IntroductionRheumatologists are the primary healthcare professionals responsible for patients with rheumatic diseases and should acquire medical ethical competencies, such as the informed consent process (ICP). The objective clinical structured examination is a valuable tool for assessing clinical competencies. We report the performance of 90 rheumatologist trainees participating in a station designed to evaluate the ICP during the 2018 and 2019 national accreditations.MethodsThe station was validated and represented a medical encounter in which the rheumatologist informed a patient with systemic lupus erythematosus (...) with clinically active nephritis about renal biopsy. A trained patient–actor and an evaluator were instructed to assess ICP skills (with a focus on kidney biopsy benefits, how the biopsy is done and potential complications) in obtaining formal informed consent, delivering bad news and overall communication with patients. The evaluator used a tailored checklist and form.ResultsCandidate performance varied with ICP content and was superior for potential benefit information (achieved by 98.9% of the candidates) but significantly reduced for potential complications (37.8%) and biopsy description (42.2%). Only 17.8% of the candidates mentioned the legal perspective of ICP. Death (as a potential complication) was omitted by the majority of the candidates (93.3%); after the patient–actor challenged candidates, only 57.1% of them gave a clear and positive answer. Evaluators frequently rated candidate communications skills as superior (≥80%), but ≥1 negative aspect was identified in 69% of the candidates.ConclusionsEthical competencies are mandatory for professional rheumatologists. It seems necessary to include an ethics competency framework in the curriculum throughout the rheumatology residency. (shrink)

The current assessment of behaviors in the inventories to diagnose autism spectrum disorders (ASD) focus on observation and discrete categorizations. Behaviors require movements, yet measurements of physical movements are seldom included. Their inclusion however, could provide an objective characterization of behavior to help unveil interactions between the peripheral and the central nervous systems. Such interactions are critical for the development and maintenance of spontaneous autonomy, self-regulation and voluntary control. At present, current approaches cannot deal with the heterogeneous, dynamic and stochastic (...) nature of development. Accordingly, they leave no avenues for real-time or longitudinal assessments of change in a coping system continuously adapting and developing compensatory mechanisms. We offer a new unifying statistical framework to reveal re-afferent kinesthetic features of the individual with ASD. The new methodology is based on the non-stationary stochastic patterns of minute fluctuations (micro-movements) inherent to our natural actions. Such patterns of behavioral variability provide re-entrant sensory feedback contributing to the autonomous regulation and coordination of the motor output. From an early age, this feedback supports centrally driven volitional control and fluid, flexible transitions between intentional and spontaneous behaviors. We show that in ASD there is a disruption in the maturation of this form of proprioception. Despite this disturbance, each individual has unique adaptive compensatory capabilities that we can unveil and exploit to evoke faster and more accurate decisions. Measuring the kinesthetic re-afference in tandem with stimuli variations we can detect changes in their micro-movements indicative of a more predictive and reliable kinesthetic percept. Our methods address the heterogeneity of ASD with a personalized approach grounded in the inherent sensory-motor abilities that the individual has already developed. (shrink)

This paper examines and analyzes five definitions of ‘existential risk.’ It tentatively adopts a pluralistic approach according to which the definition that scholars employ should depend upon the particular context of use. More specifically, the notion that existential risks are ‘risks of human extinction or civilizational collapse’ is best when communicating with the public, whereas equating existential risks with a ‘significant loss of expected value’ may be the most effective definition for establishing existential risk studies as a legitimate field of (...) scientific and philosophical inquiry. In making these arguments, the present paper hopes to provide a modicum of clarity to foundational issues relating to the central concept of arguably the most important discussion of our times. (shrink)

In this paper, I critique two conceptions of mechanisms, namely those put forth by Stuart Glennan (Erkenntnis 44:49–71, 1996; Philosophy of Science 69:S342–S353, 2002) and Machamer et al. (Philosophy of Science 67:1–25, 2000). Glennan’s conception, I argue, cannot account for mechanisms involving negative causation because of its interactionist posture. MDC’s view encounters the same problem due to its reificatory conception of activities—this conception, I argue, entails an onerous commitment to ontological dualism. In the place of Glennan and MDC, I propose (...) a “modified conception” of mechanisms, which (a) obviates the problem of negative causation by reinterpreting MDC’s activities according to a “descriptivist” account, and (b) avoids MDC’s problem by postulating a monistic ontology of entities. Thus, by solving these problems, my modified conception offers a cogent, more adequate alternative to Glennan’s and MDC’s conceptions of mechanisms. (shrink)

