(2009). Transitions to democracy: the role of moral and citizenship education in Latin America. Journal of Moral Education: Vol. 38, Moral and Citizenship Education in Latin America: Towards Reconciliation, Community Development and Democracy, pp. 391-406.

Background: Serious games have shown positive results in increasing motivation, adherence to treatment and strengthening the therapeutic alliance in multiple psychiatric disorders. In particular, patients with impulse control disorders and other disorders in which the patient suffers from inhibitory control deficits have been shown to benefit from serious games.Aim: The aim of this study was to describe the characteristics and to evaluate the usability of a new serious videogame, e-Estesia. This serious videogame was designed to improve emotion regulation in patients (...) with gambling disorder. Preliminary results from a pilot sample are also reported.Method: A pilot sample of 26 patients undergoing treatment for GD was recruited. Participants used e-Estesia on a tablet, which was connected to a thoracic band that sent heart rate and heart rate variability data to the videogame platform in order to provide biofeedback. The System Usability Scale was completed by patients to determine the usability of e-Estesia.Results and Discussion: e-Estesia performed comparatively well for all the explored groups. Around 84.6% of the patients endorsed that it was easy to use. Female patients with GD presented higher HRV during the use of the serious videogame compared to men. (shrink)

The general definition of mental disorder stated in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders seems to identify a mental disorder with a harmful dysfunction. However, the presence of distress or disability, which may be bracketed as the presence of harm, is taken to be merely usual, and thus not a necessary requirement: a mental disorder can be diagnosed as such even if there is no harm at all. In this paper, we focus on the (...) harm requirement. First, we clarify what it means to say that the harm requirement is not necessary for defining the general concept of mental disorder. In this respect, we briefly examine the two components of harm, distress and disability, and then trace a distinction between mental disorder tokens and mental disorder types. Second, we argue that the decision not to regard the harm requirement as a necessary criterion for mental disorder is tenable for a number of practical and theoretical reasons, some pertaining to conceptual issues surrounding the two components of harm and others pertaining to the problem of false negatives and the status of psychiatry vis-à-vis somatic medicine. However, we believe that the harm requirement can be maintained among the specific diagnostic criteria of certain individual mental disorders. More precisely, we argue that insofar as the harm requirement is needed among the specific diagnostic criteria of certain individual mental disorders, it should be unpacked and clarified. (shrink)

In the ongoing pandemic, death statistics influence people’s feelings and government policy. But when does COVID-19 qualify as the cause of death? As philosophers of medicine interested in conceptual clarification, we address the question by analyzing the World Health Organization’s rules for the certification of death. We show that for COVID-19, WHO rules take into account both facts and values.

This study explores the intra-organizational antecedents of sustainable governance by examining the impact of female presence at the corporate apex. Drawing upon the upper echelon theory, we investigate whether women in top positions influence sustainable governance practices. Our research focuses on a sample of companies operating within two distinct market economies: liberal market economies (LMEs) and coordinated market economies (CMEs). The United States, represented by the S&P100, and the United Kingdom, represented by the FTSE100, serve as examples of LMEs. Conversely, (...) Germany (DAX30), France (CAC40), Spain (IBEX35), and Switzerland (SMI) are illustrative of CMEs. Analyzing archival data spanning from 2010 to 2019, we confirm that the presence of a critical mass of women on the board of directors significantly increases the likelihood of establishing a sustainability committee within organizations. This relationship holds true across both LMEs and CMEs, highlighting the universal importance of gender diversity in driving sustainable governance initiatives. Interestingly, we observe that the impact of women with structural power on sustainability committee formation is specific to LMEs, suggesting the context-dependent nature of female leadership in sustainable governance. (shrink)

The diagnosis of idiopathic short stature refers to children who are considerably shorter than average without any identified medical reason. The US Food and Drug Administration authorised marketing of recombinant human growth hormone for ISS in 2003, while the European Medicines Agency refused it in 2007. This paper examines the arguments for these decisions as detailed in selected FDA and EMA documents. It combines argumentative analysis with an approach to policy analysis called ‘What’s the problem represented to be’. It argues (...) that the FDA presents its approval as an argument for equity of access to the treatment, describing short stature as a potential disadvantage, and assuming that height normalisation is a clinically meaningful result. The EMA, instead, refuses marketing authorisation with an argument that there is an imbalance of risks and benefits, describing ISS as a healthy condition, and arguing that hGH should provide some psychosocial and/or quality of life benefits to children with ISS other than height gain. This paper then discusses how these arguments could be read through different models of disability, particularly through the medical model of disability and the relational, experiential, and cultural understandings of disability. (shrink)

