Epistemic injustice, judiciary reasoning and stereotypes: from narrow, to broad, to broader

Questo saggio considera il ruolo dell'ingiustizia epistemica nel segnalare gli stereotipi nel ragionamento giuridico. Discute la proposta di Janaina Matida e Alessia Farano di ampliare il concetto di ingiustizia testimoniale e conclude con una proposta per una versione ancora più ampia del concetto.This essay deals with the role of epistemic injustice in pointing out stereotypes in legal reasoning. The Author discusses the proposal of Janaina Matida and Alessia Farano to expand the concept of witness injustice and concludes with a proposal for an even broader version of the concept

Dissenting opinion, judicial review and democracy

The purpose of this article is to discuss and argue in favour of two ideas. The first states that where dissenting opinions are allowed within the decisions of the Constitutional Courts such decisions may be more democratic than similar decisions taken where dissent cannot be disclosed. This means that dissenting opinions may be a tool to overcome or resist the most common objection to judicial review which goes under the label of countermajoritarian difficulty. The second idea states that dissenting opinions may faster the democratic nature of the entire legal system.peer-reviewe

Social and economic rights in the Constitution of the United States

The article starts by discussing the most common explanations for a substantial silence of the US constitutional culture on social and economic rights. It then suggests that the most plausible explanation seems to rest rather than on what it is usually referred to as the American exceptionalism, on a peculiar culture of rights spread among US legal thinkers and endorsed by Supreme Court Justices. A review of the past and more recent Supreme Court case law on social and economic rights is presented, as well as a tepid prediction of what will occur in the future.peer-reviewe

Il diritto come mediazione fra saperi distinti. Perché il diritto non ha fatto un passo indietro di fronte alla scienza

SOMMARIO: 1. Il diritto resiste alla scienza - 2. La scienza come criterio di legittimazione della norma giuridica - 3. Diritto come fenomeno normativo: incommensurabilità fra diritto e scienza - 4. Il diritto come super scienza - 4.1. Voracità processuale - 4.2. Verità giuridica e legittimazione dell’organo decidente - 4.3. Verità giuridica e falsificazione - 4.4. Margini del sindacato giudiziario - 5. Diritto come mediazione fra saperi distinti - 6. Conclusioni: diritto, scienza e gestione dell’incertezza. Law as system which incorporates distinct epistemological methods. Why legal reasoning did not retreat before scientific knowledge ABSTRACT: The central claim of this Article is that, despite the frequent references by legal acts to scientific knowledge, the scientific method has not supplanted or overshadowed the proper features of legal reasoning arising from the idea of law as an autonomous system of knowledge. In fact, just the opposite has occurred. It will be argued that the resistance of the legal at the scientific method can be explained on the basis of three distinct theories of law and legal reasoning: a) the first claims that law is a normative system which is incommensurable with science; b) the second qualifies law as a kind of superscience which grounds legitimacy to science itself; c) the third defines law as a normative system which accepts and incorporates forms of knowledges which the scientific method normally rejects

