Understanding the Normativity of Health Technology Assessment: Ontological, Moral, and Epistemological Commitments.

The inherent normativity of HTA can be conceptualized as a result of normative commitments, a concept that we further specify to encompass moral, epistemological and ontological commitments at play in the practice of HTA. Based on examples from literature, and an analysis of the example of assessing Non-Invasive Prenatal Testing (NIPT), we will show that inevitable normative decisions in conducting an assessment commits the HTA practitioner to moral (regarding what makes a health technology desirable), ontological (regarding which effects of health technology are conceivable), and epistemological (regarding how to obtain reliable information about health technology) norms. This highlights and supports the need for integrating normative analysis and stakeholder participation, providing guidance to HTA practitioners when making normative choices. This will foster a shared understanding between those who conduct, use, or are impacted by assessments regarding what are conceivable and desirable outcomes of using health technology, and how to collect reliable information to assess whether these outcomes are (going to be) realized. It also provides more insight into the implications of different normative choices.

Claiming and attributing (dis)taste: Issues of sharing a meal as a competent member.

Eating together is a primordial social activity with robust normative expectations. This study examines a series of instances where appreciative elements about the food during a shared meal are treated as noticeably absent and where some of the participants are attributed to exhibit a negative stance towards the food, which furthermore is used as a resource for engaging in membership categorization. Situated within the cognate approaches of ethnomethodology and conversation analysis, this study draws on video recordings of an integrated language and cooking workshop organized for immigrants in the French speaking part of Switzerland. The participants include a French teacher, two chefs and five immigrant women with various native languages. The detailed sequential, multimodal analysis details and explains how the participants treat gustatory features of eating as publicly available and accountable, and how the absence of evaluative elements contribute to the situated achievement of a plural "you" as a group that does not like "this" food. Ascribing (dis)taste for food on behalf of others, occasions accounts for just how to eat, showing the strong normative features that make up to the recognizability of sharing a meal as a competent member - including how sensorial experiences are evaluated and expressed. In this way, this study contributes to our understanding of the (non)ordinary features of eating together as a situated, embodied achievement and social institution that is built in and through interaction.

What value structure underlies shared decision making? A qualitative synthesis of models of shared decision making.

OBJECTIVE: To construct the underlying value structure of shared decision making (SDM) models. METHOD: We included previously identified SDM models (n = 40) and 15 additional ones. Using a thematic analysis, we coded the data using Schwartz's value theory to define values in SDM and to investigate value relations. RESULTS: We identified and defined eight values and developed three themes based on their relations: shared control, a safe and supportive environment, and decisions tailored to patients. We constructed a value structure based on the value relations and themes: the interplay of healthcare professionals' (HCPs) and patients' skills [Achievement], support for a patient [Benevolence], and a good relationship between HCP and patient [Security] all facilitate patients' autonomy [Self-Direction]. These values enable a more balanced relationship between HCP and patient and tailored decision making [Universalism]. CONCLUSION: SDM can be realized by an interplay of values. The values Benevolence and Security deserve more explicit attention, and may especially increase vulnerable patients' Self-Direction. PRACTICE IMPLICATIONS: This value structure enables a comparison of values underlying SDM with those of specific populations, facilitating the incorporation of patients' values into treatment decision making. It may also inform the development of SDM measures, interventions, education programs, and HCPs when practicing.

Assessing medical devices: a qualitative study from the validate perspective.

OBJECTIVES: Our objective was to explore procedures and methods used at health technology assessment (HTA) agencies for assessing medical devices and the underlying views of HTA practitioners about appropriate methodology to identify challenges in adopting new methodologies for assessing devices. We focused on the role of normative commitments of HTA practitioners in the adoption of new methods. METHODS: An online survey, including questions on procedures, scoping, and assessments of medical devices, was sent to members of the International Network of Agencies for Health Technology Assessment. Interviews were conducted with survey respondents and HTA practitioners involved in assessments of transcatheter aortic valve implantation to gain an in-depth understanding of choices made and views about assessing medical devices. Survey and interview questions were inspired by the "values in doing assessments of health technologies" approach towards HTA, which states that HTA addresses value-laden questions and information. RESULTS: The current practice of assessing medical devices at HTA agencies is predominantly based on procedures, methods, and epistemological principles developed for assessments of drugs. Both practical factors (available time, demands of decision-makers, existing legal frameworks, and HTA guidelines), as well as commitments of HTA practitioners to principles of evidence-based medicine, make the adoption of a new methodology difficult. CONCLUSIONS: There is a broad recognition that assessments of medical devices may need changes in HTA methodology. In order to realize this, the HTA community may require both a discussion on the role, responsibility, and goals of HTA, and resulting changes in institutional context to adopt new methodologies.

