Background: Using lies, in dementia care, reveals a common practice far beyond the diagnosis and prognosis, extending to the entire care process. Objectives: In this article, we report results about the attitude and the behaviour of nurses towards the use of lies to patients with dementia. Research design: An epidemiological cross-sectional study was conducted between September 2016 and February 2017 in 12 elderly residential facilities and in the geriatric, psychiatric and neurological wards of six specialised hospitals of Italy’s Campania Region. (...) Participants: In all, 106 nurses compiled an attitude questionnaire (A) where the main question was ‘Do you think it is ethically acceptable to use lies to patients with dementia?’, instead 106 nurses compiled a behaviour questionnaire (B), where the main question was ‘Have you ever used lies to patients with dementia?’ Ethical considerations: Using lies in dementia care, although topic ethically still controversial, reveals a common practice far beyond the diagnosis and prognosis, extending to the entire care process. Findings: Only a small percentage of the interviewed nurses stated that they never used lies/that it is never acceptable to use lies (behaviour 10.4% and attitude 12.3%; p = 0.66). The situation in which nurses were more oriented to use lies was ‘to prevent or reduce aggressive behaviors’. Indeed, only the 6.7% in the attitude group and 3.8% in the behaviour group were against using lies. On the contrary, the case in which the nurses were less oriented to use lies was ‘to avoid wasting time giving explanations’, in this situation were against using lies the 51.0% of the behaviour group and the 44.6% of the attitude group. Conclusion: Our results, according to other studies, support the hypothesis of a low propensity of nurses to ethical reflection about use of lies. In our country, the implementation of guidelines about a correct use of lie in the relationship between health operators and patients would be desirable. (shrink)

Infant-directed speech, the particular form of spontaneous language observed in interactions between parents and their infants, is a crucial aspect of the mother-infant interaction and an index of the attunement of maternal linguistic input to her infant communicative abilities and needs during dyadic interactions. The present study aimed to explore linguistic and pragmatic features of IDS during mother-infant interactions at 3-month of infant age. The effects of infant, maternal and dyadic factors on IDS were explored. Results evidenced few differences between (...) the groups on IDS linguistic characteristics. Moreover, observing the interaction of birth status and dyadic co-regulation, full-term mothers varied their IDS pragmatic features according to the quality of co-regulation while preterm mothers did not. Parenting stress was associated to specific linguistic IDS features independently from the birth status. Findings are discussed underling implications for the study of preterm dyads interactions and the importance to consider the interplay of several factors in affecting the quality of IDS. (shrink)

We invited five Cavell scholars to write on this topic. What follows is a vibrant exchange among Paola Marrati, Andrew Norris, Jörg Volbers, Cary Wolfe and Thomas Dumm addressing the question whether, in the contemporary political context, Cavell’s skepticism and his Emersonian perfectionism amount to a politics at all.

This volume addresses the intriguing issue of indirect reports from an interdisciplinary perspective. The contributors include philosophers, theoretical linguists, socio-pragmaticians, and cognitive scientists. The book is divided into four sections following the provenance of the authors. Combining the voices from leading and emerging authors in the field, it offers a detailed picture of indirect reports in the world’s languages and their significance for theoretical linguistics. Building on the previous book on indirect reports in this series, this volume adds an empirical (...) and cross-linguistic approach that covers an impressive range of languages, such as Cantonese, Japanese, Hebrew, Persian, Dutch, Spanish, Catalan, Armenian, Italian, English, Hungarian, German, Rumanian, and Basque. (shrink)

Fanny Bré was a volunteer nurse in the International Brigades, who fought in the Spanish Civil War (1936–1939) on the side of the democratically elected Republican government. The objective of this study is to understand the relationship between Bré's antifascist ideas, her conception of care and the activities she carried out in the Spanish hospitals of Casa Roja (Murcia), Villa Paz (Selices, Cuenca) and Vic (Barcelona). We use narrative biography to describe Bré's personal, political and professional trajectory. To do so, (...) we conducted a content analysis of primary sources archived in Spain, Russia and France and secondary sources that emerged from a thorough literature review. We identified three thematic axes: (1) a concept of nursing in the service of the antifascist struggle, (2) nursing activity for high‐quality care and (3) political action for improving hospital organisation and care. The interest of Bré's texts transcends the war in Spain because, in them, Bré questions the neutrality of care by revealing that care can itself be a political act. (shrink)