One important limitation of the current renditions of interpretivism is that its emphasis on the moral dimension of sport has overlooked the aesthetic dimension lying at the core of this account of sport. The interpretivist’s failure to acknowledge and consider the aesthetic implicitly distances this realm from the moral. Marcia Muelder Eaton calls this distancing the separatist mistake. This paper argues that interpretivism presupposes not only moral but also aesthetic principles and values. What it sets out to demonstrate is that (...) interpretivism is an integralist, or nonseparatist, account of sport, one in which ethical and aesthetic values are not exclusive. Making explicit and specifying interpretivism’s combined moral-aesthetic approach to sport not only helps to better distinguish the whole range of values that make up sport as well as their interconnection but also encourages sportspeople to pursue more coherent sport and, thus, more enriching lives. (shrink)

The current rise of neurodevelopmental disorders poses a critical need to detect risk early in order to rapidly intervene. One of the tools pediatricians use to track development is the standard growth chart. The growth charts are somewhat limited in predicting possible neurodevelopmental issues. They rely on linear models and assumptions of normality for physical growth data – obscuring key statistical information about possible neurodevelopmental risk in growth data that actually has accelerated, non-linear rates-of-change and variability encompassing skewed distributions. Here, (...) we use new analytics to profile growth data from 36 newborn babies that were tracked longitudinally for 5 months. By switching to incremental (velocity-based) growth charts and combining these dynamic changes with underlying fluctuations in motor performance – as the transition from spontaneous random noise to a systematic signal – we demonstrate a method to detect very early stunting in the development of voluntary neuromotor control and to flag risk of neurodevelopmental derail. (shrink)

European firms are currently in a process of transition toward a circular economy, which is expected to guarantee sustainable growth over time. Developing eco-efficient practices is a necessary step in this transition. This study analyzes the impact of stakeholder engagement in a circular business ecosystem on the development of these circular eco-efficient practices. Past literature has evidenced the impact of stakeholder environmental pressure on firm strategic decisions and outcomes. We adopt the stakeholder theory from a more recent vision, arguing that (...) “shaking stakeholders up” within a circular ecosystem is a more advanced strategy than the traditional approach of reacting to stakeholder pressure. Using structural equation modeling, we examine the data of 14,726 European firms and their relationships with five primary stakeholder groups. The results offer theoretical and empirical support for the idea that firms can go further in adopting eco-efficient circular practices by shaking stakeholders up, selecting them, and managing relationships with them. (shrink)

In 1903, W. E. B. Du Bois addressed the question "How does it feel to be a social problem?". In 2008, Moustafa Bayoumi answered the same question for Muslims in the United States. Both Du Bois and Bayoumi provide powerful critiques against any notion that racialized minorities are inherently problematic. Both men generally argue that one cannot blame racialized minorities for the ill treatment they endure under systematic oppression. Du Bois and Bayoumi are two of many voices fighting against the (...) popular stigmatization of racialized peoples that include public intellectuals, civil rights activists, politicians, community leaders, educators, and many others. One of the things that all these voices have in common... (shrink)

_Aims to transform logic into a reflection on the nature of language._.

Heidegger reflects on technology, language, and tradition, and he guides us into rethinking the common conceptions of technology and language. He argues that the anthropological-instrumental conception of modem technology is correct but not true, as it does not capture what is most peculiar to technology: the demand to challenge nature. The common conception of language as a mere means for exchange and understanding, on the other hand, is taken to its extremes in the technological interpretation of language as information. Heidegger (...) also argues that the technological transformation of language represents an attack on what is peculiar to language as saying, i.e., as letting-appear. Such attack constitutes a threat to our very essence. The traditional or non-technologized everyday language, however, preserves what is original and contains new possibilities. The opposition between traditional language and technological language thus concerns our essence, our world-relation and world-living. (shrink)

Gender discrimination continues to be a problem in organizations. It is therefore important that organizations use performance evaluation methods that ensure equal opportunities for men and women. This article reports the results of an experiment to investigate whether and, if so, how the gender of the rater and that of the ratee moderate the relationship between the level of subjectivity in performance appraisals and organizational attractiveness. Participants in the experiment were 313 undergraduate students. We predicted, and indeed established, that as (...) the probability increases that employee performance is evaluated by a female manager, women expect more positive outcomes of subjective, but not objective evaluation processes. Our data did not support our expectation that as the probability of being evaluated by a female manager increases, men expect less positive outcomes of subjective evaluation processes. The findings of this study contribute to our understanding of why women are over-represented in jobs with objective formula-based reward systems, such as piece-rate systems. They are also of interest to organizations that are looking for more ethical human resource management practices. (shrink)

