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Theor Popul Biol ; 141: 44-53, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34358559


The patriarchal tradition of surnaming a child after its father in Han Chinese families may contribute to their preference for sons, a major cause of the abnormally high SRB (sex ratio at birth) in China. This high SRB can subsequently contribute to the marriage squeeze on males of marriageable age. Encouraging matrilineal surnaming has been proposed as a strategy that could potentially reduce son preference and help to adjust the imbalance in SRB. Here, we model factors that are likely to influence surnaming decisions, including cultural transmission of parents' surnaming decisions, the cultural value of a daughter, reward given to matrilineal surnaming, and awareness of current imbalance in SRB. Mathematical and computational analyses suggest that offering a significant reward and raising public awareness of the problems inherent in an excess of marriage-age males may overcome the son preference and reduce the male-biased SRB.

Razão de Masculinidade , Valores Sociais , Criança , China , Países em Desenvolvimento , Feminino , Humanos , Recém-Nascido , Masculino , Núcleo Familiar
Medisan ; 25(4)2021.
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1340219


La familia posee una función esencial en la formación de las futuras generaciones, pues en ella radican los cimientos para la educación en valores que contribuirán al desarrollo de la sociedad saludable y virtuosa que se necesita. Por ello, resulta impostergable mejorar las bases teóricas y metodológicas que orienten su actuación, así como también lograr herramientas eficaces para motivar y adiestrar en el despliegue de su papel rector educativo para cimentar generaciones de calidad, lo cual constituye un reto imprescindible. Al respecto, en este artículo se buscó revitalizar y enriquecer esos principios sin obviar el contexto actual que se vive, y además se brindan herramientas que posibilitan un mejor desempeño de la familia en la labor educativa de los valores.

The family possesses an essential function in the training of the future generations, because the foundations for values education reside in it so that they will contribute to the development of the healthy and virtuous society that it is needed. Reason why it is inevitable to improve the theoretical and methodological bases that guide their performance, as well as to achieve effective tools to motivate and train in the display of its educational rector role to build quality generations, which constitutes an indispensable challenge. In this respect, this work is aimed at revitalizing and enriching those principles without obviating the current context that we are living, and some tools are also offered that facilitate a better family performance in the educational work of values.

Valores Sociais , Família , Educação
Artigo em Inglês | MEDLINE | ID: mdl-34201913


The aim of this research was to evaluate the mediating effect of the value orientations of collectivism and individualism on the relationship between ethnic identity and well-being, the latter conceived from the worldview of Andean natives. For this purpose, under an observational and cross-sectional design, 395 Lickan-Antay adults (57% women) living in areas of indigenous development and in two cities in northern Chile were surveyed. We used the Lickan-Antay BLA32 well-being scale, a short version of the Portrait 21 Values Questionnaire to measure individualistic and collectivistic values, and an adapted version of the Ethnic Identity Scale. The results show that ethnic identity had a direct positive effect on all three dimensions of well-being (harmony with community life, ethnic harmony and harmony with nature), and total indirect effects on all five dimensions of well-being, one of them originating mainly from collectivist orientations. Individualistic orientations also showed a positive, though less intense, mediating effect on well-being. We conclude that collectivist and individualistic motivational patterns coexist in Lickan-Antay natives and explain an important part of the relationship between ethnic identity and well-being. Finally, we discuss our results and suggest replication of this study in other ethnic contexts to assess the generalizability of these findings to other native peoples of the Andean region of South America.

