On occasion, I am appointed by our local probate court to help make health care decisions for patients who are no longer capable of making these decisions for themselves. I'll visit my client in the hospital and review his or her chart, and I'll have numerous opportunities to talk about the illness and treatment options with attending physicians, residents, and nurses. My phone calls to them will be returned promptly. If doctors arrive at the conclusion that nothing further can be (...) done for the patient, we'll discuss how best to proceed. This end‐of‐life talk never comes as a surprise to me because I will have been included in the team's decision‐making process, in the manner of professionals interacting with another professional. Last fall, I became a family surrogate decision‐maker after my mother was hospitalized over the course of a few months, for a number of reasons, in three hospitals in New York. I assumed I would manage her care as I did my clients’, with a sense of control and involvement in the process, but I quickly learned that I had in fact entered a kind of alternate universe as far as decision‐making was concerned. (shrink)

At the outset of an ethnographic inquiry, we navigated national and international resources to search for theoretical and practical guidance on obtaining parents and children’s informed consent/assent. While much theoretical guidance debating ethical issues to children’s participation in research was found, a paucity of published papers offering practical guidance on assent processes and/or visual representations of child assent forms and information sheets was discovered. The purpose of this article is to describe our experiences, both theoretically and practically, of negotiating the (...) process of obtaining informed consent and assent with parents and children for a non-therapeutic qualitative research study. We hope this article instigates a platform for others to explicate their experience and contributes to the construction of a coherent body of knowledge which will clearly delineate important elements that must be considered when negotiating children’s agreement to participate in research. (shrink)

Neonatal mortality during the first week of life, corresponding to the years 19750·023 per year. This decline cannot be explained by an increase in the mean birth weight (MBW=23440·835−10·107 g per year). From the most frequent of the causes of death to the least were: congenital anomalies, preterm born or low birth weight, respiratory problems, pregnancy difficulties, hypoxaemia/asphyxia, delivery difficulties and infectious diseases. This sequence changed when the specific age at death was considered. The NMR descended evenly for both sexes (...) for the causes indicated above, except for preterm born or low birth weight, in which the male mortality decrease was greater since its rate was more elevated at the beginning of the period studied. For all the causes listed, NMR was more elevated both in urban areas and for males. Early neonatal mortality (first 24 hours) was higher for pregnancy difficulties, preterm born or low birth weight, congenital anomalies and hypoxaemia/asphyxia. (shrink)

We reconstruct the group action in the group configuration theorem. We apply it to show that in an ω-categorical theory a finitely based pseudolinear regular type is locally modular, and the geometry associated to a finitely based locally modular regular type is projective geometry over a finite field.

Background: Ethical competence in nursing practice helps clinical nurses to think critically, analyse issues, make ethical decisions, solve ethical problems and behave ethically in their daily work. Thus, ethical competence contributes to the promotion of high-quality care. However, studies on ethical competence in Malawi are scanty. Objectives: The aim of this study was to explore ethical competence among clinical nurses in selected hospitals in Malawi. Methodology: A cross-sectional survey was conducted in four selected hospitals in Malawi with a sample of (...) 271 clinical nurses. Data were collected using self-administered questionnaires, which included a Moral Competence Scale for Home Care Nurses. Descriptive statistics and logistic regression were computed for the dataset using STATA version 12.0. Ethical consideration: The study protocol complied with all ethical requirements and was approved by the College of Medicine Research Ethics Committee under the University of Malawi. Results: The clinical nurses in Malawi are ethically competent. However, there is a significantly high number (p 0.05). Three determinants of high ethical competence level (strong will, judgement skills and recognition of discrepancy of intention) were identified through a reduced model after stepwise logistic regression analysis. Furthermore, results show that indicators of ethical competence include caring, confidentiality and observance of nurses dressing code. The study has also confirmed that the Moral Competence Scale for Home Care Nurses is a reliable tool to assess ethical competence in low-resource settings. Conclusion: The majority of nurses who completed the survey had low ethical competence. However, clinical nurses with high ethical competence level are required to competently manage complex ethical challenges in health facilities. Strategies for enhancing ethical competence such as continuing ethics education, establishment of ethics committees and provision of supportive supervision are recommended to enable nurses in Malawi attain a high level of ethical competence. (shrink)

