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This paper stems from the current global worsening of the scarcity of resources for healthcare, which will deepen even more in future public emergencies. This justifies strengthening the reflection on the allocation of resources which, in addition to considering technical issues, should also involve ethical concerns. The two plans in which the allocation of resources develops—macro and micro—are then systematized, both requiring the identification of ethical criteria for the respective complex decision-making. Then, we describe how the complexity at the macro (...) level focuses on the joint consideration of the rectitude of the principles, the goodness of the ends, and the integrity—respectively the deontological, teleological, and procedural perspectives; and at the micro level, it focuses in prioritizing people, which can result in the exclusion of some, as happened with the elderly during peaks of COVID-19. The main objective of this article is to show that, in public health emergency situations, in which the daily criteria for prioritizing access to health care are not efficient, it is possible not only to ration the available means but also to rationalize them. We argue that rationing and rationalization are different concepts, entail different consequences, have different ethical foundations, and draw different guidelines for patient care. We apply them to the distribution of intensive care and vaccines to the elderly thus demonstrating the ethically legitimate domain of implementation of each of these two prioritization criteria. We conclude that rationalization respects more strictly the core ethical principles of our common morality. (shrink)

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The notion of “integrity” is currently quite common and broadly recognized as complex, mostly due to its recurring and diverse application in various distinct domains such as the physical, psychic or moral, the personal or professional, that of the human being or of the totality of beings. Nevertheless, its adjectivation imprints a specific meaning, as happens in the case of “scientific integrity”. This concept has been defined mostly by via negativa, by pointing out what goes against integrity, that is, through (...) the identification of its infringements, which has also not facilitated the elaboration of an overarching and consensual code of scientific integrity. In this context, it is deemed necessary to clarify the notion of “integrity”, first etymologically, recovering the original meaning of the term, and then in a specifically conceptual way, through the identification of the various meanings with which the term can be legitimately used, particularly in the domain of scientific research and innovation. These two steps are fundamental and indispensable for a forthcoming attempt at systematizing the requirements of “scientific integrity”. (shrink)

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This Dictionary presents a broad range of topics relevant in present-day global bioethics. With more than 500 entries, this dictionary covers organizations working in the field of global bioethics, international documents concerning bioethics, personalities that have played a role in the development of global bioethics, as well as specific topics in the field.The book is not only useful for students and professionals in global health activities, but can also serve as a basic tool that explains relevant ethical notions and terms. (...) The dictionary furthers the ideals of cosmopolitanism: solidarity, equality, respect for difference and concern with what human beings- and specifically patients - have in common, regardless of their backgrounds, hometowns, religions, gender, etc. Global problems such as pandemic diseases, disasters, lack of care and medication, homelessness and displacement call for global responses.This book demonstrates that a moral vision of global health is necessary and it helps to quickly understand the basic ideas of global bioethics. (shrink)

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Biomedical research has a strong impact on a country’s scientific-technological and socioeconomic development. It can make a significant contribution at three different levels: promotion of public health; the exchange of knowledge within the scientific community; and economic/ financial profitability. Africa only attracts ~3.3% of the world’s clinical research. This small proportion is due to, among several factors, the absence of two fundamental aspects: specific robust legislation and capacity for regulatory and ethical evaluation. There are five Portuguese- speaking African countries – (...) Angola, Cabo Verde, Guinea-Bissau, Mozambique and São Tomé and Príncipe. Despite presenting different degrees of clinical research development, these countries show a common serious insufficiency in the minimum conditions necessary for hosting, collaborating or leading biomedical research projects. These countries are also excluded from the support of international organisations for capacity building because of the language barrier. The Biomedical Ethics and Regulatory Capacity Building Partnership for Portuguese-Speaking African Countries project has developed methods to build capacity and partnership through research on national law, comparisons with international standards and by issuing recommendations at a national level. Through collaborative intensive training, trainees are taught to become educators at a national level. This, in turn, creates a sustainable impact at country level. BERC-Luso is a pioneering project, owing to a combination of innovative features. The partnership project: was developed exclusively in Portuguese; involves a large number of African countries, and national and international institutions; has been further enhanced by the diversity and complementarity of its action plans; and has also benefited from a broad participatory methodology based on resolution of recipients’ problems by the recipients themselves. It thus stands out as a model for similar future projects. (shrink)

