The content-analysis of the Russian federal and regional basic legislation on the cultural policy has indicated a need in a deep revision of all existing regulatory legal acts, which support the state cultural policy implementation towards building a universal terminology and vesting the functions on the cultural policy implementation in the government as opposed to the statement of the departmental specific approach to the culture.

We believe the dichotomy of processes introduced in the target article is highly speculative, because the dichotomy is shaped by the questionable assumption of modularity and the complementary assumption of locality. As a result, the author falls into a line of circular reasoning that biases his analysis of the experimental and neuropsychological data, and weakens the proposed model.

Zonulin is a physiological modulator of intercellular tight junctions, which upregulation is involved in several diseases like celiac disease (CeD). The polyQ gliadin fragment binds to the CXCR3 chemokine receptor that activates zonulin upregulation, leading to increased intestinal permeability in humans. Here, we report a general hypothesis based on the structural connection between the polyQ sequence of the immunogenic CeD protein, gliadin, and enteric coccidian parasites proteins. Firstly, a novel interaction pathway between the parasites and the host is described based (...) on the structural similarities between polyQ gliadin fragments and the parasite proteins. Secondly, a potential connection between coccidial infections as a novel environmental trigger of CeD is hypothesized. Therefore, this report represents a promising breakthrough for coccidian research and points out the potential role of coccidian parasites as a novel trigger of CeD that might define a preventive strategy for gluten‐related disorders in general. Also see the video abstract here: https://youtu.be/oMaQasStcFI. (shrink)

many symbols. We define o, as the probability that an arbitrary machine be circular and we prove that o, is a random number that goes beyond..

Cognitive Science, Volume 46, Issue 4, April 2022.

Background: Ethical competence in nursing practice helps clinical nurses to think critically, analyse issues, make ethical decisions, solve ethical problems and behave ethically in their daily work. Thus, ethical competence contributes to the promotion of high-quality care. However, studies on ethical competence in Malawi are scanty. Objectives: The aim of this study was to explore ethical competence among clinical nurses in selected hospitals in Malawi. Methodology: A cross-sectional survey was conducted in four selected hospitals in Malawi with a sample of (...) 271 clinical nurses. Data were collected using self-administered questionnaires, which included a Moral Competence Scale for Home Care Nurses. Descriptive statistics and logistic regression were computed for the dataset using STATA version 12.0. Ethical consideration: The study protocol complied with all ethical requirements and was approved by the College of Medicine Research Ethics Committee under the University of Malawi. Results: The clinical nurses in Malawi are ethically competent. However, there is a significantly high number (p 0.05). Three determinants of high ethical competence level (strong will, judgement skills and recognition of discrepancy of intention) were identified through a reduced model after stepwise logistic regression analysis. Furthermore, results show that indicators of ethical competence include caring, confidentiality and observance of nurses dressing code. The study has also confirmed that the Moral Competence Scale for Home Care Nurses is a reliable tool to assess ethical competence in low-resource settings. Conclusion: The majority of nurses who completed the survey had low ethical competence. However, clinical nurses with high ethical competence level are required to competently manage complex ethical challenges in health facilities. Strategies for enhancing ethical competence such as continuing ethics education, establishment of ethics committees and provision of supportive supervision are recommended to enable nurses in Malawi attain a high level of ethical competence. (shrink)

Deep brain stimulation (DBS) is a developing technology. New generations of DBS technology are already in the pipeline, yet this particular fact has been largely ignored among ethicists interested in DBS. Focusing only on ethical concerns raised by the current DBS technology is, albeit necessary, not sufficient. Since current bioethical concerns raised by a specific technology could be quite different from the concerns it will raise a couple of years ahead, an ethical analysis should be sensitive to such alterations, or (...) it could end up with results that soon become dated. The goal of this analysis is to address these changing bioethical concerns, to think ahead on upcoming and future DBS concerns both in terms of a changing technology and changing moral attitudes. By employing the distinction between inherent and noninherent bioethical concerns we identify and make explicit the particular limits and potentials for change within each category, respectively, including how present and upcoming bioethical concerns regarding DBS emerge and become obsolete. Many of the currently identified ethical problems with DBS, such as stimulation-induced mania, are a result of suboptimal technology. These challenges could be addressed by technical advances, while for instance perceptions of an altered body image caused by the mere awareness of having an implant may not. Other concerns will not emerge until the technology has become sophisticated enough for new uses to be realized, such as concerns on DBS for enhancement purposes. As a part of the present analysis, concerns regarding authenticity are used as an example. (shrink)