Nos complace presentar este número especial de la Revista Las Torres de Lucca, dedicado íntegramente a la investigación sobre injusticia epistémica. El proyecto de esta publicación se gestó entre 2017 y 2018, en conversaciones entre Cristina Bernabéu e Isabel Gamero; a las que luego se sumaron Alba Moreno y Llanos Navarro. Los directores de Las Torres de Lucca, Diego Fernández Peychaux y Juan Antonio Fernández Manzano, aceptaron la propuesta con interés. Estamos muy agradecidas a ambos por ello, así (...) como por el acompañamiento que nos han hecho durante todo el proceso, desde la publicación de la convocatoria hasta la conclusión del número que ahora presentamos. La motivación que subyace a este trabajo es el interés en la noción de injusticia epistémica, en la que encontramos una poderosa herramienta para visibilizar qué voces tienen más presencia en los distintos contextos sociales situados en los que participamos y qué prácticas habría que aplicar para lograr una distribución más justa de capacidades, tan básicas y cruciales, como las de dar testimonio y comunicar las propias experiencias. El debate sobre injusticia epistémica ha crecido significativamente a raíz de la publicación del libro de Miranda Fricker Epistemic Injustice. Desde entonces, la discusión se ha desarrollado sobre todo en el contexto de la epistemología social feminista y antirracista, aunque ha tenido otras ramificaciones. Este número en particular reúne una serie de trabajos que aplican la noción de injusticia epistémica, tal y como fue propuesta por Fricker, a ámbitos diversos de discusión, que incluyen el análisis jurídico, el análisis del discurso y la estrategia políticos o el desarrollo de formas de resistencia epistémica, y que abordan problemas como la atribución errónea de género ─conocida como misgendering por su voz inglesa─ y el fenómeno del silenciamiento. Nos satisface comprobar que el debate es tan rico en sus ramificaciones y aplicaciones, así como haber podido reunir una muestra de esta riqueza. (shrink)

En el presente artículo se analizan cinco modos de entender el ideal de completitud de los sistemas jurídicos, teniendo como punto de referencia las ideas de Carlos Alchourrón. En este trabajo se propone distinguir los criterios de identificación de los textos jurídicamente relevantes; los métodos o reglas que permiten pasar de un contenido C a un contenido C1, y los criterios de validez o pertenencia de normas al sistema. En la concepción predominante entre los teóricos del derecho, las reglas lógicas (...) sirven para justificar el paso de un contenido a otro, sin embargo, no se admiten como criterios de pertenencia de normas al sistema jurídico. Esto significa que el derecho no es concebido como un sistema deductivo y que un ideal de completitud absoluta es lógicamente posible. En el trabajo se llega a la conclusión de que hay sólo dos formas no banales de entender el ideal de completitud absoluta de los sistemas jurídicos. O bien, en un espíritu formalista, mediante la introducción de reglas residuales de clausura o bien, en un espíritu moralista, aceptando que la moral crítica funcione como criterio de pertenencia al derecho. This paper analyses five different ways of understanding completeness as an ideal of legal systems. In doing so it essentially relies on the thesis discussed by Carlos Alchourrón regarding this subject. The paper stresses the need to distinguish the criteria for the identification of the legally relevant texts, the methods or rules that justify the passage from a content C to another content C1 and, the criteria for the identification of valid norms belonging to the system. According to the dominant conception in legal theory, the rules of logic justify the passage from a content to another; such rules, however, are not accepted as membership criteria. This means that the notion of system that legal theorists use to organize the law is not the notion of a deductive system. In this conception the ideal of absolute completeness is a logically possible ideal. The conclusion reached in the article is that there are only two ways of understanding the ideal of "plenitude" or absolute completeness of a legal system: in a formalist view, through the introduction of residual rules of closure, or, in a moralistic view, by accepting critical morality as a criterium for legal validity. (shrink)