Jean Mabillon and Richard Simon were both eminent seventeenth-century scholars who practiced contextualizing critical philology in order to forge unbeatable scientifical instruments against the skeptics and reinforce the authority of historical documents. But Simon’s work produced a mutation of the meaning of authenticity that would prove subversive and would generate outrage. His sociological and institutionalist understanding of the history of sacred texts not only merged both their production and their transmission into a common, ontologically homogenous historical process, but also included (...) a survey of the sociological and cultural circumstances that transformed the text into a real authority. Furthermore, this anti-essentialist understanding of the gradual formation of the text allowed a positive reevaluation of the tradition as a continuous practice aiming at keeping alive an already historical truth. (shrink)

The aim of this study was to explore the existence of moral distress among nurses in Lilongwe District of Malawi. Qualitative research was conducted in selected health institutions of Lilongwe District in Malawi to assess knowledge and causes of moral distress among nurses and coping mechanisms and sources of support that are used by morally distressed nurses. Data were collected from a purposive sample of 20 nurses through in-depth interviews using a semi-structured interview guide. Thematic analysis of qualitative data was (...) used. The results show that nurses, irrespective of age, work experience and tribe, experienced moral distress related to patient/nursing care. The major distressing factors were inadequate resources and lack of respect from patients, guardians, peers and bosses. Nurses desire teamwork and ethics committees in their health institutions as a means of controlling and preventing moral distress. There is a need for creation of awareness for nurses to recognize and manage moral distress, thus optimizing their ability to provide quality and uncompromised nursing care. (shrink)

many symbols. We define o, as the probability that an arbitrary machine be circular and we prove that o, is a random number that goes beyond..

Schools are an essential part of students’ lives and can promote and facilitate their well-being. Although research on well-being among school-aged children and adolescents has distinguished subjective well-being from social well-being, very few studies examined student’s social well-being at school. SWS is understood as students’ valuation of the circumstances and functioning of their school. This framework posits that the context of the schools can shape students’ perception of feeling integrated and making significant contributions to their schools. However, not much is (...) known regarding the joint contribution of individual, family, and school characteristics to students’ SWS. This study analyzed these joint contributions in a nationally representative sample of 6,389 children and adolescents enrolled in 5th–11th grades. Findings show that being female and younger were individual predictors of SWS. Students’ satisfaction with their family and fewer changes of schools were also significant contributors. When students’ perceptions of their schools were incorporated, the individual and family characteristics decreased or lost significance. In the full model, the highest contribution to SWS was explained by the school-level aggregated perception of school climate. These findings call for integrated policies and practices to foster students’ sense of belonging, feeling integrated, and contribution to their schools, with a focus on school-level interventions to improve SWS through positive and engaging school climates that foster students’ sense of agency. (shrink)

In this paper, we examine the scientific, legal, and ethical foundations for inclusion of transgender women athletes in competitive sport, drawing on IOC principles and relevant Court of Arbitration for Sport decisions. We argue that the inclusion of trans athletes in competition commensurate with their legal gender is the most consistent position with these principles of fair and equitable sport. Biological restrictions, such as endogenous testosterone limits, are not consistent with IOC and CAS principles. We explore the implications for recognizing (...) that endogenous testosterone values are a ‘natural physical trait’ and that excluding legally recognized women for high endogenous testosterone values constitutes discrimination on the basis of a natural physical trait. We suggest that the justificatory burden for such prima facie discrimination is unlikely to be met. Thus, in place of a limit on endogenous testosterone for women, we argue that ‘legally recognized gender’ is most fully in line with IOC and CAS principles. (shrink)