Motivação , Valores Sociais , Adulto , Chile , Estudos Transversais , Feminino , Humanos , Povos Indígenas , Masculino
BMC Infect Dis ; 21(1): 609, 2021 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-34171990


BACKGROUND: The prevalence of hepatitis C virus (HCV) among people who inject drugs (PWID) continues to be a major public-health burden in this highly stigmatised population. To halt transmission of HCV, rapid HCV self-testing kits represent an innovative approach that could enable PWID to know their HCV status and seek treatment. As no HCV test has yet been licenced for self-administration, it is crucial to obtain knowledge around the factors that may deter or foster delivery of HCV self-testing among PWID in resource-constrained countries. METHODS: A qualitative study to assess values and preferences relating to HCV self-testing was conducted in mid-2020 among PWID in the Bishkek and Chui regions of Kyrgyzstan. Forty-seven PWID participated in 15 individual interviews, two group interviews (n = 12) and one participatory action-research session (n = 20). Responses were analysed using a thematic analysis approach with 4 predefined themes: awareness of HCV and current HCV testing experiences, and acceptability and service delivery preferences for HCV self-testing. Informants' insights were analysed using a thematic analysis approach. This research received local ethics approval. RESULTS: Awareness of HCV is low and currently PWID prefer community-based HCV testing due to stigma encountered in other healthcare settings. HCV self-testing would be accepted and appreciated by PWID. Acceptability may increase if HCV self-testing: was delivered in pharmacies or by harm reduction associations; was free of charge; was oral rather than blood-based; included instructions with images and clear information on the test's accuracy; and was distributed alongside pre- and post-testing counselling with linkage to confirmatory testing support. CONCLUSIONS: HCV self-testing could increase awareness of and more frequent testing for HCV infection among PWID in Kyrgyzstan. It is recommended that peer-driven associations are involved in the delivery of any HCV self-testing. Furthermore, efforts should be maximised to end discrimination against PWID at the healthcare institutions responsible for confirmatory HCV testing and treatment provision.

Autoavaliação Diagnóstica , Hepatite C/diagnóstico , Preferência do Paciente , Abuso de Substâncias por Via Intravenosa , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Redução do Dano , Hepacivirus/isolamento & purificação , Hepatite C/complicações , Hepatite C/epidemiologia , Hepatite C/psicologia , Humanos , Quirguistão/epidemiologia , Masculino , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Preferência do Paciente/psicologia , Preferência do Paciente/estatística & dados numéricos , Prevalência , Autoteste , Testes Sorológicos/métodos , Valores Sociais , Abuso de Substâncias por Via Intravenosa/diagnóstico , Abuso de Substâncias por Via Intravenosa/epidemiologia , Abuso de Substâncias por Via Intravenosa/psicologia , Abuso de Substâncias por Via Intravenosa/virologia , Inquéritos e Questionários , Adulto Jovem
Nurs Adm Q ; 45(3): 192-196, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34060501


In response to the Future of Nursing Report, the Nurses on Boards Coalition promotes the health of communities and the nation by engaging nurses in board service. Nurses possess knowledge and skills that when leveraged in boardroom discussions and decisions may impact the health of the populations served by the board. This article highlights the insights of organizational board leaders, as they describe the impact and influence of nurse board members within their organizations.

Conselho Diretor/normas , Papel do Profissional de Enfermagem/psicologia , Valores Sociais , Conselho Diretor/organização & administração , Humanos , Enfermeiras Administradoras/psicologia
Nat Commun ; 12(1): 3567, 2021 06 11.
Artigo em Inglês | MEDLINE | ID: mdl-34117236


Humans typically consider altruism a moral good and condition their social behavior on the moral reputations of others. Indirect reciprocity explains how social norms and reputations support cooperation: individuals cooperate with others who are considered good. Indirect reciprocity works when an institution monitors and publicly broadcasts moral reputations. Here we develop a theory of adherence to public monitoring in societies where individuals are, at first, independently responsible for evaluating the reputations of their peers. Using a mathematical model, we show that adherence to an institution of moral assessment can evolve and promote cooperation under four different social norms, including norms that previous studies found to perform poorly. We determine how an institution's size and its degree of tolerance towards anti-social behavior affect the rate of cooperation. Public monitoring serves to eliminate disagreements about reputations, which increases cooperation and payoffs, so that adherence evolves by social contagion and remains robust against displacement.

