Introduction: Nurses who work in an emergency department regularly care for acute patients in a fast-paced environment, being at risk of suffering high levels of burnout. This situation makes them especially vulnerable to be accountable for decisions they did not have time to consider or have been pressured into. Research objective: The objective of this study was to find which factors influence ethical, legal and professional accountability in nursing practice in an emergency department. Research design: Data were analysed, codified and (...) triangulated using qualitative ethnographic content analysis. Participants and research context: This research is set in a large emergency department in the Midlands area of England. Data were collected from 186 nurses using participant observation, 34 semi-structured interviews with nurses and ethical analysis of 54 applicable clinical policies. Ethical considerations: Ethical approval was granted by two research ethics committees and the National Health Service Health Research Authority. Results: The main result was the clinical nursing accountability cycle model, which showed accountability as a subjective concept that flows between the nurse and the healthcare institution. Moreover, the relations among the clinical nursing accountability factors are also analysed to understand which factors affect decision-making. Discussion: The retrospective understanding of the factors that regulate nursing accountability is essential to promote that both the nurse and the healthcare institution take responsibility not only for the direct consequences of their actions but also for the indirect consequences derived from previous decisions. Conclusion: The decision-making process and the accountability linked to it are affected by several factors that represent the holistic nature of both entities, which are organised and interconnected in a complex grid. This pragmatic interpretation of nursing accountability allows the nurse to comprehend how their decisions are affected, while the healthcare institution could act proactively to avoid any problems before they happen. (shrink)

Contemporary healthcare practice has been progressively more regulated to increase efficiency, service user safety and practice quality. However, ethical issues in clinical practice that have not been implemented into regulations are undervalued by policymakers and healthcare institutions Considering the issues found by other authors, the use of a simple tool for policymakers to consider recurrent ethical issues could reduce those issues in a policy-driven clinical practice. The lack of tools to support structured ethical assessment of clinical policies was the main (...) reason to create the Clinical Policy Ethics Assessment Tool, but we realised of its possible advantages: limiting ethical dilemmas posed by policies, ensuring ethical practice by the use of policies and developing a consistent process for policymakers, institutions and healthcare professionals. Nonetheless, even if a tool can be implemented and it supports the creation of policies that reduce ethical issues, if the healthcare professionals are not aware of them they will not be implemented and the issues will continue. (shrink)

Traditional games are considered agents of enculturation. This article explores the procedure to access the cultural meanings transmitted in a traditional game. The goal is to understand what children aged 6–11 make of the game called ‘the chained bear’ and to compare the meanings retrieved with those of different traditional versions of the game. For such a purpose, through an exploratory cross-sectional study, cartoons depicting people playing the game were exhibited and viewers were asked to interpret them as a drama (...) play, as well as contributing a title, a plot and saying how they would name the characters. The results show that, beyond the individual images that each child created in their mind, most of them coincided in stories about harassment and defense and theft and protection. These plots match those of the ludic tradition, showing that the actions evoke different pictures to each individual, but share common cultural meanings in turn. The study shows a procedure to access the meanings that traditional games transmit and confirms that games contain pieces of culture, which makes them agents of enculturation. (shrink)

Introduction: Clinical policies control several aspects of clinical practice, including individual treatment and care, resource management and healthcare professionals’ etiquette. This article presents Clinical Policy Ethics Assessment Tool, an ethical assessment tool for clinical policies that could be used not only by clinical ethics committees but also by policy committees or other relevant groups. Aim: The aim of this study was to find or create a tool to identify ethical issues and/or confirm ethical validity in nursing practice policies, protocols and (...) guidelines. Methodology: The development of Clinical Policy Ethics Assessment Tool involved first a literature review, followed by modification of the Research Protocol Ethics Assessment Tool, which was created to identify research protocols’ ethical issues, and finally, a trial of Clinical Policy Ethics Assessment Tool to ensure its reliability and validity. Ethical consideration: The policies analysed trialling Clinical Policy Ethics Assessment Tool were in the public domain and did not contain any confidential information. Despite that, Clinical Policy Ethics Assessment Tool also had the approval of a research ethics committee. Results: Research Protocol Ethics Assessment Tool was chosen as the template for a Clinical Policy Ethics Assessment Tool, to which several modifications were added to adapt it to work within a nursing practice context. Clinical Policy Ethics Assessment Tool was tested twice, which resulted in a general test–retest reliability coefficient = 0.86, r = 0.84, α1 = 0.817, α2 = 0.824 and interclass correlation coefficient = 0.874. Discussion: Contemporary nursing practice in a developed country is often ruled by clinical policies. The use of Clinical Policy Ethics Assessment Tool could confirm the ethical validity of those clinical practice policies, impacting on nurses’ education, values and quality of care. Conclusion: Clinical Policy Ethics Assessment Tool has the potential to detect ethical issues and facilitate the correction and improvement of clinical policies and guidelines in a structured way. This is especially so as it has shown reliability in detecting issues in clinical policies involving human participants and in encouraging policymakers to consider common ethical dilemmas in nursing practice. (shrink)