Purpose The purpose of this paper is to describe and explore the current state of internet regulation through content filters in Swedish public libraries. Design/methodology/approach Data was collected through an electronic survey directed to library managers of Sweden’s 290 main municipal libraries. 164 answers were returned, yielding a 57% response rate. The analysis comprises descriptive statistics for quantitative data and an activity theory approach with focus on contradictions for qualitative counterparts. Findings In total, 33% of the responding libraries report having (...) content filters; 50% have not; and a surprising 18% do not know. There is a strong correlation between internet misuse and positive attitudes towards filters, and, reversely, between lack of misuse and lack of active stances concerning filters. Rather than seeing this as weakness, the authors suggest that there is strength in a context-bound flexibility open to practical experience and weighting of values, ethics, legislation and local circumstances. More troublesome indications concern the high deferral of decision-making to local authorities (municipalities) whereby libraries are left with limited insight and influence. Research limitations/implications The situation calls for professional organisations to address political mandate questions, and educational programs to strengthen future information professionals’ knowledge of IT in general; filter issues in specific; and local authority decision-making. The study highlights the need of adequate information professional competences and mandates to decide on and oversee internet regulation. Originality/value To the best of the authors’ knowledge, this is the first internationally published study on content filters in Swedish public libraries. (shrink)

El canon literario implica un proceso de selección sistemático y jerárquico de escritores, obras y géneros con el fin de delimitar un corpus modélico imitableligado fuertemente a la instrucción pedagógica. En el presente trabajo se analizará el particular proceso de formación y conformación del canon –así como surecepción y transformación respecto de los cánones previos– establecido por Quintiliano en el Libro 10 de la Institutio Oratoria, a fin de demostrar que los criterios de selección que guían dicho canon exceden la (...) mera función didáctica. (shrink)

In this article three viewpoints on the relation of body and language are discussed: the poststructuralist viewpoint of Judith Butler, the phenomenological viewpoint of Maurice Merleau-Ponty and the postmodernist viewpoint of Jean-François Lyotard. The reason juxtaposing for these three accounts is twofold. First, the topic requires a combination of post-structuralist and phenomenological insights, and second, the accounts are supplementary. Butler's account raises questions that can be answered with the help of Merleau-Ponty's work. Lyotard's anthropology of the inhuman offers a perspective (...) of finitude that is missing in the other two. The aim of the article is to outline the necessary ingredients of an adequate conception of the speaking embodied subject. (shrink)

In this essay I compare Nussbaum's and Arendt's approach to narrativity. The point of the comparison is to find out which approach is more adequate for practical philosophy: the approach influenced by cognitive theory or the one influenced by hermeneutic phenomenology. I conclude that Nussbaum's approach is flawed by methodological solipsism, which is due to her application of cognitive theory.

The doctor-patient relationship -- Consent, choice, and refusal : adults with capacity -- Treating adults who lack capacity -- Children and young people -- Confidentiality -- Health records -- Contraception, abortion, and birth -- Assisted reproduction -- Genetics -- Caring for patients at the end of life -- Euthanasia and physician assisted suicide -- Responsibilities after a patient's death -- Prescribing and administering medication -- Research and innovative treatment -- Emergency situations -- Doctors with dual obligations -- Providing treatment and (...) care in detention settings -- Education and training -- Teamwork, referral, delegation, and shared care -- Public health dimensions of medical practice -- Reducing risk, clinical error, and poor performance. (shrink)

The case of Charlie Gard sparked an ongoing public and academic debate whether in court decisions about medical treatment for children in England & Wales the best interests test should be replaced by a harm threshold. However, the literature has scantly considered (1) what the impact of such a replacement would be on future litigation and (2) how a harm threshold should be introduced: for triage or as standard for decision-making. This article directly addresses these gaps, by first analysing reported (...) cases in England & Wales about medical treatment in the context of a S31 order, thus using a harm threshold for triage and second comparing court decisions about medical treatment for children in England & Wales based on the best interest test with Dutch and German case law using a harm threshold. The investigation found that whilst no substantial increase of parental discretion can be expected an introduction of a harm threshold for triage would change litigation. In particular, cases in which harm is limited, currently only heard when there are concerns about parental decision-making, may be denied a court hearing as might cases in which the child has lost their capacity to suffer. Applying a harm threshold for triage in decisions about withholding or withdrawing life-sustaining treatment might lead to a continuation of medical treatment that could be considered futile. (shrink)

This article showcases the underlying logic of LBT and the Five Elements (5e) system from Chinese philosophy, in the context of philosophical practice. The ten types of perfectionism from LBT are thought out in the 5e frame. This endeavor shows that Logic-based Therapy and the Five Elements System work well together in practice, especially in understanding the client’s problem and identifying an uplifting philosophical strategy.