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The theme of consent is, without question, associated with the origins of bioethics and is one of its most significant paradigms that has remained controversial to the present, as is confirmed by the proposal for its debate during the last World Congress of Bioethics. Seen broadly as a compulsory minimum procedure in the field of biomedical ethics, even today it keeps open the issues that it has raised from the start: whether it is really necessary and whether it can be (...) proven to be effective. My goal will be to attempt to determine the most genuine and relevant meaning of consent, going back from its present dominant normative meaning and, from there, identifying or simply sketching other possible forms of its expression in the world we live in, so as to justify its pertinence and validity. This objective will involve three stages: (1) ‘Consent’ as a privileged paradigm of bioethics (the ethical-juridical sense), (2) The symbolic value of ‘consent’ (the social-cultural sense), and (3) ‘Consent’ as promotion of the human (the humanistic-personal sense) .It is concluded that the common notion of normative consent is not the only one, nor does it hold universal validity; that, from a historical-cultural perspective, new expressions of consent appear, adapted to different social contexts and to possibly be implemented in developing countries; and, finally, that consent is strictly indispensable in situations of extreme dependence, in its symbolic relational character, in as much as it promotes ethical relationships among strangers and ensures that they remain so. (shrink)

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Este trabalho objetivou verificar as diferenças significativas no clima para a criatividade em turmas de 5ª série do Ensino Fundamental, as possíveis relações entre as interações professor-aluno e o clima para criatividade em sala e de que forma as concepções dos professores acerca da criatividade s..

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Ortega y Gasset enriqueceu os seus estudos na Alemanha entre 1905 e 1908, nas cidades de Leipzig, Berlim e Marburgo, tendo sido aqui discípulo do neokantiano HermannCohen. Tomando essa circunstância como ponto de partida, propõe-se, neste artigo,levar a cabo uma indagação sobre as ideias estéticas de Ortega, contrastando com os fundamentos das fontes kantianas ou neokantianas da sua formação universitária alemã,traçar uma linha que permita demarcar claramente até onde Ortega segue Kant e onde,pelo contrário, o filósofo espanhol trilha o seu (...) solitário e original caminho. Tomam-se como baluartes desta análise os quatro momentos do juízo de gosto inerentes à terceira crítica kantiana e a questão da genialidade. (shrink)

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Background: Chronic Pain (CP) has serious medical and social consequences, and leads to economic burden that threatens the sustainability of healthcare services. Thus, optimized management of pain tools to support CP patients in adjusting to their condition and improving quality of life is timely. Although Acceptance and Commitment Therapy (ACT) is considered an evidence-based psychological approach for CP, evidence for the efficacy of online-delivered ACT for CP is still scarce. At the same time, studies suggest that self-compassion mediates the change (...) in disability and psychopathological symptoms in ACT interventions for CP, although self-compassion is not a specific target in ACT. Thus, an explicit focus on self-compassion might increase the efficacy of ACT interventions for CP, although this hypothesis has not been tested. This study aims to develop an eHealth ACT and compassion-based self-management intervention for CP, the iACTwithPain, and to compare its efficacy in improving health outcomes to a similar ACT-only intervention and a waiting list group. Methods: The eHealth platform that will host the interventions will be developed using a flat design identity and will be interactive. The iACTwithPain intervention will comprise 8 weekly self-management sessions, and will be developed taking into consideration the psychological flexibility model applied to CP, with the addition of explicit compassion-based components. To analyse whether the iACTwithPain intervention will present superiority in improving CP’s impact and related health markers over the two other conditions, this study will follow a RCT design with three arms. CP patients will be recruited through direct contact with patient associations and healthcare services and a national press release in Portugal. Outcome measurement will be conducted at baseline, post-intervention and at 3- and 6-months follow-ups. The interventions’ acceptability will also be assessed. Discussion: The iACTwithPain intervention is expected to improve CP patients’ psychosocial functioning, quality of life, and empowerment, by promoting adaptive disease management and regulation of pain-related internal experiences. Results will contribute to a better understanding on the pertinence of adding compassion elements to ACT for CP and to reach an optimized intervention for CP. (shrink)