Authorship and ChatGPT: a Conservative View.

Is ChatGPT an author? Given its capacity to generate something that reads like human-written text in response to prompts, it might seem natural to ascribe authorship to ChatGPT. However, we argue that ChatGPT is not an author. ChatGPT fails to meet the criteria of authorship because it lacks the ability to perform illocutionary speech acts such as promising or asserting, lacks the fitting mental states like knowledge, belief, or intention, and cannot take responsibility for the texts it produces. Three perspectives are compared: liberalism (which ascribes authorship to ChatGPT), conservatism (which denies ChatGPT's authorship for normative and metaphysical reasons), and moderatism (which treats ChatGPT as if it possesses authorship without committing to the existence of mental states like knowledge, belief, or intention). We conclude that conservatism provides a more nuanced understanding of authorship in AI than liberalism and moderatism, without denying the significant potential, influence, or utility of AI technologies such as ChatGPT.

Explaining depression in the language of burnout: Normative reasons for depression in place of deterministic causes.

In recent years, there has been renewed interest in diversifying the understanding and discussion about the causes of depression to move beyond biomedical determinism-a view that biomedical factors are the ultimate cause of an individual's depression. There is increasing emphasis on diversity in how people seek to articulate the causes of depression to incorporate non-biomedical dimensions. Furthermore, the biomedical understanding of depression has been increasingly questioned due especially to emerging limitations in pharmacotherapy. These shifts encourage social analyses that explore what narratives as to the causes of depression are constructed and presented with relative plausibility in different contexts and why and how. By analysing published memoirs of individuals diagnosed with depression in Japan, this study aims to provide fresh insights into narratives around the causes of depression. It illustrates how memoirs portray depression and its perceived causes in characteristic ways in a nation that adopts Western diagnostic systems, biomedical therapeutics and other relevant technologies. I will show that 'burnout' is the dominant theme in the Japanese data, diverging from the predominantly biomedical narrative in Western societies. This burnout narrative depicts depression as the somewhat unfortunate but unsurprising result of overwork arising from individual active adaptations to structural features of the Japanese work culture. I argue that reasons, rather than causes, articulate the making of the burnout narrative by revealing the interplay between the structural and individual and ultimately enrich the understanding of depression. The paper concludes with a call for exploring the shifting relationship between illness and normalcy that the burnout narrative implies. I suggest that further studies could explore how the boundaries between normalcy and illness are enacted and re-enacted and to what avail through public discourse and through shifting diagnostic schemata in the context of different national norms and practices.

In search of animal normativity: a framework for studying social norms in non-human animals.

Social norms - rules governing which behaviours are deemed appropriate or inappropriate within a given community - are typically taken to be uniquely human. Recently, this position has been challenged by a number of philosophers, cognitive scientists, and ethologists, who have suggested that social norms may also be found in certain non-human animal communities. Such claims have elicited considerable scepticism from norm cognition researchers, who doubt that any non-human animals possess the psychological capacities necessary for normative cognition. However, there is little agreement among these researchers about what these psychological prerequisites are. This makes empirical study of animal social norms difficult, since it is not clear what we are looking for and thus what should count as behavioural evidence for the presence (or absence) of social norms in animals. To break this impasse, we offer an approach that moves beyond contested psychological criteria for social norms. This approach is inspired by the animal culture research program, which has made a similar shift away from heavily psychological definitions of 'culture' to become organised around a cluster of more empirically tractable concepts of culture. Here, we propose an analogous set of constructs built around the core notion of a normative regularity, which we define as a socially maintained pattern of behavioural conformity within a community. We suggest methods for studying potential normative regularities in wild and captive primates. We also discuss the broader scientific and philosophical implications of this research program with respect to questions of human uniqueness, animal welfare and conservation.