The introduction of new medical treatments based on invasive technologies has often been surrounded by both hopes and fears. Hope, since a new intervention can create new opportunities either in terms of providing a cure for the disease or impairment at hand; or as alleviation of symptoms. Fear, since an invasive treatment involving implanting a medical device can result in unknown complications such as hardware failure and undesirable medical consequences. However, hopes and fears may also arise due to the cultural (...) embeddedness of technology, where a therapy due to ethical, social, political and religious concerns could be perceived as either a blessing or a threat. While Deep Brain Stimulation (DBS) for treatment resistant depression (TRD) is still in its cradle, it is important to be proactive and try to scrutinize both surfacing hopes and fears. Patients will not benefit if a promising treatment is banned or avoided due to unfounded fears, nor will they benefit if DBS is used without scrutinizing the arguments which call for caution. Hence blind optimism is equally troublesome. We suggest that specificity, both in terms of a detailed account of relevant scientific concerns as well as ethical considerations, could be a way to analyse expressed concerns regarding DBS for TRD. This approach is particularly fruitful when applied to hopes and fears evoked by DBS for TRD, since it can reveal if our comprehension of DBS for TRD suffer from various biases which may remain unnoticed at first glance. We suggest that such biases exist, albeit a further analysis is needed to explore this issue in full. (shrink)

Background: Nurses are expected to provide comprehensive, holistic and ethically accepted care according to their code of ethics and practice. However, in Malawi, this is not always the case. This article analyses moral competence concept using the Walker and Avant's strategy of concept analysis. Objective: The aim of this article is to analyse moral competence concept in relation to nursing practice and determine defining attributes, antecedents and consequences of moral competence in nursing practice. Method: Analysis of moral competence concept was (...) done using Walker and Avant's strategy of concept analysis. Results: Deductive analysis was used to find the defining attributes of moral competence, which were kindness, compassion, caring, critical thinking, ethical decision making ability, problem solving, responsibility, discipline, accountability, communication, solidarity, honesty, and respect for human values, dignity and rights. The identified antecedents were personal, cultural and religious values; nursing ethics training, environment and guidance. The consequences of moral competence are team work spirit, effective communication, improved performance and positive attitudes in providing nursing care. Conclusion: Moral competence can therefore be used as a tool to improve care in nursing practice to meet patients' problems and needs and consequently increase public's satisfaction in Malawi. (shrink)

This paper aims to investigate whether and in what respects the conceptions of the body and of agency that Judith Butler develops in Bodies That Matter are useful contributions to feminist theory. The discussion focuses on the clarification and critical assessment of the arguments Butler presents to refute the charges of linguistic monism and determinism.

Laura Malosetti Costa. Retratos públicos. Pintura y fotografía en la construcción de imágenes heroicas en América Latina desde el siglo XIX. Buenos Aires: Fondo de Cultura Económica, 2022, 326 páginas. Georges Gusdorf. El Advenimiento del yo, prefacio, traducción y notas de Pablo Pavesi. Buenos Aires: Miño y Dávila editores, 2022, 94 páginas.

Los Manuscritos de Bernau representan una obra clave para quien busca entender la teoría del tiempo husserliana. Tanto los intérpretes sobre el tema, como el propio Husserl indican que estos escritos constituyen su obra maestra. Pero la indiscutible relevancia de estos manuscritos no quita la dificultad que implica dar cuenta de una lectura consistente del texto. Nuestra intención aquí consistirá en evaluar la relación que pueda establecerse entre esta obra y los Análisis sobre las síntesis pasivas. La idea que guiará (...) el trabajo será que la labor experimental encarada por Husserl entre 1917 y 1918 provocó, en el contexto del estudio de la temporalidad, el descubrimiento de nociones centrales que luego serían profundizadas bajo el tópico de la asociación. En particular, analizaremos las transformaciones que se presentan en la noción de protención y las descripciones de la modificación retencional.The Bernau Manuscripts represents a crucial work to understand the Husserlian theory of time. The interpreters of the subject, as much as Husserl himself, point out that this studies are a master piece. But the unquestionable relevance of Bernau does not minimize the implied difficulty to achieve a consistent interpretation of the text. Our intention here is to determine the relation between this text and The Analysis Concerning Passive Synthesis. The main idea of this paper will be that the experimental work performed by Husserl between 1917-1918 leads to, in the context of time studies, the discovery of key notions. The developpment of this notions will be accomplished under the topic of association. Particularly, we will analize the transformations the notion of protension presents and the descriptions of retentional modification. (shrink)

