Ethical concerns about randomising persons to a no-treatment arm in the context of Ebola epidemic led to consideration of alternative designs. The stepped wedge design, in which participants or clusters are randomised to receive an intervention at different time points, gained popularity. Common arguments in favour of using this design are when an intervention is likely to do more good than harm, all participants should receive the experimental intervention at some time point during the study and the design might be (...) preferable for practical reasons. We examine these assumptions when considering Ebola vaccine research. First, based on the claim that a stepped wedge design is indicated when it is likely that the intervention will do more good than harm, we reviewed published and ongoing SW trials to explore previous use of this design to test experimental drugs or vaccines, and found that SW design has never been used for trials of experimental drugs or vaccines. Given that Ebola vaccines were all experimental with no prior efficacy data, the use of a stepped wedge design would have been unprecedented. Second, we show that it is rarely true that all participants receive the intervention in SW studies, but rather, depending on certain design features, all clusters receive the intervention. Third, we explore whether the SW design is appealing for feasibility reasons and point out that there is significant complexity. In the setting of the Ebola epidemic, spatiotemporal variation may have posed problematic challenges to a stepped wedge design for vaccine research. Finally, we propose a set of points to consider for scientific reviewers and ethics committees regarding proposals for SW designs. (shrink)

ZusammenfassungIm 18. Jahrhundert kommt ein historisch neuer Typus des Festes auf: das Bundesfest als Gründungsakt. Im Zuge der Dekorporierung wird das Fest zum Medium bürgerlicher Assoziation, die allmählich auf das Politische ausgreift. Im Kontext der Verzeitlichung im 18. Jahrhundert entbindet sich das Fest seiner vormaligen Funktion zyklischer Zeitreproduktion und bildet eine futurisch-utopische Form aus. Dabei avanciert der Eid, der entinstitutionalisiert wird und als universales Kohäsionsritual Verbreitung findet, zum zentralen Element einer Dramaturgie feierlicher Kommunion, in der das Fest als epochaler ›Übergangsritus‹ (...) den Zeitenumbruch zu imaginieren und zu forcieren sucht. Von der Ebene bürgerlicher Sozialbeziehungen steigt dieser neue Festtypus mit der Französischen Revolution auf die Ebene politischer Repräsentation auf.In the 18th century a new type of feasts evolve: the covenant festival as a founding act. As the corporative society dissolves, the bourgeoisie uses festivals as an instrument of social cohesion. Those associations gradually promote a political claim. Since modern society develops linear and progressive time patterns, the festivals lose the task of cyclically reproducing time. Instead, the new utopian festivals seek to imagine and to push the turn towards a new age. They therefore fulfill the function of modern ›rites of passage‹. Being detached from institutions and becoming a ritual of universal social cohesion, the oath becomes the crucial element of the festivals’ dramaturgy seeking social fusion. From the social sphere, the bourgeois covenant festivals rise to the level of political representation in the French Revolution. (shrink)

A partir da implantação da República, surgiu um movimento de intelectuais que procurou congregar e dinamizar num esforço comum os pensadores de várias áreas do conhecimento, através da revista A Águia, tendo em vista uma nova ordem moral e cívica dentro do ideal democrático. Procurámos dar a conhecer as linhas principais que consubstanciaram o espaço aberto pela revista, as influências recebidas e os debates que a animaram.

Recently, an increasing number of researchers in different parts of the world have been studying childhood from a point of view that highlights children who are considered “peripheral” – far from the ideal model associated with Western countries. We began with the intention of getting to know African children in Angola, informed by the belief that the preservation of languages is important in maintaining social knowledge and traditions. This text describes a preliminary study carried out in a culturally rich location (...) with strong traditions, but which is also marked by processes of cultural denial and devaluation. According to Ndombele and Timbane (2020), most Angolan children learn Portuguese at age seven, when they start school, especially in rural areas. This fact hinders the literacy learning process, and presents the risk of the disappearance of some native languages. Many schools teach children only in Portuguese. When visiting a school in Ganda, a rural area of Benguela, we found a group of children who, primarily through the games they played, keep the Umbundu language alive, and with that the identity and culture of their ancestors. Building on this, these children and their teachers created a syllable association game based on the music sung as they played. The game had two modalities - in the Umbundu language and in the Portuguese language – and functioned as a bilingual pedagogical tool. In the initial moment of offering the game for testing with the children, it was discovered that by singing the song of the game and discussing the possible solutions by themselves, they were able to make correct associations of the syllables in Umbundu, which they then translated into Portuguese. Thus, a resource was created together with the teachers, which, in addition to valuing the native language of the population, allowed the use of children's knowledge to create a didactic resource. In addition, it was possible to encounter the concept of childhood in the current world, deconstructing the idea of a single and ideal model, especially in light of those children who bring habits from home that do not always harmonize with the school routine, and often clash with Euro/Western model, which is based on age separation of classes as a requirement to guarantee learning, and tend to devalue other exchanges that help children learn. (shrink)

