Intencionalidad afectiva y conciencia trina en la ética de Lonergan

La comprensión sobre los sentimientos, en los escritos de Lonergan, sufre un cambio significativo, sobre todo a partir de su obra Method in Theology (1972). En este artículo presentamos una visión sistemática y coherente de los elementos implicados en aquel cambio. En primer lugar presentamos la posición de Lonergan sobre la decisión y los sentimientos en su obra Insight (1957). En segundo lugar analizamos su comprensión sobre los sentimientos en Method. Luego, analizando las actividades asociadas al cuarto nivel de conciencia, el nivel moral, mostramos cómo el sujeto, al conocer y decidir, integra sus sentimientos en cuanto que estos son respuestas intencionales a los valores. Los sentimientos tienen un rol en la estructura intencional de la conciencia. El sujeto está invitado a vivir la profundaexperiencia de la conversión afectiva y así alcanzar su auto-trascendencia afectiva

El desarrollo de la noción de autopropiación en el pensamiento de B. Lonergan. Una respuesta a la nueva regulación del sentido que demanda la cultura moderna

Lonergan señala que la cultura clasicista se ha desvanecido hoy día. Ya no existe una única comprensión de cultura que sea aceptada. En la cultura moderna se da una transposición de la lógica al método, de la ciencia como concebida en los analíticos posteriores a la ciencia como es concebida hoy, de la metafísica del alma a la autoapropiación del sujeto, de una aprehensión del hombre en términos de naturaleza humana a una aprehensión del hombre a través de la historia humana y de los primeros principios al método trascendental. Estos cambios son manifestaciones de la nueva mediación de sentido que surge en la cultura moderna, la cual está demandando una nueva regulación (control) del sentido

Hacia una fundamentación del hacernos a nosotros mismos en la reflexión ética de Bernard Lonergan

En este artículo se da una respuesta a la pregunta por los fundamentos del hacerse a sí mismo del sujeto, y de este modo se explícita un horizonte de significación, al interior del cual se puede reconocer que el ideal de autenticidad encierra en sí una fuerza moral (no es un ideal meramente arbitrario y subjetivo) y merece ser tenido en cuenta en nuestras reflexiones éticas

Ultrasound and Microwave-assisted Extraction of Proteins from Coffee Green Beans: Effects of Process Variables on the Protein Integrity

The demand for proteins is constantly increasing and green extraction methodologies are needed to achieve environmental sustainability goals. The recovery of the by-products of the agri-food chain has also become a priority from a circular economy perspective. Some by-products are still little exploited for the extraction of proteins, such as coffee by-products. In this work, various innovative extraction technologies were applied to recover the protein fraction from the non-compliant coffee green beans (CGB), using a methodological approach that allowed to correlate the process parameters with the final quality of the extracted proteins. The ultrasound-assisted extraction (UAE) technique has been shown to have a minor impact on the quality of the proteins, thanks to the possibility of refrigerating the system, while the microwave-assisted extraction (MAE) shows a certain degree of degradation due to the high temperatures reached. The results indicate that strict temperature control is required during alkaline extraction to preserve the quality of the protein fraction

Comparative case studies in integrated care implementation from across the globe: A quest for action

© 2019 The Author(s). Background: Integrated care is the coordination of general and behavioral health and is a highly promising and practical approach to improving healthcare delivery and patient outcomes. While there is growing interest and investment in integrated care implementation internationally, there are no formal guidelines for integrated care implementation applicable to diverse healthcare systems. Furthermore, there is a complex interplay of factors at multiple levels of influence that are necessary for successful implementation of integrated care in health systems. Methods: Guided by the Exploration, Preparation, Implementation, Sustainment (EPIS) framework (Aarons et al., 2011), a multiple case study design was used to address two research objectives: 1) To highlight current integrated care implementation efforts through seven international case studies that target a range of healthcare systems, patient populations and implementation strategies and outcomes, and 2) To synthesize the shared and unique challenges and successes across studies using the EPIS framework. Results: The seven reported case studies represent integrated care implementation efforts from five countries and continents (United States, United Kingdom, Vietnam, Israel, and Nigeria), target a range of clinical populations and care settings, and span all phases of the EPIS framework. Qualitative synthesis of these case studies illuminated common outer context, inner context, bridging and innovation factors that were key drivers of implementation. Conclusions: We propose an agenda that outlines priority goals and related strategies to advance integrated care implementation research. These goals relate to: 1) the role of funding at multiple levels of implementation, 2) meaningful collaboration with stakeholders across phases of implementation and 3) clear communication to stakeholders about integrated care implementation. Trial registration: Not applicable

Heterochromatin characterization and ribosomal gene location in two monotypic genera of bloodsucker bugs (Cimicidae, Heteroptera) with holokinetic chromosomes and achiasmatic male meiosis

