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Background: Moral distress is a kind of suffering that nurses may experience when they act in ways that are considered inconsistent with moral values, leading to a perceived compromise of moral integrity. Consequences are mostly negative and include physical and psychological symptoms, in addition to organizational implications. Objective: To psychometrically test the Moral Distress Risk Scale. Research design: A methodological study was realized. Data were submitted to exploratory factorial analysis through the SPSS statistical program. Participants and research context: In total, (...) 268 nurses from hospitals and primary healthcare settings participated in this research during the period of March to June of 2016. Ethical considerations: This research has ethics committee approval. Findings: The Moral Distress Risk Scale is composed of 7 factors and 30 items; it shows evidence of acceptable reliability and validity with a Cronbach’s α = 0.913, a total variance explained of 59%, a Kaiser–Meyer–Olkin = 0.896, and a significant Bartlett<0.001. Discussion: Concerns about moral distress should be beyond acute care settings, and a tool to help clarify critical points in other healthcare contexts may add value to moral distress speech. Conclusion: Psychometric results reveal that the Moral Distress Risk Scale can be applied in different healthcare contexts. (shrink)

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Background: Moral sensitivity has been identified as a foundational component of ethical action. Diminished or absent moral sensitivity can result in deficient care. In this context, assessing moral sensitivity is imperative for designing interventions to facilitate ethical practice and ensure that nurses make appropriate decisions. Objective: The main purpose of this study was to validate a scale for examining the moral sensitivity of Brazilian nurses. Research design: A pre-existing scale, the Moral Sensitivity Questionnaire, which was developed by Lützén, was used (...) after the deletion of three items. The reliability and validity of the scale were examined using Cronbach’s alpha and factor analysis, respectively. Participants and research context: Overall, 316 nurses from Rio Grande do Sul, Brazil, participated in the study. Ethical considerations: This study was approved by the Ethics Committee of Research of the Nursing School of the University of São Paulo. Findings: The Moral Sensitivity Questionnaire contained 27 items that were distributed across four dimensions: interpersonal orientation, professional knowledge, moral conflict and moral meaning. The questionnaire accounted for 55.8% of the total variance, with Cronbach’s alpha of 0.82. The mean score for moral sensitivity was 4.45 (out of 7). Discussion and conclusion: The results of this study were compared with studies from other countries to examine the structure and implications of the moral sensitivity of nurses in Brazil. The Moral Sensitivity Questionnaire is an appropriate tool for examining the moral sensitivity of Brazilian nurses. (shrink)

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O objetivo deste estudo é identificar como a adoção aparece nas histórias de vida de indivíduos adotados e como eles normalizam suas experiências relacionadas à adoção. Focaliza-se a re-historiação do “eu” na narrativa e considera-se que o seu final é determinado por quem constrói a narrativa, não por eventos relatados cronologicamente. Os dados provêm das narrativas de dois indivíduos adotados, transcritas segundo convenções utilizadas na Análise da Conversa Etnometodológica, nas quais se destaca a presença dos eventos relacionados à adoção na (...) re-historiação dos pesquisados e na constituição de seus “eus” parciais, considerando também as características rítmicas e outras propriedades da fala em interação. Foi possível constatar que o final da história influencia na maneira como a narrativa é construída e como as experiências de adoção aparecem nas narrativas, com maior ou menor grau de normalização a elas atribuído. (shrink)

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The development of neuropsychological assessment methods using virtual reality (VR) is a valid and promising option for the detection of cognitive impairment in the older people, focusing on activities composed of tasks of multiple demands. This study verified the association of age, schooling, and general cognitive status on the performance of neurologically healthy older adults in ECO-VR, a virtual reality task of multiple demands for neuropsychological assessment. A total of 111 older adults answered a sociodemographic questionnaire, the Mini Mental State (...) Examination, the Vocabulary subtest of the Wechsler Intelligence Scale for Adults (third edition), and the ECO-VR. Correlation analyses, multiple linear regression, and comparisons between groups (effects by age and schooling groups) were used to evaluate the results. The ECO-VR total score was significantly associated with age, years of education, MMSE, and Vocabulary subtest. The linear regression models identified that age was the main predictor for total score and rule breaking of ECO-VR. According to the univariate analysis, it was identified the main effect of age group and schooling group in the total ECO-VR score, but there was no interaction effect. The results are discussed in order to understand the role of sociodemographic characteristics in the performance of older adults in a virtual reality task of multiple demands. It was also verified the possibility use of virtual reality for neuropsychological assessment of older adults. (shrink)