THEODOR GOMPERZ AND JOHN STUART MILL The subject of this essay is the little known episode of an unusual friendship. To the writer its fascination lies as ...

Following the COVID-19 pandemic, many countries worldwide have put lockdowns in place to prevent the virus from spreading. Evidence shows that lockdown measures can affect mental health; it is, therefore, important to identify the psychological characteristics making individuals more vulnerable. The present study aimed, first, to identify, through a cluster analysis, the psychological attributes that characterize individuals with similar psychological responses to the COVID-19 home confinement; second, to investigate whether different psychological characteristics, such as personality traits, alexithymia, and resilience, specifically (...) influence anxiety, stress, and depression, depending on the scope of the confinement. We analyzed data from 393 participants who completed an online survey on their experiences during two different phases of the Italian lockdown, characterized by more or less strict measures of confinement. Two clusters were identified which included participants reporting a better and worse emotional response to the lockdown, respectively. Individuals in the −ER group showed lower emotional stability, resilience, and higher alexithymia. Moreover, even if lifting part of the restrictions decreased psychological distress among all participants, a reduction in perceived stress was observed only among individuals with high resilience. Finally, personality traits, alexithymia, and resilience differently affected depression, anxiety, and stress. Our results suggest that different psychological interventions should be planned depending on the context: mental health professionals should focus on enhancing the individuals’ coping strategies to alleviate stress in emergencies, while long-term intervention aiming at alleviating anxiety and depressive symptoms should focus on alexithymic tendencies and personality constructs. (shrink)

The nature of the relationship between the two types of meiotic recombination outcomes, exchange (crossing‐over) and simple gene conversion, has been debated for years. I here propose that these two types of events are not necessarily causally related and hypothesize that the primary role of events detected as simple gene conversion is in the recognition of homology during synapsis.

The processing of sensitive information in the health field is subject to rigorous standards that guarantee the protection of information confidentiality. Recently, the Italian Data Protection Authority (Garante per la Protezione dei Dati Personali) stated their formal opinion on a standard procedure in dental offices involving the submission of a questionnaire that includes the patient's health status. HIV infection status is included on the form. The Authority has stated that all health data collection must be in accordance with the current (...) Italian normative framework for personal data protection and respect the patient's freedom. This freedom allows the patient to decide, in a conscious and responsible way, whether to share health information with health personnel without experiencing any prejudice in the provision of healthcare requested. Moreover, data collection must be relevant and cannot exceed the principles of treatment goals with reference to the specific care of the concerned person. However, the need for recording information regarding HIV infection at the first appointment, regardless of the clinical intervention or therapeutic plan that needs to be conducted, should not alter the standard protection measures of the healthcare staff. In fact, these measures are adopted for every patient. (shrink)

In Italy, consent for health treatment, aside from being an ethical and deontological obligation, constitutes an essential requirement for any medical treatment according to articles 13 and 32 of the National Constitution and also in accordance with the Council of Europe's ‘Convention on Human Rights and Biomedicine’. An essential requirement for the validity of consent is that clear, exhaustive and adequate information be provided to the patient himself: the practice of informed consent is a communicative relationship in which the patient (...) can express doubts, perplexities and clarification requests to the dentist. Furthermore, dental treatment has specific peculiarities: the relationship between dentistry and aesthetics, the concomitant presence of pathologies requiring different treatments, the elongated care process and the establishment of a trustworthy relationship and familiarity with the patient represent important aspects in the configuration of the dentist-patient relationship and in the process of acquiring informed consent. The dentist must offer correct information on diagnosis, prognosis, the therapeutic perspective and the likely consequences of therapy, alternative therapy and refusal of therapy, as well as eventual commitments for the period after treatment. Particular consideration must be given to minors and patients of unsound mind: the dentist's approach to these patients needs to be clear and appropriate to the person's age and understanding ability, even if the decisional power for sanitary treatment may be in the hands of a third person. (shrink)

