Propósito: la adecuación del esfuerzo terapéutico es una decisión clínica basada en la evidencia que pretende evitar la futilidad médica. Se han señalado diferentes factores que pueden influir en esta toma de decisiones los cuales se relacionan con el paciente, el profesional médico que toma de las decisiones, barreras del sistema, cultura y economía, entre otros. El presente estudio pretende identificar aquellos factores que influyen en los médicos especialistas que laboran en la institución referente del cáncer en Colombia, a fin (...) de planear acciones que mejoren el abordaje de la toma de decisiones con respecto a la adecuación del esfuerzo terapéutico en pacientes con cáncer. Metodología: diseño cualitativo basado en 13 entrevistas en profundidad a médicos especialistas del Instituto Nacional de Cancerología de Colombia. Resultados: participaron 3 mujeres y 10 hombres, con un promedio de edad de 36 años, 7 pertenecientes a la especialidad de oncología de adultos, 2 a oncohematología pediátrica, 1 a cuidados intensivos de adultos y 3 a cuidados intensivos pediátricos. Los factores hallados se agruparon en cuatro categorías: 1) conocimiento, 2) aspectos relacionados con la toma de decisiones, 3) quién decide, 4) tipo de decisión que se toma; a su vez, estas categorías se agruparon en temas que hacen alusión a los factores que influyen en la toma de decisiones de los especialistas para adecuar los esfuerzos terapéuticos. Conclusión: la adecuación de los esfuerzos terapéuticos es importante para evitar procedimientos médicos fútiles que prolonguen el sufrimiento. Se evidenciaron algunos factores que influyen en la toma de decisiones de los especialistas: falta de preparación de los profesionales de salud en el tema de toma de decisiones al final de la vida, uso reducido de escalas que permitan mejorar la información del pronóstico y desconocimiento sobre voluntades anticipadas; estos son algunos de aquellos factores que deben fortalecerse para generar acciones que mejoren el abordaje de esta temática. (shrink)

This research aims to fill a major gap in the relevant literature on small businesses in developing countries, specifically concerning the development of models to better explain economic and environmental performance as a result of environmental compliance, thus moving toward an explanation of the sustainable behavior of these businesses. Data from 186 pottery craft businesses located in three Mexican states (Oaxaca, Puebla and Tlaxcala) reveal that environmental compliance significantly influences economic and environmental performance, with the mediating role of environmental innovation, (...) confirming the Porter hypothesis in the context of small businesses in an emerging economy. Environmental compliance is an important factor in improving the economic and environmental performance of small businesses in emerging economies. (shrink)

Parent and preschool teacher ratings of the 10 noun categories of MacArthur-Bates Communication Development Inventory were used to study expressive language in 2–4-year-old children with autism spectrum disorder across the home and preschool context. There was no significant difference in the total number of words the children said in the two contexts, but the children said significantly more words in the noun categories “Furniture and rooms” and “People” at home. Only one third of the words the children said were said (...) both at home and in the preschool, while the other two thirds were said only at home or only in preschool. This suggests that what words the children use across contexts differ substantially and that their vocabulary is larger than it seems when measured only in one context. This novel study highlights the importance of assessing the language in children with ASD in multiple contexts in order to better measure their vocabulary and to design appropriate language interventions. (shrink)

La práctica profesional es el medio que permite a los estudiantes aplicar los conocimientos aprendidos durante su proceso de formación y fortalecer las competencias del saber, saber hacer y ser/convivir. El articulo sintetiza las características y procesos desarrollados desde el curso práctica profesional en la Corporación Universitaria del Caribe en pandemia. En tanto, el proceso de práctica se adaptó a la contingencia adoptando nuevas modalidades de realización de práctica a nivel institucional (telepráctica, trabajo en casa, práctica asesor/tutor, investigación, emprendimiento y (...) telepsicología) para garantizarle a los estudiantes el espacio pedagógico que permitiera poner en práctica sus conocimientos y competencias disciplinares. (shrink)

Los canales de YouTube, Alanna y WITCHYSOFFIE, enseñan al espectador sobre hechicería y tradiciones paganas. Estas se oponen a la estigmatización, el tótem patriarcal y los tabúes religiosos generados por la Inquisición los cuales aún son mantenidos por una parte de la sociedad actual. La magia de varios grupos wiccanos se encamina hacia la espiritualidad y alabanza de un Dios creador, algo semejante con la filosofía católica. De igual forma, su estudio por la naturaleza y su aplicación en rituales se (...) enfocan en el autoconocimiento y la conexión con el universo. Los factores como la globalización y modernización actúan de manera crucial en las impresiones colectivas que se tiene sobre la brujería. (shrink)