The case of Charlie Gard sparked an ongoing public and academic debate whether in court decisions about medical treatment for children in England & Wales the best interests test should be replaced by a harm threshold. However, the literature has scantly considered (1) what the impact of such a replacement would be on future litigation and (2) how a harm threshold should be introduced: for triage or as standard for decision-making. This article directly addresses these gaps, by first analysing reported (...) cases in England & Wales about medical treatment in the context of a S31 order, thus using a harm threshold for triage and second comparing court decisions about medical treatment for children in England & Wales based on the best interest test with Dutch and German case law using a harm threshold. The investigation found that whilst no substantial increase of parental discretion can be expected an introduction of a harm threshold for triage would change litigation. In particular, cases in which harm is limited, currently only heard when there are concerns about parental decision-making, may be denied a court hearing as might cases in which the child has lost their capacity to suffer. Applying a harm threshold for triage in decisions about withholding or withdrawing life-sustaining treatment might lead to a continuation of medical treatment that could be considered futile. (shrink)

En la atención médica y en la investigación en salud resulta indispensable favorecer la toma de decisiones de los pacientes y/o participantes bajo el principio de autonomía. En particular, esta capacidad, consignada en la Convención de los Derechos de las Personas con Discapacidad, se concreta mediante la detección de necesidades de asistencia, ajustes y apoyos que dan paso a una plena y efectiva capacidad de ejercicio. Las reflexiones bioéticas hechas desde la perspectiva principialista, personalista y de los Derechos Humanos ofrecen (...) elementos para potenciar la autonomía de las personas con discapacidad, promoviendo la figura de asistencia personal y enfatizando el interés superior, la gradualidad y la revisión judicial permanente como principios de figuras sustitutivas. (shrink)

This paper aims to investigate whether and in what respects the conceptions of the body and of agency that Judith Butler develops in Bodies That Matter are useful contributions to feminist theory. The discussion focuses on the clarification and critical assessment of the arguments Butler presents to refute the charges of linguistic monism and determinism.

The accepted view that Gassendi's ethics is a Christianized form of Epicureanism is incomplete: there is extensive and direct influence of Aristotle's works on the key concepts of Gassendi's ethics, while Epicurean ethics is itself largely informed by Aristotle's views. In the first part of this paper, the notion of freedom as choice informed by rational judgment is examined, and the foundation of Gassendi's intellectualist view of freedom is established in Aristotle's notion of prohairesis. In the second part, the nature (...) of happiness is examined, as well as the relationship between happiness and pleasure, and the contemplative as well as active components of happiness. The third part examines the significance of ethics as an ongoing activity of discernment and regulation of desires: the development of a "second nature" through habitual practice of virtues. The paper concludes with a brief consideration of Aristotle's influence on Gassendi's political philosophy. (shrink)

Purpose The purpose of this paper is to describe and explore the current state of internet regulation through content filters in Swedish public libraries. Design/methodology/approach Data was collected through an electronic survey directed to library managers of Sweden’s 290 main municipal libraries. 164 answers were returned, yielding a 57% response rate. The analysis comprises descriptive statistics for quantitative data and an activity theory approach with focus on contradictions for qualitative counterparts. Findings In total, 33% of the responding libraries report having (...) content filters; 50% have not; and a surprising 18% do not know. There is a strong correlation between internet misuse and positive attitudes towards filters, and, reversely, between lack of misuse and lack of active stances concerning filters. Rather than seeing this as weakness, the authors suggest that there is strength in a context-bound flexibility open to practical experience and weighting of values, ethics, legislation and local circumstances. More troublesome indications concern the high deferral of decision-making to local authorities (municipalities) whereby libraries are left with limited insight and influence. Research limitations/implications The situation calls for professional organisations to address political mandate questions, and educational programs to strengthen future information professionals’ knowledge of IT in general; filter issues in specific; and local authority decision-making. The study highlights the need of adequate information professional competences and mandates to decide on and oversee internet regulation. Originality/value To the best of the authors’ knowledge, this is the first internationally published study on content filters in Swedish public libraries. (shrink)

El canon literario implica un proceso de selección sistemático y jerárquico de escritores, obras y géneros con el fin de delimitar un corpus modélico imitableligado fuertemente a la instrucción pedagógica. En el presente trabajo se analizará el particular proceso de formación y conformación del canon –así como surecepción y transformación respecto de los cánones previos– establecido por Quintiliano en el Libro 10 de la Institutio Oratoria, a fin de demostrar que los criterios de selección que guían dicho canon exceden la (...) mera función didáctica. (shrink)