Social and Ethical Implications of Digital Crisis Technologies: Case Study of Pandemic Simulation Models During the COVID-19 Pandemic.

BACKGROUND: Responses to public health crises are increasingly technological in nature, as the prominence of COVID-19-related statistics and simulations amply demonstrates. However, the use of technologies is preconditional and has various implications. These implications can not only affect acceptance but also challenge the acceptability of these technologies with regard to the ethical and normative dimension. OBJECTIVE: This study focuses on pandemic simulation models as algorithmic governance tools that played a central role in political decision-making during the COVID-19 pandemic. To assess the social implications of pandemic simulation models, the premises of data collection, sorting, and evaluation must be disclosed and reflected upon. Consequently, the social construction principles of digital health technologies must be revealed and examined for their effects with regard to social, ethical, and ultimately political issues. METHODS: This case study starts with a systematization of different simulation approaches to create a typology of pandemic simulation models. On the basis of this, various properties, functions, and challenges of these simulation models are revealed and discussed in detail from a socioscientific point of view. RESULTS: The typology of pandemic simulation methods reveals the diversity of model-driven handling of pandemic threats. However, it is reasonable to assume that the use of simulation models could increasingly shift toward agent-based or artificial intelligence models in the future, thus promoting the logic of algorithmic decision-making in response to public health crises. As algorithmic decision-making focuses more on predicting future dynamics than statistical practices of assessing pandemic events, this study discusses this development in detail, resulting in an operationalized overview of the key social and ethical issues related to pandemic crisis technologies. CONCLUSIONS: This study identifies 3 major recommendations for the future of pandemic crisis technologies.

What is recovering? Reflection on the place of perception, time and norms in health recovery / Qu'est-ce qui se rétablit ? Réflexion sur la place de la perception, du temps et de la norme dans le rétablissement en santé

The notion of recovery is frequently evoked in healthcare, but it carries with it a number of ambiguities: do we envisage a return to a state that preceded the illness, or a way of composing a new way of living based on the illness? In order to think more precisely about recovery, this paper proposes to take a philosophical look at the notion of norm and to develop its importance through an approach to time, body and world. This analysis will make it possible to clarify the existential aspects involved in health recovery, and to describe the issues at stake in the care relationship in terms of these dimensions of subjective experience.

La notion de rétablissement est fréquemment évoquée en santé ; toutefois, elle porte avec elle des ambigüités : envisage-t-on le retour à un état qui a précédé la maladie ou une manière de composer une nouvelle façon de vivre à partir de la maladie ? Afin de penser avec plus de précision le rétablissement, cet article propose de s'intéresser philosophiquement à la notion de norme, et de développer son importance à travers l'approche du temps, du corps et du monde. Cette analyse permettra à la fois de préciser les aspects existentiels concernés par le rétablissement en santé et de décrire les enjeux de la relation de soin à l'aune de ces dimensions du vécu subjectif.

Non-Indigenous and Indigenous food-related interactions: How does the transmission of a normativity perpetuate colonialism?

OBJECTIVES: Type 2 diabetes has been considered an epidemic among Indigenous Peoples in Canada. They also suffer more from obesity than non-Indigenous people in the country, a condition that is considered an epidemic worldwide. Various public health and social services professionals are working in Indigenous communities across the country to raise awareness about certain lifestyle habits. The main objective of this article is to analyze the food normativity transmitted to an Indigenous population and to examine its reception. More specifically, the aim is to understand the opportunities of transmission (content and format) and the relational dynamics that these encounters between mostly non-Indigenous professionals and Indigenous Peoples imply. METHOD: The analysis is based on an ethnographic fieldwork in the Anicinabe community of Lac Simon (Abitibi, Quebec). Conducted with a relational approach, interviews and participant observation were carried out. RESULTS: It appears that the Anicinabek have a great knowledge of the "good" eating habits as defined by a biomedical food normativity. A reflexive analysis of my presence in the community as a non-Indigenous anthropologist and an analysis of the Anicinabek's responses to food recommendations lead me to argue that a form of food colonialism, inscribed in welfare (assistance) colonialism, persists while food surveillance seems to be integrated by the Anicinabek. This food normativity is the bearer of a biomedical conception of food and the colonial history of the country colours its transmission to Indigenous Peoples. CONCLUSION: Greater autonomy, namely Indigenous food sovereignty, seems necessary to deconstruct this food assistance structure.

