Over the past two decades, there has been a growing political and intellectual retrospection on the brittleness, limitations, successes, and failures of liberal democracy and liberalism as a doctri...

Most aspects of agriculture in Cuba prior to 1989 were comparable to California: a high energy input, conventional agriculture (based on what the Cubans now call the “classical model”) in which little was done to protect the nation's soils from erosion, loss of fertility, salinization, and other forms of degradation. In stark contrast the new “Alternative Model,” which has been rapidly replacing the previous model since 1989, emphasizes soil conservation and rehabilitation and the general improvement of the nation's soils as (...) the key to sustaining low-input production and attainment of food security. One of the first steps in implementing the new model was the launching of an ambitious program to reclassify, evaluate, and map the nation's soils in great detail, and to interpret the maps for management of sustainable production. A main feature of this program is coordinated fertility trials to determine, for each combination of crop and soil, the minimum quantity of plant nutrients needed to produce the crop. The build up and maintenance of soil fertility and productivity is being accomplished with various organic and mineral amendments and biofertilizers, produced or mined within the country (locally, where possible) and through rational management utilizing cover crops, green manures, crop successions (intercropping and rotations), and other appropriate technologies. Rehabilitation of degraded soils, tillage reduction, reforestation, vermiculture, vermicomposting, and other forms of waste cycling are other features of the new model that are important to soil conservation and maintenance for sustainable production. (shrink)

Synaesthesia is a condition in which one type of stimulation evokes the sensation of another, as when the hearing of a sound produces photisms, i.e. mental percepts of colours. R is a 20 year old colour blind subject who, in addition to the relatively common grapheme-colour synaesthesia, presents a rarely reported cross modal perception in which a variety of visual stimuli elicit aura-like percepts of colour. In R, photisms seem to be closely related to the affective valence of stimuli and (...) typically bring out a consistent pattern of emotional responses. The present case study suggests that colours might be an intrinsic category of the human brain. We developed an empirical methodology that allowed us to study the subject's otherwise inaccessible phenomenological experience. First, we found that R shows a Stroop effect (delayed response due to interference) elicited by photisms despite the fact that he does not show a regular Stroop with real colours. Secondly, by manipulating the colour context we confirmed that colours can alter R's emotional evaluation of the stimuli. Furthermore, we demonstrated that R's auras may actually lead to a partially inverted emotional spectrum where certain stimuli bring out emotional reactions opposite to the normal ones. These findings can only be accounted for by considering R's subjective colour experience or qualia. Therefore the present paper defends the view that qualia are a useful scientific concept that can be approached and studied by experimental methods. (shrink)

El pensamiento ético y bioético es una de las áreas de conocimiento recurrentes en el ejercicio reflexivo del profesional de la salud en Cuba; sin embargo, se detectan insuficiencias relacionadas con imprecisiones y falta de claridad en el pensamiento ético-moral por parte de este personal, según se observa en materiales evaluados para su publicación, en los ejercicios para el proceso de obtención de categorías docentes y en la presentación de las evaluaciones de posgrados. El artículo tiene el objetivo de argumentar (...) precisiones teórico- metodológicas para la elaboración de trabajos en ética y bioética. The ethical and bioethical thought is one of the recurrent areas of knowledge in the reflexive exercise of health professionals in Cuba. However, according to the observations of evaluated materials for their publication, in the exercises for the process of obtaining educational categories and in the presentation of postgraduate evaluations, inadequacies related with imprecision and lack of clarity are detected in the ethical-moral thought on the part of health professionals. The article has the objective of arguing theoretical- methodological precisions for the elaboration of works in ethics and bioethics. (shrink)

Background and objectives: Definitions of medical futility, offered by healthcare professionals, bioethicists and other experts, have been rigorously debated by many investigators, but the perceptions of patients of futility have been explored only by a few. Patients were allowed to discuss their concerns about end-of-life care, so that their ideas about treatment futility or utility could be extrapolated by us.Methods: In this cross-sectional study, in-depth, semistructured interviews were conducted with 30 elderly people who were receiving outpatient care in a large, (...) urban Veterans Affairs medical centre in the US. Each of their healthcare providers was also interviewed. Participants were asked to consider four terms commonly used in advance directive forms and to discuss what these terms meant to them. Audiotapes of the open-ended interviews were transcribed and responses were coded and categorised by constant comparison, a commonly used qualitative method.Results: The following four factors were taken into account by the participants when discussing end-of-life interventions and outcomes: expected quality of life; emotional and financial costs of treatment; likelihood of treatment success; and expected effect on longevity.Conclusions: Although the terms “utility” or “futility” were not generally used by the participants, segments of speech indicating their perceptions of these terms were identified. Treatment was not always discussed in the same way by patients and providers, but seemed to reflect the same four concerns. Therefore, it may be fruitful for providers to focus on these concerns when discussing end-of-life treatment options with their patients. (shrink)

