Abstract Purpose: To review the current advances and current of the study of consciousness in order to discuss the advantages of a research program on consciousness defined by biology and complexity sciences. Methodological design: A review of the scientific literature of consciousness showed conceptual and methodological findings and their limitations. An analysis of the methods of complexity sciences and biology was carried out to discuss how this approach is able to contribute to the study of consciousness. Results: Among the comparative development of different current theories on consciousness we have the Theory of the integration of information and the Theory of the global work area. We also present a working scheme with the methods of complexity sciences and suggest evolutionary biology as a framework for the interpretation of the results. Research Limitations: A lack of consensus on definition makes it difficult to integrate empirical data into a general theory of consciousness. Findings: Six points were discussed as necessary for the research program of evolutionary biology and complexity, such as: the adaptive functional analysis of consciousness, the emergence of modular structures, evolutionary novelties, the genetic correspondence of cognitive abilities, the effect of the environment and reciprocal causality.

Resumen Objetivo: Presentar los avances y problemas vigentes del estudio de la consciencia con el fin de discutir las ventajas de un programa de investigación centrado en ella, definido por la biología evolutiva y las ciencias de la complejidad. Diseño metodológico: Se realizó una revisión de la literatura científica de los estudios de la consciencia. La revisión se centró en mostrar los hallazgos y limitaciones conceptuales y metodológicas. Posterior a eso, se realizó un análisis de los métodos de las ciencias de la complejidad y la biología evolutiva para discutir sus alcances en el estudio de la consciencia. Resultados: Se presenta el desarrollo comparativo de diferentes teorías actuales sobre la consciencia, entre ellas: la Teoría de la integración de la información y la Teoría del área de trabajo global. También se presenta un esquema de trabajo con los métodos de las ciencias de la complejidad y se sugiere a la biología evolutiva como un marco para la interpretación de los resultados. Limitaciones de la investigación: La falta de consenso en la definición dificulta la integración de los datos empíricos en una teoría general de la consciencia. Hallazgos: Se argumenta a favor de seis puntos necesarios para el programa de investigación de la biología evolutiva y de la complejidad. Los puntos son: el análisis funcional adaptativo de la consciencia, la emergencia de estructuras modulares, las novedades evolutivas, la correspondencia genética de las capacidades cognitivas, el efecto del medio y la causalidad recíproca.

Abstract Introduction: The awareness concept can be associated with the decision-making process of young people regarding their health. Currently, there is not much precision in the literature on the use of empirical indicators that would help to understand their relevance in the field of health care. Nursing plays an important role by using objective tools that help promote healthy behaviors based on consciousness. Objective: Identify, through a systematic bibliographic search, the reliability and validity of measurement instruments based on consciousness seen as a cognitive process, perception, comprehension and projection in young people. Methodology: Systematic review according to the criteria established by PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses); the search was carried out in Pubmed, Scopus, Web of Science, Science Citation Index, Social Sciences Citation Index and Ovid. It took place in the period ranged by June-September 2022, using the descriptors Adolescent and Tools and Awareness. From 923 potential articles found, a sample of 10 were selected, published in Spanish and English that addressed consciousness or one of its levels. Results: The articles were of a methodological type that made reference to the first level of consciousness, that is, perception. No studies were found that addressed comprehension and projection, substantive elements to know the state of consciousness in the health area. Conclusion: There is a need to have measurement tools that address consciousness in a comprehensive manner, that is, as a cognitive process that includes perception, comprehension and projection, essential elements for making decisions in young people with respect to their health.