O objetivo deste artigo é entender a medida ou a importância da ética na concepção teórica de Jeremy Bentham. Para que fosse identificado o espaço desse tema nos escritos do autor, foi necessário estabelecer os limites entre a ética e a legislação, uma vez que, para alguns casos, quando a tendência geral do ato é má, torna-se desvantajosa a aplicação de penas formais restando espaço para as regras da ética, por meio da sanção moral. Em outras palavras, será possível compreender (...) que estudar o espaço da ética no sistema teórico de Bentham requer que sejam estabelecidos os limites entre a ética e a legislação. É tese deste trabalho que o próprio princípio de utilidade coloca a fronteira entre ambos os campos, pois, em última instância, é sempre efetuado um balanço entre prazer e dor ou custo e benefício para decidir sobre a necessidade de se formular regras para punir os agentes. Ou seja, a aplicação de punição a determinadas transgressões tende a gerar custos sociais mais elevados do que o benefício auferido, fazendo com que para alguns tipos de ofensas a legislação não deva ser aplicada, mas apenas as regras da ética. (shrink)

BackgroundThis study analyzed the difference in psychological distress of the healthcare workers in three different periods of the coronavirus disease 2019 (COVID-19) pandemic in Argentina. Specifically, from the third week of the mandatory quarantine through the two following weeks.MethodsAnalysis of the responses of 1,458 members of the health personnel was done on a questionnaire on healthcare workers concerns regarding the care of patients with coronavirus, indicators of depression, anxiety, intolerance of uncertainty, and coping.ResultsThe psychological indicators that were considered presented differences (...) between the evaluated periods. Perceived concerns about the possibility of infecting loved ones and infecting themselves were greatest in the periods after the onset of the pandemic. In addition, the perception of how the work environment worsened and how lack of sleep interfered with their work was also higher in periods 2 and 3. The same results were found in the indicators of depression, anxiety, and intolerance of uncertainty. Finally, the indicators of high tension and concurrent lack of emotional control, which was greater in the last periods evaluated, were also expressed in the coping strategies (showing emotional lability, only contained by hypercontrol).ConclusionThe differences found in the psychological indicators between the evaluated periods support the need for early psychological care of health personnel which should be a priority of public health and a fundamental fact to increase its immediate effectiveness in the care of infected patients. (shrink)

Genetic counselling is an important aspect of prenatal care in many developed countries. This tendency has also begun to emerge in Br.

Human experience has a symbolic structure. By focusing on the symbolism of human action, this essay considers the reciprocal influences and the essential differences between Paul Ricœur’s hermeneutics and Clifford Geertz’s cultural anthropology. Through reference to Ricœur’s Lectures on Ideology and Utopia, the section on “Ideology, Utopia, and Politics” in From Text to Action, and Geertz’s 1973 book The Interpretation of Cultures, this paper aims at reconstructing the dialogue between these thinkers. I begin with a broad framing of the encounter (...) between Ricœur and Geertz, and then turn to the notion of the symbolic mediation of action, considering it as the shared key concept between these authors. These reflections will lead to an examination of the semiotic conception of culture, opening up the discussion of a nonpejorative dimension of ideology. (shrink)

Introducción al dossier: “Revisitando el Cordobazo cincuenta años después”.

In 2003, the Food and Drug Administration approved the use of growth hormone treatment for idiopathic short stature children, i.e. children shorter than average due to an unknown medical cause. Given the absence of any pathological conditions, this decision has been contested as a case of medicalisation. The aim of this paper is to broaden the debate over the reasons for and against the treatment, to include considerations of the sociocultural phenomenon of the medicalisation of short stature, by means of (...) a critical understanding of the concept of medicalisation. After defining my understanding of medicalisation and describing both the treatment and the condition of idiopathic short stature, I will problematise two fundamental issues: the medical/non-medical distinction and the debate about the goals of medicine. I will analyse them, combining perspectives of bioethics, medical sociology, philosophy of medicine and medical literature, and I will suggest that there are different levels of normativity of medicalisation. Ultimately, this study shows that: the definition of idiopathic short stature, focusing only on actual height measurement, does not provide enough information to assess the need for treatment or not; the analysis of the goals of medicine should be broadened to include justifications for the treatment; the use of growth hormone for idiopathic short stature involves strong interests from different stakeholders. While the treatment might be beneficial for some children, it is necessary to be vigilant about possible misconduct at different levels of medicalisation. (shrink)