Drawing on a landscape analysis of existing data-sharing initiatives, in-depth interviews with expert stakeholders, and public deliberations with community advisory panels across the U.S., we describe features of the evolving medical information commons. We identify participant-centricity and trustworthiness as the most important features of an MIC and discuss the implications for those seeking to create a sustainable, useful, and widely available collection of linked resources for research and other purposes.

Carlos Eduardo Alchourrón y Eugenio Bulygin efectuaron contribuciones de fundamental importancia para el desarrollo de la teoría de los sistemas jurídicos. Sus ideas evidencian una evolución de la presentación de una visión estática a una visión dinámica de tales sistemas. El objetivo central del presente trabajo consiste en mostrar que existe, no obstante, una cierta tensión en las tesis sostenidas por los autores entre dos concepciones diferentes de los sistemas jurídicos: por una parte, aquella que trata de reconstruir el conjunto (...) de las normas que resultan relevantes para la solución de un caso; por la otra, aquella que trata de ofrecer una caracterización satisfactoria del derecho como institución. Las diferentes finalidades que cada una de esas reconstrucciones persiguen obligan a refinar algunas ideas vinculadas con la dinámica del derecho para evitar derivaciones incompatibles con las intuiciones jurídicas ordinarias. Carlos Eduardo Alchourrón and Eugenio Bulygin have made contributions of fundamental importance for the development of the theory of legal systems. Their ideas reflex an evolution from a static to a dynamic vision of such systems. The main purpose of the present paper is to show that, notwithstanding, there exists a certain tension in the thesis defended by Alchourrón and Bulygin between two different conceptions of a legal system. On the one hand, a conception related to the reconstruction of the set of relevant norms to solve a certain case; on the other, a conception related to a satisfactory characterization of law as an institution. The different concerns of each of those reconstructions force to refine certain ideas associated with the dynamics of law to avoid derivations which appear incompatible with ordinary legal intuitions. (shrink)

A considerable number of books and papers have analyzed normative concepts using new techniques developed by logicians; however, few have bridged the gap between the English legal culture and the Continental tradition in legal philosophy. This book addresses this issue by offering an introductory study on the many possibilities that logical analysis offers the study of legal systems. The volume is divided into two sections: the first covers the basic aspects of classical and deontic logic and its connections, advancing an (...) explanation of the most important topics of the discipline by comparing different systems of deontic logic and exploring some of the most important paradoxes in its domain. The second section deals with the role of logic in the analysis of legal systems by discussing in what sense deontic logic and the logic of norm-propositions are useful tools for a proper understanding of the systematic structure of law. (shrink)

Several studies have explored differences between North American and European doctor patient relationships. They have focused primarily on differences in philosophical traditions and historic and socioeconomic factors between these two regions that might lead to differences in behaviour, as well as divergent concepts in and justifications of medical practice. However, few empirical intercultural studies have been carried out to identify in practice these cultural differences. This lack of standard comparative empirical studies led us to compare differences between France and the (...) USA regarding end-of-life decision-making. We tested certain assertions put forward by bioethicists concerning the impact of culture on the acceptance of advance directives in such decisions. In particular, we compared North American and French intensive care professional's attitudes toward: (1) advance directives, and (2) the role of the family in decisions to withhold or withdraw life-support. (shrink)

In Italy, judicial and extrajudicial requests for paternity testing have increased in recent years. A retrospective analysis of such private extrajudicial requests received by the legal medicine unit of the Department of Environmental Medicine and Public Health of Padua University was conducted to identify problem areas most helpful in determining whether to accept private parties’ requests for paternity testing. Such testing is most delicate when a presumptive father may be seeking to disown paternity and when testing is wanted without the (...) consent of a member of the mother–child–father triangle. Tests that could establish paternity where none has been recognised are less problematic, as the child will not lose out. Legal and ethical–deontological aspects of consent, of the protection of minors and of children’s and parents’ need for follow-up interviews to deal with the outcome of such testing are carefully considered by the Padua University team when deciding whether to accept a request for testing. It is argued that because such issues are not dealt with by mail-order laboratories, the use of such services is inappropriate. (shrink)