Mãe-cuidadora de criança/adolescente com Paralisia Cerebral: O cuidar de si

The care for oneself allows the person to add the various stages of life in a healthy way in the physical, emotional and spiritual aspects. Objective: To understand how the woman-mother of child/teenager with Cerebral Palsy takes care of herself. Method: A qualitative study with a phenomenological-hermeneutical approach held in the Association of Parents and Friends of Exceptional Children in a municipality located in the south of Rio Grande do Sul, Brazil, with ten mothers/caregivers of children/adolescents with cerebral palsy, between April and June 2015. For the collection of information there was used the participant observation and phenomenological interview, the interpretation by means of the hermeneutical approach. With regard to ethical considerations, the research was approved by the Ethics Committee of the Medical School of the Federal University of Pelotas, Opinion N 1,001,573. It was also presented, read and delivered the word of Informed Consent Form (ICF). Results: The care for herself the woman-mother is tied to the care for the child/adolescent. It refers to taking care of herself, sometimes means taking care of the health, which may be related to the treatment of beauty, mention yet, not taking self-care unless at the time of the shower, and, even so, the son is next. Conclusion: The study brings contributions to the practice of nurse to subsidize strategies for these women of taking care of themselves, to assist them in the process of adaptation to the new situation and in the process of taking care of the child.El cuidado de sí mismo permite a la persona integrar las diversas etapas de la vida de una manera saludable en los aspectos físicos, emocionales y espirituales. Objetivo: Comprender cómo la mujer-madre de niño/adolescente con Parálisis Cerebral toma el cuidado de sí misma. Método: Un estudio cualitativo con un enfoque fenomenológico/hermenéutico realizado en la Asociación de Padres y Amigos de niños excepcionales en un municipio del sur del estado de Rio Grande do Sul/Brasil, con diez madres/cuidadoras de niños y adolescentes con parálisis cerebral, entre abril y junio de 2015. Para la recogida de información se utilizó la observación participante y la entrevista fenomenológica, la interpretación por medio del enfoque de la hermenéutica. Con respecto a las consideraciones éticas, la investigación fue aprobada por el Comité de Ética de la Facultad de Medicina de la Universidad Federal de Pelotas, Opinión N 1.001.573. También se presentó, leyó y se entregó el Formulario de Consentimiento Libre e Informado (ICF). Resultados: El cuidado de sí misma de la mujer-madre está vinculado al cuidado del niño/adolescente. Refiere que el cuidar de sí misma, a veces significa cuidar de la salud, pudiendo estar relacionado con el tratamiento de belleza, menciona, también, no cuidar de sí misma a no ser en el momento del baño, y, aun así, el hijo está junto a ella. Conclusión: El estudio aporta contribuciones a la práctica de la enfermera para subsidiar estrategias capaces de facilitar a estas mujeres el cuidado de sí mismas, al ayudarlas en el proceso de adaptación a la nueva situación, y en el proceso de cuidar del niño/adolescente.O cuidar de si possibilita a pessoa integrar as várias fases da vida de maneira saudável nos aspectos físicos, emocionais e espirituais.    Objetivo: Compreender como a mulher-mãe de criança/adolescente com Paralisia Cerebral cuida de si. Método: Estudo qualitativo, com abordagem fenomenológica/hermenêutica, realizado na Associação de Pais e Amigos dos Excepcionais em um município ao sul do Rio Grande do Sul/Brasil, com dez mães/cuidadoras de crianças/adolescentes com paralisia cerebral, entre abril e junho de 2015. Para a coleta de informações utilizou-se observação participante e entrevista fenomenológica, a interpretação por meio da abordagem hermenêutica. Quanto às considerações éticas, a pesquisa foi aprovada pelo Comitê de Ética em Pesquisa da Faculdade de Medicina da Universidade Federal de Pelotas, Parecer nº 1.001.573. Também foi apresentado, lido e entregue o termo de Consentimento Livre e Esclarecido (TCLE). Resultados: O cuidar de si da mulher-mãe está atrelado ao cuidado da criança/adolescente. Refere que cuidar de si, por vezes, significa cuidar da saúde, podendo estar relacionado ao tratamento da beleza, menciona ainda, não ter cuidado consigo a não ser no momento do banho, e, mesmo assim o filho está junto.  Conclusão: O estudo traz contribuições à prática da enfermeira ao subsidiar estratégias capazes de facilitar a estas mulheres o cuidar de si, ao auxilia-las no processo de adaptação à nova situação e no processo de cuidar a criança/adolescente

Sustaining the Continued Effectiveness of an Antimicrobial Stewardship Program in Preterm Infants

Background: There are wide variations in antibiotic use in neonatal intensive care units (NICUs). Limited data are available on antimicrobial stewardship (AS) programs and long-term maintenance of AS interventions in preterm very-low-birth-weight (VLBW) infants. Methods: We extended a single-centre observational study carried out in an Italian NICU. Three periods were compared: I. "baseline" (2011-2012), II. "intervention" (2016-2017), and III. "maintenance" (2020-2021). Intensive training of medical and nursing staff on AS occurred between periods I and II. AS protocols and algorithms were maintained and implemented between periods II and III. Results: There were 111, 119, and 100 VLBW infants in periods I, II, and III, respectively. In the "intervention period", there was a reduction in antibiotic use, reported as days of antibiotic therapy per 1000 patient days (215 vs. 302, p < 0.01). In the "maintenance period", the number of culture-proven sepsis increased. Nevertheless, antibiotic exposure of uninfected VLBW infants was lower, while no sepsis-related deaths occurred. Our restriction was mostly directed at shortening antibiotic regimens with a policy of 48 h rule-out sepsis (median days of early empiric antibiotics: 6 vs. 3 vs. 2 in periods I, II, and III, respectively, p < 0.001). Moreover, antibiotics administered for so-called culture-negative sepsis were reduced (22% vs. 11% vs. 6%, p = 0.002), especially in infants with a birth weight between 1000 and 1499 g. Conclusions: AS is feasible in preterm VLBW infants, and antibiotic use can be safely reduced. AS interventions, namely, the shortening of antibiotic courses in uninfected infants, can be sustained over time with periodic clinical audits and daily discussion of antimicrobial therapies among staff members

Pathological gambling in adolescence: a narrative review

Pathological gambling is an emerging and increasing phenomenon in Western counties. This work is aimed at reviewing the existing literature on this topic, paying special attention to its development, course and outcome in adolescence. We will explore epidemiological data, the instruments for the diagnostic and clinical assessment, the course and the outcome of the disorder, the comorbidity with other psychiatric syndromes and disorders. The main risk factors will be described at individual, social and community level. We provide an overview of the available pharmacological and psychological treatments and we report a clinical vignette in order to describe the psychological and psychopathological features of pathological gambling in adolescence. 