Los estudios realizados sobre la evaluación en la universidad muestran cómo aumenta el estrés emocional en periodos de exámenes y calificaciones. En un aprendizaje integral, la evaluación no puede depender de la nota de un examen. Las nuevas metodologías de enseñanza y aprendizaje buscan un acercamiento colaborativo entre profesor y estudiante, con una meta común: la evaluación integral del estudiantado. Los objetivos de este trabajo son comprobar si otro tipo de evaluación, más dinámica y democrática es posible. ¿La evaluación continua, (...) autoevaluación, coevaluación o heteroevaluación unida con la gamificación, evitarán enfrentamientos, situaciones de estrés y distanciamiento entre profesor y estudiante? (shrink)

Background: The intensive care unit environment focuses on interventions and support therapies that prolong life. The exercise by nurses of their autonomy impacts on perception of the role they assume in the multidisciplinary team and on their function in the intensive care unit context. There is much international research relating to nurses’ involvement in end-of-life situations; however, there is a paucity of research in this area in Brazil. In the Brazilian medical scenario, life support limitation generated a certain reluctance of (...) a legal nature, which has now become unjustifiable with the publication of a resolution by the Federal Medical Council. In Brazil, the lack of medical commitments to end-of-life care is evident. Objective: To understand the process by which nurses exercise autonomy in making end-of-life decisions in intensive care units. Research design: Symbolic Interactionism and Corbin and Strauss theory methodology were used for this study. Participants and research context: Data were collected through single audio-recorded qualitative interviews with 14 critical care nurses. The comparative analysis of the data has permitted the understanding of the meaning of nurse’s experience in exercising autonomy relating to end-of-life decision-making. Ethical considerations: Institutional ethics approval was obtained for data collection. Participants gave informed consent. All data were anonymized. Findings: The results revealed that nurses experience the need to exercise autonomy in intensive care units on a daily basis. Their experience expressed by the process of increase opportunities to exercise autonomy is conditioned by the pressure of the intensive care unit environment, in which nurses can grow, feel empowered, and exercise their autonomy or else can continuously depend on the decisions made by other professionals. Conclusion: Nurses exercise their autonomy through care. They work to create new spaces at the same time that they acquire new knowledge and make decisions. Because of the complexity of the end-of-life situation, nurses must adopt a proactive attitude that inserts them into the decision-making process. (shrink)

La discussione generale sulla filosofia della scienza contemporanea è complicata dal numero e dall’eterogeneità delle scienze, mentre lo studio di temi specifici porta inevitabilmente a dissertazioni specialistiche che mancano nel dare ragione della trama di senso sottostante. Questo Piccolo trattato di epistemologia intende occupare uno spazio vuoto, proponendo alcuni temi chiave per la comprensione dei meccanismi alla base della conoscenza scientifica: i rapporti tra filosofia e scienze, siano esse naturali o umane; la complessa relazione tra fatti e valori; la distinzione (...) tra scoperta e giustificazione; la necessità di un discorso etico sulla ricerca, che chiami in causa categorie come fiducia, empatia, altruismo ed egoismo. Con un approccio chiaro e rigoroso, il volume intende rivolgersi a quell’ampia fascia di pubblico interessata alle tematiche centrali dell’epistemologia, della filosofia e delle scienze. (shrink)

Reason and rationality represent crucial elements of the self-image of human beings and have unquestionably been among the most debated issues in Western philosophy, dating from ancient Greece, through the Middle Ages, and to the present day. Many words and thoughts have already been spent trying to define the nature and standards of reason and rationality, what they could or ought to be, and under what conditions something can be said to be rational. This volume focuses instead on the relationships (...) of reason and rationality to some relevant specific topics, i.e., science, knowledge, gender, politics, ethics, religion, aesthetics, language, logic, and metaphysics, trying to uncover and clarify both the connections and differences in their various characterisations and uses. (shrink)