Background: Frailty is a common syndrome among older adults and patients with several comorbidities. Grip strength is a representative parameter of frailty because it is a valid indicator of current and long-term physical conditions in the general population and patients with severe mental illnesses. Physical and cognitive capacities of people with SMIs are usually impaired; however, their relationship with frailty or social functioning have not been studied to date. The current study aimed to determine if GS is a valid predictor (...) of changes in cognitive performance and social functioning in patients with type-2 diabetes mellitus and SMIs. Methods: Assessments of social functioning, cognitive performance, and GS were conducted in 30 outpatients with type 2 diabetes mellitus, 35 with major depressive disorder, 42 with bipolar disorder, 30 with schizophrenia, and 28 healthy controls, twice during 1-year, follow-up period. Descriptive analyses were conducted using a one-way analysis of variance for continuous variables and the chi-squared test for categorical variables. Differences between groups for the motor, cognitive, and social variables at T1 and T2 were assessed using a one-way analysis of covariance, with sex and age as co-variates. To test the predictive capacity of GS at baseline to explain the variance in cognitive performance and social functioning at T2, a linear regression analysis was performed. Results: Predictive relationships were found among GS when implicated with clinical, cognitive, and social variables. These relationships explained changes in cognitive performance after one year of follow-up; the variability percentage was 67.7%, in patients with type-2 diabetes mellitus and 89.1% in patients with schizophrenia. Baseline GS along with other variables, also predicted changes in social functioning in major depressive disorder, bipolar disorder, and schizophrenia, with variability percentages of 67.3, 36, and 59%, respectively. Conclusion: GS combined with other variables significantly predicted changes in cognitive performance and social functioning in people with SMIs or type-2 diabetes mellitus. Interventions aimed to improve the overall physical conditions of patients who have poor GS could be a therapeutic option that confers positive effects on cognitive performance and social functioning. (shrink)

Esta revisión narrativa aborda la evolución histórica y legal de las voluntades anticipadas a nivel global y local desde su surgimiento. Parte del principio de autonomía en la bioética moderna y su relación con la vulnerabilidad del paciente, así como la consideración de la muerte por parte de los profesionales de la salud. Destaca el papel esencial del documento de voluntades anticipadas como una herramienta valiosa en la relación médico paciente-familia, siendo fundamental para comprender la perspectiva del paciente. Se define (...) el documento considerando la literatura médica y se discute su aplicación, subrayando la importancia de no esperar hasta un deterioro clínico avanzado para su implementación. La revisión también examina la legislación nacional e internacional, así como el conocimiento médico actual, con el objetivo de facilitar decisiones consensuadas entre todas las partes involucradas en el cuidado del paciente. (shrink)

This paper focuses on the description and analysis of three codices from Biblioteca Nacional in Madrid with the aim of redefining their origin, dating, authorship, and content. Connecting their production to the environment of the Sacromonte affair and identifying Pedro de Castro’s hand allows to expand what was known so far about his attempts to learn Arabic and delve into the most controversial aspects of the Lead Books. The grammatical and religious contents, in addition to the copious marginal notes linked (...) to the sources he used, provide valuable information on his selection of works. Grammatical materials such as al-Āŷurrūmiyya, of which different versions are preserved in these codices, were being published in Rome and Leiden and would be widely disseminated. The building up of his library, to which these codices must have belonged, runs in parallel to the construction of an orientalist knowledge in modern Europe. (shrink)