Daily experience of a heal th care team : a case report

As autoras apresentam o relato de experiência do cotidiano de uma equipe de saúde sob o enfoque de alguns aspectos da micro sociologia, no qual o ser humano manifesta toda a sua teatralidade. A “ vida cotidiana” é desvelada a partir de um olhar mais atento dos profissionais que atuam na área da saúde. A vida cotidiana é o “palco” onde o enredo do viver se dá em toda sua complexidade, as alegrias, os sonhos, os conflitos e o sofrimento do dia a dia de cada ser humano. Através deste relato são analisados alguns aspectos da “centralidade subterrânea” que determina a existência humana. Constata-se que a categoria poder representada pelo jogo, tem destaque nas relações sociais de trabalho desta equipe. A teatralidade é outro elemento encontrado na análise realizada.The autors present daily experience report of a health staff, based in some aspects of micro sociology in which the human being manifests ali of its "theatrical behavior". Daily life is revealed in a closer look by the health field professionals. Daily life is the "stage" where the plot of life takes place in ali of its complexity, the joy, the dreams, the conflicts and the suffering of each day, of each human being. This report analysis some aspects of the " underground centralízation of actions", which determines human existence. lt has been observed that the power category represented by the "game" had outstanding relevance in the work social relations of the staff. The "theatrical b~bavior" was the other element found in the analysis made

Ultrasound-Guided Centrally Inserted Central Catheter (CICC) Placement in Newborns: A Safe Clinical Training Program in a Neonatal Intensive Care Unit

Background: Centrally inserted central catheters (CICCs) are increasingly used in neonatal care. CICCs have garnered attention and adoption owing to their advantageous features. Therefore, achieving clinical competence in ultrasound-guided CICC insertion in term and preterm infants is of paramount importance for neonatologists. A safe clinical training program should include theoretical teaching and clinical practice, simulation and supervised CICC insertions. Methods: We planned a training program for neonatologists for ultrasound-guided CICCs placement at our level III neonatal intensive care unit (NICU) in Modena, Italy. In this single-centre prospective observational study, we present the preliminary results of a 12-month training period. Two paediatric anaesthesiologists participated as trainers, and a multidisciplinary team was established for continuing education, consisting of neonatologists, nurses, and anaesthesiologists. We detail the features of our training program and present the modalities of CICC placement in newborns. Results: The success rate of procedures was 100%. In 80.5% of cases, the insertion was obtained at the first ultrasound-guided venipuncture. No procedure-related complications occurred in neonates (median gestational age 36 weeks, IQR 26-40; median birth weight 1200 g, IQR 622-2930). Three of the six neonatologists (50%) who participated in the clinical training program have achieved good clinical competence. One of them has acquired the necessary skills to in turn supervise other colleagues. Conclusions: Our ongoing clinical training program was safe and effective. Conducting the program within the NICU contributes to the implementation of medical and nursing skills of the entire staff

Criança/adolescente no cuidado ao irmão com deficiência no mundo da família

Objetivo: Compreender o significado para a criança/adolescente de participar do cuidado do irmão com deficiência.Método: Pesquisa a luz da abordagem fenomenológica heideggeriana, realizada na região norte do Rio Grande do Sul. Participaram 20 crianças/adolescentes que conviviam com o irmão com deficiência. As informações foram coletadas mediante entrevista fenomenológica, interpretadas a luz da hermenêutica de Paul Ricoeur.Resultados: A criança/adolescente auxilia a família no cuidado do irmão com deficiência, na alimentação, no banho, no vestir-se, dentre outras atividades, em alguns momentos observa-se excessiva responsabilização da criança/adolescente para com o cuidado do irmão.Considerações finais: Constata-se ser imprescindível a inclusão da criança/adolescente que vive com irmão com deficiência e suas famílias no planejamento e implantação das atividades de cuidado à saúde. Destaca-se como contribuição da pesquisa à qualificação da prática dos profissionais de saúde, em especial da enfermeira(o), no âmbito do cuidado à criança/adolescente que vive esse fenômeno. Palavras-chave: Criança. Adolescente. Crianças com deficiência. Empatia. Enfermage