BackgroundThe coronavirus disease 2019 pandemic has greatly affected people’s mental health resulting in severe psychological consequences. One of the leading causes of long-term disability worldwide is aphasia. The language changes experienced by a person with aphasia often have a sudden and long-lasting negative impact on social interaction, quality of life, and emotional wellbeing. The main aim of this study was to investigate the impact of COVID-19 on the different psychosocial dimensions which affect PWA.MethodsThis retrospective study included 73 PWA and 81 (...) elderly matched controls. All patients were in the chronic phase. They were all discharged from rehabilitation services, which left them with different degrees of language deficits. All participants were administered the hospital anxiety and depression scale through an online survey. PWA also took part in the stroke and aphasia quality of life scale questionnaire.ResultsAlthough the comparison between two different time points [one month before and one month after the lockdown ] led to a significant increase in depression and anxiety symptoms in both groups, lower rates of depression and anxiety were found in PWA compared to the healthy group. Significant deterioration was also present in PWA in the communication and psychosocial scales of the SAQOL-39 test, which correlated with the observed changes in the psychological domains. Interestingly, the results were not significantly influenced by the degree of aphasia severity. Similarly, in both groups, none of the demographic variables significantly affected the scores in the different subscales.ConclusionsThis evidence which, at first glance, seems to suggest that PWA have been partially spared from the impact of COVID-19, actually masks a dramatic situation that has always characterized this population. Indeed, given that PWA already live in a state of social isolation and emotional instability, these conditions might have, paradoxically, limited the effects of the coronavirus. However, as our results showed a deterioration in the emotional state and communication skills of our patients, possible solutions are discussed in order to prevent further decline of their cognitive abilities. (shrink)

Applying value relevance analysis to a sample of European banks, we test the following: (i) the direct effects of the sustainability report on stock price; (ii) whether the report modifies the value relevance of financial accounting variables (indirect effects); and (iii) whether the value relevance of sustainability reports varies across countries. Results show that investors appreciate the additional and complementary disclosure provided by the sustainability report and that this disclosure produces a positive effect on stock prices. Estimates of the indirect (...) effects demonstrate that it has a negative influence on book value per share, whereas the effect on earnings per share is not significant. Cross-country analysis shows that the value relevance of the sustainability report varies across European countries, consistent with the hypothesis that the value relevance of the sustainability report is likely to be influenced by different institutional contexts. (shrink)

This volume deals with the rapports among the extant Greek commentaries on Aristotle's _Metaphysics_: Alexander of Aphrodisias, Syrianus, Asclepius, Ps. Alexander. It traces the precise map of these texts and provides a starting point for any future research in the field.

Perception of music and speech is based on similar auditory skills, and it is often suggested that those with enhanced music perception skills may perceive and learn novel words more easily. The current study tested whether music perception abilities are associated with novel word learning in an ambiguous learning scenario. Using a cross-situational word learning (CSWL) task, nonmusician adults were exposed to word-object pairings between eight novel words and visual referents. Novel words were either non-minimal pairs differing in all sounds (...) or minimal pairs differing in their initial consonant or vowel. In order to be successful in this task, learners need to be able to correctly encode the phonological details of the novel words and have sufficient auditory working memory to remember the correct word-object pairings. Using the Mistuning Perception Test (MPT) and the Melodic Discrimination Test (MDT), we measured learners’ pitch perception and auditory working memory. We predicted that those with higher MPT and MDT values would perform better in the CSWL task and in particular for novel words with high phonological overlap (i.e., minimal pairs). We found that higher musical perception skills led to higher accuracy for non-minimal pairs and minimal pairs differing in their initial consonant. Interestingly, this was not the case for vowel minimal pairs. We discuss the results in relation to theories of second language word learning such as the Second Language Perception model (L2LP). (shrink)