Facial information is a powerful channel for human-to-human communication. Characteristically, faces can be defined as biological objects that are four-dimensional (4D) patterns, whereby they have concurrently a spatial structure as well as temporal dynamics. The spatial characteristics of facial objects possess three dimensions (3D), namely breadth, height and importantly, depth. The temporal properties of facial objects are defined by how a 3D facial structure evolves dynamically over time; where time is referred to as the fourth dimension (4D). Our entire perspective (...) of another’s face, whether it be social, affective or cognitive perceptions, is therefore built on a combination of 3D and 4D visual cues. Counterintuitively, over the past few decades of experimental research in psychology, facial stimuli have largely been presented to participants as a spatial pattern that has been flattened into two dimensions (2D), while remaining largely static. The following review aims to advance and update facial researchers, on the recent revolution in computer-generated, realistic 4D facial models produced from real-life human subjects. We delve in-depth to summarize recent studies which have utilized facial stimuli that possess 3D structural cues (geometry and depth) and 4D temporal cues (3D structure + dynamic viewpoint and movement). In sum, we have found that higher-order perceptions such as identity, gender, ethnicity, emotion and personality, are critically influenced by the 4D characteristics embedded within natural human faces. In future, it is recommended that facial stimuli incorporate the 4D space-time perspective with the proposed time-resolved methods. (shrink)

In this paper, we propose a new and simple method for image encryption. It uses an external secret key of 128 bits long and an internal secret key. The novelties of the proposed encryption process are the methods used to extract an internal key to apply the zigzag process, affine transformation, and substitution-diffusion process. Initially, an original gray-scale image is converted into binary images. An internal secret key is extracted from binary images. The two keys are combined to compute the (...) substitution-diffusion keys. The zigzag process is firstly applied on each binary image. Using an external key, every zigzag binary image is reflected or rotated and a new gray-scale image is reconstructed. The new image is divided into many nonoverlapping subblocks, and each subblock uses its own key to take out a substitution-diffusion process. We tested our algorithms on many biomedical and nonmedical images. It is seen from evaluation metrics that the proposed image encryption scheme provides good statistical and diffusion properties and can resist many kinds of attacks. It is an efficient and secure scheme for real-time encryption and transmission of biomedical images in telemedicine. (shrink)

: Hypotheses are the first step in scientific and clinical enquiry. They guide all of the subsequent steps in an investigation, and influence data collection, analysis, and interpretation. But how do we build scientific and clinical hypotheses? In both research and clinical contexts, a professional’s idiosyncratic way of perceiving reality, her prejudices and biases will influence the process of hypothesis formulation. We compare the process of formulating a scientific hypothesis in the field of neuroscience with the process of building a (...) clinical hypothesis in the systemic therapeutic approach. This comparison is intended to highlight the biases that influence researchers and clinicians when formulating hypotheses. Our aim is to raise awareness of the most common biases, and to point out how the tools developed by clinicians could be useful to researchers, and vice versa. Keywords: Hypotheses; Clinical Psychology; Neuroscience; Bias; Interdisciplinary Approach La costruzione di ipotesi nella psicologia clinica e nella neuroscienza: similitudini e differenze Riassunto: Le ipotesi sono il primo passo della ricerca scientifica e clinica. Sono la guida di tutti i passi successivi e influenzano la racconta dei dati, la loro analisi e l’interpretazione. Come si costruiscono le ipotesi scientifiche e quelle cliniche? Sia nell’ambito della ricerca che nei contesti clinici le idiosincrasie con cui un professionista percepisce la realtà, i suoi bias e pregiudizi influenzeranno il processo di formulazione dell’ipotesi. In questa sede intendiamo confrontare il processo di formulazione di un’ipotesi scientifica nel campo della neuroscienza e il processo di costruzione dell’ipotesi clinica nell’approccio della terapia sistemica. Questo confronto vuole mettere in luce i bias che influenzano ricercatori e terapeuti nella formulazione delle ipotesi. Il nostro scopo è mettere in luce gli errori sistematici più comuni, mostrando come gli strumenti sviluppati dai terapeuti possano essere utili per i ricercatori e viceversa. Parole chiave: Ipotesi; Psicologia clinica; Neuroscienza; Bias; Approccio interdisciplinare. (shrink)