This article presents narratives from 13 Indigenous early career academics (ECAs) at one university in Auckland, New Zealand. These experiences are likely to represent those of Indigenous Māori and Pasifika ECAs nationally, given the small, centralised nature of the national academy of Aotearoa New Zealand. The narratives contain testimony, fictionalised vignettes of experience, and poetic expressions. Meeting the demands of an academic role in one’s first years of working at a university is a big deal for anyone; the extra pressures (...) and challenges for Indigenous Māori and Pacific staff are immense, yet little understood by White ‘others.’ A writing workshop was the initial catalyst of this collective writing project. Through these insider narratives, this article presents a collective description of, and response to, the experience of Māori and Pasifika early career academics. (shrink)

A comunicação divide-se em três partes. Na primeira, trata de apresentar os pressupostos conceituais da tese de Rousseau de que a vontade geral é irrepresentável. Na segunda, com base no ocorrido já ao início da Revolução Francesa, mostra que, historicamente, a tese não teve herdeiros. Na terceira parte apresenta as razões que autorizam sustentar a priori que todo poder político é necessariamente representativo e chama atenção para o fato e para o modo em que o Estado de Direito contemporâneo trata (...) de controlar e remediar as distorções políticas inerentes à natureza representativa do poder político. Palavras-chave: Rousseau. Vontade geral. Poder político. Representação política. (shrink)

En urbanisme, l’approche phénoménologique permet de se pencher sur l’expérience de l’individu et, plus précisément, sur le rapport que celui-ci entretient avec son milieu de vie. Cette approche permet de concevoir des milieux de vie mieux adaptés aux besoins et aux expectatives des individus et suppose des démarches d’aménagement qui accordent un rôle important au citoyen. Toutefois, si l’approche phénoménologique est couramment utilisée dans le cadre de travaux théoriques, elle est difficilement adoptée sur le terrain, en dépit de son utilité (...) et des justifications que l’on peut donner à son utilisation au plan éthique. Dans le présent article, nous explorons les raisons d’une telle disparité en levant le voile sur une double difficulté : difficulté professionnelle, d’une part, à dépasser le modèle déterministe du rapport personne–environnement ; diffi- culté scientifique, d’autre part, à ancrer la production de connaissances dans les processus de transformation du milieu de vie. (shrink)

We consider, from a physical perspective, the case where the interface between an organism and its environment becomes large enough that it acts as a buffer regulating their matter and energy exchanges. We illustrate the physiological and evolutionary role of buffers through the example of lungfish estivation. Then we ponder the relevance of buffers of this kind to the quest for a general definition of concepts like niche construction, the extended phenotype, and related ones, whose meaning is conveyed at present (...) mostly through particular examples. Finally, we comment on the potential significance of buffers to organism—environment codetermination in the sense originally suggested by Lewontin. (shrink)

O ensaio “Transcendência do ego – esboço de uma descrição fenomenológica” pode ser considerado o marco zero da identidade filosófica de Sartre. Tal afirmacão, como é de se imaginar, não se deve apenas às razões cronológicas – o primeiro texto propriamente filosófico e de larga visada escrito pelo autor.

The goal of this study is analyse the influence of perceived supervisor support (PSS) by employees at a micro level and the role of the cultural values of “power distance” and “masculinity” at a macro level on direct employee participation in decision making (PDM). Furthermore, the influence of the gender of managers and employees is taken into account. The analysis is based upon the Sixth European Working Conditions Survey carried out by Eurofound in 2016. The results of a Hierarchical linear (...) model indicate that all predictors significantly influenced PDM and PSS positively and cultural values negatively. When the gender of managers and employees is considered, the findings suggest that PSS has a larger impact on PDM when male managers address female employees. Regarding the moderating effect of PSS on cultural values, it is shown that masculinity and power distance lose importance when employees have the support of their supervisors. (shrink)