How much do animals matter--morally? Can we keep considering them as second class beings, to be used merely for our benefit? Or, should we offer them some form of moral egalitarianism? Inserting itself into the passionate debate over animal rights, this fascinating, provocative work by renowned scholar Paola Cavalieri advances a radical proposal: that we extend basic human rights to the nonhuman animals we currently treat as "things." Cavalieri first goes back in time, tracing the roots of the debate (...) from the 1970s, then explores not only the ethical but also the scientific viewpoints, examining the debate's precedents in mainstream Western philosophy. She considers the main proposals of reform that recently have been advanced within the framework of today's prevailing ethical perspectives. Are these proposals satisfying? Cavalieri says no, claiming that it is necessary to go beyond the traditional opposition between utilitarianism and Kantianism and focus on the question of fundamental moral protection. In the case of human beings, such protection is granted within the widely shared moral doctrine of universal human rights' theory. Cavalieri argues that if we examine closely this theory, we will discover that its very logic extends to nonhuman animals as beings who are owed basic moral and legal rights and that, as a result, human rights are not human after all. (shrink)

Culminada la Guerra Fría, la sociedad global consideró superadas la colisión ideológica y la polarización de teorías. Sin embargo, al finalizar el siglo xx y descollando el siglo xxi surgieron indicios que apuntaban en dirección contraria. Los primeros con el resurgimiento del marxismo que a partir de la tesis humanista de la filosofía de la praxis revive desde Latinoamérica el legado de Mariátegui, el Che Guevara y Camilo Torres R. El artículo se pregunta si el paradigma del marxismo humanista arroga (...) los fundamentos del buen vivir o vivir bien para enfrentar al capitalismo neoliberal y su proyecto desarrollista. La aproximación al tema se hace de manera cualitativa y descriptiva. A través del método de análisis del discurso político expuesto en la teoría crítica al desarrollismo se aborda la caracterización del capitalismo neoliberal y el modelo de desarrollo, continuando con las tesis que desde el marxismo humanista y la estrategia de revolución cultural se estructura para la emancipación en Latinoamérica. Finalmente, se exponen los planteamientos del buen vivir a partir de la apropiación que hacen los neomarxistas para dar la batalla contra el capitalismo neoliberal. (shrink)

Although remote working can involve positive outcomes both for employees and organizations, in the case of the sudden and forced remote working situation that came into place during the COVID-19 crisis there have also been reports of negative aspects, one of which is technostress. In this context of crisis, leadership is crucial in sustainably managing and supporting employees, especially employees with workaholic tendencies who are more prone to developing negative work and health outcomes. However, while research on the role of (...) the positive aspects of leadership during crises does exist, the negative aspects of leadership during the COVID-19 crisis have not yet been studied. The present study aimed to explore the role of authoritarian leadership in a sample of 339 administrative university employees who worked either completely from home or from home and the workplace. The study examined the moderating effect of a manager on this relationship and the connections between workaholism and technostress through conditional process analysis. Results pointed out that high authoritarian leadership had an enhancing effect, whereas low authoritarian leadership had a protective effect on the relationship between workaholism and technostress, only in the group of complete remote workers. Thus, authoritarian leadership should be avoided and training leaders to be aware of its effect appears to be essential. Limitations, future directions for the study, and practical implications are also discussed. (shrink)

A partir de los paralelismos lexemáticos entre conf. 5, 15 y la 'Eneida', el artículo estudia los paralelismos semánticos y semióticos entre ambos textos, para señalar como uno de los hipotextos de conf. 5, 15 el de los libros IV-VI de la 'Eneida' virgiliana.

A pesar de los innumerables beneficios, hay varias críticas y preocupaciones en relación con el uso de la Inteligencia Artificial (IA), especialmente en Brasil, donde no hay ninguna legislación federal en vigor hasta el momento. Las legislaciones estatales existentes y los proyectos de ley que se están votando en el Congreso, como el PL 21/20, son defectuosos e incompletos, especialmente en lo que respecta a algunas aplicaciones de la IA que implican altos riesgos para los derechos y libertades fundamentales, además (...) de traer a menudo un sesgo potencial, duplicando o potenciando el racismo institucionalizado existente en la sociedad u otras formas de discriminación. Existe una inequidad codificada que propicia infraestructuras injustas, sinembargo, donde hay poder hay resistencia, y en este sentido es necesario señalar la importancia de las contra codificaciones basadas en la solidaridad y que repiensan la justicia, es decir, un enfoque emancipador de la tecnología. Este es el cambio paradigmático necesario, y siendo necesario, tiene que ser posible y debe buscarse con el máximo esfuerzo. Se trata de verdaderas formas de resistencia, como instrumentos abolicionistas para el “Nuevo Código Jim”, nuevas formas de discriminación de raza, género y clase existentes a través del uso de las nuevas tecnologías, en el sentido de prácticas de diseño orientadas a la justicia. (shrink)

El artículo expone en detalle el texto agustiniano de conf. 12,37 y explica cómo el obispo ha hablado aparentemente acerca del Génesis: en realidad, ha disertado sobre su obra y ha indicado lo que puede ser de provecho para el lector, desarrollando con amplitud una fuente clásica, un pasaje de Cicerón (Top. 33).

