Ethic analysis of the role of incentive system in the organ donation after citizen’s death / 器官移植

Organ transplantation has demonstrated its significant values by its excellent effectiveness in health reconstruction and life survival, where organ donation is a major component in promoting the development of organ transplantation in China. In recent years, an important progress has been made in organ transplantation in China with an annually increased organ donation rate. In spite of this, there is a serious fact confronted by us that the donated organ quantity is insufficient, which may be solved by further improvement of medical science and public health policy. According to the international experience, an incentive system may improve the organ donation rate effectively although the hidden ethic property of the incentive system itself may have an essentially conflict with the altruism contained in the organ donation. Therefore, in this article, the property of the incentive system, the interaction between organ donation and incentive system and the ethic justification of the system was reviewed, aiming to provide a reference for the further development of the organ donation and transplantation business in China.

Defects and Amendment Suggestions of Human Organ Transplantation Ordinance / 中国医学伦理学

This paper put forward suggestions on the Human Organ Transplantation Ordinance, including: clarify the priority of the protection of the rights and interests of organ owner in Article 1; conditionally increase the range of relatives who can donate cadaver organs; clarify whether relatives can donate cadaver organs of people without full civil capacity and strictly regulate them; allow matured juveniles to donate living organs under strict restrictions; distinguish between donor and organ owner in legal expression.

El efecto de la desvinculación moral sobre el acoso escolar, el ciberacoso y otros comportamientos disruptivos en niños(as) y adolescentes. Una revisión de la literature / The Effect of moral disengagement on bullying, cyberbullying, and other disruptive behaviors in children and adolescents. A review of the literatura

Resumen Introducción: Un creciente número de estudios han demostrado vínculos consistentes entre la teoría de la desvinculación moral de Bandura y los comportamientos disruptivos e inhumanos. Recientemente se han explorado las relaciones directas e indirectas de la desvinculación moral con el acoso escolar, el ciberacoso y otros comportamientos agresivos en niños(as) y adolescentes, lo cual amerita una revisión de los principales hallazgos. Objetivo: Revisar la literatura y evidencia empírica sobre el efecto de la desvinculación moral en la participación de niños(as) y adolescentes en el acoso escolar, el ciberacoso y otros comportamientos agresivos. Método: Se trató de un estudio de revisión documental. La búsqueda bibliográfica se efectuó en la Web of Science. Se incluyeron 45 estudios empíricos para el análisis. Resultados: Se encontró que la desvinculación moral y sus diferentes estrategias sociocognitivas tienen efectos directos e indirectos que predicen la participación de niños(as) y adolescente en el acoso escolar, el ciberacoso, comportamientos agresivos y antisociales. Adicionalmente, la empatía, las relaciones de amistad, la crianza, las tendencias prosociales, la ira y los rasgos insensibles-no emocionales son factores que, en conjunto, contribuyen al desarrollo, mantenimiento o disminución de conductas de acoso y ciberacoso. También se reportó que los hombres presentan una mayor tendencia que las mujeres al acoso escolar, el ciberacoso, la agresión y uso de la desvinculación moral. Conclusiones: Se señala la importancia de los procesos de cognición moral para el desarrollo de estrategias de intervención psicoeducativa y psicosocial destinadas a prevenir y reducir el acoso y ciberacoso en niños(as) y adolescentes.

Abstract Introduction: A growing number of studies have demonstrated consistent links between Bandura's moral disengagement theory and disruptive and inhumane behaviors. The direct and indirect relation- ships of moral disengagement with bullying, cyberbullying, and other aggressive behaviors in children and adolescents have recently been explored, ensuring a review of key findings. Objective: To review the literature and empirical evidence on the effect of moral disengagement on children's and adolescents' engagement in bullying, cyberbullying, and other aggressive behaviors. Method: This was a documentary review study. The literature search was carried out in the Web of Science. Forty-five empirical studies were included for analysis. Results: Were found that moral disengagement and its different socio-cognitive strategies have direct and indirect effects that predict child and adolescent involvement in bullying, cyberbullying, aggressive and antisocial behaviors. Additionally, empathy, friendship relationships, parenting, prosocial tendencies, anger and callous-unemotional traits are factors that together contribute to the development, maintenance or decrease of bullying and cyberbullying behaviors. It was also reported that males present a greater tendency than females to bullying, cyberbullying, aggression, and use of moral disengagement. Conclusions: The importance of moral cognition processes for the development of psychoeducational and psychosocial intervention strategies aimed at preventing and reducing bullying and cyberbullying in children and adolescents is pointed out.

