Éthique et transfusion sanguine [Ethics and blood transfusion.]

Le don de sang représente un acte solidaire. Il est le plus souvent bénévole et, selon les pays et les circonstances, non rémunéré. Les éléments de la réflexion éthique sont, entre autres, l'augmentation des besoins, les critères d'exclusion de plus en plus nombreux, l'exigence sécuritaire et les modifications des structures de nos sociétés. Compte tenu de cela, les acteurs de la chaîne transfusionnelle doivent s'interroger sur certains paramètres : la valeur du don, le sens du bénévolat, l'opportunité de rémunérer l'acte de livrer une partie de soi, non plus comme un don et comme une expression d'altruisme et de solidarité, mais comme une prestation commerciale définie par des règles économiques. Blood donation is an act of solidarity. Most often, this act is done on a volunteer basis and, depending on countries and circumstances, is not remunerated. The increase in need, the always-greater number of deferral criteria, the safety issues and the changes in the structures of our societies are among the many subjects for ethical debates. Taking these into account, the actors of the transfusion must analyze certain parameters: the value of a donation, the meaning of volunteering, the appropriateness of remunerating the act of giving a part of one's self, no longer as a donation or an expression of altruism and solidarity, but as a commercial act regimented by economic laws.

An electronic portfolio for quantitative assessment of surgical skills in undergraduate medical education.

BACKGROUND We evaluated a newly designed electronic portfolio (e-Portfolio) that provided quantitative evaluation of surgical skills. Medical students at the University of Seville used the e-Portfolio on a voluntary basis for evaluation of their performance in undergraduate surgical subjects. METHODS Our new web-based e-Portfolio was designed to evaluate surgical practical knowledge and skills targets. Students recorded each activity on a form, attached evidence, and added their reflections. Students self-assessed their practical knowledge using qualitative criteria (yes/no), and graded their skills according to complexity (basic/advanced) and participation (observer/assistant/independent). A numerical value was assigned to each activity, and the values of all activities were summated to obtain the total score. The application automatically displayed quantitative feedback. We performed qualitative evaluation of the perceived usefulness of the e-Portfolio and quantitative evaluation of the targets achieved. RESULTS Thirty-seven of 112 students (33%) used the e-Portfolio, of which 87% reported that they understood the methodology of the portfolio. All students reported an improved understanding of their learning objectives resulting from the numerical visualization of progress, all students reported that the quantitative feedback encouraged their learning, and 79% of students felt that their teachers were more available because they were using the e-Portfolio. Only 51.3% of students reported that the reflective aspects of learning were useful. Individual students achieved a maximum of 65% of the total targets and 87% of the skills targets. The mean total score was 345 ± 38 points. For basic skills, 92% of students achieved the maximum score for participation as an independent operator, and all achieved the maximum scores for participation as an observer and assistant. For complex skills, 62% of students achieved the maximum score for participation as an independent operator, and 98% achieved the maximum scores for participation as an observer or assistant. CONCLUSIONS Medical students reported that use of an electronic portfolio that provided quantitative feedback on their progress was useful when the number and complexity of targets were appropriate, but not when the portfolio offered only formative evaluations based on reflection. Students felt that use of the e-Portfolio guided their learning process by indicating knowledge gaps to themselves and teachers.

An electronic portfolio for quantitative assessment of surgical skills in undergraduate medical education.