This text was first published in Theory, Culture & Society, May 13, 2015. For a special issue of Body & Society on ‘Rhythm, Movement, Embodiment', Paola Crespi presents two previously untranslated texts, Rudolf Bode's ‘Rhythm and its Importance for Education' and Rudolf Laban's ‘Eurhythmy and Kakorhythmy'. In the following interview she uncovers further unpublished and untranslated sources and she discusses some of the main themes of these texts in relation to the more widely known text - Danse, théâtre et (...) spectacle vivant – GALERIE – Nouvel article. (shrink)

Concetta Pennuto, « Pulsations du corps en médecine », Histoire, médecine et santé, 11, été 2017, p. 55-76. Cet article propose une illustration de la manière dont la musique a fourni, par le biais de ses harmonies et son langage, un outil aux médecins pour comprendre et maîtriser les pulsations du coeur. Après une courte exploration de l'acte de prendre le pouls dans l'Antiquité et au Moyen Âge, l'étude présente des exemples de médecins modernes qui utilisent non seulement les (...) moyens de l'harmonie - Médecine – Nouvel article. (shrink)

In this study, Paola Marrati approaches—in an extremely insightful, rigorous, and well-argued way—the question of the philosophical sources of Derrida's thought through a consideration of his reading of both Husserl and Heidegger. A central focus of the book is the analysis of the concepts of genesis and trace as they define Derrida's thinking of historicity, time, and subjectivity. Notions such as the contamination of the empirical and the transcendental, dissemination and writing, are explained as key categories establishing a guiding (...) thread that runs through Derrida's early and later works. Whereas in his discussion of Husserl Derrida problematizes the relationship between the ideality of meaning and the singularity of its historical production, in his interpretation of Heidegger he challenges the very idea of the originary finitude of temporality. This book is essential reading not only for those interested in the philosophical roots of deconstruction, but for all those interested in the central questions of history and temporality, subjectivity and language, that pervade contemporary debates in cultural, literary, and visual theory alike. (shrink)

This book takes the reader on a philosophical quest to understand the dark side of emotions. The chapters are devoted to the analysis of negative emotions and are organized in a historical manner, spanning the period from ancient Greece to the present time. Each chapter addresses analytical questions about specific emotions generally considered to be unfavorable and classified as negative. The general aim of the volume is to describe the polymorphous and context-sensitive nature of negative emotions as well as changes (...) in the ways people have interpreted these emotions across different epochs. The editors speak of ‘the dark side of the emotions’ because their goal is to capture the ambivalent – unstable and shadowy – aspects of emotions. A number of studies have taken the categorial distinction between positive and negative emotions for granted, suggesting that negative emotions are especially significant for our psychological experience because they signal difficult situations. For this reason, the editors stress the importance of raising analytical questions about the valence of particular emotions and focussing on the features that make these emotions ambivalent: how – despite their negativity – such emotions may turn out to be positive. This opens up a perspective in which each emotion can be understood as a complex interlacing of negative and positive properties. The collection presents a thoughtful dialogue between philosophy and contemporary scientific research. It offers the reader insight by illuminating the dark side of the emotions. (shrink)

While moral perfectionists rank conscious beings according to their cognitive abilities, Paola Cavalieri launches a more inclusive defense of all forms of subjectivity. In concert with Peter Singer, J. M. Coetzee, Harlan B. Miller, and other leading animal studies scholars, she expands our understanding of the nonhuman in such a way that the derogatory category of "the animal" becomes meaningless. In so doing, she presents a nonhierachical approach to ethics that better respects the value of the conscious self. Cavalieri (...) opens with a dialogue between two imagined philosophers, laying out her challenge to moral perfectionism and tracing its influence on our attitudes toward the "unworthy." She then follows with a roundtable "multilogue" which takes on the role of reason in ethics and the boundaries of moral status. Coetzee, Nobel Prize winner for Literature and author of _The Lives of Animals_, emphasizes the animality of human beings; Miller, a prominent analytic philosopher at Virginia Polytechnic Institute, dismantles the rationalizations of human bias; Cary Wolfe, professor of English at Rice University, advocates an active exposure to other worlds and beings; and Matthew Calarco, author of _Zoographies: The Question of the Animal from Heidegger to Derrida_, extends ethical consideration to entities that traditionally have little or no moral status, such as plants and ecosystems. As Peter Singer writes in his foreword, the implications of this conversation extend far beyond the issue of the moral status of animals. They "get to the heart of some important differences about how we should do philosophy, and how philosophy can relate to our everyday life." From the divergences between analytical and continental approaches to the relevance of posthumanist thinking in contemporary ethics, the psychology of speciesism, and the practical consequences of an antiperfectionist stance, _The Death of the Animal_ confronts issues that will concern anyone interested in a serious study of morality. (shrink)