Abstract Members of the family Cimicidae (Heteroptera: Cimicomorpha) are temporary bloodsuckers on birds and bats as primary hosts and humans as secondary hosts. Acanthocrios furnarii (2n = 12 = 10 + XY, male) and Psitticimex uritui (2n = 31 = 28 + X 1 X 2 Y, male) are two monotypic genera of the subfamily Haematosiphoninae, which have achiasmatic male meiosis of collochore type. Here, we examined chromatin organization and constitution of cimicid holokinetic chromosomes by determining the amount, composition and distribution of constitutive heterochromatin, and number and location of nucleolus organizer regions (NORs) in both species. Results showed that these two bloodsucker bugs possess high heterochromatin content and have an achiasmatic male meiosis, in which three regions can be differentiated in each autosomal bivalent: (i) terminal heterochromatic regions in repulsion; (ii) a central region, where the homologous chromosomes are located parallel but without contact between them; and (iii) small areas within the central region, where collochores are detected. Acanthocrios furnarii presented a single NOR on an autosomal pair, whereas P. uritui presented two NORs, one on an autosomal pair and the other on a sex chromosome. All NORs were found to be associated with CMA 3 bright bands, indicating that the whole rDNA repeating unit is rich in G + C base pairs. Based on the variations in the diploid autosomal number, the presence of simple and multiple sex chromosome systems, and the number and location of 18S rDNA loci in the two Cimicidae species studied, we might infer that rDNA clusters and genome are highly dynamic among the representatives of this family

Experiences of postpartum anxiety during the COVID-19 pandemic: A mixed methods study and demographic analysis

Introduction The first wave of the COVID-19 pandemic saw the reconfiguration of perinatal maternity services, national lockdowns and social distancing measures that affected the perinatal experiences of new and expectant parents. This study aimed to explore the occurrence of postpartum anxieties in people who gave birth during the pandemic. Methods An exploratory concurrent mixed-methods design was chosen to collect and analyse the quantitative and qualitative data of an online survey during the first UK lockdown. The survey included the Postpartum Specific Anxiety Scale – Research Short Form – for use in global Crises psychometric tool, and open-ended questions in relation to changes in birth plans and feelings about those changes and giving birth in a pandemic. Differences in measured scores were analysed for the participant’s ethnicity, sexual orientation and disability using independent Student’s t-tests, and for age, the analysis was done using Pearson’s correlation. Qualitative data from open-ended questions were analysed thematically. Results A total of 1,754 new and expectant parents completed the survey between 10th and 24th April 2020, and 381 eligible postnatal women completed the psychometric test. We found 52.5% of participants reported symptoms consistent with a diagnosis of postnatal anxiety – significantly higher than the rates usually reported. Younger women and sexual minority women were more likely to score highly on the PSAS than their older or heterosexual counterparts (p<0.001). Younger participants reported anxieties in the ‘infant safety and welfare’ category, whilst lesbian, gay, bisexual and pansexual participants scored highly in the ‘psychosocial adjustment to motherhood’ category. Discussion Postpartum anxiety is under-reported, and demographic differences in the rates of postpartum anxiety are under-researched. This research demonstrates for the first time a difference in postpartum anxiety rates amongst sexual minority women

Comparative case studies in integrated care implementation from across the globe : a quest for action

The case studies represent integrated care implementation efforts from five countries and continents (United States, United Kingdom, Vietnam, Israel, and Nigeria), targeting a range of clinical populations and care settings. The study addresses two research objectives: 1) To highlight current integrated care implementation efforts that target a range of healthcare systems, patient populations and implementation strategies and outcomes, and 2) To synthesize the shared and unique challenges and successes across studies using the Exploration, Preparation, Implementation, Sustainment (EPIS) framework. Funding is a vital condition for successful transformation of healthcare delivery.National Institute of Mental HealthAgency for Healthcare Research and Qualit

Can birth outcome inequality be reduced using targeted caseload midwifery in a deprived diverse inner city population? A retrospective cohort study, London, UK.