This paper aims to offer an analysis of the critique of reason developed by Max Horkheimer and Theodor W. Adorno in three of his most important books: Dialectic of Enlightenment, The critique of instrumental reason and Minima Moralia. Two fundamental questions are posed: Does the thought of the authors set a radical critique? If this is the case, wouldn't it imply a series of meta theorical problems and contradictions? In order to treat these questions, the statement is divided into two (...) parts. The first explores the recurring issues of the critique of reason. In the second, we elaborate a brief reconstruction of two opposite hermeneutics of Horkheimer and Adorno's works: on the one hand, the lecture of Frankfurt School's second generation ; on the other hand, Juan José Sánchez's exposition. Our principal contribution to this debate is to warn Sánchez that, in his justified intention of separating from Habermas and postmodern's reading, he finally weakens the contradictory and negative tone of Adorno and Horkheimer's philosophy.La temática que se aborda en este artículo es la crítica a la razón elaborada por Max Horkheimer y Theodor W. Adorno en tres obras fundamentales: Dialéctica de la Ilustración, Crítica de la razón instrumental y Minima Moralia. Las preguntas que se buscan responder son las siguientes: ¿Constituye el pensamiento conjunto de los autores una crítica radical? Si así fuera, ¿no implicaría una serie de problemas meta teóricos y contradicciones ? El escrito se divide en dos partes. En la primera se abordan los motivos recurrentes de la crítica a la razón. En la segunda, se elabora una sucinta reconstrucción de dos interpretaciones contrapuestas de las obras mencionadas: por un lado, la de los miembros de la segunda generación de la Escuela de Frankfurt, en particular la de Jürgen Habermas y la de Albrecht Wellmer; por otro lado, la del comentarista español Juan José Sánchez. El aporte teórico de este artículo consiste en advertirle a este último autor que, en su justificado afán de distanciarse de la lectura habermasiana y de la postmoderna, termina debilitando el tono contradictorio y negativo de la filosofía conjunta de Adorno y Horkheimer. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Full Collection of Personal NarrativesGianna O'Leary, Paul Hostovsky, Yilu Ma, Leo Almazan, Hilda Sanchez-Herrera, Marisa Rueda Will, Elaine Hsieh, Manuel Patiño, Felicity Ratway, Liliana Crane, Laisson DeSouza, Nilsa Ricci, Linda Pollack-Jackson, Kelley Cooper, Mateo Rutherford-Rojas, Rosa C. Moreno, Maja Milkowska-Shibata, Patricia Coronado, and Catalina Meyer• A Day in the Life of a Spanish Interpreter• Deaf Interpreter• "Call me Dr. XXX!"• Translating Care for the Voiceless Patient• Are We (...) There Yet? A Narrative of Firsthand Interpreter Experiences in the Medical Field and Insights to Aid Language Access Compliance• One Interpreter's Journey of Interpreting for Pregnancy Loss• More Than Words: Communicating for the Quality of Care• From Linguistic Bridge Builder to Aspiring Physician• Towards Language Justice: A Call to Identify and Overcome Structural Barriers• Voices in the Shadows: The Hidden Complexities of Being a Medical Interpreter• The Voice of Patients: The Exclusive Work of a Human Who Can Advocate• Don't Mute the Messenger• The Ramp and the Stop Sign• How Policies and Practices in Medical Settings Impact Communication Access with Deaf Patients and Caregivers• And When May I Cry? Juggling Emotions in Healthcare Interpreting• To Engage or Not to Engage: An Interpreter and a Mother's Need for Connection in the Cardiothoracic Unit• Witnessing Trauma: Emotional Challenges in Medical Interpretation• Being an Interpreter—Beyond Linguistics• 1-800-Quit-NowCopyright © 2024 Johns Hopkins University Press... (shrink)

Tuberculosis en América Latina y el Caribe: reflexiones desde la bioética Tuberculose na América Latina e no Caribe: reflexões da bioética The objective of this article is to analyze the conditions of access to health services by people with tuberculosis in Latin America and the Caribbean, reflecting on the public health aspects involved from a bioethical perspective. A literature review of the context of tuberculosis in LAC based on epidemiological data was performed. The results were analyzed from its relationship with (...) the social determinants of health and the ethical principles that guide medical practice. Tuberculosis is a pressing public health problem in the region because of its family, social, economic and health impact. It mainly affects vulnerable individuals and populations. Health services violate ethical principles. Tuberculosis is a serious ethics and public health problem in the region that causes death, disability and increased poverty. It is imperative to ensure the right to health services and to understand the individual and public health consequences of non-adherence to treatment. It is important that national tuberculosis control strategies include principles of dignity and non-discrimination of the sick, changes in the social determinants of the disease, and respect for the ethnicity, language culture and identity of patients. Para citar este artículo / To reference this article / Para citar este artigo Muñoz del Carpio-Toia A, Sánchez-Pérez HJ, Verges de López C, López-Dávila LM, Sotomayor-Saavedra MA, Sorokin P. Tuberculosis en América Latina y el Caribe: reflexiones desde la bioética. pers. bioét. 2018; 22: 331-357. DOI: 10.5294/pebi.2018.22.2.10. (shrink)