RéSUMé: OBJECTIFS: Depuis plusieurs années déjà, le diabète de type 2 est considéré au stade épidémique chez les Premières Nations au Canada. Ils souffrent aussi davantage d'obésité que les non-Autochtones au pays, une condition qualifiée d'épidémie à l'échelle mondiale. Divers représentants de la santé publique et des services sociaux travaillent dans les communautés autochtones du pays notamment pour les sensibiliser à certaines habitudes de vie. L'objectif principal de cet article est d'analyser la normativité alimentaire transmise à une population autochtone et à en examiner la réception. Plus précisément, il s'agit d'examiner les occasions de transmission (contenu et format) et de comprendre les dynamiques relationnelles que ces occasions de rencontre entre professionnels non-autochtones et Autochtones impliquent. MéTHODE: La présente analyse s'appuie sur des données récoltées dans le cadre d'une enquête ethnographique d'un an au sein de la communauté anicinabe de Lac Simon (Abitibi, Québec). Menées avec une approche relationnelle, des entrevues avec des membres de la communauté ainsi que de l'observation participante ont été réalisées permettant ainsi un accès aux quotidiens des Anicinabek autant au sein de la réserve que lors de séjours sur le territoire. RéSULTATS: À Lac Simon, comme dans d'autres communautés autochtones, les sources de sensibilisation sont nombreuses et accessibles depuis des années : formations, ateliers, activités communautaires et rencontres individualisées sur demande. D'ailleurs, une connaissance des « bonnes habitudes ¼ alimentaires par les Anicinabek est notable. Une analyse réflexive de ma présence au sein de la communauté en tant qu'anthropologue non-autochtone et une analyse des réponses des Anicinabek face aux conseils alimentaires m'amène à soutenir qu'une forme de colonialisme alimentaire, inscrit dans un colonialisme d'assistance, persiste alors qu'une surveillance alimentaire apparait comme intégrée par les Anicinabek. Cette normativité alimentaire est porteuse d'une conception biomédicale de l'alimentation et l'historique colonial du pays teinte sa transmission au sein des populations autochtones. CONCLUSION: Une plus grande autonomie, voire une souveraineté alimentaire autochtone, semble nécessaire pour déconstruire cet encadrement alimentaire.

Imitation fidelity increases with age in boys, but not in girls: An intriguing finding in a cohort of children aged 3 to 6 years.

Imitation that entails faithful reproduction of demonstrated behavior by reenacting a sequence of actions accurately is a fast and efficient way to acquire new skills as well as to conform to social norms. Previous studies reported that both culture and gender might impinge on young children's fidelity of imitation. We analyzed the imitative behavior of 87 children whose ages ranged from 3 to 6 years. An instrumental task was administered that offered partial (opaque apparatus) or total (transparent apparatus) information about causal connection between the demonstrated actions and their effect in achieving a desired reward. Imitative fidelity (imitating the actions that were demonstrated by an adult model yet were unnecessary for achieving the instrumental goal) increased as a function of age in boys, whereas no differences were found in girls. This lack of increase in girls can be ascribed to their displaying higher degrees of imitation fidelity at an earlier age.

"Mom and dad = cis woman + cis man" and the stigmatization of trans parents: an empirical test of norm-centered stigma theory.