Consensos em discursos sobre a violência policial: o posicionamento de estudantes universitários / Consensus in discourses on police violence: the positioning of university students / Consenso en discursos sobre violencia policial: el posicionamiento de estudiantes universitarios

Este artigo teve como objetivo analisar se a cor da pele do imigrante (negro ou branco) influencia as justificativas para a tomada de posição frente a uma situação de violência policial cuja vítima era um imigrante suspeito de tráfico de drogas. Participaram do estudo 300 estudantes universitários paraibanos. Os dados foram processados pelo software Iramuteq, por meio da classificação hierárquica descendente (CHD). Como resultado, na condição de imigrante branco, não foram verificados posicionamentos favoráveis à conduta policial. Já na condição de imigrante negro, houve discordância com a ação policial, todavia, houve também culpabilização do imigrante, por vezes utilizada como argumento para tentar justificar ou tolerar a abordagem policial. Assim, constatou-se a existência de um consenso desfavorável em relação à figura do imigrante negro, embasado em argumentos preconceituosos que costumam ser utilizados pela sociedade no intento de proteger os grupos majoritários e fomentar a manutenção da estrutura social, reforçando o preconceito racial e as desigualdades sociais.(AU)

This article aimed to analyze if the immigrants' skin color (black or white) influences the justifications for the positioning in the face of police violence whose victim is an immigrant suspected of drug trafficking. A total of 300 university students from the state of Paraíba participated in the study. The data were processed by the IRAMUTEQ software, by descending hierarchical classification (DHC). As a result, in the condition of white immigrant, no favorable positions were verified for police conduct. In the condition of black immigrant, on the other hand, there was disagreement with the police action, however, blaming the immigrant also occurred, sometimes used as an argument to try to justify or tolerate the police approach. Thus, an unfavorable consensus regarding the figure of the black immigrant was found, based on prejudiced arguments usually used by society in an attempt to protect the majority groups and promote the maintenance of the social structure, reinforcing racial prejudice and social inequalities.(AU)

Este artículo tuvo como objetivo analizar si el color de la piel del inmigrante (blanco o negro) influye en las justificaciones para tomar una posición frente a una situación de violencia policial cuya víctima era un inmigrante sospechoso de narcotráfico. 300 estudiantes de Paraíba participaron en el estudio. Los datos fueron procesados ​​por el software IRAMUTEQ, utilizando la clasificación jerárquica descendente (CHD). Como resultado, como inmigrante blanco, las posiciones favorables a la conducta policial no fueron verificadas. Sin embargo, como inmigrante negro, hubo desacuerdo con la acción policial, sin embargo, la presencia de culpar al inmigrante a veces se usaba como argumento para tratar de justificar o tolerar el enfoque policial. Por lo tanto, hubo un consenso desfavorable con respecto a la figura del inmigrante negro, basado en argumentos prejuiciosos que la sociedad suele utilizar en un intento de proteger a los grupos mayoritarios y promover el mantenimiento de la estructura social, reforzando los prejuicios raciales y las desigualdades sociales.(AU)

Creencias sobre la violencia y sus efectos en la prevalencia de la violencia en el noviazgo / Beliefs about violence and its effects on the prevalence of dating violence

Resumen La violencia en el noviazgo es un fenómeno multifactorial que requiere de estudios que profundicen respecto a los efectos que tienen las creencias culturales en el comportamiento tanto del agresor como de la víctima. Teniendo esto en cuenta, el objetivo de la presente investigación fue determinar la relación entre las creencias acerca de la violencia y la prevalencia de la violencia en el noviazgo. Para ello, se contó con una muestra de 420 estudiantes de dos universidades públicas mexicanas que respondieron el Inventario de creencias acerca de la violencia hacia la esposa, el Inventario de conflictos en las relaciones de noviazgo, y un cuestionario de información sociodemográfica. Los datos recolectados fueron examinados por medio de un análisis de correlación canónica, y los resultados mostraron que el modelo en general fue estadísticamente significativo (Wilks X = .654, F(20, 677.54) = 4.626,p < .05); que el tamaño del efecto del modelo general fue de .346, lo que indica que este explicó el 34.6 % de la varianza compartida por los dos conjuntos de variables; y que, específicamente en la primera función, el coeficiente de mayor magnitud fue el de la variable de justificación de la violencia (r2 s = 76.2; h 2 = 90.0), seguido por la del apoyo que se le puede brindar a la víctima (r2 s = 57.1; h2 = 94.5).