IntroductionThe assessments of the motor symptoms in Parkinson’s disease are usually limited to clinical rating scales, and it depends on the clinician’s experience. This study aims to propose a machine learning technique algorithm using the variables from upper and lower limbs, to classify people with PD from healthy people, using data from a portable low-cost device. And can be used to support the diagnosis and follow-up of patients in developing countries and remote areas.MethodsWe used Kinect®eMotion system to capture the spatiotemporal (...) gait data from 30 patients with PD and 30 healthy age-matched controls in three walking trials. First, a correlation matrix was made using the variables of upper and lower limbs. After this, we applied a backward feature selection model using R and Python to determine the most relevant variables. Three further analyses were done using variables selected from backward feature selection model, movement disorders specialist, and all the variables from the dataset. We ran seven machine learning models for each model. Dataset was divided 80% for algorithm training and 20% for evaluation. Finally, a causal inference model using the DoWhy library was performed on Dataset B due to its accuracy and simplicity.ResultsThe Random Forest model is the most accurate for all three variable Datasets followed by the support vector machine. The CIM shows a relation between leg variables and the arms swing asymmetry and a proportional relationship between ASA and the diagnosis of PD with a robust estimator.ConclusionsMachine learning techniques based on objective measures using portable low-cost devices are useful and accurate to classify patients with Parkinson’s disease. This method can be used to evaluate patients remotely and help clinicians make decisions regarding follow-up and treatment. (shrink)

Physical activity, body composition and sedentary behavior may affect the health of children. Therefore, this study examined the effect of an educational hybrid physical education program on physical fitness, body composition and sedentary and PA times in adolescents. A 9-month group-randomized controlled trial was conducted in 150 participants allocated into the control group and experimental group. Cardiorespiratory fitness, speed, strength, agility, flexibility and body mass index were assessed through previously validated field tests. Sedentary time, PA at school and afterschool were (...) evaluated with the Youth Activity Profile-Spain questionnaire. Significant differences were observed concerning to the CG in APA-weekend, speed-agility and agility. Regarding the intervention, cardiorespiratory fitness, speed-agility, strength, flexibility, agility, PA in school, APA-weekday, APA-weekend, APA-week, and sedentary time increased significantly in the EG. The use of a hybrid program based on teaching personal and social responsibility and gamification strategies produced enhancements in cardiorespiratory fitness, agility, speed, APA-weekdays and APA-weekends, reducing the sedentary time. (shrink)

Research and clinical trial development for rare diseases pose unique bioethical challenges. Much of the literature on rare diseases focuses on patient advocacy and drug development to manage or cu...

Desde su creación el CSIC ha tratado de estar próximo a las inquietudes y problemas de nuestra sociedad y esta voluntad se vio fortalecida tras la aprobación de nuestra Constitución. En este contexto, se presenta un recorrido en el tiempo de lo acontecido desde el establecimiento de la Delegación de Madrid en 1987 hasta la actualidad. Se describe la complejidad del sistema científico en esta Comunidad y las particulares circunstancias de los centros del CSIC. Se resalta el interés de la (...) presidencia en el nombramiento de los delegados y se reseñan sus funciones y la importancia del trabajo desarrollado. (shrink)

La inteligencia artificial y la robótica son dos realidades que han venido para quedarse y cuya implicación en nuestra sociedad afecta a distintos ámbitos. El hecho de que nos encontremos ante una tecnología capaz de emular actitudes humanas como son el aprendizaje o la adaptación, convierten a la IA, y en concreto a los robots dotados de la misma, en máquinas imprevisibles. Asimismo, nos encontramos con la agravante de la posible interacción entre máquinas y sujetos de carácter vulnerable como son (...) los consumidores o los pacientes, lo que entraña un riesgo aún mayor. Precisamente por ello es necesario un análisis desde el punto de vista jurídico, así como también ético, de las consecuencias del manejo de los robots inteligentes en nuestra sociedad. (shrink)

Unsolicited email campaigns remain as one of the biggest threats affecting millions of users per day. During the past years several techniques to detect unsolicited emails have been developed. This work provides means to validate the hypothesis that the identification of the email messages’ intention can be approached by sentiment analysis and personality recognition techniques. These techniques will provide new features that improve current spam classification techniques. We combine personality recognition and sentiment analysis techniques to analyse email content. We enrich (...) a publicly available dataset adding these features, first separately and after in combination, of each message to the dataset, creating new datasets. We apply several combinations of the best email spam classifiers and filters to each dataset in order to compare results. (shrink)

Desde el ámbito filosófico cada vez más autores muestran interés por abordar la reflexión filosófica de la ingeniería. Del lado de la ingeniería, existe una demanda definida por las sociedades profesionales y los organismos de acreditación de las titulaciones de ingeniería de inclusión de las ciencias sociales y humanidades en la formación de los ingenieros que, sin embargo, presenta deficiencias en su implantación. El objetivo del presente trabajo es justificar la inclusión de la reflexión filosófica en la formación de los (...) titulados en ingeniería y, para mejorar la situación actual, presentar una propuesta de asignaturas que muestre cuál pueda ser su espacio. La propuesta consiste en la inclusión de una asignatura específica que relacione la ingeniería y la sociedad, donde la reflexión filosófica juega un papel significativo, como complemento a la inclusión de la reflexión filosófica sobre problemas concretos en asignaturas específicas de corte tecnológico. (shrink)

Consent can only be voluntary, freely given and uncoerced. Can this legal adult standard also apply to children? High-risk surgery is seldom a wanted choice, but compared with the dangers of the un...