O filósofo da arte, Arthur Danto, propõe um sistema filosófico no qual a questão de saber o que é arte exerce uma função estrutural. No entanto, o que propomos aqui é uma espécie de recuo que se volta a uma questão de fundo: o que Danto entende por filosofia? Visto que o percurso, oferecido pelo autor, para responder à questão, passa pela aproximação entre filosofia e literatura, tentaremos explorar os limites entre essas duas práticas textuais e expor os passos argumentativos (...) através dos quais Danto pretende devolver à filosofia a complexidade que é aplainada pela prática acadêmica/filosófica da contemporaneidade, ao aproximar-se demasiadamente do modelo estabelecido pela prática científica. Para tanto, será necessário explorar – tanto na filosofia, quanto na literatura – o estatuto do estilo, o papel da semântica e a centralidade da figura do leitor, tomado como sujeito real no qual o texto realiza seu caráter transfigurativo. Por fim, não obstante a grande importância atribuída pelo autor à aproximação entre filosofia e literatura, a tarefa que se impõe é a de saber se restam, ainda, elementos característicos capazes de distingui-las. (shrink)

Las tecnologías se insertan en la innovación educativa, dando la posibilidad de incorporar herramientas digitales en los abordajes investigativos. En este escenario Scrivener y Evernote sonherramientas digitales para la escritura académica, permiten insertar notas escritas, notas de voz, resúmenes, documentos, imágenes, citas de autores, audios, links, entre otros. La formulación delproblema parte de la necesidad de incrementar investigaciones en todos los niveles educativos de forma fácil y automatizada. El objetivo de este estudio es reflexionar sobre el aporte significativo que poseen (...) las herramientas virtuales en la escritura académica. La metodología empleada está enmarcada dentro del paradigma cualitativo de tipo no experimental y documental, posee un muestreo probabilístico intencional de 57 fuentes documentales primarias que reúnen artículoscientíficos, libros, fuentes oficiales, informes técnicos, autores y organizaciones que respaldan las teorías de las herramientas digitales para sustentar de forma científica el artículo. La conclusiónradica en que las herramientas Scrivener y Evernote generan un aporte significativo al desarrollo de la escritura académica, logrando contribuir al impulso de la publicación de artículos académicos y científicos que, asociados a las tecnologías de la información y comunicación, promueven el desarrollo de este tipo de comunidades investigativas, para lograr una mayor optimización de recursos intelectuales como un desafío para potenciar la cultura académica. (shrink)

Given the costs of litigation high-profile court cases about withdrawing life-sustaining medical treatment for seriously ill children in England & Wales tend to be followed by discussion about how to avoid similar cases in future. Whilst two proposals, mediation and replacing the best interests standard with a harm threshold, have received broad attention, a proposal to replace the court by a specialist review committee has not been further investigated. This article analyses the effects of a putative replacement of the courts (...) by a specialist review committee using the process enacted by the futility clauses in the Texas Advance Directives Act (TADA) as a model. Under TADA life-sustaining treatment may legally be withdrawn when a review committee deems it futile and no alternative healthcare provider can be identified. The investigation finds that installing a national review committee with the power to decide whether life-sustaining treatment is futile would have reduced the number of court cases about withdrawal thereof in England & Wales to a handful over the last 3 decades. In addition to shorter procedures and costs savings, a national review committee modelled after TADA would have advantages for both clinicians and parents. Advantages for clinicians are more limited exposure to delivery of clinical care that may cause moral distress and less exposure to adverse press and social media content. Advantages for parents are that the process would establish them as ethical decision makers and offer the possibility of a transfer of the care of the child provided an alternative healthcare provider can be found. As such decisions taken by a specialist review committee may be more acceptable for parents than those of the courts. (shrink)

Does home-based family involvement influence academic performance? To answer this question, a case study research was carried out with 96 children from all six levels of primary education at a public school, and their families. Data regarding home-based family involvement were collected using a questionnaire. Academic achievement was measured from school marks. The results reveal that, apart from two of the factors considered, home–family involvement as a whole is not significantly related to academic achievement. These two factors are access to (...) informal education resources and parents’ employment. Family involvement related to the access of children to informal education resources is significantly related to a better academic achievement. Those students with both parents working perform best, and those with none working, worst. Although gender does not appear to significantly influence academic achievement and family involvement, the results show that girls attain better school performance and re... (shrink)

