COMPROMISE AND/OR INTEGRITY? SOME NORMATIVE REMARKS

In a compromise parties make a strategic calculation that a sacrifice of some their commitments is the best tactic to advance their other values and interests over their current positions. But if we try to figure a compromise as a way to get to agreements that can minimize harm and promote mutual respect between individuals, and could increase the level of cooperation between them, we can consider a compromise shaped in that way as an agreement that can translate at its best some of the individual’s deliberative ideals, as fairness and mutual respect. This kind of compromise will be different from simple negotiation, and more demanding to each one of the parties. It will require first and foremost a reciprocal recognition of moral fairness. But can we ever compromise on matters of ethical principle without compromising our integrity?Num acordo, as partes fazem um cálculo estratégico de que o sacrifício de alguns dos seus compromissos é a melhor tática para avançar os seus outros valores e interesses sobre as suas posições atuais. Mas se tentarmos chegar a um compromisso como forma de chegar a acordos que possam minimizar danos e promover o respeito mútuo entre indivíduos, e aumentar o nível de cooperação entre eles, podemos considerar um compromisso moldado dessa forma como um acordo que pode traduzir no seu melhor alguns dos ideais deliberativos do indivíduo, como justiça e respeito mútuo. Esse tipo de compromisso será diferente da simples negociação e mais exigente para cada uma das partes. Exigirá, antes de tudo, um reconhecimento recíproco da equidade moral. Mas será que podemos fazer compromissos envolvendo princípios éticos sem comprometer a nossa integridade

New Wine in Old Bottles: The Kind of Political Philosophy We Need

There isn’t an overall consensus on the aim, meaning and role(s) of contemporary political philosophy. The relationship between philosophy and politics has been addressed and sharpened – not just today but in different ways and from various, separate and sometimes conflicting perspectives (Leopold & Stears, 2008). Regardless, the main aims, meaning and role of a field of study are key issues, and the quality and credibility of the research will most likely depend on our capacity to draw a path through this conflicting background. The purpose of this paper is to contribute to drafting elements of a new road map that could lead contemporary political philosophy out of this crippling impasse. It builds on a specific version of political theory – Walzer’s interpretation path reviewed (Walzer, 1985) – and addresses a kind of political practice able to reconcile political philosophy’s normative commitments – as is the case with the Rawls’ four roles of political philosophy (Rawls, 2007) – with its actual ambitions and conditions of achievability (Hall, 2015; Galston, 2010)

Un liberalismo per il XXI secolo: le sfide della contemporaneità

I contributi presenti in questo Quaderno di Biblioteca della Libertà intendono valutare le sfide non risolte del liberalismo, inteso sia nei termini di un paradigma socio-politico di stampo ideale-normativo, che come insieme di pratiche e istituzioni a cui ha costantemente fatto riferimento la maggior parte dei regimi democratici occidentali. Le sfide del XXI secolo richiedono un aggiornamento e ripensamento del liberalismo, che deve e dovrà rendersi disponibile anche alla possibilità di accettare revisioni radicali di alcuni dei pilastri centrali della teoria liberale. L’obiettivo primario di questo Quaderno consiste nel rivendicare l’importanza della teoria liberale, e pur tuttavia segnalare la necessità e l’urgenza di affrontare le sfide tutt’oggi irrisolte del liberalismo contemporaneo, con lucidità e flessibilità intellettuale

A novel magnetic resonance imaging scoring system for active and chronic changes in children and adolescents with juvenile idiopathic arthritis of the hip

Abstract Background Hip involvement predicts severe disease in juvenile idiopathic arthritis (JIA) and is accurately assessed by MRI. However, a child-specifc hip MRI scoring system has not been validated. Objective To test the intra- and interobserver agreement of several MRI markers for active and chronic hip changes in children and young adults with JIA and to examine the precision of measurements commonly used for the assessment of growth abnormalities. Materials and methods Hip MRIs from 60 consecutive children, adolescents and young adults with JIA were scored independently by two sets of radiologists. One set scored the same MRIs twice. Features of active and chronic changes, growth abnormalities and secondary post-infammatory changes were scored. We used kappa statistics to analyze inter- and intraobserver agreement for categorical variables and a Bland–Altman approach to test the precision of continuous variables. Results Among active changes, there was good intra- and interobserver agreement for grading overall infammation (kappa 0.6–0.7). Synovial enhancement showed a good intraobserver agreement (kappa 0.7–0.8), while the interobserver agreement was moderate (kappa 0.4–0.5). Regarding acetabular erosions on a 0–3 scale, the intraobserver agreement was 0.6 for the right hip and 0.7 for the left hip, while the interobserver agreement was 0.6 for both hips. Measurements of joint space width, caput–collum–diaphyseal angle, femoral neck–head length, femoral width and trochanteric distance were imprecise. Conclusion We identifed a set of MRI markers for active and chronic changes in JIA and suggest that the more robust markers be included in future studies addressing clinical validity and long-term patient outcomes

Off-label long acting injectable antipsychotics in real-world clinical practice: a cross-sectional analysis of prescriptive patterns from the STAR Network DEPOT study