RESUMEN: En el actual contexto científico que forma la concepción darwiniana de las especies aún persisten las interpretaciones esencialistas de los conceptos de especie. ¿Se trata aquí sólo de la ignorancia de la teoría biológica? O, más bien, ¿es posible comprender la persistencia de los enfoques esencialistas sobre la base de la potencialidad de estos enfoques para explicar el logro de ciertos valores epistémicos de los actuales conceptos de especie? Me propongo responder afirmativamente a esta última pregunta. En la sección (...) 1 argumento que Samir Okasha (2002) no logra mostrar que hay otras razones, distintas a la de la ignorancia de la biología, que motivan el error de Kripke y de Putnam acerca de las especies. En la sección 2 propongo mi respuesta a la pregunta inicial en términos de algunos valores epistémicos que comparten las ideas esencialistas acerca de las especies y algunos de los actuales conceptos de especie.ABSTRACT: In the current scientific context that forms Darwinian conception of species, essentialist interpretations of the species concept persist. Is this only because of an ignorance of the biological theory? Or rather, is it possible to understand the persistence of essentialist approaches on the basis of the potentiality of these approaches to account for the achievement of certain epistemic values of the current species concepts? I intend to give a positive answer to this second question. In Section 1, I argue that Samir Okasha (2002) does not succeed in demonstrating that there are other reasons, which are different from that one regarding the ignorance about biology, which cause Kripke and Putnam to be mistaken about the species. In Section 2, I put forward my answer to the initial question in terms of some epistemic values sharing the essentialist ideas about the species and some of the current species concepts. (shrink)

No two individuals with the autism diagnosis are ever the same—yet many practitioners and parents can recognize signs of ASD very rapidly with the naked eye. What, then, is this phenotype of autism that shows itself across such distinct clinical presentations and heterogeneous developments? The “signs” seem notoriously slippery and resistant to the behavioral threshold categories that make up current assessment tools. Part of the problem is that cognitive and behavioral “abilities” typically are theorized as high-level disembodied and modular functions—that (...) are assessed discretely (impaired, normal, enhanced) to define a spectral syndrome. Even as biology reminds us that organic developing bodies are not made up of independent switches, we remain often seduced by the simplicity of mechanistic and cognitive models. Developmental disorders such as autism have accordingly been theorized as due to different modular dysfunctions—typically of cortical origin, i.e., failures of “theory of mind” (Baron-Cohen et al., 1985), of the “mirror neuron system” (Ramachandran and Oberman, 2006), of “weak central coherence” (Happe and Frith, 2006) or of the balance of “empathizing” and “systemizing” (Baron-Cohen, 2009), just to list a few. -/- The broad array of autonomic (Ming et al., 2005; Cheshire, 2012) and sensorimotor (Damasio and Maurer, 1978; Maurer and Damasio, 1982; Donnellan and Leary, 1995; Leary and Hill, 1996; Donnellan and Leary, 2012; Donnellan et al., 2012) differences experienced and reported by people with autism have by such theories typically been sidelined as “co-morbidities,” possibly sharing genetic causes, but rendered as incidental and decisively behaviorally irrelevant symptoms—surely disconnected from cognition. But what if the development of cortically based mental processes and autonomous control relies on the complexities and proper function of the peripheral nervous systems? Through such an “embodied” lens the heterogeneous symptoms of autism invites new interpretations. We propose here that many behavioral-level findings can be re-defined as downstream effects of how developing nervous systems attempt to cope and adapt to the challenges of having various noisy, unpredictable, and unreliable peripheral inputs. (shrink)

I argue for a substantive interpretation of Carlos Vaz Ferreira’s account of intellectual flourishing as intellectual liberation. For Vaz Ferreira, I argue, there is an inescapable master-slave dynamic between language and language users, so that flourishing intellectually essentially involves a type of mastery of language that frees up thinking from enslaving linguistic/conceptual confusions and thus facilitates the acquisition of truth. Central to this project are Vaz Ferreira’s most interesting, and radical, views on the nature of language signification and thus on (...) human’s ability to accurately describe and know reality, for failing to keep these linguistic limitations in mind, Vaz Ferreira argues, is a central way for language to enslave humans to confused thinking and thus prevent their intellectual flourishing. (shrink)

The text is part of the investigative concerns from the authors with regard to the dialogue between literature and science teaching. It starts from several theoretical approaches around the general didactics, university or superior didactics, science’s didactics and for last, literature’s didactics. This is largely due to our search which is focused in articulate the university didactics with science and literature’s didactics, meanwhile, we pretend to answer to the questions ¿How are the specific didactics of science and literature going to (...) contribute to the university didactics and how is the last one going to contribute to these specific didactics? ¿Is it the dialogue between science and literature possible? The paper has been made in middle education, in Educative Institution José Miguel de Restrepo y Puerta, from Copacabana and also in university education, in the academic unities of Dietetics and Nutrition School, Agricultural Sciences and Medicine, from the University of Antioquia. Finally, the partial results indicate: i) the necessity of general Didactics as a discipline focused on teaching and learning processes to ask itself for its internal problems and establish relations with specific didactics. (shrink)

La vida de sor juana inés de la cruz, su pensamiento ligado a la poesía, al encuentro con los mitos. leída por teólogos, por filósofos y poetas, parece haber superado las fronteras del lenguaje, las fronteras de la simple fe; este texto intenta entender la condición mística de su pensamiento.