A proposta deste estudo é abordar de forma teórica o pensamento do filósofo e cientista político, germano-americano, Eric Voegelin, buscando compreender a relação que promove entre o gnosticismo e a modernidade, tendo como foco sua afirmação de que o gnosticismo é o fundamento da modernidade. Para esta pesquisa, são utilizados como base teórica fundamental dois conceitos de sua teoria: religiões políticas e gnosticismo. Divide-se o trabalho em uma introdução ao tema e três capítulos, seguidos da conclusão. Na introdução, se aborda (...) o contexto histórico-político que fornece o estofo para o surgimento da modernidade e movimentos totalitários; com a biografia do autor, buscam-se elementos essenciais para a compreensão de sua posição de combate irrestrito às ideologias, principalmente ao nacional-socialismo alemão e socialismo stalinista. A partir da crítica ao movimento positivista, que considera a ciência natural e seus métodos o modo por excelência de apreensão da realidade, Voegelin demonstra que a dimensão simbólica, espiritual e transcendente do ser fica relegada a uma posição inferior, inexistente ou banalizada, causando uma deformação da verdade, que pode se manifestar em dogmas ou doutrinas ideológicas. No segundo capítulo, introduz-se sua noção de que o gnosticismo é o fundamento da sociedade moderna, na medida em que a insatisfação com a ordem corrente, a crença e desejo de mudança do indivíduo por meio do conhecimento, se firmam como contrários ao desenvolvimento do ser, apontando uma tendência nos movimentos ideológicos modernos à imanentização da escatologia cristã. No terceiro capítulo, apresentam-se as principais discussões a respeito dos limites e alcances de sua teoria, sua aproximação com uma filosofia da consciência e as possibilidades de utilizá-la para a compreensão dos fenômenos totalitários na atualidade, vistos como uma doença pneumopatológica. Concluiu-se que Voegelin, categórico ao apontar para a necessidade de uma nova abordagem para a ciência social e política, evidenciou uma estrutura religiosa nos movimentos modernos, ditos seculares; o conceito de gnosticismo como fundamento da modernidade, apesar de revisto pelo próprio autor e ainda fomentar controvérsias, pode ser um ponto de partida para estudos complementares, uma vez que enfatiza a necessidade de ampliação da consciência para a restauração da ordem social e política, e de incluir o aspecto transcendente do ser, que se expressa em seus símbolos e em suas experiências religiosas ao longo da história, para a compreensão da modernidade. (shrink)

: This article discusses the parallels between Friedrich von Hayek and Bruno Leoni’s criticisms of democracy. Both men were leading protagonists of the classical liberal tradition. The thesis contained of this paper is that Hayek, although critical of democratic systems that do not reconcile liberty and equality, still believed in the democratic principle and tried ….

Introduction:Despite being considered as a contravention under some countries’ legislation, the therapeutic use of Cannabis sativa has been growing in Brazil, due to the promising results observed in many pathologies. Such a scenario has fostered the need to deepen discussions on the subject and possibly revise legislation governing the substance use and access.Objectives:Identify the types of stigma related to the therapeutic use of Cannabis and describe the strategies people use to overcome stigma.Methods:This integrative review was carried out in the databases (...) PubMed, Scopus, CINAHL, MEDLINE, PsycINFO, Web of Science, and Cochrane Library, with 565 articles being retrieved. Triads’ cross-check were done, first maintaining the “cannabis” and “therapeutic use” pair, added by “stigma,” “bioethics,” “ethics,” “social consequences,” and “legal consequences.” The final selection resulted in six articles.Ethical Consideration:However, the ethical issues that pervade and regulate decisions on this subject must be considered.Results:Different dimensions and types of stigma related to the therapeutic use of Cannabis have been identified. The bioethical principle of autonomy was an expression of citizenship and human rights, mitigating internal conflicts related to self-stigma and the effects of external stigma on the person’s life.Conclusion:It was possible to identify the types of stigma related to the therapeutic use of Cannabis is an internal dimension represented and an external dimension, represented and to identify strategies adopted to face this stigma: skills training group for users, elaboration of laws and specific programs to clarify the therapeutic use of Cannabis with a greater social scope, and support for family members. Thus, contributing to the building of people’s autonomy in a broader context of decision-making autonomy and executive autonomy will provide the development of people’s capacity to perform complex tasks of self-management and, consequently, to continue promoting and preserving their decision-making process and their capacity to plan and perform tasks associated with managing their lives and their treatments. (shrink)