Abstract Dating violence is a multifactorial phenomenon that requires in-depth studies regarding the effects that cultural beliefs have on the behavior of both the aggressor and the victim. With this in mind, the objective of this research was to determine the relationship between beliefs about violence and the prevalence of dating violence. To this end, a sample of 420 students from two Mexican public universities answered the Inventory of Beliefs about Wife Violence, the Inventory of Conflicts in Dating Relationships, and a sociodemographic information questionnaire. The data collected were examined through a canonical correlation analysis, and the results showed that the overall model was statistically significant (Wilks X = .654, F (20, 677.54) = 4.626, p < .05); that the effect size of the overall model was .346, indicating that it explained 34. 6 % of the variance shared by the two sets of variables; and that, specifically in the first function, the coefficient of greatest magnitude was that of the variable of justification of the violence (r2 s = 76.2; h2 = 90.0), followed by that of the support that can be given to the victim (r2 s = 57.1; h2 = 94.5).

De vuelta a la clínica: sin justificación no existe pregunta de investigación que valga / Back to the clinic: without justification there is no worthwhile research question

Resumen La formulación de una pregunta de investigación clínica requiere la concurrencia de experiencia clínica y conocimiento en metodología y estadística. Inicialmente, la pregunta de investigación debe contar con una estructura que deje claro qué se busca (consecuencia o desenlace), en quién (estado basal) y por acción de qué (maniobra). Posteriormente, su argumentación debe explorar cuatro aspectos: factibilidad y sensatez del cuestionamiento, ausencia de respuesta previa, relevancia de la respuesta a obtener y aplicabilidad. Una vez que estos aspectos han sido cubiertos en forma satisfactoria puede considerarse que la pregunta es "clínicamente relevante", que es diferente a significancia estadística (la probabilidad de que el resultado se deba al azar y que no refleja la relevancia de la pregunta ni de los resultados). Nunca se debe olvidar que toda maniobra conlleva eventos adversos, que cuando son graves demeritan los buenos resultados. Es imperativo estimar la posible respuesta desde la estructura de la pregunta; la función de la investigación clínica es corroborar o rechazar una hipótesis, no probar empíricamente para ver qué resulta.

Abstract A clinical research question requires the concurrence of clinical experience and knowledge on methodology and statistics in that who formulates it. Initially, a research question should have a structure that clearly establishes what is that which is being sought (consequence or outcome), in whom (baseline status), and by action of what (maneuver). Subsequently, its reasoning must explore four aspects: feasibility and reasonableness of the questioning, lack of a prior answer, relevance of the answer to be obtained, and applicability. Once these aspects are satisfactorily covered, the question can be regarded as being "clinically relevant", which is different from being statistically significant, which refers to the probability of the result being driven by chance, which does not reflect the relevance of the question or the outcome. One should never forget that every maneuver entails adverse events that, when serious, discredit good results. It is imperative to have the possible answer estimated from within the structure of the question. The function of clinical research is to corroborate or reject a hypothesis, rather than to empirically test to find out what the outcome is.

Fear of Crime and Cultivation Effect. Social and Psychological Predictors / Miedo al crimen y efecto de cultivo. Predictores sociales y psicológicos

Abstract Within the framework of the study of cultivation, the present research attempts to study the association between general TV consumption, particular TV news, and fear of crime. The analysis considers narrative transportation and system justification as psychological predictor variables; in addition, sex, level of crime in the area of residence, and social class as social covariates. Participants were 516 young (M = 20.5 years, SD = 4.7) Costa Ricans. A hierarchical regression analysis (stepwise) was conducted. Results indicated that people who experienced more narrative transportation, less system justification, women, and low social class, have higher levels of fear of crime. Results are discussed from the need to expand the cultivation hypothesis of fear of crime.