BACKGROUND We evaluated a newly designed electronic portfolio (e-Portfolio) that provided quantitative evaluation of surgical skills. Medical students at the University of Seville used the e-Portfolio on a voluntary basis for evaluation of their performance in undergraduate surgical subjects. METHODS Our new web-based e-Portfolio was designed to evaluate surgical practical knowledge and skills targets. Students recorded each activity on a form, attached evidence, and added their reflections. Students self-assessed their practical knowledge using qualitative criteria (yes/no), and graded their skills according to complexity (basic/advanced) and participation (observer/assistant/independent). A numerical value was assigned to each activity, and the values of all activities were summated to obtain the total score. The application automatically displayed quantitative feedback. We performed qualitative evaluation of the perceived usefulness of the e-Portfolio and quantitative evaluation of the targets achieved. RESULTS Thirty-seven of 112 students (33%) used the e-Portfolio, of which 87% reported that they understood the methodology of the portfolio. All students reported an improved understanding of their learning objectives resulting from the numerical visualization of progress, all students reported that the quantitative feedback encouraged their learning, and 79% of students felt that their teachers were more available because they were using the e-Portfolio. Only 51.3% of students reported that the reflective aspects of learning were useful. Individual students achieved a maximum of 65% of the total targets and 87% of the skills targets. The mean total score was 345 ± 38 points. For basic skills, 92% of students achieved the maximum score for participation as an independent operator, and all achieved the maximum scores for participation as an observer and assistant. For complex skills, 62% of students achieved the maximum score for participation as an independent operator, and 98% achieved the maximum scores for participation as an observer or assistant. CONCLUSIONS Medical students reported that use of an electronic portfolio that provided quantitative feedback on their progress was useful when the number and complexity of targets were appropriate, but not when the portfolio offered only formative evaluations based on reflection. Students felt that use of the e-Portfolio guided their learning process by indicating knowledge gaps to themselves and teachers.

Capitalism in the classroom : the impact of self-enhancement values and normative assessment on student motivation, goals and attitudes towards cheating

Abstract The neo-liberal capitalist ideology has come under heavy fire with anecdotal evidence indicating a link between these same values and unethical behavior. Academic institutions reflect social values and act as socializing agents for the young. Can this explain the high and increasing rates of cheating that currently prevail in education? Our first chapter examines the question of whether self-enhancement values of power and açhievement, the individual level equivalent of neo-liberal capitalist values, predict positive attitudes towards cheating. Furthermore, we explore the mediating role of motivational factors. Results of four studies reveal that self-enhancement value endorsement predicts the adoption of performance-approach goals, a relationship mediated by introjected regulation, namely desire for social approval and that self-enhancement value endorsement also predicts the condoning of cheating, a relationship mediated by performance-approach goal adoption. However, self-transcendence values prescribed by a normatively salient source have the potential to reduce the link between self-enhancement value endorsément and attitudes towards cheating. Normative assessment constitutes a key tool used by academic institutions to socialize young people to accept the competitive, meritocratic nature of a sociéty driven by a neo-liberal capitalist ideology. As such, the manifest function of grades is to motivate students to work hard and to buy into the competing ethos. Does normative assessment fulfill these functions? Our second chapter explores the reward-intrinsic motivation question in the context of grading, arguably a high-stakes reward. In two experiments, the relative capacity of graded high performance as compared to the task autonomy experienced in an ungraded task to predict post-task intrinsic motivation is assessed. Results show that whilst the graded task performance predicts post-task appreciation, it fails to predict ongoing motivation. However, perceived autonomy experienced in non-graded condition, predicts both post-task appreciation and ongoing motivation. Our third chapter asks whether normative assessment inspires the spirit of competition in students. Results of three experimental studies reveal that expectation of a grade for a task, compared to no grade, induces greater adoption of performance-avoidance, but not performance-approach, goals. Experiment 3 provides an explanatory mechanism for this, showing that reduced autonomous motivation experienced in previous graded tasks mediates the relationship between grading and adoption of performance avoidance goals in a subsequent task. The above results, when combined, provide evidence as to the deleterious effects of self enhancement values and the associated practice of normative assessment in school on student motivation, goals and ethics. We conclude by using value and motivation theory to explore solutions to this problem.