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This article proposes to identify risk factors for moral distress from the literature, validate them through expert analysis and provide the basis for a new tool to assess the risk of moral distress among nurses. Moral distress is related to the psychological, emotional and physiological aspects of nursing. It arises from constraints caused by various circumstances and can lead to significant negative consequences. A scoping review and validation through expert analysis were used. The research question guiding this study was as (...) follows: What is known about risk factors for moral distress in nursing? The research was conducted using multiple sources including electronic databases and lists of references from relevant literature. The final sample consisted of 38 studies. A validation analysis was conducted by experts during December 2014 and June 2015. To exclude a risk factor item, at least 80% of the experts had to agree with the exclusion. In total, 53 risk factors for moral distress were identified, reviewed by the experts and grouped to form a new instrument that may help to identify risk for moral distress and to address its consequences. (shrink)

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Background Compulsory treatments represent a legal means of imposing treatment on an individual, usually with a mental illness, who refuses therapeutic intervention and poses a risk of self-harm or harm to others. Compulsory outpatient treatment in psychiatry, also known as community treatment order, is a modality of involuntary treatment that broadens the therapeutic imposition beyond hospitalization and into the community. Despite its existence in over 75 jurisdictions worldwide, COT is currently one of the most controversial topics in psychiatry, and it (...) presents significant ethical challenges. Nonetheless, the ethical debate regarding compulsory treatment almost always stops at a preclinical level, with the different ethical positions arguing for or against its use, and there is little guidance to support for the individual clinicians to act ethically when making the decision to implement COT. Main body The current body of evidence is not clear about the efficacy of COT. Therefore, despite its application in several countries, evidence favouring the use of COT is controversial and mixed at best. In these unclear circumstances, ethical guidance becomes paramount. This paper provides an ethical analysis of use of COT, considering the principlist framework established by Ross Upshur in 2002 to justify public health interventions during the 2002–2004 severe acute respiratory syndrome outbreak. This paper thoroughly examines the pertinence of using the principles of harm, proportionality, reciprocity, and transparency when considering the initiation of COT. Conclusion Ross Upshur’s principlist model provides a useful reflection tool for justifying the application of COT. This framework may help to inform sounder ethical decisions in clinical psychiatric practice. (shrink)

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This study explored the evidence of validity of internal structure of the 12-item Functional Assessment of Chronic Illness Therapy—Spiritual Wellbeing Scale in Brazilian adolescents with chronic health conditions. The study involved 301 Brazilian adolescents with cancer, type 1 diabetes mellitus, or cystic fibrosis. Exploratory Factor Analysis, Confirmatory Factor Analysis, and Item Response Theory were used to test the internal structure. Reliability was determined with Cronbach’s Alpha and McDonald’s Omega. The EFA suggested a one-dimensional scale structure in contrast to the original (...) 2-factor model or the 3-factor model which were not reproduced in the current CFA. All quality indicators for the EFA one-factor exceeded the required criteria. The FACIT-Sp-12 for adolescents yielded strong evidence for a 1-factor model and with good reliability. (shrink)