Princípios Morais , Comportamento Social , Normas Sociais , Altruísmo , Transtorno da Personalidade Antissocial , Evolução Biológica , Comportamento Cooperativo , Teoria do Jogo , Humanos , Modelos Psicológicos , Evolução Social , Valores Sociais
Invest. educ. enferm ; 39(2): [e12], 15 junio 2021. table 1, table 2, table 3, table 4
Artigo em Inglês | LILACS, BDENF - Enfermagem, COLNAL | ID: biblio-1254721


Objective. This study was carried out to examine professional and ethical values related to the profession from nurses' perspectives. Methods. This was a cross-sectional survey carried out among 124 randomly selected nurses working at a tertiary care hospital in South India. The data was collected using Nursing Professional Values scale (NPVS-3). This tool consisted of 28 items to assess nurses' professional values in three domains namely; Caring (10 items), activism(10items), and professionalism (8items). The maximum range of scores is 28­140. The higher the score, the stronger the nurse's professional value orientation. Results. The mean total score of the Professional Value scale was high (121.07±15.32). The mean score of the participants was higher in the caring domain (44.02±5.75) than activism (42.19±6.33) and professionalism domains (34.86±4.27). Pearson correlational analysis revealed that nurses with less experience had greater mean professional values score than nurses with higher experience (p<0.01). Conclusion. The present study showed that nurses have high professional and ethical values, although they perceive that the most important values are those related to direct patient care. Continuing education programs should be designed so that nurses understand that nonclinical professional values are also equally important in promoting the nursing profession

Objetivo. Este estudio se llevó a cabo para evaluar los valores profesionales y éticos relacionados con la profesión desde la perspectiva de los enfermeros. Métodos. Se trata de un estudio transversal realizado entre 124 enfermeras seleccionadas aleatoriamente quienes trabajan en un hospital de atención terciaria del sur de la India. Los datos se recogieron utilizando la escala de valores profesionales de enfermería (NPVS-3). Este instrumento consta de 28 ítems con respuesta tipo Likert de 1-5 que evalúa los valores profesionales de los enfermeros en tres dominios: cuidado (10 ítems), activismo (10 ítems) y profesionalismo (8 ítems). El rango máximo de las puntuaciones es de 28 a 140, cuanto mayor sea la puntuación, mayor será la orientación hacia los valores profesionales de enfermería. Resultados. La puntuación media total de la escala de valores profesionales fue alta (121.07±15.32). La puntuación media de los participantes fue más alta en el dominio de cuidado (44.02±5.75) que en el del activismo (42.19±6.33) y en el de profesionalismo (34.86±4.27). El análisis correlacional de Pearson reveló que las enfermeras con menos experiencia tenían una mayor puntuación media en valores profesionales que las enfermeras con mayor experiencia (p<0.01). Conclusión. El presente estudio mostró que las enfermeras tienen altos valores profesionales y éticos, aunque perciben que los valores más importantes son los relacionados con el cuidado directo al paciente. Deben diseñarse programas de formación continua para que las enfermeras comprendan que los valores profesionales no clínicos también son igualmente importantes para promover la profesión de enfermería