La evaluación como elemento clave de la formación basada en competencias: tres casos en el ámbito de la ingenierías

El Espacio Europeo de Educación Superior implica cambios organizativos y académicos referentes a la formación basada en competencias. El proyecto AlineaME, coordinado por la Unidad de Soporte a la Calidad y la Innovación Docente de la Escuela Superior Politécnica - Universidad Pompeu Fabra, propuso a docentes del área TIC y a pedagogos la reflexión conjunta en aras a diseñar recomendaciones centradas en la alineación entre los tres elementos clave del proyecto: competencias, metodología y evaluación (C*M*E). Este trabajo recoge tres casos de aplicación de recomendaciones, concretamente de Ingeniería Telemática (dos casos - Universidad de Valladolid y Pompeu Fabra) y de Ingeniería Técnica en Informática de Gestión (un caso - Universidad de Sevilla).Las recomendaciones aplicadas hacen referencia a la necesidad de explicitar la alineación C*M*E en los Planes Docentes de Asignaturas y de presentar esta alineación al estudiantado. También a la integración de la evaluación de la asignatura como tarea-proceso de aprendizaje. La metodología seguida para laaplicación de ambas es (salvo pequeñas diferencias) parecida en los tres casos. La primera recomendación consistió en recoger en el Plan Docente la Alineación y en verbalizar dicha alineación en la sesión de presentación de la asignatura. La segunda se incorporó incluyendo actividades formativas en las que se favorecía la evaluación entre iguales. Para evaluar la aplicación de recomendaciones se recogieron evidencias en clave de satisfacción por parte del estudiantado así como valoraciones de los propios docentes. Para ello se diseñaron instrumentos específicos.En cuanto a la presentación de la alineación C*M*E en los Planes Docentes de asignaturas, los resultados indican que los alumnos son más conscientes de qué, cómo y por qué van a trabajar y ser evaluados. Globalmente valoran positivamente su utilidad para la autorregulación. Asimismo, plantear la evaluación como tarea deaprendizaje resultó ser para los estudiantes un interesante elemento de reflexión.

The gain-loss asymmetry and single-self preferences

Kahneman and Tversky asserted a fundamental asymmetry between gains and losses, namely a reflection effect which occurs when an individual prefers a sure gain of $ pz to anuncertain gain of $ z with probability p, while preferring an uncertain loss of $z with probability p to a certain loss of $ pz.We focus on this class of choices (actuarially fair), and explore the extent to which thereflection effect, understood as occurring at a range of wealth levels, is compatible with single-self preferences.We decompose the reflection effect into two components, a probability switch effect,which is compatible with single-self preferences, and a translation effect, which is not. To argue the first point, we analyze two classes of single-self, nonexpected utility preferences, which we label homothetic and weakly homothetic. In both cases, we characterize the switch effect as well as the dependence of risk attitudes on wealth.We also discuss two types of utility functions of a form reminiscent of expected utility but with distorted probabilities. Type I always distorts the probability of the worst outcome downwards, yielding attraction to small risks for all probabilities. Type II distorts low probabilities upwards, and high probabilities downwards, implying risk aversion when the probability of the worst outcome is low. By combining homothetic or weak homothetic preferences with Type I or Type II distortion functions, we present four explicit examples: All four display a switch effect and, hence, a form of reflection effect consistent a single self preferences.

Ethics and creative accounting: Some empirical evidence on accounting for intangibles in Spain

Recent research shows that financial reports are losing relevance. Mainly thisis due to the growing strategic importance of intangible assets in theperformance of a company. A possible solution is to modify accounting standardsso that statements include more self-generated intangible assets, taking intoaccount with their inherent risk and difficulty of valuation. We surveyed loanofficers who were asked to assess the credit-worthiness of a hypotheticalcompany. The only information given was a simplified version of financialstatements. Half the group got statements where research and development costshad been capitalized. The other half got statements in which these costs hadbeen treated as an expense. The findings show that capitalization wassignificantly more likely to attract a positive response to a loan request. Thepaper raises the question of whether accounting for intangibles might providemanagers with one more creative accounting technique and, in consequence, itsethical implications.

John Addington Symonds. A Problem in Greek Ethics. Plutarch's Eroticus quoted only in some footnotes? Why?