Riassunto: In questo contributo analizzeremo il criterio del danno, presente nella definizione generale di disturbo mentale del DSM. La questione ha rilevanza sia da un punto di vista filosofico, perché il danno è una componente normativa e valoriale, non oggettiva, sia da un punto di vista clinico, perché chi ha difeso il criterio del danno ha spesso sostenuto che in sua assenza avremmo troppi falsi positivi. Infine, ha importanza dal punto di vista socio-sanitario in relazione al rapporto tra la psichiatria (...) e la medicina non psichiatrica, nello specifico tra il DSM e l’ICD. Sosterremo che ci sono buone ragioni per non mantenere il danno come criterio necessario nella definizione generale del disturbo mentale. Dopo una breve introduzione, forniremo una panoramica storica sul ruolo del criterio del danno nelle varie edizioni del DSM. Successivamente si illustrerà la principale obiezione contro l’inclusione del criterio del danno nella definizione generale di disturbo mentale, ossia il problema dei falsi negativi, per poi presentare e discutere ulteriori ragioni – medico-pratiche e concettuali – che depongono a sfavore dell’attribuzione di un forte peso al criterio del danno. In sede conclusiva ribadiamo come la decisione presa dalla task force del DSM-5 di escludere il criterio del danno dalla definizione generale di disturbo mentale debba essere sostenuta. Parole chiave: Danno; Disabilità; Disagio; Disturbo mentale; DSM “Harm” as Criterion for the Definition of Mental Disease in DSM. Some Epistemological Reflections: In this paper, we analyse the harm requirement in the general definition of mental disorder in the Diagnostic and Statistical Manual for Mental Disorders. This issue has both philosophical and clinical relevance: on the one hand the harm requirement is a normative, value-laden, non-objective component in the definition of mental disorder; on the other hand, the harm requirement has often been defended on the grounds that it prevents an increase in false positives. The issue is also important in assessing the relationship between psychiatry and somatic medicine, more precisely, between the DSM and the International Classification of Diseases. We argue that there are good reasons not to maintain the harm requirement in the general definition of mental disorder. After a brief introduction, we overview the history of the harm requirement across the various editions of the DSM. Then, we examine the main objection to the inclusion of the harm requirement in the general definition of mental disorder, that is, the problem of false negatives, and also present several other points – both practical and conceptual – that help demonstrate why the harm requirement is inadequate as a definiens of mental disorder. To conclude, we stress that the decision of the DSM-5 task force not to regard the harm requirement as a necessary component of mental disorder should be endorsed. Keywords: Harm; Disability, Distress; Mental Disorder; DSM. (shrink)

Background Only a few studies have been conducted to assess physicians’ knowledge of legal standards. Nevertheless, prior research has demonstrated a dearth of medical law knowledge. Our study explored physicians’ awareness of legal provisions concerning informed consent and confidentiality, which are essential components of the physician-patient relationship of trust. -/- Methods A cross-sectional study assessed attending physicians’ legal knowledge of informed consent and confidentiality regulations. The study was conducted in nine hospitals in Dolj County, Romania. Physicians were given a questionnaire (...) with ten scenarios and instructed to select the response that best reflected their practice. We assessed the responses of physicians who claimed their practice to be entirely legal. Their legal knowledge was evaluated by comparing their answers to applicable laws. We also calculated a score for the physicians who admitted to committing a legal breach. -/- Results Of the 305 respondents, 275 declared they never committed any law violation. However, their median correct answer score was 5.35 ± 1.66 out of 10. The specialty was the strongest predictor of legal knowledge, with emergency physicians rating the lowest and non-surgical physicians scoring the highest. Physicians who worked in both private and public sectors were better knowledgeable about legal issues than those who worked exclusively in the public sector. Results indicate that physicians are aware of the patient’s right to informed consent but lack comprehensive understanding. While most physicians correctly answered simple questions, only a tiny minority identified the correct solution when confronted with ethical dilemmas. The physicians who acknowledged breaching the law, on the other hand, had a slightly higher knowledge score at 5.45 ± 2.18. -/- Conclusion Legal compliance remains relatively low due to insufficient legal awareness. Physicians display limited awareness of legal requirements governing patient autonomy, confidentiality, and access to health data. Law should be taught in all medical schools, including undergraduate programs, to increase physicians’ legal knowledge and compliance. (shrink)

La posizione e il ruolo della filosofia nelle Università sono sempre stati oggetto di interesse, in particolare da parte dei detentori della disciplina, evidentemente convinti di un suo statuto speciale all’interno del percorso formativo. In questo articolo si prendono brevemente in esame le posizioni di alcuni filosofi che si sono esplicitamente esposti al riguardo, da Kant a Heidegger, da Ortega y Gasset a Martha Nussbaum, quali testimoni illustri dell’imprescindibilità dei contenuti e dei metodi della filosofia per ogni campo del sapere, (...) tanto più oggi, che l’utilità del pensiero umanistico viene disconosciuta in favore di una formazione sempre più tecnica e specializzata. (shrink)

Name der Zeitschrift: Nietzsche-Studien Jahrgang: 45 Heft: 1 Seiten: 221-221.