Objetivo. Este estudo foi realizado com o objetivo de avaliar os valores profissionais e éticos relacionados à profissão na perspectiva dos enfermeiros. Métodos. Este é um estudo transversal de 124 enfermeiras selecionadas aleatoriamente que trabalham em um hospital terciário no sul da Índia. Os dados foram coletados por meio da Nursing Professional Values Scale (NPVS-3). Esse instrumento é composto por 28 itens com resposta do tipo Likert de 1 a 5 que avaliam os valores profissionais do enfermeiro em três domínios: cuidado (10 itens), ativismo (10 itens) e profissionalismo (8 itens). A faixa máxima de pontuação é de 28 a 140, quanto maior a pontuação, maior a orientação para os valores do profissional de enfermagem. Resultados. A pontuação média total da escala de valores profissionais foi elevada (121.07±15.32). A pontuação média dos participantes foi maior no domínio cuidar (44.02±5.75) do que no ativismo (42.19±6.33) e no domínio profissionalismo (34.86±4.27). A análise correlacional de Pearson revelou que enfermeiras menos experientes tiveram uma pontuação média mais alta em valores profissionais do que enfermeiras mais experientes (p<0.01). Conclusão. O presente estudo mostrou que os enfermeiros possuem elevados valores profissionais e éticos, embora percebam que os valores mais importantes são aqueles relacionados ao cuidado direto ao paciente. Os programas de educação continuada devem ser planejados de forma que os enfermeiros entendam que os valores profissionais não clínicos também são igualmente importantes na promoção da profissão de enfermagem.

Humanos , Valores Sociais , Estudos Transversais , Ética em Enfermagem , Profissionalismo , Índia
Enferm. foco (Brasília) ; 12(1): 132-138, jun. 2021. tab
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1255351


Objetivo: Analisar publicações sobre valores pessoais e profissionais de enfermeiros e sua relação com a formação e a prática clínica de enfermagem. Metodologia: Revisão integrativa de artigos indexados nas bases MEDLINE, LILACS e CINAHL publicados entre 2014 a 2019, que abordaram os valores pessoais e profissionais na enfermagem, sendo analisados por estatística descritiva das frequências e analise de conteúdo temático de Bardin. Resultados: Foram selecionados treze artigos, em português, espanhol e inglês, em oito revistas distintas. Os países que tiveram instituições filiadas aos estudos foram Turquia, Canadá, Espanha, Colômbia, Estados Unidos, Brasil e Irã. Os locais de desenvolvimento dos estudos foram em instituições de ensino superior, hospitais e unidades básicas de saúde. A metodologia mais utilizada foi a quantitativa. As categorias temáticas constituídas foram: instrumentos para avaliação de valores da enfermagem, descrição sobre os valores na enfermagem e fatores associados, diferenças intergeracionais e evolução dos valores. Conclusão: Concluiu-se que a busca pelo conhecimento sobre os valores da enfermagem é universal, porém pouco abordada no contexto brasileiro. A dignidade humana foi o valor mais representado nos estudos. A formação de valores contribui para a formação e aprimoramento de profissionais qualificados que contribui a segurança na prática clínica. (AU)

Objective: To analyze publications on nurses' personal and professional values and their relationship with nursing education and clinical practice. Methodology: Integrative review of articles indexed in the MEDLINE, LILACS and CINAHL databases published between 2014 and 2019, which addressed personal and professional values in nursing, being analyzed by descriptive statistics of the frequencies and analysis of thematic content of Bardin. Results: Thirteen articles were selected, in Portugueses, Spanish and English, in eight different journals. The countries that had institutions affiliated to the studies were Turkey, Canada, Spain, Colombia, United States, Brazil and Iran. The places where the studies were developed were in higher education institutions, hospitals and basic health units. The most used methodology was quantitative. The constituted thematic categories were: instruments for evaluating nursing values, description of nursing values and associated factors, intergenerational differences and evolution of values. Conclusion: It was concluded that the search for knowledge about nursing values is universal, but little addressed in the Brazilian context. Human dignity was the most represented value in studies. The formation of values contributes to the training and improvement of qualified professionals that contributes to safety in clinical practice. (AU)