Abstrato Introdução: O conceito de consciencialização pode ser relacionado com o processo de tomada de decisão dos jovens relativamente à sua saúde. Atualmente, não existe muita precisão na literatura sobre a utilização de indicadores empíricos que ajudem a compreender a sua relevância no domínio dos cuidados de saúde. A enfermagem desempenha um papel importante ao utilizar ferramentas objetivas que ajudam a promover comportamentos saudáveis baseados na consciência. Objetivo: Identificar, através de uma pesquisa bibliográfica sistemática, a fiabilidade e a validade dos instrumentos de medida baseados na consciência vista como um processo cognitivo, perceção, compreensão e projeção nos jovens. Metodologia: Revisão sistemática de acordo com os critérios estabelecidos pelo PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses); a busca foi realizada nas bases Pubmed, Scopus, Web of Science, Science Citation Index, Social Sciences Citation Index e Ovid. Foi realizada no período de junho a setembro de 2022, utilizando os descritores Adolescent e Tools and Awareness. Dos 923 artigos potenciais encontrados, foi selecionada uma amostra de 10, publicados em espanhol e inglês, que abordavam a consciência ou um de seus níveis. Resultados: Os artigos eram do tipo metodológico que faziam referência ao primeiro nível de consciência, que é a perceção. Não foram encontrados estudos que abordassem a compreensão e a projeção, elementos substantivos para conhecer o estado de consciência na área da saúde. Conclusão: É necessário dispor de instrumentos de medição que abordem a consciência de uma forma abrangente, ou seja, como um processo cognitivo que inclui a perceção, a compreensão e a projeção, elementos essenciais para a tomada de decisões dos jovens em relação à sua saúde.

Resumen Introducción: La conciencia puede estar relacionada con la toma de decisiones de los jóvenes respecto a su salud, en la actualidad existe poca claridad en la literatura sobre uso de indicadores empíricos que ayuden a esclarecer su pertinencia en el ámbito de la salud. Enfermería cumple un papel importante al utilizar herramientas objetivas que ayuden a promover conductas saludables basadas en la conciencia. Objetivo: Identificar mediante búsqueda bibliográfica sistemática, confiabilidad y validez de instrumentos de medida basados en la conciencia visto como proceso cognitivo percepción, comprensión y proyección en jóvenes. Metodología: Revisión sistemática de acuerdo con los criterios establecidos por la declaración Preferred Reporting Items for Sistematyc Reviews and Meta-analyses; la búsqueda se realizó en Pubmed, Scopus, Web of Science Science Citation Index y Social Sciences Citation Indexy Ovid. En el periodo junio -septiembre 2022, utilizando descriptores: Adolescent and tools and awareness. De 923 artículos potenciales publicados en español e inglés que abordaran conciencia o alguno de sus niveles, se seleccionó una muestra de 10. Resultados: Los artículos fueron de tipo metodológico, hacían referencia al primer nivel de la conciencia: percepción. No se encontraron estudios que abordaran comprensión y proyección, elementos sustantivos para conocer el estado de la conciencia en el área de salud. Conclusión: Existe la necesidad de contar con herramientas de medida que aborden la conciencia de manera integral, es decir como un proceso cognitivo el cual se incluya percepción, comprensión y proyección, elementos indispensables para la toma de las decisiones en los jóvenes respecto a su salud.

Abstract Purpose: To review the current advances and current of the study of consciousness in order to discuss the advantages of a research program on consciousness defined by biology and complexity sciences. Methodological design: A review of the scientific literature of consciousness showed conceptual and methodological findings and their limitations. An analysis of the methods of complexity sciences and biology was carried out to discuss how this approach is able to contribute to the study of consciousness. Results: Among the comparative development of different current theories on consciousness we have the Theory of the integration of information and the Theory of the global work area. We also present a working scheme with the methods of complexity sciences and suggest evolutionary biology as a framework for the interpretation of the results. Research Limitations: A lack of consensus on definition makes it difficult to integrate empirical data into a general theory of consciousness. Findings: Six points were discussed as necessary for the research program of evolutionary biology and complexity, such as: the adaptive functional analysis of consciousness, the emergence of modular structures, evolutionary novelties, the genetic correspondence of cognitive abilities, the effect of the environment and reciprocal causality.