At the outset of an ethnographic inquiry, we navigated national and international resources to search for theoretical and practical guidance on obtaining parents and children’s informed consent/assent. While much theoretical guidance debating ethical issues to children’s participation in research was found, a paucity of published papers offering practical guidance on assent processes and/or visual representations of child assent forms and information sheets was discovered. The purpose of this article is to describe our experiences, both theoretically and practically, of negotiating the (...) process of obtaining informed consent and assent with parents and children for a non-therapeutic qualitative research study. We hope this article instigates a platform for others to explicate their experience and contributes to the construction of a coherent body of knowledge which will clearly delineate important elements that must be considered when negotiating children’s agreement to participate in research. (shrink)

O presente artigo parte da enunciação da tese de que são os tumultos uma das principais razões para o ordenamento republicano. A partir da análise do capítulo quatro do livro I dos Discursos sobre a primeira década de Tito Lívio, da autoria de Nicolau Maquiavel, é possível afirmar que a república, forma de governo que na tipologia maquiaveliana se opõe à monarquia ou principado, encontra na duplicidade dos humores existentes no tecido social a causa de sua liberdade, na medida em (...) que da tensão entre o desejo insaciável de poder dos grandes e o desejo popular de proteção contra a opressão enseja a criação de um espaço institucional propício para o exercício legislativo voltado para o bem comum. O campo da política deixa de ser observado enquanto obra da fortuna ou da virtù, tal como defendido pela tradição humanista, para ser analisado a partir da realidade social concreta. (shrink)

Background: Nurses are expected to provide comprehensive, holistic and ethically accepted care according to their code of ethics and practice. However, in Malawi, this is not always the case. This article analyses moral competence concept using the Walker and Avant's strategy of concept analysis. Objective: The aim of this article is to analyse moral competence concept in relation to nursing practice and determine defining attributes, antecedents and consequences of moral competence in nursing practice. Method: Analysis of moral competence concept was (...) done using Walker and Avant's strategy of concept analysis. Results: Deductive analysis was used to find the defining attributes of moral competence, which were kindness, compassion, caring, critical thinking, ethical decision making ability, problem solving, responsibility, discipline, accountability, communication, solidarity, honesty, and respect for human values, dignity and rights. The identified antecedents were personal, cultural and religious values; nursing ethics training, environment and guidance. The consequences of moral competence are team work spirit, effective communication, improved performance and positive attitudes in providing nursing care. Conclusion: Moral competence can therefore be used as a tool to improve care in nursing practice to meet patients' problems and needs and consequently increase public's satisfaction in Malawi. (shrink)

The introduction of new medical treatments based on invasive technologies has often been surrounded by both hopes and fears. Hope, since a new intervention can create new opportunities either in terms of providing a cure for the disease or impairment at hand; or as alleviation of symptoms. Fear, since an invasive treatment involving implanting a medical device can result in unknown complications such as hardware failure and undesirable medical consequences. However, hopes and fears may also arise due to the cultural (...) embeddedness of technology, where a therapy due to ethical, social, political and religious concerns could be perceived as either a blessing or a threat. While Deep Brain Stimulation (DBS) for treatment resistant depression (TRD) is still in its cradle, it is important to be proactive and try to scrutinize both surfacing hopes and fears. Patients will not benefit if a promising treatment is banned or avoided due to unfounded fears, nor will they benefit if DBS is used without scrutinizing the arguments which call for caution. Hence blind optimism is equally troublesome. We suggest that specificity, both in terms of a detailed account of relevant scientific concerns as well as ethical considerations, could be a way to analyse expressed concerns regarding DBS for TRD. This approach is particularly fruitful when applied to hopes and fears evoked by DBS for TRD, since it can reveal if our comprehension of DBS for TRD suffer from various biases which may remain unnoticed at first glance. We suggest that such biases exist, albeit a further analysis is needed to explore this issue in full. (shrink)