Resumen En el marco de la teoría del cultivo, la presente investigación estudia la asociación entre el consumo general de televisión, noticias televisivas y el miedo al crimen. El análisis considera el transporte narrativo y la justificación del sistema como variables predictoras psicológicas; además, el sexo, el nivel de delincuencia en el área de residencia y la clase social como covariables sociales. Los participantes fueron 516 jóvenes costarricenses (M = 20.5 años, DE = 4.7). Se realizó un análisis de regresión jerárquica (stepwise). Los resultados indican que las personas que experimentaron más transporte narrativo, menos justificación del sistema, las mujeres y la clase social baja tienen mayores niveles de miedo al crimen. Se discuten los resultados a partir de la necesidad de ampliar la hipótesis de cultivo del miedo al crimen.

"Ver" e "Crer": percepção e justificação semântica / "Seeing" and "Believing": perception and semantic justification

Defino o "problema da significação perceptual" como juízos perceptuais significam a realidade. Ofereço quatro argumentos, questionando como as perspectivas internalista e externalista lidam com esta questão. O internalismo semântico não consegue justificar como: (i) experiências perceptuais são fenômenos semânticos, supervenientes a fenômenos sintáticos; (ii) o sujeito acessa o conteúdo de suas experiências perceptuais; e (iii) juízos perceptuais derivam de experiências perceptuais. O externalismo semântico não consegue justificar como: (iv) eventos epistemologicamente subjetivos, sob condições fenomenológicas específicas, derivam de processos causais ou funcionais; e (v) juízos perceptuais acerca de fatos empíricos distinguem-se de juízos perceptuais acerca de eventos epistemologicamente subjetivos. Internalismo e externalismo devem ser restritos a distintas e específicas dimensões da relação/processo perceptual, exceto a semântica.

I define "the perceptual meaning problem" how our beliefs can signify empirical reality. Ioffer four arguments by which I criticize both internalism and externalism perspectives indealing with this issue. Semantic internalism cannot justify how: (i) perceptual experiencesare semantic phenomena, supervenient to syntactic phenomena; (ii) the subject accessesthe content of his own perceptual experiences; and (iii) perceptual beliefs derive fromperceptual experiences. Semantic externalism cannot justify how: (iv) epistemologicallysubjective events under specific phenomenological conditions derive from causal orfunctional processes; (v) perceptual beliefs of empirical facts distinguishes themselvesfrom perceptual beliefs of epistemologically subjective events. Internalism and externalismmust be restricted to specific and distinct dimensions of perceptual relation/process butthe semantic one.

Radiation Safety in Nuclear Medicine Procedures / 대한핵의학회잡지

Since the nuclear disaster at the Fukushima Daiichi Nuclear Power Plant in 2011, radiation safety has become an important issue in nuclear medicine. Many structured guidelines or recommendations of various academic societies or international campaigns demonstrate important issues of radiation safety in nuclear medicine procedures. There are ongoing efforts to fulfill the basic principles of radiation protection in daily nuclear medicine practice. This article reviews important principles of radiation protection in nuclear medicine procedures. Useful references, important issues, future perspectives of the optimization of nuclear medicine procedures, and diagnostic reference level are also discussed.

Perspectivas e desafios da "nova" Política Nacional de Promoção da Saúde: para qual arena política aponta a gestão? / Perspectives and challenges of the "new" National Health Promotion Policy: to which political arena does management point?

Resumo A “nova” Política Nacional de Promoção da Saúde projeta perspectivas e desafios para a arena política. É nesse locus que se estabelecem os acordos e os desacordos circunscritos às tomadas de decisão, as quais nortearão a sua implementação. Este estudo visou entender essas questões buscando refletir sobre a formação das arenas, contribuindo na construção de estratégias coerentes à política. Trata-se de estudo qualitativo, fundamentado na teoria da justificação e seus mundos, conforme Boltanski e Thévenot. Os entrevistados foram atores envolvidos com a gestão dessa política. Na análise, verificou-se a presença dos mundos: cívico-visão e conceitos; por projetos-execução; e industrial-limites impostos. Estes mundos definem as arenas onde as perspectivas e os desafios apontados aparecem. As configurações advindas dos cruzamentos dos mundos esboçam arenas estabelecidas mediante seus interesses e características resultantes da construção de acordos. Ressaltam-se ainda grandezas dos mundos que podem configurar-se em controvérsias ou conflitos, principalmente entre as subcategorias presentes em mais de um mundo. A consciência crítica e o estabelecimento de um jogo político claro serão exigidos dos atores envolvidos para promover acordos e/ou desacordos relativos à nova política.