Background: Empirical research on transgender individuals and their families is growing but investigations of attitudes toward trans parents are sparse. This gap is especially important to address because transgender parents face unique strains due to their violations of hetero-cis-normativity and the "Mom and Dad = Cis Woman + Cis Man" stereotype. Methods: Using a sample of adults aged 18-64 stratified by U.S. census categories of age, gender, race/ethnicity and census region collected from online panelists (N = 2,948), this study provides an intersectional investigation of Norm-Centered Stigma Theory (NCST) with hetero-cis-normativity (a system of norms, privilege, and oppression that situates heterosexual cisgender people above all others) as the centralized overarching concept that helps us to understand negativity directed toward transgender parents. Specifically, social power axes including gender identity (cisgender woman, cisgender man, nonbinary; trans people were excluded from the current study), sexual identity (heterosexual, lesbian, gay, bisexual), and interactions among these axes of social power are investigated. Results: Findings indicate that hetero-cis-normativity is strongly related to negativity toward trans mothers and fathers and that there is overall greater stigma toward trans dads when compared to trans moms. In addition, gender, sexual identity, and interactions among these experiences of social power have complex relationships with the stigmatization of trans parents. Conclusion: Results provide support for the use of Norm-Centered Stigma Theory to help us best understand the constellation of hostilities directed toward trans people and their families.

Regimes of normativization: reconsiderations of assistive technologies with Vonnegut's "Harrison Bergeron".

This article delves into Kurt Vonnegut's "Harrison Bergeron" to examine the profound implications of assistive technologies within the context of normativity. While Vonnegut's narrative unfolds in a dystopian future where "desistive devices" are used to enforce equality, Vonnegut's insights subtly underscore the intricate facets of othered-being that challenge the normativity of assistive technologies. Drawing from the insights of crip studies, this examination argues that assistive technologies often perpetuate and idealize normative bodymind ideals, presenting a consistent framing of the normative human. Through a discourse analysis, this study demonstrates how assistive technologies, despite their variability in individual experiences, embody a normative rationality of human, mindbody existence. These technologies, rather than accommodating diversity, tend to impose a particular standard of "normalcy." In conclusion, the analysis proposes a departure from this normative trajectory. It advocates for a future direction in assistive technologies that fosters and embraces "aberrant-being." By challenging established norms and persistently questioning the constructs of normativity, assistive technologies can evolve to engage with aberrant-being and enliven cripped-embodiment. This exploration paves the way for a more inclusive and diverse future in assistive technology, where human differences are cherished rather than subdued.

This piece highlights the need for a critical examination of the normative underpinnings within the field of assistive technologies, emphasizing that these technologies often perpetuate societal norms and may inadvertently limit the diverse experiences of individuals with disabilities.It calls for a shift in the design and implementation of assistive technologies, advocating for a more individualized approach that moves beyond accommodationism and grapples with the multiplicity of beingness that disability invokes.By drawing from the insights of crip studies and the critique of normativity in Kurt Vonnegut's "Harrison Bergeron," this piece invites the field of assistive technologies to challenge established norms, embrace othered invocations of being, and embrace the rich tapestry of human experiences, regardless of their deviation from traditional notions of ability and functionality.

The core epistemic responsibilities of universities: Results from a Delphi study.

Epistemic responsibilities (ERs) of universities concern equipping and empowering its researchers, educators and students to attain, produce, exchange and disseminate knowledge. ERs can potentially guide universities in improving education, research and in service to society. Building on earlier philosophical work, we applied empirical methods to identify core ERs of universities and their constituting elements. We used a three-round Delphi survey, alternating between closed questions to gain consensus, and open questions to let panelists motivate their answers. 46 panelists participated in our study. We reached consensus on six ERs: 1) to foster research integrity, 2) to stimulate the development of intellectual virtues, 3) to address the big questions of life, 4) to cultivate the diversity of the disciplinary fields, 5) to serve and engage with society at large, and 6) to cultivate and safeguard academic freedom. Together the six ERs contain 27 elements. Consensus rates ranged from 73%-100% for both the ERs and their elements. Participants' detailed responses led to substantial improvements in the accompanying descriptions of the ERs. Our findings can inform the debate about the roles and responsibilities of universities, and inform researchers and policy makers to emphasize epistemic tasks of universities.

Ecosystem health and malfunctions: an organisational perspective.