¿El conflicto armado ha transformado los roles de la mujer en Colombia? En este artículo se quiere evaluar la diversidad de escenarios y roles que las mujeres adquirieron durante el conflicto armado en Colombia. Para dirigir el rumbo de esta investigación y la posibilidad de evaluar alguno escenarios de posacuerdo, este texto se propone: realizar una consideración epistemológica por parte del feminismo latinoamericano que tenga en cuenta la pluralidad de relatos violentos en Latinoamérica analizar relatos de mujeres partícipes en la (...) guerra que permitan evaluar el rol de la mujer más allá de su simple victimización; examinar la situación de la mujer dentro de los conflictos bélicos colombianos y presentar cómo se diferencia de las situaciones de guerra ocurridas en Europa. Todos estos puntos permiten evaluar cómo la guerra en Colombia ha sido fundamental para contemplar los roles de las mujeres más allá del de víctima, como, por ejemplo, las mujeres activistas que han participado en la reconciliación y el ejercicio de memoria histórica durante el acuerdo de paz y el posacuerdo. Dicho logro promueve un porvenir del feminismo que abre nuevos espacios de acción para la mujer, los cuales, debido a la limitación de este trabajo, quedan aún por explorar. (shrink)

José Echegaray y Eizaguirre (Madrid, 19 de abril de 1832-Madrid, 14 de septiembre de 1916) fue un personaje polifacético. Ingeniero de Caminos, matemático, físico-matemático, divulgador científico, dramaturgo, economista y político, alcanzó en todas estas actividades renombre: número 1 de su promoción en la Escuela de Ingenieros de Caminos, más tarde profesor en ella de diversas materias (como cálculo y mecánica), ministro primero de Fomento y de Hacienda después, ateneísta distinguido, figura prominente en la creación —con, esencialmente, las funciones que (...) hoy desempeña- del Banco de España, académico de Ciencias y de la Española, presidente del Ateneo,…. (shrink)

En este artículo se estudia la aparición, auge y colapso de la inédita experiencia de democracia liberal partitocrática en Bolivia (1985-2006), a través de la trayectoria de dos movimientos autoidentificados como izquierdistas, el Movimiento de Izquierda Revolucionaria (1971), de Jaime Paz Zamora, última y más grande manifestación de la «izquierda patricia» boliviana, y el Movimiento al Socialismo (1997), de Evo Morales, vehículo político de la renacida oposición sindical rural al sistema vigente. También se exploran las causas de su colapso; (...) a saber: el crecimiento de las expectativas y el malestar de los sectores urbanos; la reactivación de la tradición sindical militante, en una versión más dinámica y mejor organizada, y, en el plano de la cultura política, la difusión y generalización del katarismo y sus variaciones indianistas. (shrink)

Introducción: El dormir mal podría ser la causa de hipertensión arterial y de otras enfermedades crónicas no transmisibles.Objetivo: Conocer la calidad de sueño de las personas con hipertensión arterial.Metodología: Se realizo un estudio descriptivo, se aplico el cuestionario de Índice de Calidad de Sueño de Pittsburgh.Resultados: Se evaluó la calidad de sueño en 85 personas con hipertensión arterial, de abril a diciembre del 2021. El 84% tiene un índice de mala y muy mala calidad de sueño.Conclusión: Las personas con (...) hipertensión con mala y muy mala calidad de sueño puede afectar sus cifras de tensión arterial. (shrink)