Objectives(1) To report maternal and newborn outcomes of pregnant women in areas of social deprivation in inner city London. (2) To compare the effect of caseload midwifery with standard care on maternal and newborn outcomes in this cohort of women.DesignRetrospective observational cohort study.SettingFour council wards (electoral districts) in inner city London, where over 90% of residents are in the two most deprived quintiles of the English Index of Multiple Deprivation (IMD) (2019) and the population is ethnically diverse.ParticipantsAll women booked for antenatal care under Guys and St Thomas' National Health Service Foundation Trust after 11 July 2018 (when the Lambeth Early Action Partnership (LEAP*) caseload midwifery team was implemented) until data collection 18 June 2020. This included 523 pregnancies in the LEAP area, of which 230 were allocated to caseload midwifery, and 8430 pregnancies from other areas.Main outcome measuresTo explore if targeted caseload midwifery (known to reduce preterm birth) will improve important measurable outcomes (preterm birth, mode of birth and newborn outcomes).ResultsThere was a significant reduction in preterm birth rate in women allocated to caseload midwifery, when compared with those who received traditional midwifery care (5.1% vs 11.2%; risk ratio: 0.41; p=0.02; 95% CI 0.18 to 0.86; number needed to treat: 11.9). Caesarean section births were significantly reduced in women allocated to caseload midwifery care, when compared with traditional midwifery care (24.3% vs 38.0%; risk ratio: 0.64: p=0.01; 95% CI 0.47 to 0.90; number needed to treat: 7.4) including emergency caesarean deliveries (15.2% vs 22.5%; risk ratio: 0.59; p=0.03; 95% CI 0.38 to 0.94; number needed to treat: 10) without increase in neonatal unit admission or stillbirth.ConclusionThis study shows that a model of caseload midwifery care implemented in an inner city deprived community improves outcome by significantly reducing preterm birth and birth by caesarean section when compared with traditional care. This data trend suggests that when applied to targeted groups (women in higher IMD quintile and women of diverse ethnicity) that the impact of intervention is greater

Midwifery continuity of care versus standard maternity care for women at increased risk of preterm birth : a hybrid implementation–effectiveness, randomised controlled pilot trial in the UK

Background: Midwifery continuity of care is the only health system intervention shown to reduce preterm birth (PTB) and improve perinatal survival, but no trial evidence exists for women with identified risk factors for PTB. We aimed to assess feasibility, fidelity, and clinical outcomes of a model of midwifery continuity of care linked with a specialist obstetric clinic for women considered at increased risk for PTB. Methods and findings: We conducted a hybrid implementation–effectiveness, randomised, controlled, unblinded, parallel-group pilot trial at an inner-city maternity service in London (UK), in which pregnant women identified at increased risk of PTB were randomly assigned (1:1) to either midwifery continuity of antenatal, intrapartum, and postnatal care (Pilot study Of midwifery Practice in Preterm birth Including women’s Experiences [POPPIE] group) or standard care group (maternity care by different midwives working in designated clinical areas). Pregnant women attending for antenatal care at less than 24 weeks' gestation were eligible if they fulfilled one or more of the following criteria: previous cervical surgery, cerclage, premature rupture of membranes, PTB, or late miscarriage; previous short cervix or short cervix this pregnancy; or uterine abnormality and/or current smoker of tobacco. Feasibility outcomes included eligibility, recruitment and attrition rates, and fidelity of the model. The primary outcome was a composite of appropriate and timely interventions for the prevention and/or management of preterm labour and birth. We analysed by intention to treat. Between 9 May 2017 and 30 September 2018, 334 women were recruited; 169 women were allocated to the POPPIE group and 165 to the standard group. Mean maternal age was 31 years; 32% of the women were from Black, Asian, and ethnic minority groups; 70% were in employment; and 46% had a university degree. Nearly 70% of women lived in areas of social deprivation. More than a quarter of women had at least one pre-existing medical condition and multiple risk factors for PTB. More than 75% of antenatal and postnatal visits were provided by a named/partner midwife, and a midwife from the POPPIE team was present at 80% of births. The incidence of the primary composite outcome showed no statistically significant difference between groups (POPPIE group 83.3% versus standard group 84.7%; risk ratio 0.98 [95% confidence interval (CI) 0.90 to 1.08]; p = 0.742). Infants in the POPPIE group were significantly more likely to have skin-to-skin contact after birth, to have it for a longer time, and to breastfeed immediately after birth and at hospital discharge. There were no differences in other secondary outcomes. The number of serious adverse events was similar in both groups and unrelated to the intervention (POPPIE group 6 versus standard group 5). Limitations of this study included the limited power and the nonmasking of group allocation; however, study assignment was masked to the statistician and researchers who analysed the data. Conclusions: In this study, we found that it is feasible to set up and achieve fidelity of a model of midwifery continuity of care linked with specialist obstetric care for women at increased risk of PTB in an inner-city maternity service in London (UK), but there is no impact on most outcomes for this population group. Larger appropriately powered trials are needed, including in other settings, to evaluate the impact of relational continuity and hypothesised mechanisms of effect based on increased trust and engagement, improved care coordination, and earlier referral on disadvantaged communities, including women with complex social factors and social vulnerability. Trial registration: We prospectively registered the pilot trial on the UK Clinical Research Network Portfolio Database (ID number: 31951, 24 April 2017). We registered the trial on the International Standard Randomised Controlled Trial Number (ISRCTN) (Number: 37733900, 21 August 2017) and before trial recruitment was completed (30 September 2018) when informed that prospective registration for a pilot trial was also required in a primary clinical trial registry recognised by WHO and the International Committee of Medical Journal Editors (ICMJE). The protocol as registered and published has remained unchanged, and the analysis conforms to the original plan