A recent idea of "ecosystem health" was introduced in the 1970s and 1980s to draws attention to the fact that ecosystems can become ill because of a reduction of properties such as primary productivity, functions and diversity of interactions among system components. Starting from the 1990s, this idea has been deeply criticized by authors who argued that, insofar as ecosystems show many differences with respect to organismic features, these two kinds of systems cannot share a typical organismic property such as health. In recent years, an organisational approach in philosophy of biology and ecology argued that both organisms and ecosystems may share a fundamental characteristic despite their differences, namely, organisational closure. Based on this kind of closure, scholars have also discussed health and malfunctional states in organisms. In this paper, we examine the possibility of expanding such an organisational approach to health and malfunctions to the ecological domain. Firstly, we will see that a malfunction is related to a lower effectiveness in the functional behaviour of some biotic components with respect to other systemic components. We will then show how some introduced species do not satisfactorily interact in an organisational closure with other ecosystem components, thus posing a threat to the self-maintenance of the ecosystem in which they are found. Accordingly, we will argue that an ecosystem can be said to be healthy when it is a vital environment organisationally grounded on its intrinsic capacity to ensure, under favourable conditions, appropriate functional behaviours for ecosystem components and ecosystem self-maintenance.

Lifespan Development Seen through Niche Construction Theory.

I will here pick up on a suggestion made by Greve (2023) in this journal, namely that a proper understanding of lifespan development means defending a non-reductionist psychology taking biological processes seriously, but without reducing psychology to physiology. I will here suggest and argue for the use of niche construction theory as a way of providing a psychological theoretical perspective on lifespan development broad enough to contain both naturalistic and normative elements in a non-reductionist manner.

Foucault and medicine: challenging normative claims.

Some of Michel Foucault's work focusses on an archeological and genealogical analysis of certain aspects of the medical episteme, such as 'Madness and Civilization' (1964/2001), 'The Birth of the Clinic' (1973) and 'The History of Sexuality' (1978/2020a). These and other Foucauldian works have often been invoked to characterize, but also to normatively interpret mechanisms of the currently existing medical episteme. Writers conclude that processes of patient objectification, power, medicalization, observation and discipline are widespread in various areas where the medical specialty operates and that these aspects have certain normative implications for how our society operates or should operate. The Foucauldian concepts used to describe the medical episteme and the normative statements surrounding these concepts will be critically analyzed in this paper.By using Foucault's work and several of his interpreters, I will focus on the balance between processes of subjectification and objectification and the normative implications of these processes by relating Foucault's work and the work of his interpreters to the current medical discipline. Additionally, by focusing on the discussion of death and biopower, the role of physicians in the negation and stigmatization of death is being discussed, mainly through the concept of biopower. Lastly, based on the discussion of panopticism in the medical discipline, this paper treats negative and positive forms power, and a focus will be laid upon forms of resistance against power. The discussed aspects will hopefully shed a different and critical light on the relationship between Foucault's work and medicine, something that eventually can also be deduced from Foucault's later work itself.

Finding value-ladenness in evolutionary psychology: Examining Nelson's arguments.

Faced with the charge of value-ladenness in their theories, researchers in evolutionary psychology (EP) argue that their science is entirely free of values; their hypotheses only concern scientific facts, without any socio-cultural value judgments. Lynn Hankinson Nelson, a renowned feminist scholar of science, denies this. In her book and papers, Nelson finds that their hypotheses do contain evaluative components. One such example is the fear of snakes. While this fear was adaptive to the environment in the past, evolutionary psychologists argue that this trait is now "maladaptive" because city-dwellers would rarely encounter snakes in their environment. However, Nelson argues that labeling this trait "maladaptive" implies that this fear is irrational since this claim cannot be understood otherwise. This paper argues that this and other arguments made by Nelson for demonstrating the value-ladenness in EP's hypotheses have serious flaws. For instance, we argue that investigating the psychological mechanisms behind the fear and their developmental and energy costs would allow for proper interpretation of evolutionary psychologists' claims for the maladaptive fear of snakes without any normative implication. We also maintain that some of her arguments fail to demonstrate their connection to the point at the center of the debates between EP and feminism. While Nelson may be right in stating that EP's hypotheses have evaluative components, she does not prove their strong political or normative implications, which is central to the debate over EP.