Abstract The “new” National Health Promotion Policy opens up prospects and challenges for the political arena. This is the space where agreements and disagreements relating to decision-making, which will underpin its implementation, are established. This study sought to understand these questions, seeking to reflect upon the formation of arenas, in order to contribute with strategies coherent with the policy. It is a qualitative study, based on the theory of justification and its ‘polities’ according to Boltanski and Thévenot. Those interviewed were social actors involved with management of this policy. The analysis verified the presence of the polities such as: civic –vision and concepts; project –execution; and industrial – imposed limits. These polities define the arenas where the designated prospects and challenges appear. The configurations arising from the intersection points of these polities reveal arenas established through interests and issues resulting from agreements. It further highlights the grandeur of polities that may be found in controversies or conflicts, especially among the subcategories present in more than one polity. Critical awareness and the establishment of a clear political game are required of the social actors involved in promoting agreements and/or disagreements related to the new policy.

General Principles of Radiation Protection in Fields of Diagnostic Medical Exposure

After the rapid development of medical equipment including CT or PET-CT, radiation doses from medical exposure are now the largest source of man-made radiation exposure. General principles of radiation protection from the hazard of ionizing radiation are summarized as three key words; justification, optimization, and dose limit. Because medical exposure of radiation has unique considerations, diagnostic reference level is generally used as a reference value, instead of dose limits. In Korea, medical radiation exposure has increased rapidly. For medical radiation exposure control, Korea has two separate control systems. Regulation is essential to control medical radiation exposure. Physicians and radiologists must be aware of the radiation risks and benefits associated with medical exposure, and understand and implement the principles of radiation protection for patients. The education of the referring physicians and radiologists is also important.

Imaging Guidelines for Enhancing Justifications for Radiologic Studies

Justification in the field of radiology refers to the appropriate use of radiologic imaging modalities, and may be achieved by establishing clinical imaging guidelines (CIGs). Recently, CIGs have been shown to be useful in selecting the proper medical imaging modality, resulting in the reduction of inappropriate radiologic examinations, thereby enhancing justifications. However, the development of CIGs is both time-consuming and difficult as the methodology of evidence-based medicine should be adhered to. Thus, although the radiologic societies in developed countries such as the United Kingdom and USA are already developing and implementing CIGs in their clinical practices, CIGs are not yet readily available in many other countries owing to differences in medical circumstances and resources. In this review, we assess the role and limitations of CIGs by examining the current status of CIGs in developed countries, and also describe the specific efforts made to establish CIGs in Korea.

Patient Dose Management: Focus on Practical Actions

Medical radiation is a very important part of modern medicine, and should be only used when needed and optimized. Justification and optimization of radiation examinations must be performed. The first step of reduction of medical exposure is to know the radiation dose in currently performed examinations. This review covers radiation units, how various imaging modalities report dose, and the current status of radiation dose reports and legislation. Also, practical tips that can be applied to clinical practice are introduced. Afterwards, the importance of radiology exposure related education is emphasized and the current status of education for medical personal and the public is explained, and appropriate education strategies are suggested. Commonly asked radiation dose related example questions and answers are provided in detail to allow medical personnel to answer patients. Lastly, we talk about computerized programs that can be used in medical facilities for managing patient dose. While patient dose monitoring and management should be used to decrease and optimize overall radiation dose, it should not be used to assess individual cancer risk. One must always remember that medically justified examinations should always be performed, and unneeded examinations should be avoided in the first place.

Radiological Justification for and Optimization of Nuclear Medicine Practices in Korea

Nuclear medicine is a rapidly growing discipline that employs advanced novel hybrid techniques that provide unique anatomical and functional information, as well as targets for molecular therapy. Concomitantly, there has been an increase in the attention paid to medical radiation exposure. A radiological justification for the practice of nuclear medicine has been implemented mainly through referral guidelines based on research results such as prospective randomized clinical trials. The International Commission on Radiological Protection recommends diagnostic reference levels as a practical mechanism to optimize medical radiation exposure in order to be commensurate with the medical purpose. The Korean Society of Nuclear Medicine has been implementing radiological optimization through a survey of the protocols on how each hospital determines the dose of administration of each radiopharmaceutical. In the case of nuclear medicine, radiation exposure of caregivers and comforters of patients discharged after administration of therapeutic radiopharmaceuticals can occur; therefore, optimization has been implemented through written instructions for patients, based on international recommendations. The development of patient-radiation-dose monitoring software, and a national registry and management system of patient-radiation-dose is needed to implement radiological optimization through diagnostic reference levels. This management system must work in agreement with the "Institute for Quality Management of Nuclear Medicine", and must take into account the medical reality of Korea, such as low medicine fee, in order to implement reasonable radiological justification and optimization.