El desarrollo de la ciencia y la tecnología y de las competencias técnicas ha impulsado el desarrollo de las sociedad haciéndolas más complejas, causando que las aptitudes emocionales se conviertan en factores de éxito, ya que afectan el desempeño humano en todos los escenarios donde se desenvuelve, no obstante a pesar de las investigaciones en este área, actualmente no se cuenta con modelos que relacionen dichas aptitudes con el rendimiento organizacional, lo cual dio origen a esta investigación que busca determinar (...) el impacto de dichas competencias en la ejecución de proyectos en la empresa ENGISERV VENEZUELA C.A. Para realizar el estudio la metodología usada considero que se trata de una investigación de campo, no experimental y transversal. La población fue de 35 expertos en proyectos y la muestra se seleccionó por el método probabilístico aleatorio simple, Concluyéndose que las competencias emocionales afectan el rendimiento de los proyectos cerca 83,4%. Palabras Clave: Inteligencia emocional, competencias emocionales, rendimiento de proyectos. Referencias [1]J. García. «Caminos de la reflexión La teoría Orteguiana de las ideas y las creencias en el contexto de la escuela de Madrid».Edición 8, España: Biblioteca Nueva 2009. [2]D. McClelland. «Testing for Competencies rather than intelligence». American Psychologist. Edicion 1, NewYork, Harvard University 1973. [3]Levy-Leboyer, Claude. «Gestión de las Competencias».Edición 1, Ediciones Gestión 2000. Barcelona, España 1997. [4]R. Bisquerra. “Educación emocional y competencias básicas para la vida”. RIE, vol 21, pp. 1, 7-43. Junio 2003. [5]R. Fragoso "Inteligencia emocional y competencias emocionales en educación superior, ¿un mismo concepto?” RIES, vol. VI, no. 16, pp.110-125. Marzo 2015. [6]J. Sánchez “La competencia emocional en la escuela: una propuesta de organización dimensional y criterial”, RFEA. vol. 25, pp. 79-96, Abril 2010”. [7]Goleman, D. «Working with emotional intelligence». Bantam. 1998. [8]M. Vivas "La educación emocional: conceptos fundamentales." RUI, vol. 4, no. 2, pp.1-21. Agosto.2003. [9]W. Pinkerton. «Project management achieving project bottom-line success», Edicion 1, Pennsylvania Mc-Graw-Hill, 2003. [10]D. Goleman. «Inteligencia emocional en la empresa» Barcelona, España. Editorial Kairós, 2018. [11]C. Michelena. «Estrategias para la elaboración de un proyecto de investigación». Caracas: Insertos Médicos de Venezuela, 2004. [12]R. Sierra. «Técnicas de Investigación Social». Buenos Aires: Editorial Paraninfo.1992. [13]P. Baptista. C. Fernández y R Hernández. “Metodología de la investigación”. México DF: McGraw–Hill.2010. [14]M. Carbonero. “Formación inicial docente y competencias emocionales”: Educ. Pesqui. vol.45. pp.3-20 Abril, 2019. [15]American Management Association. «Leading with emotional intelligence», Nueva York, AMA 2012. (shrink)

Introduction to the Institutional Logics Perspective -- Precursors to the Institutional Logics Perspective -- Defining the Inter-institutional System -- The Emergence, Stability and Change of the Inter-institutional System -- Micro-Foundations of Institutional Logics -- The Dynamics of Organizational Practices and Identities -- The Emergence and Evolution of Field-Level Logics -- Implications for Future Research.

Introduction : schizoanalysis, digital screens and new brain circuits -- Schizoid minds, delirium cinema and powers of machines of the invisible -- Illusionary perception and powers of the false -- Surveillance screens and powers of affect -- Signs of time : meta/physics of the brain-screen -- Degrees of belief : epistemology of probabilities -- Powers of creation : aesthetics of material-force -- The open archive : cinema as world-memory -- Divine in(ter)vention : micropolitics and resistance -- Logistics of perception 2.0 (...) : multiple screens as affective weapons -- Conclusion : the neuro-image : brain-screens from the future. (shrink)

This paper presents a pilot study that explores instances of objectless awareness during sleep: conscious experiences had during sleep that prima facie lack an object of awareness. This state of objectless awareness during sleep has been widely described by Indian contemplative traditions and has been characterised as a state of consciousness-as-such; while in it, there is nothing to be aware of, one is _merely_ conscious (cf. Evans-Wentz, 1960 ; Fremantle, 2001 ; Ponlop, 2006 ). While this phenomenon has received different (...) names in the literature, such as ‘witnessing-sleep’ and ‘clear light sleep’ among others, the specific phenomenological profile of this state has not yet been rigorously studied. This paper aims at presenting a preliminary investigation of objectless consciousness during sleep using a novel tool in qualitative research that can guide future research. Five participants experiencing objectless consciousness during sleep were interviewed following the _Micro-phenomenological Interview_ technique (MPI; Petitmengin, 2005, 2006 ). All participants reported an experience they had during sleep in which there was no scenery and no dream. This period labelled as ‘No Scenery/Void’ was either preceded by the dissolution of a lucid dream or by other forms of conscious mentation. The analysis of the results advances four experiential dimensions during this state of void, namely (1) Perception of absence, (2) Self-perception, (3) Perception of emotions, and (4) Perception of awareness. While the results are primarily explorative, they refer to themes found in the literature to describe objectless sleep and point at potential avenues of research. The results from this study are taken as indications to guide future operationalisations of this phenomenon. (shrink)