La obra poética de Olga Orozco (1920-1999) es profundamente religiosa. El cuerpo es uno de los temas centrales en su preocupación por alcanzar lo divino. En este sentido, el cuerpo tiene doble valencia: opera como impedimento y también como condición de posibilidad. El abordaje interdisciplinario entre literatura y filosofía que asume este trabajo permite una relectura original del cuerpo en Orozco, que revela las implicancias filosóficas de su intuición poética. La primera parte recorre pasajes en los que el cuerpo es (...) considerado un obstáculo que aísla a los seres y dificulta el retorno a la divinidad. Se analizan sus figuras oscuras y despectivas, como “muro”, “lastre”, “sombra”. La segunda parte examina el poema titulado “El narrador”, del libro _En el revés del cielo_ (1987), como punto de inflexión. El cuerpo reviste allí una significación nueva. La poeta le atribuye el poder de narrar su propia historia. Se puede vislumbrar la profunda analogía entre cuerpo y lenguaje: su función mediadora. El recurso a herramientas conceptuales de la fenomenología hermenéutica ayuda a pensar, desde el poema, la experiencia ambivalente del cuerpo. La noción de carne como alteridad primera explica el extrañamiento que describe la poeta y es condición indispensable para la mediación del sí mismo con el mundo, con los otros y con la ipseidad. La hermenéutica de “El narrador” arroja la luz del registro poético a la interpretación del cuerpo como signo y como condición de posibilidad del encuentro con la alteridad. Seguramente, otras lecturas de Orozco iluminen diversos temas antropológicos y metafísicos, ya que poesía y pensamiento se orientan hacia el mismo misterio. (shrink)

La pandemia ha provocado una crisis global de salud, un estancamiento en el comercio internacional y un quiebre en la cooperación internacional. Se convirtió en el escenario en donde se hicieron evidentes la desigualdad y la vulnerabilidad de muchos estados, como India. Se plantea que eventos como el Covid-19 se constituyen en catalizadores de cambios y transformaciones; es la ocasión para capitalizar los beneficios de la cooperación bilateral y multilateral, y así promover un mayor desarrollo. La pregunta que surge es (...) cuál puede ser el rol de América Latina en la política de desarrollo de India en la pospandemia. Ambos necesitan una estrategia multidimensional para potenciar el comercio bilateral y activar convenios de cooperación en diferentes áreas que no han sido puestos en marcha o han tenido una aplicación limitada. El objetivo es explorar la profundización de la asociación de India con América Latina para colaborar en el desarrollo mutuo en la era de la pospandemia, tomando como eje su política exterior en las dimensiones comercial, diplomática y de la cooperación. La investigación se basó en un estudio de carácter exploratorio y descriptivo, con la utilización de una metodología cualitativa y con énfasis en las fuentes secundarias. La presencia del otro gigante asiático en la región latinoamericana ha generado muchas especulaciones y pocas acciones concretas, más allá del incremento en el comercio y las inversiones. Entonces, explorar las oportunidades y desafíos que el mundo pospandemia presenta a las vinculaciones entre ambos se vuelve prioritario. (shrink)

De re aedificatoria by Leon Battista Alberti, Trattato di Architettura by Filarete, Trattati di architettura, ingegneria e arte militare by Francesco di Giorgio Martini, and Leonardo da Vinci’s works of engineering and inventions exemplify the ways in which fifteenth-century Italian thinkers could blend speculative and rational approaches. Libellus vere aureus was published in Leuven in 1516. Mambrino Roseo praised the simple, earnest people of Garamanti in Institutione del prencipe christiano, dating to 1543. The first version of More’s Latin text in (...) vernacular Italian was published in Venice in 1548, and the first translation into English by Ralph Robinson was printed in London in... (shrink)