The article discusses a relatively obscure but significant aspect of work of the Russian and Soviet thinker Alexander Bogdanov—his science fiction novels. The author points out that, using the form...

Deep brain stimulation (DBS) is a developing technology. New generations of DBS technology are already in the pipeline, yet this particular fact has been largely ignored among ethicists interested in DBS. Focusing only on ethical concerns raised by the current DBS technology is, albeit necessary, not sufficient. Since current bioethical concerns raised by a specific technology could be quite different from the concerns it will raise a couple of years ahead, an ethical analysis should be sensitive to such alterations, or (...) it could end up with results that soon become dated. The goal of this analysis is to address these changing bioethical concerns, to think ahead on upcoming and future DBS concerns both in terms of a changing technology and changing moral attitudes. By employing the distinction between inherent and noninherent bioethical concerns we identify and make explicit the particular limits and potentials for change within each category, respectively, including how present and upcoming bioethical concerns regarding DBS emerge and become obsolete. Many of the currently identified ethical problems with DBS, such as stimulation-induced mania, are a result of suboptimal technology. These challenges could be addressed by technical advances, while for instance perceptions of an altered body image caused by the mere awareness of having an implant may not. Other concerns will not emerge until the technology has become sophisticated enough for new uses to be realized, such as concerns on DBS for enhancement purposes. As a part of the present analysis, concerns regarding authenticity are used as an example. (shrink)

Este artículo representa el primer paso para demostrar que la akrasia[1] proporciona la característica estructural subyacente en los juicios de culpabilidad o responsabilidad ética y jurídica por actos negligentes; el trabajo explica el fenómeno de la akrasia y compara las concepciones clásicas y contemporáneas de este fenómeno. Argumentamos que actuamos inadvertidamente porque actuamos acráticamente, lo que se explica en términos de un compromiso defectuoso específico del razonamiento práctico por parte del agente ejecutor, es decir, una falta de integración entre el (...) carácter y el pensamiento que debe entenderse como una falla para habitar la perspectiva deliberativa-aspiracional. (shrink)

It’s relatively easy to say that the debates about whether trans and intersex women athletes deserve full and equal inclusion in women’s sport is a contentious contemporary issue. I’ve already argued for the legal, ethical, and scientific basis for full and equal inclusion of trans and intersex women in women’s sport. In this paper, I want to analyze what I take to be a representative selection of recent arguments against full and equal inclusion of trans and intersex women in women’s (...) sport. In short, these arguments tend to be based on mere assumption, unsupported “common sense,” straw arguments, fallacious question begging, and a number of hypotheticals and unsupported counterfactuals rather than established fact. Essentially, they’re based on a lot of “ifs.”. (shrink)

Let [Formula: see text] be an integer. We show that the set of real numbers that are Poisson generic in base [Formula: see text] is [Formula: see text]-complete in the Borel hierarchy of subsets of the real line. Furthermore, the set of real numbers that are Borel normal in base [Formula: see text] and not Poisson generic in base [Formula: see text] is complete for the class given by the differences between [Formula: see text] sets. We also show that the (...) effective versions of these results hold in the effective Borel hierarchy. (shrink)

In this paper we consider the problem of how to measure the strength of statistical evidence from the perspective of evidence amalgamation operations. We begin with a fundamental measurement amalgamation principle : for any measurement, the inputs and outputs of an amalgamation procedure must be on the same scale, and this scale must have a meaningful interpretation vis a vis the object of measurement. Using the p value as a candidate evidence measure, we examine various commonly used approaches to amalgamation (...) of evidence across similar studies, including standard forms of meta-analysis. We show that none of these methods satisfies MAP. Thus an underlying measurement problem remains. We argue that a successful approach to evidence amalgamation necessitates a solution to the problem of evidence measurement, and we suggest some lines of reasoning that might guide further work towards this end. (shrink)