In this chapter, I defend a pluralistic approach to intertheoretic reduction, in which reduction is not understood in terms of a single philosophical “generalized model”, but rather as a family of models that can help achieve certain epistemic and ontological goals. I will argue then that the reductive model (or combination of models) that best suits to a particular case study depends on the specific goals that motivate the reduction in the intended case study.

In Nicomachean Ethics 7.7 (= Eudemian Ethics 6.7), Aristotle distinguishes softness (malakia) from lack of self-control (akrasia) and endurance (karteria) from self-control (enkrateia). This paper argues that unqualified softness consists of a disposition to give up acting to avoid the painful toil (ponos) required to execute practical resolutions, and (coincidentally) to enjoy the pleasures of rest and relaxation. The enduring person, in contrast, persists in her commitments despite the painful effort required to enact them. Along the way, I argue that (...) this interpretation qualifies our understanding of the pleasures and pains with which temperance and intemperance are concerned. (shrink)

It is commonly thought that that the best system account of lawhood ((Mill (1843), Ramsey (1978)[fp. 1928], Lewis (1973)) makes available a nice explanation for why laws are ‘distinctively appropriate targets of scientific inquiry’ (Hall, 2015). The explanation takes the following general form: laws are especially valuable for agents like us because they efficiently encode a lot of valuable (non-nomic) information in a tractable format. The goal of this paper is to challenge this style of explanation: I argue that the (...) general principle it presupposes is in conflict with our best account of practical rationality. After considering and rejecting a number of proposals for dissolving the tension, I conclude that BSA proponents may need to scale back the explanatory ambitions of their theory; in particular, they may need to give up the hope of non-circular explanations of the value of nomic information. I end by outlining some challenges for the humean world-view that results after this shift. (shrink)

Studies on informed consent to medical research conducted in low or middle-income settings have increased, including empirical investigations of consent to genetic research. We investigated voluntary participation and comprehension of informed consent among women involved in a genetic epidemiological study on breast cancer in an urban setting of Nigeria comparing women in the case and control groups.

Via a close reading of The Ethics of Ambiguity and The Second Sex, this chapter examines how Simone de Beauvoir's analogical thinking about race and gender shape her arguments concerning oppression and freedom. First, Beauvoir uses gender as an analytical category to examine women's oppression. In contrast, Beauvoir uses race, age, class and ethnicity as descriptive experiences that provide evidence for her analysis of women's oppression. Second, Beauvoir's analysis of women's oppression relies on an uncritical analogical method to develop arguments (...) about gender oppression, with the race/gender analogy granted special prominence. Third, the substance of Beauvoir's analogies undermines her theory of existentialist freedom: manipulating root metaphors that depict Black people as silent slaves or non‐independent women as complicit in their own subordination makes existential freedom difficult if not impossible for the majority of human beings. (shrink)

There is a well-known scene from The Adventures of Tom Sawyer that illustrates what might be considered benign manipulation: Tom has the job of whitewashing a fence but would rather spend the time with friends. By feigning enthusiasm for the job he manages to get his friends to hang around and do it for him. They even pay to do it - with various little items that he later trades for..

A recent special issue in the Journal of Business Ethics gathered together a variety of papers addressing the challenges of putting virtue ethics into practice :563–565, 2013). The editors prefaced their outline of the various papers with the assertion that exploring the practical dimension of virtue ethics can help business leaders discover their proper place in working for a better world, as individuals and within the family, the business community and society in general :563–565, 2013). Scholars are yet to explore (...) the role of virtuous organisational leaders in the pursuit of Eudaimonia. This paper is a qualitative study which considered company directors’ self-understandings in light of a virtue ethics conceptual framework. The aim of the study is to explore whether virtue ethics rather than deontology and consequentialism is a better vehicle for expressing directors’ self-understandings about their ideals and role. (shrink)