Introduction Information on the off-label use of Long-Acting Injectable (LAI) antipsychotics in the real world is lacking. In this study, we aimed to identify the sociodemographic and clinical features of patients treated with on- vs off-label LAIs and predictors of off-label First- or Second-Generation Antipsychotic (FGA vs. SGA) LAI choice in everyday clinical practice. Method In a naturalistic national cohort of 449 patients who initiated LAI treatment in the STAR Network Depot Study, two groups were identified based on off- or on-label prescriptions. A multivariate logistic regression analysis was used to test several clinically relevant variables and identify those associated with the choice of FGA vs SGA prescription in the off-label group. Results SGA LAIs were more commonly prescribed in everyday practice, without significant differences in their on- and off-label use. Approximately 1 in 4 patients received an off-label prescription. In the off-label group, the most frequent diagnoses were bipolar disorder (67.5%) or any personality disorder (23.7%). FGA vs SGA LAI choice was significantly associated with BPRS thought disorder (OR = 1.22, CI95% 1.04 to 1.43, p = 0.015) and hostility/suspiciousness (OR = 0.83, CI95% 0.71 to 0.97, p = 0.017) dimensions. The likelihood of receiving an SGA LAI grew steadily with the increase of the BPRS thought disturbance score. Conversely, a preference towards prescribing an FGA was observed with higher scores at the BPRS hostility/suspiciousness subscale. Conclusion Our study is the first to identify predictors of FGA vs SGA choice in patients treated with off-label LAI antipsychotics. Demographic characteristics, i.e. age, sex, and substance/alcohol use co-morbidities did not appear to influence the choice towards FGAs or SGAs. Despite a lack of evidence, clinicians tend to favour FGA over SGA LAIs in bipolar or personality disorder patients with relevant hostility. Further research is needed to evaluate treatment adherence and clinical effectiveness of these prescriptive patterns

The Role of Attitudes Toward Medication and Treatment Adherence in the Clinical Response to LAIs: Findings From the STAR Network Depot Study

Background: Long-acting injectable (LAI) antipsychotics are efficacious in managing psychotic symptoms in people affected by severe mental disorders, such as schizophrenia and bipolar disorder. The present study aimed to investigate whether attitude toward treatment and treatment adherence represent predictors of symptoms changes over time. Methods: The STAR Network \u201cDepot Study\u201d was a naturalistic, multicenter, observational, prospective study that enrolled people initiating a LAI without restrictions on diagnosis, clinical severity or setting. Participants from 32 Italian centers were assessed at three time points: baseline, 6-month, and 12-month follow-up. Psychopathological symptoms, attitude toward medication and treatment adherence were measured using the Brief Psychiatric Rating Scale (BPRS), the Drug Attitude Inventory (DAI-10) and the Kemp's 7-point scale, respectively. Linear mixed-effects models were used to evaluate whether attitude toward medication and treatment adherence independently predicted symptoms changes over time. Analyses were conducted on the overall sample and then stratified according to the baseline severity (BPRS < 41 or BPRS 65 41). Results: We included 461 participants of which 276 were males. The majority of participants had received a primary diagnosis of a schizophrenia spectrum disorder (71.80%) and initiated a treatment with a second-generation LAI (69.63%). BPRS, DAI-10, and Kemp's scale scores improved over time. Six linear regressions\u2014conducted considering the outcome and predictors at baseline, 6-month, and 12-month follow-up independently\u2014showed that both DAI-10 and Kemp's scale negatively associated with BPRS scores at the three considered time points. Linear mixed-effects models conducted on the overall sample did not show any significant association between attitude toward medication or treatment adherence and changes in psychiatric symptoms over time. However, after stratification according to baseline severity, we found that both DAI-10 and Kemp's scale negatively predicted changes in BPRS scores at 12-month follow-up regardless of baseline severity. The association at 6-month follow-up was confirmed only in the group with moderate or severe symptoms at baseline. Conclusion: Our findings corroborate the importance of improving the quality of relationship between clinicians and patients. Shared decision making and thorough discussions about benefits and side effects may improve the outcome in patients with severe mental disorders

When thinking inside the box is good: the nuanced relationship between conformity and creativity

Creativity is one of the most valued employee skills, but there exists a tension in organizations, as managers want workers who are creative and, at the same time, who conform to existing norms in the organization. In the current paper we propose and study a nuanced relationship between conformity and creativity in the workplace, looking for conditions in which conformity is not detrimental for creativity. We test how the interaction of conformity with the personality dimensions of openness to experience and conscientiousness predicts creativity. Our results suggest that, while openness does not interact with conformity to predict creativity, conscientiousness does. In particular, when individuals are highly conscientious, conformity has a positive impact on creativity, while the conformity-creativity relationship is negative for individuals that are not very conscientious

Generational differences in workers' expectations: millennials want more of the same things

With the current research we applied the theoretical framework of the psychological contract to the study of generational differences in the workplace with the aim of understanding how Millennials and non-Millennials differ in their expectations at work. We collected data from more than 1,000 workers of a large Italian company, not only assessing several established dimensions of workplace expectations, but also proposing two new ones: feedback and work meaning. We found that Millennial workers generally expect more than their non-Millennial colleagues, but that the importance ranking of the various dimensions is largely similar across generations. The results of the study held even after controlling for age, work experience and job tenure effects. We further compared the Millennials from our organizational sample to more than 150 Millennial workers sampled online and found no meaningful differences. Theoretical and managerial implications follo

Introduzione al Quaderno di Biblioteca della Libertà: Un liberalismo per il XXI secolo: le sfide della contemporaneità

I contributi presenti in questo Quaderno di Biblioteca della Libertà intendono valutare le sfide non risolte del liberalismo, inteso sia nei termini di un paradigma socio-politico di stampo ideale-normativo, che come insieme di pratiche e istituzioni a cui ha costantemente fatto riferimento la maggior parte dei regimi democratici occidentali. Le sfide del XXI secolo richiedono un aggiornamento e ripensamento del liberalismo, che deve e dovrà rendersi disponibile anche alla possibilità di accettare revisioni radicali di alcuni dei pilastri centrali della teoria liberale. L’obiettivo primario di questo Quaderno consiste nel rivendicare l’importanza della teoria liberale, e pur tuttavia segnalare la necessità e l’urgenza di affrontare le sfide tutt’oggi irrisolte del liberalismo contemporaneo, con lucidità e flessibilità intellettuale