Does home-based family involvement influence academic performance? To answer this question, a case study research was carried out with 96 children from all six levels of primary education at a public school, and their families. Data regarding home-based family involvement were collected using a questionnaire. Academic achievement was measured from school marks. The results reveal that, apart from two of the factors considered, home–family involvement as a whole is not significantly related to academic achievement. These two factors are access to (...) informal education resources and parents’ employment. Family involvement related to the access of children to informal education resources is significantly related to a better academic achievement. Those students with both parents working perform best, and those with none working, worst. Although gender does not appear to significantly influence academic achievement and family involvement, the results show that girls attain better school performance and re... (shrink)

We contribute to feminist and gender scholarship on cultural notions of motherhood by analyzing the importance of motherhood among mothers and non-mothers. Using a national probability sample of U.S. women ages 25-45, we find a continuous distribution of scores measuring perceptions of the importance of motherhood among both groups. Employing OLS multiple regression, we examine why some women place more importance on motherhood, focusing on interests that could compete with valuing motherhood, and controlling for characteristics associated with becoming a mother. (...) Contrary to cultural schemas that view mother and worker identities as competing, we find that education level is not associated with the importance of motherhood for either group and that valuing work success is positively associated with valuing motherhood among mothers. Consistent with feminist explanations for delayed fertility, valuing leisure is negatively associated with valuing motherhood for non-mothers. (shrink)

Traditional literature considers complex biometric sources such as words, letters and signatures for writer verification/identification. In this work the use of small segments of the handwritten stroke for writer verification is proposed. A grapheme is defined as the concatenation of smaller segments or fragments. Two models of grapheme are developed based on the idea that the segments are parts of a circle with or without direction. The average of Gray Level of the Perpendicular Line to the Skeleton and Local Binary (...) Pattern are adopted as descriptors. A database of 3,000 images of 50 writers, with 6 types of segments and with 10 samples per segment has been developed. A binary output support vector machine was applied as classifier. Thus, 50 classifiers were trained using 100 balanced data sets generated using subsampling of the majority class. Experiments are carried out with the proposed models, with an identity verification hit rate of 97 % on average. The positive results of experiments show that it is possible to achieve high precision in writer verification using segment of graphemes. (shrink)

Right from the start of the Spanish Civil War, thousands of prisoners were executed by shooting. Today, many of them remain anonymous, but others, thanks to their writing, have passed into history. In the final hours before their execution, these men and women had the chance to write a few farewell letters to their nearest and dearest. These letters, known by historians as ?chapel letters,? passed either through official channels exercising prior censorship or else were sent clandestinely. In their farewell (...) letters, the condemned to death informed their families of their tragic fate and dedicated their last words to them. Genuine family relics, material and spiritual testaments, instruments of denunciation and propaganda, these chapel letters are regarded as the most sincere documents of any historical period. Since prisoners expressed in them their most intimate feelings and thoughts, they constitute the most exceptional testimony of all epistolary forms practised behind bars. By using an interdisciplinary approach this essay seeks to define the material and functional characteristics of this genre and to contextualise it in the framework of ordinary writings and scribal culture. (shrink)

El objetivo de este trabajo es demostrar, en primer lugar, que el problema de la verdad no se encuentra completamente ausente en la estética kantiana y que no lo está, en segundo lugar, porque la autonomización de la dimensión estética es pensada a partir de una experiencia de la unidad de la subjetividad. A los fines de demostrar estos dos puntos, procuro reconstruir, en primer lugar, el contexto epistémico de la KU. En un segundo momento, me remito a la delimitación (...) kantiana de la autonomía del juicio del gusto y finalmente reviso aquellos momentos en los cuales Kant va más allá de sus propias pretensiones. Aquí me refiero especialmente a la idea de un acuerdo espontáneo entre las facultades cognoscitivas en la medida en que ella revela la imbricación de la determinación de la autonomía del juicio estético con problemáticas de carácter extraestético que remiten a la posibilidad de una autolegitimación de la modernidad. (shrink)