Apoptosis is now widely recognized as a common form of cell death and represents a mechanism of cell clearance in many physiological situations where deletion of cells is required. Peptide growth factors, initially characterised as stimulators of cell proliferation, have now been shown to inhibit death in many cell types. Deprivation of growth factors leads to the induction of apoptosis, i.e. condensation of chromatin and degradation in oligonucleosomesized fragments, formation of plasma and nuclear membrane blebs and cell fragmentation into apoptotic (...) bodies which can be taken up by neighbouring cells. Here we discuss the mechanism(;s) by which growth factors may inhibit apoptosis. (shrink)

In a variety of synaesthesia, photisms result from affect-laden stimuli as emotional words, or faces of familiar people. For R, who participated in this study, the sight of a familiar person triggers a mental image of "a human silhouette filled with colour". Subjective descriptions of synaesthetic experiences induced by the visual perception of people's figures and faces show similarities with the reports of those who claim to possess the ability to see the aura. It has been proposed that the purported (...) auric perception may be easily explained by the presence of a specific subtype of cross-modal perception. We analyse the subjective reports of four synaesthetes who experience colours in response to human faces and figures. These reports are compared with descriptions of alleged auric phenomena found in the literature and with claims made by experts in esoteric spheres. The discrepancies found suggest that both phenomena are phenomenologically and behaviourally dissimilar. (shrink)

We examine ethical considerations in access to facial transplantation (FT), with implications for promoting health equity. As a form of vascularised composite allotransplantation, FT is still considered innovative with a relatively low volume of procedures performed to date by a small number of active FT programmes worldwide. However, as numbers continue to increase and institutions look to establish new FT programmes, we anticipate that attention will shift from feasibility towards ensuring the benefits of FT are equitably available to those in (...) need. This manuscript assesses barriers to care and their ethical implications across a number of considerations, with the intent of mapping various factors relating to health equity and fair access to FT. Evidence is drawn from an evolving clinical experience as well as published scholarship addressing several dimensions of access to FT. We also explore novel concerns that have yet to be mentioned in the literature. (shrink)

Iván Ortega Rodríguez livre une contribution où M. Henry est mis en confrontation avec Patočka, notamment sur la corrélation entre la vie et le monde, autrement dit sur l’« a priori de corrélation ». Comme le rappelle l’auteur de cette étude, tant Patočka que M. Henry adoptent cette corrélation a priori comme point de départ, et donc eu égard aux questions portant respectivement sur l’apparaître, sur ce qui apparaît et sur cette vie subjective qui semble devoir accompagner toute donation. (...) Aussi Iván Ortega Rodríguez soutient-il que tout semble se jouer entre M. Henry et Patočka dans leur conception de l’apparaître. Autant la donation henryenne nous invite à nous singulariser dans notre expérience selon le pathos de la vie auto-affective, autant elle nous invite chez Patočka à sortir hors de nous-mêmes selon la priorité accordée à l’aspect de « champ » que nous trouvons dans le se-montrer, là où se place tout ce qui est donné. (shrink)

The reference to the vagina as “it” or “down there” is symptomatic of two larger cultural problems: not naming the vagina when speaking about the vagina, and conflating the vagina with the external female genitalia. The euphemisms and obfuscating language have implications both for lay understandings of female bodies and for the practice of health care. Granting and using a name gives both the named and the namer power and legitimacy.

Introduction: Schools have become a primary setting for providing mental health care to youths in the U.S. School-based interventions have proliferated, but their effects on mental health and academic outcomes remain understudied. In this study we will implement and evaluate the effects of a flexible multidiagnostic treatment called Modular Approach to Therapy for Children with Anxiety, Depression, Trauma, or Conduct Problems on students' mental health and academic outcomes.Methods and Analysis: This is an assessor-blind randomized controlled effectiveness trial conducted across five (...) school districts. School clinicians are randomized to either MATCH or usual care treatment conditions. The target sample includes 168 youths referred for mental health services and presenting with elevated symptoms of anxiety, depression, trauma, and/or conduct problems. Clinicians randomly assigned to MATCH or UC treat the youths who are assigned to them through normal school referral procedures. The project will evaluate the effectiveness of MATCH compared to UC on youths' mental health and school related outcomes and assess whether changes in school outcomes are mediated by changes in youth mental health.Ethics and Dissemination: This study was approved by the Harvard University Institutional Review Board. We plan to publish the findings in peer-reviewed journals and present them at academic conferences.Clinical Trial Registration:ClinicalTrials.gov ID: NCT02877875. Registered on August 24, 2016. (shrink)