It is certainly astonishing that an innovating study about the Greek pederasty in England like the one by John Addington Symonds does not quote Plutarch's Eroticus -in fact, it is only cited in some footnotes-, if one bears in mind that this dialogue is an accurate philosophical reflection on Greek eros, in which very often significant ethical themes are approached. The aim of this article is just to reveal the different reasons for such an omission.

Self-similarity of complex networks and hidden metric spaces

We demonstrate that the self-similarity of some scale-free networks with respect to a simple degree-thresholding renormalization scheme finds a natural interpretation in the assumption that network nodes exist in hidden metric spaces. Clustering, i.e., cycles of length three, plays a crucial role in this framework as a topological reflection of the triangle inequality in the hidden geometry. We prove that a class of hidden variable models with underlying metric spaces are able to accurately reproduce the self-similarity properties that we measured in the real networks. Our findings indicate that hidden geometries underlying these real networks are a plausible explanation for their observed topologies and, in particular, for their self-similarity with respect to the degree-based renormalization.

The social disembedding of business theory and practice. A (neo-)institutional analysis of the homo economicus and corporate social responsibility, and the inherent responsibility of business scholars

Aim Structure of the Thesis In the first article, I focus on the context in which the Homo Economicus was constructed - i.e., the conception of economic actors as fully rational, informed, egocentric, and profit-maximizing. I argue that the Homo Economicus theory was developed in a specific societal context with specific (partly tacit) values and norms. These norms have implicitly influenced the behavior of economic actors and have framed the interpretation of the Homo Economicus. Different factors however have weakened this implicit influence of the broader societal values and norms on economic actors. The result is an unbridled interpretation and application of the values and norms of the Homo Economicus in the business environment, and perhaps also in the broader society. In the second article, I show that the morality of many economic actors relies on isomorphism, i.e., the attempt to fit into the group by adopting the moral norms surrounding them. In consequence, if the norms prevailing in a specific group or context (such as a specific region or a specific industry) change, it can be expected that actors with an 'isomorphism morality' will also adapt their ethical thinking and their behavior -for the 'better' or for the 'worse'. The article further describes the process through which corporations could emancipate from the ethical norms prevailing in the broader society, and therefore develop an institution with specific norms and values. These norms mainly rely on mainstream business theories praising the economic actor's self-interest and neglecting moral reasoning. Moreover, because of isomorphism morality, many economic actors have changed their perception of ethics, and have abandoned the values prevailing in the broader society in order to adopt those of the economic theory. Finally, isomorphism morality also implies that these economic actors will change their morality again if the institutional context changes. The third article highlights the role and responsibility of business scholars in promoting a systematic reflection and self-critique of the business system and develops alternative models to fill the moral void of the business institution and its inherent legitimacy crisis. Indeed, the current business institution relies on assumptions such as scientific neutrality and specialization, which seem at least partly challenged by two factors. First, self-fulfilling prophecy provides scholars with an important (even if sometimes undesired) normative influence over practical life. Second, the increasing complexity of today's (socio-political) world and interactions between the different elements constituting our society question the strong specialization of science. For instance, economic theories are not unrelated to psychology or sociology, and economic actors influence socio-political structures and processes, e.g., through lobbying (Dobbs, 2006; Rondinelli, 2002), or through marketing which changes not only the way we consume, but more generally tries to instill a specific lifestyle (Cova, 2004; M. K. Hogg & Michell, 1996; McCracken, 1988; Muniz & O'Guinn, 2001). In consequence, business scholars are key actors in shaping both tomorrow's economic world and its broader context. A greater awareness of this influence might be a first step toward an increased feeling of civic responsibility and accountability for the models and theories developed or taught in business schools.

Quette place pour l'automesure glycémique dans la prise en charge du diabète de type 2 [Which role for self-monitoring of blood glucose in type 2 diabetes?]