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BackgroundThis pilot study aims to test the usability of the iACTwithPain platform, an online ACT-based intervention for people with chronic pain, to obtain information on which intervention and usability aspects need improvement and on expected retention rates.MethodsSeventy-three Portuguese women with chronic pain were invited to complete the first three sessions of the iACTwithPain intervention assess their quality, usefulness and the platform’s usability. Twenty-one accepted the invitation. Additionally, eight healthcare professionals working with chronic medical conditions assessed the platform and the intervention (...) from a practitioner’s point of view.ResultsThis study presented a considerable attrition rate (71.43%) among chronic pain participants, with six completers. There were no significant differences in demographic or clinical variables between dropouts and completers except for completed education (participants who dropped out presented less education than completers). Reasons for dropout were related to difficult personal events occurring during the time of the intervention, lack of time, or having forgotten. There seemed to be an overall satisfaction with both the intervention, its contents and form of presentation of information, and the platform, concerning its design, appearance, and usability. Real image videos were preferred over animations or audio by chronic pain participants. Healthcare professionals emphasized the appealing and dynamic aspects of the animation format.ConclusionThis study informs the ongoing improvement of the iACTwithPain platform and provides valuable information on aspects researchers should consider while developing online psychological interventions for chronic pain. Further implications are discussed. (shrink)

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This article proposes to analyse some aspects of the appropriation of New School thinking in Brazil, particularly Deweyan pragmatism, in the 1950s and 1960s. The analysis is based on the assumption that the developmentalist ideology that punctuated the debate on the economic, political and social restructuring of the country in these two decades constituted fertile ground for the return and expansion of pragmatist thinking amongst Brazilian educators, articulating itself, sometimes in contradictory ways, with this ideology. The focus of the analysis (...) will be on the writings of the group of educators which circulated around the figure of Anísio Teixeira, at the time director of the National Institute for Pedagogic Studies, an organ linked to the Ministry of Education and Culture, which set itself the task of producing research that would support public policy in the field of education, as well as constituting itself as a center for teacher education and the stimulus and development of innovative experiences in the public school system. The appropriation of Deweyan pragmatism, in this context, had a triple perspective: pragmatism as scientific method, implying a specific conception of science, particularly the social sciences, with emphasis on the application of scientific knowledge in the solution of practical problems; as a way of democratic life; and as a synonym for experimentalism, in the sphere of schooling. (shrink)

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O ato de amamentar apresenta diversos benefícios tanto à mãe quanto ao bebê. No entanto, amamentar um bebê com cardiopatia requer inúmeros desafios. Este estudo tem o propósito de compreender a vivência do aleitamento materno de bebês com cardiopatia congênita e as propostas dos serviços de saúde à paciente com essas condições. Estudo descritivo, qualitativo, realizado por meio de entrevista semiestruturada com mães de bebês internados em hospital de referência em cardiopediatria. Utilizou-se a técnica de análise de conteúdo de Minayo, (...) com referencial teórico específico para embasamento da discussão. Os resultados encontrados apontam para a dura realidade dessas mães que se deparam com inúmeras dificuldades diante do enfrentamento da doença e das repercussões emocionais e físicas advindas dela. O impacto emocional e inviabilização dos cuidados com a amamentação exige uma equipe de saúde especializada para oferecer suporte afetivo, fortalecer vínculo mãe-bebê e minimizar prejuízos que a doença pode ocasionar. (shrink)

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Na doença falciforme, o genótipo HbSS da anemia falciforme, considerado a forma mais grave, prevalente no continente africano, tem alta morbidade e mortalidade. Objetivo: identificar se a estrutura instalada na atenção às pessoas com anemia falciforme e seus familiares, contribui para a redução da mortalidade precoce em Angola. Material e Método: pesquisa exploratória descritiva, realizada em Luanda-Angola, no período entre agosto e dezembro de 2022. Foram aplicados questionários estruturados para 20 pessoas com doença falciforme e 15 familiares, todos com mais (...) de 21 anos. A metodologia utilizada foi bola de neve. Para análise e discussão dos dados, foi utilizado o referencial teórico de Donabedian, com ênfase no eixo estrutura. Resultados: diagnóstico feito por sinais e sintomas, idade do diagnóstico entre 1 e 5 anos. A crise de dor predominou entre eventos agudos. Conclusão: inexistência de estrutura instalada de saúde em Luanda que garantam no serviço público gratuito o acesso à medicamentos, transfusão de sangue, vacinas especiais e exames complementares. A transferência de tecnologias sociais da organização de sociedade civil brasileira para a de Luanda mostra ser adequada. (shrink)