This paper tackles the question of whether the order of concepts was still a relevant aspect of scientific rigour in the 19th and 20th centuries, especially in the case of authors who were deeply influenced by the Leibnizian project of a universal characteristic. Three case studies will be taken into account: Hermann Graßmann, Giuseppe Peano and Kurt Gödel. The main claim will be that the choice of primitive concepts was not only a question of convenience in modern hypothetico-deductive investigations, but (...) sometimes also the result of philosophical investigations onto the foundation of scienti­fic disciplines. The question of the "right" order of concepts is an ideal to be followed rather than a task that can be fulfilled, but remains nonetheless an essential part of the axiomatic enterprise. This paper aims to question whether there is in fact such a stark contrast, as there is often claimed to be in the literature, between the debates relating to the right order of concepts and the foundational questions concerning modern axiomatics. The scientific rupture determined by the appearance of hypothetico-deductive systems in mathema­tics and logic should thus not be dissociated from some relevant continuities concerning the ideal of knowledge as the search for a general theory of concepts deriving from some fundamental elements. (shrink)

A key role in inference is played by randomization, which has been extensively used in clinical trials designs. Randomization is primarily intended to prevent the source of bias in treatment allocation by producing comparable groups. In the frequentist framework of inference, randomization allows also for the use of probability theory to express the likelihood of chance as a source for the difference of end outcome. In the Bayesian framework, its role is more nuanced. The Bayesian analysis of clinical trials can (...) afford a valid rationale for selective controls, pointing out a more limited role for randomization than it is generally accorded. This paper is aimed to offer a view of randomization from the perspective of both frequentist and Bayesian statistics and discussing the role of randomization also in theoretical decision models. (shrink)

The present study aims at exploring whether the level of well-being vary as a function of fertility status in different phases of the ovulatory cycle. We investigated the multidimensional well-being, including the cognitive component of subjective well-being related to judgments about one’s life satisfaction, the psychological well-being concerning the full growth and self-realization of the individual, and self-esteem, that is the personal judgment of overall self-worth and is recognized as one indicator of well-being. On the basis of the cycle phase (...) estimation at the moment of the experiment, one hundred and sixteen normally cycling women were divided into “fertile” and “non-fertile” groups and were administered the Psychological Well-Being Scale, the Basic Self-Esteem Scale and the Satisfaction with Life Scale. A Multivariate Analysis of Variance has been performed to examine whether there were differences between groups according to their ovulatory phase. All dimensions of psychological well-being, self-esteem and satisfaction with life were found to be stable in the different phases of the menstrual cycle. The implications of these results are discussed. (shrink)

We asked a series of questions to Luca Cobbe and Paola Rudan, authors of two books foregrounding the turning point of the 18th century by which, moving from the experience of the revolution, the structure of the constitution and configuration of government were deeply rethought. The two works, respectively about David Hume and Jeremy Bentham, contribute significantly to illuminate the way by which obedience has been reconsidered when society and opinion became the sources of political legitimation. This dialogue at (...) distance clearly shows the presence of a plurality of constitutional registers which were necessary for the affirmation of the centrality of government in the era of the rising popular sovereignty. (shrink)

To contribute to our understanding of the relationship between philosophical ideas and medical and healthcare models. A diachronic analysis is put in place in order to evaluate, from an innovative perspective, the influence over the centuries on medical and healthcare models of two philosophical concepts, particularly relevant for health: how Man perceives his identity and how he relates to Nature. Five epochs are identified—the Archaic Age, Classical Antiquity, the Middle Ages, the Modern Age, the ‘Postmodern’ Era—which can be seen, à (...) la Foucault, as ‘fragments between philosophical fractures’. From a historical background perspective, up to the early 1900s progress in medical and healthcare models has moved on a par with the evolution of philosophical debate. Following the Second World War, the Health Service started a series of reforms, provoked by anti-positivistic philosophical transformations. The three main reforms carried out however failed and the medical establishment remained anchored to a mechanical, reductionist approach, perfectly in line with the bureaucratic stance of the administrators. In this context, future scenarios are delineated and an anthropo-ecological model is proposed to re-align philosophy, medicine and health care. (shrink)