Se analiza la relación entre la escritura y la presencia en la obra de Maurice Blanchot, se delimita el fundamento textual de la presencia en el orden de la literatura y se toman como referentes teóricos los conceptos de “espacio literario” y “pensamiento del afuera” de Michel Foucault. Si bien el propósito de examinar dicha relación es deconstruir el vínculo entre presencia y lenguaje, Blanchot conduce a considerar esa continuidad en términos de una presencia nunca completa ni devenida que se (...) conserva como una discontinuidad, una promesa y una ausencia que deben preservarse. (shrink)

O propósito do artigo é apresentar o conceito de ‘tópica política’ como o recurso teórico necessário para elucidação das determinações formais que estruturam as relações políticas em seu nível mais geral. A primeira seção do texto evoca os contextos doutrinários em que o conceito de tópica foi introduzido com intenções em alguma medida análogas às que animam o artigo, sendo brevemente considerados os usos do termo nas obras de Aristóteles, Kant e Freud. A segunda seção examina os conceitos de divisão (...) e unidade, tratando de mostrar que as sociedades humanas são ao mesmo tempo necessariamente divididas e unificadas. Divididas na medida em que, como já mostrara Aristóteles e como o repetirá Tomás de Aquino, sendo a sociedade composta por uma multidão, o estatuto de sua unidade é necessariamente sui generis: ela não pode ser absolutamente una, pois, se o fosse, já não poderia ser uma cidade. Unificadas na medida em que as diferenças e distinções sociais, na medida em que adquirem caráter político, sobrevêm sempre dentro de uma sociedade, a unidade desta última tendo estatuto necessariamente reflexivo. A terceira seção introduz o exame dos conceitos de identidade e representação a partir da análise crítica da tese do jovem Marx de acordo com a qual a democracia é a verdade da monarquia mas a monarquia não é verdade da democracia. A seção prossegue com a retomada do exame destas noções a partir das análises de Carl Schmitt. A quarta e última seção do texto trata de explicitar os ganhos críticos, heurísticos e metapolíticos que a introdução do conceito de tópica na teoria política pode proporcionar. (shrink)

El presente estudio examina la percepción que 100 profesoras y profesores de educación primaria en México manifestaron tener acerca de personajes que participaron en acontecimientos históricos de la historia nacional. La metodología ha sido de tipo mixto, a través de un cuestionario con preguntas abiertas y cerradas. Los resultados muestran que dichos personajes fueron principalmente varones, y hace ver que su actuar estuvo relacionado con hechos de violencia. Se plantea que el estudio de esa violencia, considerada una cuestión socialmente viva, (...) permitiría a la didáctica de la historia trascender, en el aula y en los programas respectivos, a un enfoque propicio para que el alumnado construya una conciencia histórica que fundamente su interpretación del pasado y del presente en su entidad, Sonora, México, con vías a contribuir a la construcción de la paz. Más aún, propone lo mismo respecto de otros tipos de violencia. (shrink)

The Community FoodBank of NJ was a $100 million charitable organization that distributed over 44 million pounds of food each year through its partner organizations like food pantries, soup kitchens and the like. Its mission was to “fight hunger and poverty in New Jersey [USA] by assisting those in need and seeking long term solutions.” In a time of governmental cutbacks and shrinking private donations, the nonprofit sought new sources of revenue. One idea was to leverage perishable bakery donations and (...) an in-house commercial kitchen, by creating and marketing an up-scale bagel crisp. After product development and market testing, the resulting business plan won a “Break the Gala Addiction” cash prize from the Prudential Foundation to further the social entrepreneurship effort. Now the organization needs to decide if it should use its scarce resources to scale the business internally—to maximize job creation, leverage existing facilities and capture all the revenue, or if it should outsource production and distribution for a percentage of sales so that it can focus on other efforts more tightly aligned to its mission. Students are encouraged to use ethical frameworks to think through the nonprofit’s dilemma. (shrink)