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Dreams are a complex phenomenon which the philosophical field knows very little about. However, scientists like Freud or Jung, were able to prove that dream interpretation brings different advantages to our lives. For that reason, the purpose of this paper is to demonstrate that dreams, when understood, can offer us a new life perspective, especially in difficult times. Therefore, with the help of an innovative phenomenological approach introduced byMaria Zambrano, which focuses on the form of the dream and (...) its relation with time perception, rather than the dream content, we are going to observe that people have many types of consciousness, as well as different forms of access to time which relate to multiple perception modes and emotional states. Applying this theory,Maria J.Neves, is able to demonstrate that a phenomenological dream analysis can produce significant changes in peoples’ lives. (shrink)

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Counselling acts consist in indicating useful activities, remedying human deficiencies. Counselling acts are guided by practical cognition. Since counselling activities are oriented towards the future, their crucial element is foresight. It is cognitive reflection foreseeing the implementation of counselling acts. Counselling acts are actualised in rhetorical and communicational context which is associated with persuasive delivery of counselling content. Belonging to the rhetorical canon, invention disposes of factors that influence the justifying formulation of advisory content. Invention factors introduce the anticipatory determinations (...) and concretisations of counselling content. At rhetorical level, inventive methodology plays anticipatory functions which are convergent with tasks of foresight in practical cognition. (shrink)

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In the present paper I have tried to demonstrate that the priamels with which Callimachus embellishes his hymns to Zeus and Delos are built on a carefully and cleverly designed ring-compositional structure, more complex and intricately fashioned in Zeus, through multiple interwoven priamels, of a simpler form but very sophisticatedly allusive in Delos. In both sections under discussion there is a parallelism between the gods evoked (Zeus, Apollo) and Ptolemy Philadelphus, more explicit in Zeus, more veiled in Delos; in both (...) priamels, moreover, Callimachus makes use of the idea of fortification, a characteristic motif related to god and ruler as well. The sophisticated reader is invited to appreciate the fine rhythm created by the successive chiasms in the priamel of Zeus, overtly culminating in the king's praise, and challenged to recognise the clues hinting at the notion of interrelation and interdependence between the poet, Apollo and Ptolemy in the priamel of Delos. The examination of these passages reveals once more Callimachus' skill in his material's organisation, his elegance of style and his unwearying zest for a literary accomplishment as rich and interesting as possible. (shrink)

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In the present work, our aim is to emphasize the tensions between the concepts of irony and essay which Lukács uses in The soul and the Forms, and the way in which such concepts were used by Friedrich Schlegel at the end of the 18th. century. With that purpose, we will utilize the categories of "modern episteme" and "episteme of the forms" as they are formulated by Elías Palti. We believe that these categories will allow us to detect certain breaks (...) in the discursive level that remain hidden under the apparent continuity of some topics and make difficult the reading of The soul and the Forms.Nuestro objetivo en el presente trabajo es enfatizar las tensiones que existen entre el uso de los conceptos de ironía y ensayo, que hace Lukács en El Alma y las formas, y el modo en que tales conceptos son empleados por Friedrich Schlegel, a fines del siglo XVIII. A tal efecto nos valdremos de las categorías de episteme moderna y episteme de las formas, tal como son formuladas por Elías Palti. Creemos que es posible, en virtud de ellas, detectar ciertas rupturas a nivel discursivo que permanecen ocultas bajo la aparente continuidad de algunos tópicos y cuyo desconocimiento dificulta la lectura de El alma y las Formas. (shrink)