Objetivo: Analizar publicaciones sobre los valores personales y profesionales del enfermero y su relación con la formación y práctica clínica en enfermería. Metodología: Revisión integradora de artículos indexados en las bases de datos MEDLINE, LILACS y CINAHL publicados entre 2014 y 2019, que abordaron valores personales y profesionales en enfermería, siendo analizados mediante estadística descriptiva de las frecuencias y análisis de contenido temático de Bardin. Resultados: Se seleccionaron trece artículos, en portugués, español e inglés, en ocho revistas diferentes. Los países que tenían instituciones afiliadas a los estudios fueron Turquía, Canadá, España, Colombia, Estados Unidos, Brasil e Irán, los lugares donde se desarrollaron los estudios fueron en instituciones de educación superior, hospitales y unidades básicas de salud. La metodología más utilizada fue la cuantitativa. Las categorías temáticas constituidas fueron: instrumentos de evaluación de los valores de enfermería, descripción de los valores de enfermería y factores asociados, diferencias intergeneracionales y evolución de valores. Conclusión: Se concluyó que la búsqueda del conocimiento sobre los valores de la enfermería es universal, pero poco abordada en el contexto brasileño. La dignidad humana fue el valor más representado en los estudios. La formación de valores contribuye a la formación y mejora de profesionales cualificados que contribuyan a la seguridad en la práctica clínica. (AU)

Capacitação Profissional , Valores Sociais , Ética em Enfermagem , Cuidados de Enfermagem
Sci Rep ; 11(1): 9351, 2021 04 30.
Artigo em Inglês | MEDLINE | ID: mdl-33931689


Cooperative decisions are well predicted by stable individual differences in social values but it remains unclear how they may be modulated by emotions such as fear and anger. Moving beyond specific decision paradigms, we used a suite of economic games and investigated how experimental inductions of fear or anger affect latent factors of decision making in individuals with selfish or prosocial value orientations. We found that, relative to experimentally induced anger, induced fear elicited higher scores on a cooperation factor, and that this effect was entirely driven by selfish participants. In fact, induced fear brought selfish individuals to cooperate similarly to prosocial individuals, possibly as a (selfish) mean to seek protection in others. These results suggest that two basic threat-related emotions, fear and anger, differentially affect a generalized form of cooperation and that this effect is buffered by prosocial value orientation.

Ira/fisiologia , Comportamento Cooperativo , Emoções/fisiologia , Medo/fisiologia , Teoria do Jogo , Relações Interpessoais , Comportamento Social , Adulto , Feminino , Humanos , Masculino , Valores Sociais
Nurs Adm Q ; 45(3): 197-200, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33935210


Nursing regulation is a specialty area of nursing practice that some may perceive as only performing licensing and disciplinary functions. However, highly effective boards strive to meet their mission of public protection through continuous innovation. This article describes several innovative programs initiated by a board of nursing. Among the examples include regulatory waivers during the pandemic, collaborations with stakeholder organizations, a resource for nursing peer-review committees, and an alternative remediation option for practice breakdown. With strong leadership and committed teams, regulation can both protect the public and play a part in actualizing the value of nursing.

Enfermagem/métodos , Controle Social Formal/métodos , Valores Sociais , Criatividade , Humanos , Enfermagem/instrumentação
J Health Organ Manag ; ahead-of-print(ahead-of-print)2021 May 25.
Artigo em Inglês | MEDLINE | ID: mdl-34018706


PURPOSE: This paper aims to investigate the Portuguese general public views regarding the criteria that should guide critical COVID-19 patients to receive medical devices (ventilators and IUC beds) during the current pandemic context. Based on rationing principles and protocols proposed in ethical and medical literature the authors explore how Portuguese general public evaluates the fairness of five allocation principles: "prognosis", "severity of health condition", "patients age", "instrumental value" (frontline healthcare professionals should be prioritized during the pandemic) and "lottery". DESIGN/METHODOLOGY/APPROACH: An online questionnaire was used to collect data from a sample of 586 Portuguese citizens. Descriptive statistics and non-parametric tests were used to define a hierarchy of prioritization criteria and to test for the association between respondents support to them and their socio-demographic and health characteristics. FINDINGS: Respondents gave top priority to prognosis when faced with absolute scarcity, followed closely by the severity of health condition, patient's age with instrumental value receiving lowest support, on average. However, when the age of the patients was confronted with survival, younger-first principle prevailed over recovery. In a pandemic context, lottery was considered the least fair allocation method. The findings suggest that respondents' opinions are aligned with those of ethicists but are partially in disagreement with the protocol suggested for Portugal. ORIGINALITY/VALUE: This study represents the first attempt to elicit public attitudes towards distributive criteria during a pandemic and, therefore, in a real context where the perception is that life and death decisions have to be made.