A partir del siglo XIII se puede hablar de una "secularización" de la experiencia mística, y en esta nueva etapa que se inicia en la historia del misticismo cristiano, al Maestro Eckhart cabría definirlo con seguridad como el excepcional teólogo que proclama y justifica teológicamente-la posibilidad de reintegrar la identidad ontológica con Dios sin necesidad de abandonar el mundo. La doctrina mística del Maestro Eckhart integra armónicamente la contemplación y la actividad en el mundo, posibilitando con su propia vida y (...) sus instrucciones que la verdadera contemplación sea acción cristiana, y que la acción cristiana surja como estilo contemplativo de vida. (shrink)

In a successful series of papers, Schroer and Schroer presented a reductionist narrative account of personal identity. They claimed that their reductionist account had advantages over traditional narrative theories. In this paper I intend to show that they were wrong. Although it is possible to defend a reductionist narrative account, the Schroers’ theory has a problem of circularity. And solving that problem will cause their theory to have much more problems than non-reductionist narrative theories. Consequently, they should either present a (...) new and improved reductionist narrative account, or accept that non-reductionist narrative theories are better suited to account for the problem of personal identity. (shrink)

Scant attention has been paid to the notion of property in Hannah Arendt’s thought, and this paper aims to address this gap. For Arendt, property is the realm of privacy, located in the house. She argues that the modern age represented its loss with the expropriation of the peasant classes after the Reformation. As a result, wealth started to be accumulated and became productive through the labor of the new propertyless classes. This new way of dealing with property needed a (...) new notion of property for the laborers. Locke’s understanding gave the laborers the hope of being property-owners through their labor and simultaneously justified the unending accumulation of money; nevertheless, property in its true meaning was never recovered. Arendt believes that recovering property under conditions of equality is an essential consideration, and this egalitarian vision of property only can be achieved if law protects prop- erty as well as set limits on the accumulation of wealth. (shrink)

This essay is about experience, and not only about ideas. I have been drawn to write about John Cameron Mitchell’s Shortbus for a number of reasons: First, I find his work to be part of a new turn in LGBT art and media that take queer lives as a point of departure, and not only as narrative focus, for their work. These areworks that are not just about being queer, but cross the line into being queer works. Of those who (...) can be said to be a part of this recent turn, I find Mitchell’s work to be both especially philosophical and formally interesting. Not only does his work take up philosophical questions over what it means to be human, and the nature of love and sex, but also his works are produced through an organic, cooperative process that re-frames what it could mean to queer representation, political or otherwise. (shrink)

La jurisdicción constitucional nació el 24 de febrero de 1803 en una desangelada sala en la planta baja del Capitolio cedida por el Congreso de los Estados Unidos al Tribunal Supremo cuando su presidente, el Chief Justice John Marshall hizo pública la sentencia en el caso Marbury v. Madison. En ella se establecía la revisión judicial de las leyes (y también de los actos del Gobierno, pero éste es otro tema) sacándosela de la manga de la toga como de una (...) chistera extraen un conejo los prestidigitadores, pues la Constitución del nuevo país, promulgada en 1787 y todavía vigente, no preveía expresamente tal competencia. (shrink)

Die Absicht des vorliegenden Buches ist es, das Geflecht der unterschiedlichen Fragestellungen, die mit dem Stichwort „Fichte und seine Zeit“ verbunden sind, in Betracht zu ziehen und ihre internen Zusammenhänge und ihre Geschlossenheit deutlich zu machen. The intention of this book is to take the network of different issues that are associated with the main theme " Fichte and his time" into consideration and make their internal relationships and their closeness significantly.

Während des Studiums des Zweiten Vortrags der WL 1804 und meiner Arbeit an der italienischen Übersetzung dieses Textes wurde mir klar, daß Fichte in dieser Phase dem Skeptizismus und damit der philosophischen Infragestellung des systematischen Denkens noch viel Aufmerksamkeit schenkte.

In this article, we defend the existence of disagreements in areas of discourse that involve anagent’s perspective, as the semantic theory known as “Radical Relativism” putsit. In the face of the idea that such disagreements exist and can only be explainedby a radical relativist semantics, contextualist theorists have offered arguments to deny their existence or to provide an explanation of them which does not imply departing from the standard semantic theory. These arguments will be our targetof criticism. We raise the (...) debate in terms of the distinction between semantic andpragmatic aspects of disagreement, and we defend a simple vision of disagreement, which we believe the relativist must have in mind if he wants to argue that disagreements belonging to areas that involve an agent’s perspective can count as evidence in his favor. (shrink)