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Sense of agency refers to the ability to influence one’s functioning and environment, relating to self-efficacy and wellbeing. In youth, agency may be challenged by external demands or redefinition of self-image. Music, having heightened relevance for the young, has been argued to provide feelings of self-agency for them. Yet, there is little empirical research on how music impacts adolescents’ daily sense of agency. The current study investigated whether music listening influences adolescents’ perceived agency in everyday life and which individual and (...) contextual determinants would explain such an influence. Participants were 44 adolescents (48% female, 36% with training in music, mean age 14), recruited through local schools. The mobile Experience Sampling app MuPsych was used to collect brief self-reports of personal music listening experiences during daily life. This method assessed the change in the listener’s perceived control over both their emotional states (Internal Agency), and their external environment (External Agency), over five minutes of music listening. Also measured were changes in mood states, and contextual variables (social situation, concurrent activity, and reason for listening). The impact of music on the sense of agency was analyzed using multilevel structural equation modelling. There was no general increase of agency across all music episodes, but agency fluctuations were determined by specific individual and contextual factors. Music training predicted increases in both internal and external agency during music listening, and external agency increased more for male participants. Certain context features such as listening alone, paying attention to music, and listening for enjoyment were related to greater increases in agency. Increases in agency significantly correlated with increases in mood valence. Our findings confirmed the plasticity and situational embeddedness of the sense of agency. Music indeed can support agency, but the impact is dependent on specific individual and contextual factors. Sense of agency can be seen as a health resource and significant part of youth development, and current findings provide new insight into when and by whom such affordance is likely to be employed. (shrink)

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The concept of shared mental models refers to the shared understanding among team members about how they should behave in different situations. This article aimed to develop a new shared mental model measure, specifically designed for the refereeing context. A cross-sectional study was conducted with three samples: national and regional football referees (n = 133), national football referees and assistant referees and national futsal referees (n = 277), and national futsal referees (n = 60). The proposed version of the Referee (...) Shared Mental Models Measure (RSMMM) has 13 items that are reflected on a single factor structure. The RSMMM presented good validity evidence both based on the internal structure and based on relations to other variables (presenting positive associations with team work engagement, team adaptive performance, and team effectiveness). Such promising psychometric properties point to an optimistic outlook regarding its use to measure shared mental models in futsal and football referee teams. -/- . (shrink)

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From an early age, exposure to a spoken language has allowed us to implicitly capture the structure underlying the succession of speech sounds in that language and to segment it into meaningful units. Statistical learning, the ability to pick up patterns in the sensory environment without intention or reinforcement, is thus assumed to play a central role in the acquisition of the rule-governed aspects of language, including the discovery of word boundaries in the continuous acoustic stream. Although extensive evidence has (...) been gathered from artificial languages experiments showing that children and adults are able to track the regularities embedded in the auditory input, as the probability of one syllable to follow another syllable in the speech stream, the developmental trajectory of this ability remains controversial. In this work, we have collected Event-Related Potentials while 5-year-old children and young adults were exposed to a speech stream made of the repetition of eight three-syllable nonsense words presenting different levels of predictability to mimic closely what occurs in natural languages and to get new insights into the changes that the mechanisms underlying auditory statistical learning might undergo through the development. The participants performed the aSL task first under implicit and, subsequently, under explicit conditions to further analyze if children take advantage of previous knowledge of the to-be-learned regularities to enhance SL, as observed with the adult participants. These findings would also contribute to extend our knowledge of the mechanisms available to assist SL at each developmental stage. Although behavioral signs of learning, even under explicit conditions, were only observed for the adult participants, ERP data showed evidence of online segmentation in the brain in both groups, as indexed by modulations in the N100 and N400 components. A detailed analysis of the neural data suggests, however, that adults and children rely on different mechanisms to assist the extraction of word-like units from the continuous speech stream, hence supporting the view that SL with auditory linguistic materials changes through development. (shrink)

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Psychodrama is an effective psychotherapeutic model but interventions with adolescents require age-tailored techniques that maximize engagement and facilitate communication processes. This study describes a novel adaptation of a therapeutic mask technique to psychodrama with adolescents. Over the course of eight group sessions of psychodrama, five adolescents created their own mask and explored its therapeutic use. Their experiences were captured at the end of each session with the Helpful Aspects of Therapy form, and at the end of the study with the (...) Clinical Change Interview. Awareness/insight/self-understanding, empowerment and relief were the most significant aspects experienced by the adolescents, along with perceived increase of calmness and world connection, satisfaction in interpersonal communication and better emotional expression and regulation. The mask technique was experienced as a playful and engaging task that facilitated insight and interpersonal communication. Findings provide preliminary evidence on the clinical utility of mask-based psychodrama with adolescents. (shrink)