La justificación del sistema: aportes para la construcción de un diálogo interdisciplinario / The system justification: contributions for the construction of an interdisciplinary dialogue

La teoría de la justificación del sistema señala que los individuos justifican y racionalizan los sistemas sociales a los que pertenecen, de manera que las decisiones políticas, sociales y económicas tienden a ser percibidas como justas y legítimas aunque estas los afecten y perjudiquen (Jost & Banaji, 1994). Este fenómeno ha sido estudiado principalmente desde la sociología con una perspectiva marxista, dando cuenta de cómo los grupos dominantes difunden ideas que justifican y mantienen las jerarquías sociales que promueven la desigualdad en la sociedad (Marx & Engels, 1846/1991). Desde esta perspectiva, los grupos dominados se encontrarían alienados, sin saber de la dominación de la que son objeto, dado que la toma de conciencia de su condición los llevaría a rebelarse (Sidanius & Pratto, 1999). Si bien esta perspectiva ha gozado de un amplio consenso (Sidanius & Pratto, 1999), Jost (2007), desde la psicología política, la considera incompleta dado que la aceptación de ideas que justifican y mantienen las jerarquías sociales no necesariamente es una actividad consciente, realizada de forma activa y deliberada, sino que la misma puede ser producto de los beneficios psicológicos que ofrece al individuo, como la percepción de un mundo ordenado y controlable facilitando una reducción de la ansiedad (Jost & Hunyady, 2002). El objetivo de este trabajo es analizar las diferencias teóricos conceptuales entre ambas perspectivas con el fin de generar aportes para la construcción de un diálogo interdisciplinario.

The system justification theory states that individuals justify and rationalize the social systems to which they belong, so that the political, economic and social decission tend to be perceived as fair and legitimate although these may affect them and damaging (Jost & Banaji, 1994). This phenomenon has been studied mainly from a sociological approach with a marxist perspective, realizing how dominant groups disseminate ideas that justify and maintain social hierarchies that promote inequality in society (Marx & Engels, 1846/1991). From this perspective, the dominated groups would ind themselves alienated, unaware of domination of which they are subject, as awareness of their condition would lead to revolt (Sidanius & Pratto, 1999). While this perspective has enjoyed a wide consensus (Sidanius & Pratto, 1999), Jost (2007), from political psychology approach, considered incomplete since the acceptance of ideas that justify and maintain social hierarchies is not necessarily a conscious activity, conducted actively and deliberate, but rather it may be the result of the psychological benefits offered by the individual, as the perception of an ordered and controllable facilitating a reduction in anxiety (Jost & Hunyady, 2002).The aim of this paper is to analyze the theoretical and conceptual differences between the two perspectives in order to generate contributions for the construction of an interdisciplinary dialogue.

Strategies of computed tomography radiation dose reduction: justification and optimization

Medical imaging is an indispensible diagnostic tool in modern medicine enabling fast and accurate diagnosis. Recent technological advances in medical equipment and increased utilization of the imaging modality have resulted in a significant increase in the exposure to ionizing radiation. After the rapid adoption of multi-detector computed tomography, computed tomography (CT) is now the single largest source of diagnostic radiation exposure to patients. The risks and benefits from radiation must be carefully considered in all examinations using ionizing radiation, and the principles of justification and optimization should be considered in the proper use of CT examination. Justification means that the examination must be medically indicated and useful. Optimization means that the imaging should be performed using doses that are ALARA (as low as reasonably achievable), consistent with the diagnostic task. This includes understanding and changing CT protocols to perform the same diagnostic task with the minimal amount of radiation exposure while maintaining diagnostic accuracy. Protocols and guidelines are important tools for radiation dose reduction. Understanding the parameters and dose information for CT examination is essential for optimization. If the exam is justified, then the parameters must be optimized to the imaging indication, scan area, body size, age, and weight of the patients. The physician should always assess the radiation risk-benefit ratio for each patient before ordering an examination that uses radiation. Continuing education is essential for the implementation of the principles of patient radiation dose reduction. Physicians and radiologists must be aware of the radiation risks associated with CT exams.