This book explores Gilles Deleuze's contribution to film theory. According to Deleuze, we have come to live in a universe that could be described as metacinematic. His conception of images implies a new kind of camera consciousness, one that determines our perceptions and sense of selves: aspects of our subjectivities are formed in, for instance, action-images, affection-images and time-images. We live in a matrix of visual culture that is always moving and changing. Each image is always connected to an assemblage (...) of affects and forces. This book presents a model, as well as many concrete examples, of how to work with Deleuze in film theory. It asks questions about the universe as metacinema, subjectivity, violence, feminism, monstrosity, and music. Among the contemporary films it discusses within a Deleuzian framework are Strange Days, Fight Club, and Dancer in the Dark. (shrink)

This paper focuses on the cognitive/computational and evolutionary levels. It describes three proposals to make cognition computationally tractable, namely: Resource Rationality, the Adaptive Toolbox and Massive Modularity. While each of these proposals appeals to evolutionary considerations to dissolve the intractability of cognition, Rich, Blokpoel, de Haan, and van Rooij argue that, in each case, the intractability challenge is not resolved, but just relocated to the level of evolution.

A medical information commons is a networked data environment utilized for research and clinical applications. At three deliberations across the U.S., we engaged 75 adults in two-day facilitated discussions on the ethical and social issues inherent to sharing data with an MIC. Deliberants made recommendations regarding opt-in consent, transparent data policies, public representation on MIC governing boards, and strict data security and privacy protection. Community engagement is critical to earning the public's trust.

We describe and analyze 13 cases handled by our ethics consultation service (ECS) in which families requested continuation of physiological support for loved ones after death by neurological criteria (DNC) had been declared. These ethics consultations took place between 2005 and 2013. Patients’ ages ranged from 14 to 85. Continued mechanical ventilation was the focal intervention sought by all families. The ECS’s advice and recommendations generally promoted “reasonable accommodation” of the requests, balancing compassion for grieving families with other ethical and (...) moral concerns such as stewardship of resources, professional integrity, and moral distress. In cases we characterized as finitegoal accommodation, a “reasonable accommodation” strategy proved effective in balancing stakeholders’ interests and goals, enabling steady progress toward resolution. When a family objected outright to a declaration of DNC and asked for an indefinite accommodation, the “reasonable accommodation” approach offered clinicians little practical direction, and resolution required definitive action by either the family or the clinical team. Based on our analysis and reflections on these 13 cases, we propose ethically justified and practical guidelines to assist healthcare professionals, administrators, and ECSs faced with similar cases. (shrink)

BackgroundInformed consent is a key element of ethical clinical research. Addicted population may be at risk for impaired consent capacity. However, very little research has focused on their comprehension of consent forms. The aim of this study is to assess the capacity of addicted individuals to provide consent to research.Methods53 subjects with DSM-5 diagnoses of a Substance Use Disorder and 50 non psychiatric comparison subjects participated in the survey from December 2014 to March 2015. This cross-sectional study was carried out (...) at a community-based Outpatient Treatment Center and at an urban-located Health Centre in Spain. A binary judgment of capacity/incapacity was made guided by the MacArthur Competence Assessment Tool for Clinical Research and a clinical interview. Demographics and clinical characteristics were assessed by cases notes and the Mini-Mental State Examination, the Global Assessment Functional Scale and the Clinical Global Impression Scale.ResultsNPCs performed the best on the MacCAT–CR, and patients with SUD had the worst performance, particularly on the Understanding and Appreciation subscales. 32.7 % SUD people lacked research-related decisional capacity. There were no statistically significant differences between the groups in terms of capacity to consent to research.ConclusionsThe findings of our study provide evidence that a large proportion of individuals with SUD had decisional capacity for consent to research. It is therefore inappropriate to draw conclusions about capacity to make research decisions on the basis of a SUD diagnosis. In the absence of advanced cognitive impairment, acute withdrawal or intoxication, we should assume that addicted persons possess decision-making capacity. Thus, the view that people with SUD would ipso facto lose decision-making power for research consent is flawed and stigmatizing. (shrink)

This essay presents some thoughts on schizoanalysis and visual culture around the proposition that cinema survives in the digital age as a type of image that, after the movement-image and the time-image, could be called the neuro-image. By considering clinical schizophrenia as ‘degree zero’ of schizoanalysis in a more critical sense, a reading of The Butterfly Effect unfolds the temporal dimensions of schizoanalysis as typical for a definition of ‘the neuro-image’. The argument is that the neuro-image speaks from the (always (...) speculative) future. (shrink)