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Este artigo visa algumas considerações sobre a Paideia para evidenciar, dar suporte e organização à sua presença viva na educação. Ele faz uma abordagem teórica da trajetória da vida educativa e suas oportunidades, que além de buscar conhecer e entender o desenvolvimento integral da pessoa humana no campo educacional, encontre e resgate a construção de um pensamento que sustente a ideia de uma “pedagogia humanista franciscana” não so- mente na vida prática, mas também no trabalho sistematizá-la e ou recriá-la em (...) produções escritas. Esse processo deve buscar o entendimento do papel da – pandeia na formação integral do homem – para ampliar e contribuir com a pedagogia franciscana em sua capacidade de ir além dos aspectos curriculares para atingir seu ideal da educação integral e humanista. Necessário é que tal pedagogia estabeleça relações capazes de englobar o desenvolvimento de todas as dimensões do ser humano, sejam elas físicas, motoras, estéticas, intelectuais, espirituais, afetivas, po- líticas, econômicas e sociais. O ser humano que surge de dentro da formação baseada na educação franciscana deve ser corajoso para assumir o risco e a criatividade e, em momento algum, deixar de ser cavalheiro a de buscar e a criação do belo, do grandioso e do amor. A pedagogia franciscana fruto de uma “Visão franciscana da vida e do mundo entende a educação como transformadora de um ser humano justo, ético e conciliador das relações buscan- do o desenvolvimento integral deste, em todas as perspectivas do campo educacional. (shrink)

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The usual definition of (non-contextual) hidden variables is found to be too restrictive, in the sense that, according to it, even some classical systems do not admit hidden variables. A more general concept is introduced and the term “approximate hidden variables” is used for it. This new concept avoids the aforementioned problems, since all classical systems admit approximate hidden variables. Standard quantum systems do not admit approximate hidden variables, unless the corresponding Hilbert space is 2-dimensional. However, an appropriate non-standard quantum (...) system, which arises by focussing on momentum and position and neglecting the remaining observables, admits approximate hidden variables. Systems associated with JBW-algebras (resp. von Neumann algebras) and satisfying some mild conditions admit approximate hidden variables iff they are classical, that is, iff the corresponding JBW-algebra (resp. von Neumann algebra) is associative (resp. commutative). (shrink)

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In biology the idea of matter as something passive has been abandoned in favour of the idea that matter has the capacity of self-activity. In modern physics too matter functions more as an agent, with which the experimenter has a relation, than as passive material which he can handle as he likes. So in both fields of study the antithesis between idealism and materialism has been given up, so that the relation instead of the difference between man and nature became (...) the starting point of scientific inquiry. (shrink)

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The study of actions is of major importance in social science regardless of whether the investigator is or isn’t a behaviorist. Actions constitute much if not all of an observational substratum which both prompts explanation and confirms prediction. Actions are of interest both as samples of what an animal can do and as symptoms of underlying structures, either psychic or physical. Doubtless, actions as symptoms of underlying structures are, in the long run, of greater importance in social science than actions (...) as samples of capacities, for to be able to predict an organism’s further performance on the basis of knowledge of capacities is not necessarily to understand the organism. Understanding actions, if it is indeed the desideratum of social science—as I take it to be—involves more, however, than the viewing of actions as symptomatic of underlying structures. Actions are obviously bearers of meaning in and for a given social context, and this meaning is for both the agent and actual or imagined spectators. Spectators can be said to do their viewing both at the time the action takes place and also, in a sense, at later times when recalling or reading reports of a now past action. (shrink)