COVID-19/epidemiologia , COVID-19/prevenção & controle , Alocação de Recursos para a Atenção à Saúde , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Opinião Pública , Fatores Etários , Tomada de Decisões , Pessoal de Saúde , Prioridades em Saúde , Humanos , Pandemias , Pneumonia Viral/virologia , Portugal , Prognóstico , SARS-CoV-2 , Índice de Gravidade de Doença , Valores Sociais , Inquéritos e Questionários , Valor da Vida
Public Health ; 194: 17-18, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33845274


OBJECTIVES: Epilepsy is a common disease in the pediatric neurology department; as it a chronic disease, many years are spent seeing doctors and taking drugs. The objective of the study is to understand the values of parents to help doctors to more effectively communicate and to improve patient compliance. STUDY DESIGN: The study was designed to investigate guardians' values of children with epilepsy and analyze the relevant factors that may affect these values and the correlation of the guardians' values and medical decision making. METHODS: Two hundred guardians (93 men and 107 women) of children with epilepsy from three hospitals in Wuhan, China, were selected at random and investigated by means of interview survey. Statistical analysis by ratio was conducted on the general data, whereas statistical analyses by Pearson and Spearman rank correlation were conducted for the relative factors. RESULTS: A high educational level among male guardians indicated a strong tendency to read up on epilepsy, which influenced their care given. A high educational level among female guardians indicated better capability to take care of child patients and follow directions for antiepileptic drug administration. Female guardians were more likely to see the same doctors during a long disease period than male guardians. CONCLUSION: The guardians' values were influenced by many factors, such as gender, education, and duration of disease. Guardians' values need to be considered as they are helpful for doctors in decision-making.

Epilepsia/terapia , Pais/psicologia , Valores Sociais , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , China/epidemiologia , Tomada de Decisão Clínica , Comunicação , Epilepsia/epidemiologia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Cooperação do Paciente/estatística & dados numéricos , Relações Médico-Paciente , Fatores Socioeconômicos , Inquéritos e Questionários , Adulto Jovem
Artigo em Inglês | MEDLINE | ID: mdl-33803264


Urban riverfront space has diversified ecosystem services, but due to excessive changes in the geographical environment, such as drastic changes in land use, people gain social value at a great ecological cost. Obtaining benefits from the ecosystem in this way is not sustainable. Therefore, this paper uses the SolVES model to evaluate the social value of ecosystem services on the east bank of the Fenghe River, while also studying the contribution of different environmental variables to social value. The main results are as follows. (1) Environmental variables affect the spatial distribution characteristics of social value. The distance to water (DTW) means the social value was distributed in strips, and the distance to road (DTR) concentrated the social value along the road. The landscape type (LT) means the social value was concentrated in the landscape space. (2) When DTW, DTR, and LT were collectively used as environmental variables, the distribution characteristics of various social values were similar to when LT was used as the only environmental variable. (3) The results of MaxEnt show that LT made a greater contribution to the aesthetic, recreation, therapeutic, and historic values, and was the largest contribution factor to the aesthetic, therapeutic, and historic values, with contribution rates of 47.6, 50.5, and 80.0%, respectively. DTW is the factor that contributed the most to recreation, with a contribution rate of 43.1%. Improving social value based on the influence and contribution of environmental variables can reduce the damage to the ecological environment caused by changes in geographic factors. This is sustainable for both the ecosystem and the services it provides to mankind.