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In the 1980s, new reproductive technologies such as in vitro fertilisation and embryo transfer became commercially available in the United States, and somatic cell nuclear transfer—the cloning process by which Dolly the Sheep would be conceived in 1996—was in its experimental phase. While anxieties concerning these new technologies escalated in the popular sensorium, Laurie Anderson explored the phenomenon of cloning in a short musical film called What You Mean We? (1986) in which Anderson consults a design team to clone herself (...) in order to manage her demanding workload. The videographic image of the clone is Anderson herself, performing in drag, and her clone’s body is partially created through the use of a pitch shifter which changes Anderson’s voice to that of the cloned—but ostensibly male—version of herself. In this article, I investigate Anderson’s technological consideration of the body, which extends beyond her own corporeality, to interrogate the biological and affective capacities of clones. I consider how Anderson addresses the convergence of reproductive technologies, the market and the creation of subjects within this market as participating in a shift in how voices are heard, governed and reproduced in the latter half of the twentieth century. (shrink)

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This edited collection considers how feminist strategies and philosophies might initiate, reshape, and critique approaches to library reference services.

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Conocida esta enfermedad por el nombre de tisis, algunos países tenían registros de las muertes producidas por la tuberculosis, aunque después de la revolución industrial del siglo XVIII, se hicieron frecuentes los registros debido a la alta mortalidad. Las causas fueron varias: las malas condiciones de trabajo, las casas insalubres y atestadas de seres humanos, la dieta poco variada, entre otras. Se va a definir la imagen idealizada de la tuberculosis por el estudio de diversos poemas de autores que plasmaron (...) el pensamiento general de esa época, un muestreo de una enfermedad que se sigue manifestando, pero sin el concepto añadido de belleza romántica. (shrink)

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Macor, Laura A. (ed.). Reading Schiller: Ethics, Aesthetics, and Religion, Philosophical Readings 5. 2013.

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Juan Casiano es un gran buscador de Dios que recorre junto con su amigo Germán las tierras que ven surgir el monacato y, enriquecido por la experiencia de aquellos hombres y discípulo de los alejandrinos, especialmente de Evagrio Póntico y de Orígenes, introduce en Occidente la doctrina espiritual que bebe de esas fuentes. ¿Qué ve? ¿Qué escucha? ¿Qué recibe de estos monjes? ¿Cuál es la influencia de los grandes maestros alejandrinos en este discípulo? ¿Qué experiencia realiza después de tantos años (...) en el desierto? ¿Qué novedad aporta a Occidente? ¿Cómo reacciona ante las cuestiones teológicas y eclesiológicas de su tiempo, él que no es teólogo ni investigador? Estas y otras preguntas son una invitación a descubrir las raíces de la experiencia de Casiano, a profundizar los escritos para conocer con mayor precisión su identidad. John Cassian is a great seeker of God walking with his friend Germán land they see emerge monasticism and enriched by the experience of those men and disciple of the Alexandrians, especially of Evagrius of Pontus and Origen, introduced into the West's spiritual doctrine drinking from those sources. What do you see? What do you hear? What you get from these monks? What is the influence of the great Alexandrian scholars in this disciple? What experience takes after so many years in the wilderness? Which brings novely to the West? How do you react to the theological and ecclesiological issues of his time, he is not a theologian or a researcher? These and other questions are an invitation to discover the roots of the experience of Cassian's mitings deepen to know more precisely their identity. (shrink)

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O presente estudo tem como objetivo conhecer os sentidos produzidos por ouvidores de vozes sobre suas experiências com as vozes. Trata-se de uma pesquisa qualitativa de caráter exploratório. Se deu através de entrevistas semi-estruturadas realizadas com dezesseis ouvidores de vozes usuários de um Centro de Atenção Psicossocial da cidade de Pelotas/RS. Evidenciou-se que o sentido que o ouvidor atribui às vozes é subjetivo, individual, e dependente de fatores externos, como os discursos a que esse ouvidor é exposto no seu meio (...) histórico e social ao longo do tempo. Fica nítida a importância de não se minimizar as características e os conteúdos das vozes, a fim de auxiliar os ouvidores a estabelecerem sentidos e possíveis relações com suas histórias de vida. (shrink)

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