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El estudio de la segunda persona como condición del Yo en el discurso poético toma impulso en los estudios de teoría literaria a partir del surgimiento del ámbito relativamente reciente de la pragmática de la comunicación lírica. Esta perspectiva de estudio actual admite que el Yo lírico no se reduce a la categoría de mero «sujeto enunciativo» que explica en sí mismo el proceso locutivo de la enunciación; sino que es considerado la proyección del sujeto hacia la alteridad del interlocutor (...) (Yo) al interlocutario (Tú), es decir, la expresión del sujeto de la enunciación al destinatario postulado en el discurso. En ese sentido, la presencia textual del Yo y del Tú es interpretada como signo de una relación dialógica que se convierte en el sentido fundamental de la estructura poemática. En este contexto, se indagan los modos de postulación del Tú como signo de manifestación dialógica en la poesía de Juan Gelman. Para el objetivo de este trabajo, el marco teórico se compone de las posturas de Émile Benveniste (2004) sobre la enunciación; de Carmen Bobes Naves (1991) y de Jesús Maestro (1998) acerca de las manifestaciones de la expresión dialógica en el discurso lírico; y deMargarida Bassols y Anna M. Torrent (1997), de Amparo Tusón (2015) y de Álvarez Muro Alexandra (2001) sobre las condiciones formales de la conversación. (shrink)

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CADERNOS DE FILOSOFIA EXTRAVAGANTE - ANTÓNIO TELMO Vários Autores Um dos sinais do Quinto Império é que ainda há andorinhas O provérbio diz que uma andorinha não faz a Primavera Mas eu acho que faz Enquanto houver um homem onde resida a espiritualidade há sempre um princípio do Quinto Império António Telmo Este terceiro volume dos Cadernos de Filosofia Extravagante é o primeiro que se publica após a partida de António Telmo, que os imaginou, concebeu e fundou Constitui por isso, (...) na íntegra, um preito de homenagem ao autor da História Secreta de Portugal, nele se inserindo, bem a propósito, as actas do Colóquio A Obra e o Pensamento de António Telmo, realizado em 14 e 15 de Fevereiro de 2011, no Palácio da Independência, em Lisboa, por iniciativa do Instituto de Filosofia Luso-Brasileira, documento a que acrescem alguns testemunhos de amigos que, por uma ou outra razão, não puderam participar naquela comemoração, e duas entrevistas, uma das quais se encontrava por publicar, pelo filósofo concedidas na última década Por outro lado, nestas páginas o leitor poderá ainda encontrar dois escritos do autor de O Bateleur – um poema e um conto – nunca antes dados ao papel em letra de forma E, o que talvez seja mais, uma série significativa de correspondência epistolar até agora mantida inédita, tendo o filósofo por destinatário São missivas de Álvaro Ribeiro, José Marinho, Agostinho da Silva, Dalila Pereira da Costa e António Quadros, definindo um arco temporal que vai da publicação de Arte Poética, em 1963, à de Filosofia e Kabbalah, em 1990 Quase trinta anos de uma vida filosófica singular em que, a cada passo, são bem notórias a admiração e a amizade que mestres e condiscípulos lhe dedicam Autores- António Telmo, Pedro Martins, Renato Epifânio, Américo Rodrigues, Helena Estriga, António Braz Teixeira, Joaquim Domingues, Abel de Lacerda Botelho, Roque N Brás de Oliveira, M NVieira, Luís Paixão, António Carlos Carvalho, Cynthia Guimarães Taveira, Rui Lopo, António Quadros Ferro, Carlos Aurélio, António Cândido Franco, Rodrigo Sobral Cunha, Carlos Vargas, Manuel Ferreira Patrício, Pedro Sinde, Paulo Santos, Pedro Paquim Ribeiro, Maurícia Teles da Silva, J Pinharanda Gomes, António Quadros, Avelino de Sousa, Elísio Gala, José Paulo Ribeiro Albuquerque, Helder Cortes, Eduardo Aroso, Isabel Xavier, Jesus Carlos, Álvaro Ribeiro, José Marinho, Agostinho da Silva, Dalila Pereira da Costa. (shrink)

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Examines the work of Kierkegaard as an ironist, reevaluating the works he penned under pseudonyms to show both their ironic character and the serious purpose that informed the deception Kierkegaard carried out.

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