Enfermedades de origen laboral en docentes escolares: una revisión sistemática / Occupational Diseases in School Teachers: A Systematic review

Introducción. La docencia es una de las principales profesiones vinculadas con el desarrollo de una sociedad; como cualquier labor, se encuentra expuesta a diferentes factores de riesgo que pueden generar una enfermedad de origen laboral. Objetivo. Identificar y caracterizar la literatura actual que presente las principales enfermedades de los docentes escolares como consecuencia de su trabajo y/o las condiciones laborales. Materiales y Métodos. Revisión sistemática con búsqueda en las bases de datos Academic Search Complete (EBSCOHOST), APA - PSYCNET, ERIC (Education Resources Information Center), MEDLINE (PubMed), SCOPUS y Open Grey. Se realiza selección pareada independiente bajo criterios de inclusión y análisis de forma narrativa, incluyendo generalidades, información de la enfermedad y desenlaces en docentes. Resultados. Se incluyeron 47 estudios, de los cuales el 25,5 % fueron publicados en 2015; Brasil fue el país con mayor aporte temático. La mayoría de los estudios agrupó a los docentes escolares sin distinción de su ciclo (primaria, bachillerato y media). Las principales enfermedades identificadas fueron trastornos de la voz 51,1 %, musculoesqueléticos 23,4 % y psicosociales 21,3 %. Adicionalmente, se identificó que al menos el 50 % de los reportes por país estuvieron relacionados con trastornos de la voz; Brasil e India fueron los países de mayor representatividad. Conclusiones. Las principales enfermedades laborales docentes fueron las relacionadas con trastornos de la voz, musculoesqueléticos y psicosociales; a su vez, estas se relacionan con riesgos físicos, condiciones de seguridad, riesgos biomecánicos y psicosociales en el contexto escolar.

Introduction. Teaching is one of the main professions linked to the development of a society, and like any other labor it is exposed to different risk factors that can generate an occupational disease. Objective. To identify and characterize the current literature on the main illnesses suffered by schoolteachers as a result of their work and/or working conditions. Methodology. Systematic review with search in the databases Academic Search Complete (EBSCOHOST), APA - PSYCNET, ERIC (Education Resources Information Center), MEDLINE (PubMed), SCOPUS and Open Grey. We performed independent paired selection under inclusion criteria and narrative analysis including generalities, disease information and outcomes in teachers. Results. Forty-seven studies were included, 25.5% of which were published in 2015, and Brazil was the country with the largest thematic contribution. Most of the studies grouped schoolteachers regardless of their cycle (primary, secondary and high school). The main illnesses identified were voice disorders 51.1%, musculoskeletal disorders 23.4% and psychosocial disorders 21.3%. In addition, it was found that at least 50% of the reports per country were related to voice disorders, with Brazil and India being the most representative. Conclusions. The main occupational illnesses identified were related to voice, musculoskeletal and psychosocial disorders; these in turn are related to physical, safety, biomechanical and psychosocial risks in the school context.

["In God alone my soul can find rest" (Ps 62:2) : Silence and pain in the Psalms and their narrativizations in Taizé]. / "Zu Gott allein ist meine Seele still" (Ps 62,2) : Stille und Schmerz in den Psalmen und deren Narrativierungen in Taizé.

BACKGROUND: A theological perspective on dealing with crises that focuses on modes of endurance and gestalt, is supported by interdisciplinary resilience research. OBJECTIVE: How can silence contribute to a productive coping with crises and pain? MATERIAL AND METHODS: Texts and practices of the Christian tradition are discussed with respect to their ways of dealing with critical and painful situations, namely a) the Psalm texts of the Old Testament, which are examined by means of exegetical methods for historical and cultural aspects of meaning and b) the practice of silence in the prayers of the Taizé community, which are examined from a narrative hermeneutical perspective. RESULTS: By understanding silence as an ambiguous and ambivalent phenomenon, it can contribute to a productive way of dealing with pain that enables perception, confrontation and acceptance. It is crucial not to regard the silence of a sufferer as a mere endurance, but also to have an eye on the creative potentials. Cultural and religious narratives and practices can help to locate oneself in a "space of silence" in such a way that a resilient way of dealing with experiences of pain becomes possible. CONCLUSION: In order for silence to promote resilience, it is necessary to keep an eye on productive as well as destructive processes of silence as an ambivalent phenomenon: These processes occur in an uncontrollable way and are shaped by implicit normative assumptions. Silence can be experienced as loneliness, isolation and the loss of quality of life, or silence can become a place of encounter, of arrival, of security, and in prayer of trust in God.