Justificação moral e acordo político: sobre a possibilidade de uma complementariedade entre um construtivismo moral e um construtivismo político na teoria de Rawls / Moral justification and political agreement: on the possibility of a complementary between a moral constructivism and political constructivism in Rawls’ theory

A relação entre moral e política na teoria de Rawls nunca foi um dos assuntos que prendeu muito a atenção dos estudiosos, uma vez que este sempre foi um dos pontos pacíficos da teoria do filósofo. Mas não parece que essa relação seja tão simples assim. Por isso, o presente projeto de pesquisa tem como pretensão compreender em que sentido o construtivismo político de Rawls exposto em justiça como equidade deve ser entendido e sustenta que há uma relação de complementariedade entre um construtivismo moral e um construtivismo político em um mesmo modelo de justificação, o que Rawls expressamente não admite. Nesse caso, propõe-se que em aspectos fundamentais é preciso ir além de Rawls para uma discussão mais profunda da justiça em sociedades marcadas pelo pluralismo de concepções de bem. Partindo da literatura clássica de Rawls, em especial o texto Liberalismo político, e de outros autores, principalmente Forst, busca-se mostrar que Rawls, do ponto de vista da fundamentação teórica, tornou sua teoria cada vez mais política, acabando por deixa-la vulnerável a críticas historicistas, relativistas e pragmatistas.

The relationship between morality and politics in Rawls' theory was never one of those issues that really caught the attention of scholars, since this has always been one of peaceful points of the theory of the philosopher. But it seems that this relationship is that simple. Therefore, this research project is to pretend to understand the sense in which Rawls's political constructivism exposed in justice as fairness should be understood and maintains that there is a relationship of complementarity between a moral and a political constructivism constructivism in one model of justification what Rawls expressly admits. In this case, it is proposed that in key aspects is necessary to go beyond Rawls for a deeper discussion of justice in societies marked by pluralism of conceptions of the good. Starting from the classical literature of Rawls, but in particular the political Liberalism text, and other authors, mainly Forst, we seek to show that Rawls, from the point of view of theoretical foundation, became his increasingly political theory, eventually Let it vulnerable to historicist, relativist and pragmatist criticism.

Intolerancia a la ambigüedad, conservadurismo político y justificación de la inequidad económica, legal, educativa y étnica en la ciudad de Lima – Perú / Intolerância à ambiguidade, conservadorismo político e justificativa da inequidade econômica, legal, educativa e étnica na cidade de Lima, Peru / Intolerance to ambiguity, political conservatism, and justification of economic, legal, educational, and ethnic inequality in the city of Lima – Peru

Se analiza la relación entre el conservadurismo político y la justificación de cuatro formas de inequidad: económica, legal, educativa y étnica, en una muestra de estudiantes y graduados universitarios de la ciudad de Lima. Se evaluaron la intolerancia a la ambigüedad, el autoritarismo de ala derecha (RWA), la orientación hacia la dominancia social (SDO) y la orientación política de derecha. Un diagrama de sendero muestra que la intolerancia a la ambigüedad influye directamente sobre el RWA y la SDO, y estos a su vez lo hacen sobre los cuatro tipos de justificación de la inequidad. La SDO ejerce una influencia de mayor intensidad en comparación con el RWA.

The article analyzes the relationship between political conservatism and the justification of economic, legal, educational, and ethnic inequality in a sample of students and university graduates from the city of Lima. The following aspects were evaluated: intolerance toward ambiguity, right-wing authoritarianism (RWA), social dominance orientation (SDO), and rightist political orientation. A Path-analysis shows that intolerance toward ambiguity directly influences RWA and SDO, and that these variables, in turn, influence the four types of justification of inequality. SDO exerts a greater influence than RWA.

Analisa-se a relação entre o conservadorismo político e a justificativa de quatro formas de inequidade: econômica, legal, educativa e étnica, em uma amostra de estudantes e universitários formados da cidade de Lima. Avaliaram-se a intolerância à ambiguidade, o autoritarismo de direita (RWA), a orientação à dominância social (SDO) e a orientação política de direita. Um diagrama de trilha mostra que a intolerância à ambiguidade influencia diretamente sobre o RWA e a SDO, e estes, por sua vez, fazem isso sobre os quatro tipos de justificativa da inequidade. A SDO exerce uma influência de maior intensidade em comparação com o RWA.