Ecossistema , Rios , China , Conservação dos Recursos Naturais , Humanos , Valores Sociais
Health Res Policy Syst ; 19(1): 47, 2021 Mar 31.
Artigo em Inglês | MEDLINE | ID: mdl-33789671


BACKGROUND: At the height of the COVID-19 pandemic, Thailand had almost depleted its critical care resources, particularly intensive care unit (ICU) beds and ventilators. This prompted the necessity to develop a national guideline for resource allocation. This paper describes the development process of a national guideline for critical resource allocation in Thailand during the COVID-19 pandemic. METHODS: The guideline development process consisted of three steps: (1) rapid review of existing rationing guidelines and literature; (2) interviews of Thai clinicians experienced in caring for COVID-19 cases; and (3) multi-stakeholder consultations. At steps 1 and 2, data was synthesized and categorized using a thematic and content analysis approach, and this guided the formulation of the draft guideline. Within step 3, the draft Thai critical care allocation guideline was debated and finalized before entering the policy-decision stage. RESULTS: Three-order prioritization criteria consisting of (1) clinical prognosis using four tools (Charlson Comorbidity Index, Sequential Organ Failure Assessment, frailty assessment and cognitive impairment assessment), (2) number of life-years saved and (3) social usefulness were proposed by the research team based on literature reviews and interviews. At consultations, stakeholders rejected using life-years as a criterion due to potential age and gender discrimination, as well as social utility due to a concern it would foster public distrust, as this judgement can be arbitrary. It was agreed that the attending physician is required to be the decision-maker in the Thai medico-legal context, while a patient review committee would play an advisory role. Allocation decisions are to be documented for transparency, and no appealing mechanism is to be applied. This guideline will be triggered only when demand exceeds supply after the utmost efforts to mobilize surge capacity. Once implemented, it is applicable to all patients, COVID-19 and non-COVID-19, requiring critical care resources prior to ICU admission and during ICU stay. CONCLUSIONS: The guideline development process for the allocation of critical care resources in the context of the COVID-19 outbreak in Thailand was informed by scientific evidence, medico-legal context, existing norms and societal values to reduce risk of public distrust given the sensitive nature of the issue and ethical dilemmas of the guiding principle, though it was conducted at record speed. Our lessons can provide an insight for the development of similar prioritization guidelines, especially in other low- and middle-income countries.

COVID-19 , Cuidados Críticos , Estado Terminal , Alocação de Recursos para a Atenção à Saúde , Acesso aos Serviços de Saúde , Pandemias , Guias de Prática Clínica como Assunto , Tomada de Decisões , Revelação , Ética Médica , Recursos em Saúde , Hospitalização , Humanos , Unidades de Terapia Intensiva , Prognóstico , SARS-CoV-2 , Discriminação Social , Valores Sociais , Participação dos Interessados , Tailândia , Confiança
AJOB Neurosci ; 12(2-3): 89-102, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33798021


Our present moral traits are unable to provide the level of large-scale co-operation necessary to deal with risks such as nuclear proliferation, drastic climate change and pandemics. In order to survive in an environment with powerful and easily available technologies, some authors claim that we need to improve our moral traits with moral enhancement. But this is prone to produce paradoxical effects, be self-reinforcing and harm personal identity. The risks of moral enhancement require the use of a safety framework; such a framework should guarantee practical robustness to moral uncertainty, empirical adequacy, correct balance between dispositions, preservation of identity, and be sensitive to practical considerations such as emergent social effects. A virtue theory can meet all these desiderata. Possible frameworks incorporate them to variable degrees. The social value orientations framework is one of the most promising candidates.