There is a sustained controversy in the literature about the role and utility of self-monitoring of blood glucose (SMBG) in type 2 diabetes. The study results in this field do not provide really useful clues for the integration of SMBG in the follow-up of the individual patient, because they are based on a misconception of SMBG. It is studied as if it was a medical treatment whose effect on glycemic control is to be isolated. However, SMBG has no such intrinsic effect. It gains its purpose only as an inseparable component of a comprehensive and structured educational strategy. To be appropriate this strategy cannot be based on the health care professionals' view on diabetes only. It rather has to be tailored to the individual patient's needs through an ongoing process of shared reflection with him.

In a better world (2011): the ethics of a doctor facing violence

The main theme"In a Better World" (S. Bier, 2011), is violence and its possible answers: forgiveness and revenge. The film revolves around a doctor Anton who works in a refugee camp in sub-Saharan Africa. His family lives in a quiet village in Denmark, where his teenage son suffers bullying at school. This movie shows the fragility of a modern society, normal in appearance but with deep fissures that reflect the tragedies plaguing much of the African continent. It helps to understand the reality experienced by more than 10 million refugees and 15 million internally displaced persons surviving in sub-Saharan Africa. Hævnen, the original title whose meaning in Spanish is revenge, invites reflection on another possible response to violence-forgiveness. It is an excellent film for teaching and learning issues related to humanitarian work developed by health professionals in refugee camps around world.

In a better world (2011): the ethics of a doctor facing violence

The main theme"In a Better World" (S. Bier, 2011), is violence and its possible answers: forgiveness and revenge. The film revolves around a doctor Anton who works in a refugee camp in sub-Saharan Africa. His family lives in a quiet village in Denmark, where his teenage son suffers bullying at school. This movie shows the fragility of a modern society, normal in appearance but with deep fissures that reflect the tragedies plaguing much of the African continent. It helps to understand the reality experienced by more than 10 million refugees and 15 million internally displaced persons surviving in sub-Saharan Africa. Hævnen, the original title whose meaning in Spanish is revenge, invites reflection on another possible response to violence-forgiveness. It is an excellent film for teaching and learning issues related to humanitarian work developed by health professionals in refugee camps around world.

Helping medical students to acquire a deeper understanding of truth-telling.

PROBLEM: Truth-telling is an important component of respect for patients' self-determination, but in the context of breaking bad news, it is also a distressing and difficult task. INTERVENTION: We investigated the long-term influence of a simulated patient-based teaching intervention, integrating learning objectives in communication skills and ethics into students' attitudes and concerns regarding truth-telling. We followed two cohorts of medical students from the preclinical third year to their clinical rotations (fifth year). Open-ended responses were analysed to explore medical students' reported difficulties in breaking bad news. CONTEXT: This intervention was implemented during the last preclinical year of a problem-based medical curriculum, in collaboration between the doctor-patient communication and ethics programs. OUTCOME: Over time, concerns such as empathy and truthfulness shifted from a personal to a relational focus. Whereas 'truthfulness' was a concern for the content of the message, 'truth-telling' included concerns on how information was communicated and how realistically it was received. Truth-telling required empathy, adaptation to the patient, and appropriate management of emotions, both for the patient's welfare and for a realistic understanding of the situation. LESSONS LEARNED: Our study confirms that an intervention confronting students with a realistic situation succeeds in making them more aware of the real issues of truth-telling. Medical students deepened their reflection over time, acquiring a deeper understanding of the relational dimension of values such as truth-telling, and honing their view of empathy.

Coherent patterns and self-induced diffraction of electrons on a thin nonlinear layer

Electron scattering on a thin layer where the potential depends self-consistently on the wave function has been studied. When the amplitude of the incident wave exceeds a certain threshold, a soliton-shaped brightening (darkening) appears on the layer causing diffraction of the wave. Thus the spontaneously formed transverse pattern can be viewed as a self-induced nonlinear quantum screen. Attractive or repulsive nonlinearities result in different phase shifts of the wave function on the screen, which give rise to quite different diffraction patterns. Among others, the nonlinearity can cause self-focusing of the incident wave into a beam, splitting in two "beams," single or double traces with suppressed reflection or transmission, etc.