In this work, we present a new approach to solve the location management problem by using the reporting cells strategy. Location management is a very important and complex problem in mobile computing which aims to minimize the costs involved. In the reporting cells location management scheme, some cells in the network are designated as reporting cells . The choice of these cells is not trivial because they affect directly to the cost of the mobile network. This article is focused on (...) the use of high performance computing to execute a parallel heuristic that places optimally the RCs in a mobile network, minimizing its total cost. The main goal of this work is to demonstrate that the collaborative work of different evolutionary algorithms can obtain very good results. For this reason, we have implemented a parallel heuristic and six evolutionary algorithms that works in a parallel way on a cluster to solve the RCs problem. (shrink)

As innovations in the field of vascular composite allotransplantation (VCA) progress, whole-eye transplantation (WET) is poised to transition from non-human mammalian models to living human recipients. Present treatment options for vision loss are generally considered suboptimal, and attendant concerns ranging from aesthetics and prosthesis maintenance to social stigma may be mitigated by WET. Potential benefits to WET recipients may also include partial vision restoration, psychosocial benefits related to identity and social integration, improvements in physical comfort and function, and reduced surgical (...) risk associated with a biologic eye compared to a prosthesis. Perioperative and postoperative risks of WET are expected to be comparable to those of facial transplantation (FT), and may be similarly mitigated by immunosuppressive protocols, adequate psychosocial support, and a thorough selection process for both the recipient and donor. To minimize the risks associated with immunosuppressive medications, the first attempts in human recipients will likely be performed in conjunction with a FT. If first-in-human attempts at combined FT-WET prove successful and the biologic eye survives, this opens the door for further advancement in the field of vision restoration by means of a viable surgical option. This analysis integrates recent innovations in WET research with the existing discourse on the ethics of surgical innovation and offers preliminary guidance to VCA programs considering undertaking WET in human recipients. (shrink)

Despite the current theoretical developments regarding the proof of facts in law, it is still an open problem to offer an adequate reconstruction of a logic of evidence. This paper presents some preliminary ideas for such a reconstruction. Starting from the assumption that the produc-tion and evaluation of certain evidence in a legal process has already been completed, it examines which candidates would be suitable as basic principles for a logic of evidence. The similarities and differences of the resulting system (...) with other modal logic systems with which it appears to have analogies, in particular alethic logic, deontic logic, epistemic logic, and the logic of truth, are examined. (shrink)

¿Cómo justificar la validez jurídica de aquellas normas cuya creación no puede ser evaluada como regular o irregular por apelación a ninguna otra norma jurídica? Entre las respuestas más ilustres a este problema se cuentan la norma fundante kelseniana y la regla de reconocimiento de Hart, pero cada una de esas ideas ha sido objeto de serias críticas. Eugenio Bulygin ha efectuado aportes decisivos en esta discusión: ha advertido que cuando se examina el fundamento último de la validez de las (...) normas jurídicas es preciso discriminar un sentido prescriptivo y uno descriptivo de validez, y que la norma fundante de Kelsen no es sino el producto de una confusión entre ambos; ha resaltado que la regla de reconocimiento debe interpretarse como una regla conceptual que especifica los criterios de identificación de las normas jurídicas, y ha señalado que las normas de competencia no pueden reconstruirse como normas de conducta. Si bien con tales aportes ha sentado las bases para ofrecer una solución, su reconstrucción requiere de ciertas precisiones para poder ser considerada una respuesta enteramente satisfactoria a la pregunta respecto del fundamento último de la validez jurídica. How is it possible to ground the legal validity of those rules whose creation cannot be assessed as regular or irregular by reference to any other legal rule? Kelsen's basic norm and Hart's rule of recognition are among the most famous answers to this question, but both ideas have been seriously challenged. Eugenio Bulygin has made decisive contributions to this discussion. He has shown that in the analysis of the ultimate ground of validity of legal rules, two different senses of validity should be distinguished: a prescriptive and a descriptive sense, and that the Kelsenian basic norm is nothing but the product of confusion between these two different senses. He has also claimed that the rule of recognition has to be understood as a conceptual rule specifying the criteria of identification of legal rules, and those power-conferring rules cannot be interpreted as prescriptive norms of conduct. Although these contributions have provided a basic framework for a possible solution, Bulygin's ideas need a refinement in order to be considered as a satisfactory answer to the question concerning the ultimate ground of legal validity. (shrink)