Análisis de la referencia de pacientes a un hospital de tercer nivel pediátrico / Analysis of patients referred to a pediatric third-level hospital

Análisis descriptivo de las referencias de pacientes que llegan al Hospital del Niño "Dr. Ovidio Aliaga Uria", tomando en cuenta la red de referencia, el nivel de atención del que fue referido, justificación de referencias, calidad de las mismas, diagnóstico dado, tratamiento indicado, coordinación y la necesidad de internación de estos pacientes. Resultados: Entre julio y septiembre de 2012, se realizaron 300 referencias, 51% fueron justificadas, y 49% injustificadas. Según el nivel de atención, el 1er nivel fue el que tuvo más referencias injustificadas, seguido del 3er nivel y luego del 2do nivel. El 1er tuvo la mayor cantidad de referencias de mala calidad, con manejos errados, trasladados sin personal médico ni ambulancia, independientemente del estado del paciente, referidos directamente al tercer nivel sin coordinación previa, saltando al segundo nivel.

Descriptive analysis of patient referral to Children's Hospital "Dr. OvidioAliaga Uria": network of health facilities and level, justification, their quality, treatment, coordination and the need of hospitalization were revisited. Results: between july and September of 2012, 300 referrals were realized, 51% justified and 49% were unjustified. The 1st level had more unjustified references, followed the third level. The 1st level had the highest number of poor quality references, with wrong treatments, without medical or ambulance regardless of patient condition, referred directly to the third level without coordination, bypassing the second level.

Percepción de inseguridad pública y justificación de la violencia de estado en un grupo de habitantes del estado de México: análisis de argumentos / Perception of public insecurity and justification of state violence in a group of habitants of the State of México: analysis of arguments / Percepção de insegurança pública e justificação da violência de estado em um grupo de habitantes do Estado do México: análise de argumentos

El objetivo central del trabajo fue el de analizar los argumentos que emplearon residentes de un municipio de México para justificar distintas prácticas violentas perpetradas por el Estado, y que han sido usadas como estrategia en los últimos años para tratar el tema de la inseguridad pública. Para ello se llevó a cabo una investigación inserta en el paradigma cualitativo, utilizando la entrevista semiestructurada como herramienta principal. El análisis argumentativo del discurso reveló que la justificación, más que estar basada en una percepción de inseguridad generalizada, paradójicamente tenía su sustento en el descontento social con las autoridades encargadas de la procuración e impartición de justicia. Los argumentos más frecuentes fueron el de la eficacia, el de la defensa y el del castigo proporcional. En cada uno de ellos se hizo presente la construcción social del delincuente, el sistema de significación sobre "lo violento", el concepto de justicia y el grado de daño percibido para el participante.

The main objective of this paper was to analyze the arguments employed by residents of a municipality of the State of Mexico to justify some violent practices perpetrated by the State and that have been used as a strategy in recent years to address the issue of public insecurity. To this effect, a research work from the qualitative paradigm was carried out,using the semi- structured interview as the main tool. The argumentative discourse analysis revealed that the justification, rather than being based on a perception of widespread insecurity, paradoxically, haditssupport on social discontent with the authorities responsible for the administration and enforcement of justice. The most frequent arguments were: efficiency, defense, and proportional punishment. In each one of them, the social construction of offenders, the meaning system about "the violent", the concept of justice and the degree of damage perceived for the participant were present.

O objetivo central do trabalho foi analisar os argumentos que empregaram residentes de um município do México para justificar diferentes práticas violentas cometidas pelo Estado, e que têm sido usadas como estratégia nos últimos anos para tratar o tema da insegurança pública. Para isso realizou-se uma pesquisa dentro do paradigma qualitativo, utilizando a entrevista semiestruturada como ferramenta principal. A análise argumentativa do discurso revelou que a justificação, mais que estar baseada em uma percepção de insegurança generalizada, paradoxalmente tinha seu sustento no descontentamento social com as autoridades encarregadas da procuração e distribuição de justiça. Os argumentos mais frequentes foram o da eficácia, o da defesa e o do castigo proporcional. Em cada um deles se fez presente a construção social do delinquente, o sistema de significação sobre "o violento", o conceito de justiça e o grau de dano percebido para o participante.