Princípios Morais , Virtudes , Valores Sociais
Global Health ; 17(1): 46, 2021 04 14.
Artigo em Inglês | MEDLINE | ID: mdl-33853631


Health innovations are generally oriented on a techno-economic vision. In this perspective, technologies are seen as an end in themselves, and there is no arrangement between the technical and the social values of innovation. This vision prevails in sanitary crises, in which management is carried out based on the search for punctual, reactive, and technical solutions to remedy a specific problem without a systemic/holistic, sustainable, or proactive approach. This paper attempts to contribute to the literature on the epistemological orientation of innovations in the field of public health. Taking the Covid-19 and Ebola crises as examples, the primary objective is to show how innovation in health is oriented towards a techno-economic paradigm. Second, we propose a repositioning of public health innovation towards a social paradigm that will put more emphasis on the interaction between social and health dimensions in the perspective of social change. We will conclude by highlighting the roles that public health could play in allowing innovations to have more social value, especially during sanitary crises.

Tecnologia Biomédica , COVID-19/terapia , Reforma dos Serviços de Saúde , Prioridades em Saúde , Doença pelo Vírus Ebola/terapia , Saúde Pública , Acesso à Informação , COVID-19/prevenção & controle , Análise Custo-Benefício , Difusão de Inovações , Equidade em Saúde , Acesso aos Serviços de Saúde , Doença pelo Vírus Ebola/prevenção & controle , Humanos , Preparações Farmacêuticas , Condições Sociais , Meio Social , Valores Sociais , Tecnologia , Vacinas
J Genet Psychol ; 182(3): 129-148, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33704026


This cross-cultural study compared the prosocial behaviors of 101 Dutch, 37 urban Indian and 91 urban Chinese preschoolers, investigated (potential) cultural differences on their mothers' values and goals, and examined how mothers' values and goals relate to preschoolers' prosocial behaviors. Preschoolers' prosocial behaviors were observed in three standardized, behavioral assessments. Mothers reported on their own values and socialization goals for their children. Results showed no cultural difference in prosocial behaviors. However, Indian and Chinese mothers rated self-enhancement values as more important than Dutch mothers, and Indian mothers rated self-transcendence values and relational goals as more important than the Chinese and Dutch mothers. No difference was found on autonomous goals. These findings suggest that current cultural differences on parental socialization processes are beyond the individualistic-collectivistic dichotomy often used to classify cultures and are more reflective of the independence of these two dimensions. Mothers in urban Indian and urban Chinese societies can be categorized into an autonomous-relatedness cultural model. Additionally, there might be an ongoing shift toward an independence model in the urban, Chinese societies. Furthermore, culture moderated the association between autonomous goals and observed prosocial behaviors, with this association being significant within the Dutch sample only. No other associations between values or goals and children's prosocial behavior were found. Overall, these findings support the ecocultural model of children's prosocial development, and further suggest that young preschoolers from different cultures are more alike than different in prosocial behaviors.

Comportamento Infantil , Comparação Transcultural , Comportamento Social , Pré-Escolar , China , Feminino , Objetivos , Humanos , Índia , Masculino , Mães , Países Baixos , Pais , Valores Sociais , Socialização , População Urbana
Ned Tijdschr Geneeskd ; 1652021 01 21.
Artigo em Holandês | MEDLINE | ID: mdl-33651494


A pediatric case study showed that genetic testing to obtain a diagnosis becomes increasingly complex. Expectant parents found out prenatally, with an ultrasound that their child has skeletal abnormalities. The search for a diagnosis that followed after this test result shows how complex this can be. This case study furthermore shows that professionals might have aims for testing which differ from parents' wishes. While professionals in this case wanted to have a diagnosis in an efficient way, the parents involved in this case did not want further testing, supported by their religious believes. As they explained, they will accept their child unconditionally. But when the health problems of their daughter become more severe they accepted testing. This difference in opinions about genetic testing pleas for pre-test counselling which focusses on exploring parental values. Discussing values contributes to a satisfactory diagnostic trajectory and follow-up.

Aconselhamento Genético/psicologia , Testes Genéticos/ética , Pais/psicologia , Relações Profissional-Paciente/ética , Valores Sociais , Atitude , Criança , Feminino , Humanos , Masculino