The presence of stigmatizing language in the electronic health record (EHR) has been used to measure implicit biases that underlie health inequities. The purpose of this study was to identify the presence of stigmatizing language in the clinical notes of pregnant people during the birth admission. We conducted a qualitative analysis on N = 1117 birth admission EHR notes from two urban hospitals in 2017. We identified stigmatizing language categories, such as Disapproval (39.3%), Questioning patient credibility (37.7%), Difficult patient (21.3%), (...) Stereotyping (1.6%), and Unilateral decisions (1.6%) in 61 notes (5.4%). We also defined a new stigmatizing language category indicating Power/privilege. This was present in 37 notes (3.3%) and signaled approval of social status, upholding a hierarchy of bias. The stigmatizing language was most frequently identified in birth admission triage notes (16%) and least frequently in social work initial assessments (13.7%). We found that clinicians from various disciplines recorded stigmatizing language in the medical records of birthing people. This language was used to question birthing people's credibility and convey disapproval of decision‐making abilities for themselves or their newborns. We reported a Power/privilege language bias in the inconsistent documentation of traits considered favorable for patient outcomes (e.g., employment status). Future work on stigmatizing language may inform tailored interventions to improve perinatal outcomes for all birthing people and their families. (shrink)

We live in dangerous times, ruled by the imperatives of what Hannah Arendt calls “the catastrophic interiority of the selfish I” 1 which threatens the planet and the survival of humanity. But I believe, nevertheless, that it is possible to reinvent the world since, by and large, it is evident that its shape reflects our notions of reality and value, the way we weave together the various strands of existence. Antonio Gramsci may have had something like this in mind when (...) he wrote that it is only by “the conquest of greater consciousness” that we will be able to bring a different kind of culture into being because, “man is above all spirit,” a creature, that is, with imagina- tion, the ability to reconfigure the way we see ourselves and the world. Just as importantly, he argues that this may mean returning to some things we once knew but have now forgotten or ignored. Poetry or, to be more accurate, poetic ways of seeing, may be one of these things, to the extent that it generates ways of seeing beyond the merely rational. In this essay I therefore want to explore the work of Judith Wright and the ways in which it explores the possibilities of being ‘true to the earth’. 2. (shrink)

Background Inadequate knowledge among health care providers (HCPs) and parents of affected children limits the understanding and utility of secondary genetic findings (SFs) in under-represented populations in genomics research. SFs arise from deep DNA sequencing done for research or diagnostic purposes and may burden patients and their families despite their potential health importance. This study aims to evaluate the perspective of both groups regarding SFs and their choices in the return of results from genetic testing in the context of orofacial (...) clefts.Methods Using an online survey, we evaluated the experiences of 252 HCPs and 197 parents across participating cleft clinics in Ghana and Nigeria toward the return of SFs across several domains.Results Only 1.6% of the HCPs felt they had an expert understanding of when and how to incorporate genomic medicine into practice, while 50.0% agreed that all SFs should be returned to patients. About 95.4% of parents were willing to receive all the information from genetic testing (including SFs), while the majority cited physicians as their primary information source (64%).Conclusions Overall, parents and providers were aware that genetic testing could help in the clinical management of diseases. However, they cited a lack of knowledge about genomic medicine, uncertain clinical utility, and lack of available learning resources as barriers. The knowledge gained from this study will assist with developing guidelines and policies to guide providers on the return of SFs in sub-Saharan Africa and across the continent. (shrink)

Hacking’s Law of Likelihood says – paraphrasing– that data support hypothesis H1 over hypothesis H2 whenever the likelihood ratio for H1 over H2 exceeds 1. But Hacking noted a seemingly fatal flaw in the LR itself: it cannot be interpreted as the degree of “evidential significance” across applications. I agree with Hacking about the problem, but I don’t believe the condition is incurable. I argue here that the LR can be properly calibrated with respect to the underlying evidence, and I (...) sketch the rudiments of a methodology for so doing. (shrink)

The aim of this study was to explore the existence of moral distress among nurses in Lilongwe District of Malawi. Qualitative research was conducted in selected health institutions of Lilongwe District in Malawi to assess knowledge and causes of moral distress among nurses and coping mechanisms and sources of support that are used by morally distressed nurses. Data were collected from a purposive sample of 20 nurses through in-depth interviews using a semi-structured interview guide. Thematic analysis of qualitative data was (...) used. The results show that nurses, irrespective of age, work experience and tribe, experienced moral distress related to patient/nursing care. The major distressing factors were inadequate resources and lack of respect from patients, guardians, peers and bosses. Nurses desire teamwork and ethics committees in their health institutions as a means of controlling and preventing moral distress. There is a need for creation of awareness for nurses to recognize and manage moral distress, thus optimizing their ability to provide quality and uncompromised nursing care. (shrink)