto mais perfeita, tanto mais incompleta. Por trás dessas distinções, Suárez elabora um aspecto dinâmico da substância. A abordagem é aristotélica, sem incluir aspectos de filosofia social ou filosofia existencial. (shrink)

El presente estudio establece cómo los elementos iranios que estructuraban la realidad: el ganado, la tierra, el fuego, los metales, el agua, la vegetación y el hombre, trascendidos a realidades espirituales mediadoras entre la divinidad y la humanidad, son asumidos en la tradición bíblica desde el Antiguo Testamento hasta el libro del Apocalisis como personalidades angélicas. Como realidades que motivan la experiencia de lo sagrado perdura este fondo espiritual en pensadores próximos en el tiempo como Rilke, Flechner, D’Ors, Petersen, o (...) Corbin. (shrink)

This book is a critical examination of the philosophical and moral issues in relation to human enhancement and the various related medical developments that are now rapidly moving from the laboratory into the clinical realm. In the book, the author critically examines technologies such as genetic engineering, neural implants, pharmacologic enhancement, and cryonic suspension from transhumanist and bioconservative positions, focusing primarily on moral issues and what it means to be a human in a setting where technological interventions sometimes impact strongly (...) on our humanity. The author also introduces the notion that death is a process rather than an event, as well as identifies philosophical and clinical limitations in the contemporary determination of brain death as a precursor to organ procurement for transplantation. The discussion on what exactly it means to be dead is later applied to explore philosophical and clinical issues germane to the cryonics movement. Written by a physician/ scientist and heavily referenced to the peer-reviewed medical and scientific literature, the book is aimed at advanced students and academics but should be readable by any intelligent reader willing to carry out some side-reading. No prior knowledge of moral philosophy is assumed, as the various key approaches to moral philosophy are outlined early in the book. (shrink)