Resumen Objetivo: Presentar los avances y problemas vigentes del estudio de la consciencia con el fin de discutir las ventajas de un programa de investigación centrado en ella, definido por la biología evolutiva y las ciencias de la complejidad. Diseño metodológico: Se realizó una revisión de la literatura científica de los estudios de la consciencia. La revisión se centró en mostrar los hallazgos y limitaciones conceptuales y metodológicas. Posterior a eso, se realizó un análisis de los métodos de las ciencias de la complejidad y la biología evolutiva para discutir sus alcances en el estudio de la consciencia. Resultados: Se presenta el desarrollo comparativo de diferentes teorías actuales sobre la consciencia, entre ellas: la Teoría de la integración de la información y la Teoría del área de trabajo global. También se presenta un esquema de trabajo con los métodos de las ciencias de la complejidad y se sugiere a la biología evolutiva como un marco para la interpretación de los resultados. Limitaciones de la investigación: La falta de consenso en la definición dificulta la integración de los datos empíricos en una teoría general de la consciencia. Hallazgos: Se argumenta a favor de seis puntos necesarios para el programa de investigación de la biología evolutiva y de la complejidad. Los puntos son: el análisis funcional adaptativo de la consciencia, la emergencia de estructuras modulares, las novedades evolutivas, la correspondencia genética de las capacidades cognitivas, el efecto del medio y la causalidad recíproca.

Resumo: Introdução: As estomias de eliminação são definidas como uma externalização de parte do sistema digestivo em razão de agravos inflamatórios, oncológicos ou congênitos, gerando um conjunto de implicações biopsicossociais Objetivo: Identificar algumas percepções e representações sociais construídas por pessoas com estomias de eliminação em torno da sua condição. Metodologia: Trata-se de um estudo descritivo e exploratório, de abordagem qualitativa, pautado na Teoria das Representações Sociais, realizado através de relatos de pacientes com estomias de eliminação em uma consulta ambulatorial de enfermagem em estomaterapia, processados por meio do software IRaMuTeQ. Resultados: infere-se uma série de interpretações que revelam os desafios e as consequências impostas por esses dispositivos, a exemplo as barreiras sociais, laborais e alimentares, que somam-se aos estigmas e sentimentos negativos associados à autoimagem e a autopercepção na consciência desses indivíduos, bem como as potencialidades observadas como a família, comunidade e a espiritualidade dos participantes, exigindo dos profissionais de saúde a compreensão. Considerações finais: O trabalho expressa representações construídas em torno de algumas percepções dos pacientes em torno do uso da estomia, podendo auxiliar na compreensão desse estado, embasando uma prática profissional mais empática e antenada aos aspectos psicológicos, sociais e espirituais

Resumen: Introducción: Las ostomías de eliminación se definen como una externalización de parte del sistema digestivo por efectos nocivos inflamatorios, oncológicos o congénitos, que generan un conjunto de implicaciones biopsicosociales. Objetivo: Identificar algunas percepciones y representaciones sociales construidas por personas con ostomías de eliminación en torno a su condición. Metodología: Se trata de un estudio descriptivo y exploratorio, con enfoque cualitativo, basado en la teoría de las representaciones sociales, realizado a través de relatos de pacientes con ostomía de eliminación en una consulta ambulatoria de enfermería en estomaterapia, procesados mediante el software IRaMuTeQ. Resultados: Se infieren una serie de interpretaciones que revelan los desafíos y consecuencias que imponen estos dispositivos, como barreras sociales, laborales y alimentarias, que se suman a los estigmas y sentimientos negativos asociados a la autoimagen y la autopercepción en la conciencia de estos individuos, así como las potencialidades observadas como familia, comunidad y espiritualidad de los participantes, que requieren comprensión por parte de los profesionales de la salud. Consideraciones finales: El trabajo expresa representaciones construidas en torno a las percepciones de algunos pacientes sobre el uso de la ostomía, que pueden ayudar a comprender ese estado, apoyando una práctica profesional más empática y sintonizada con los aspectos psicológicos, sociales y espirituales

Abstract: Introduction: Elimination ostomies are defined as an externalization of part of the digestive system due to harmful inflammatory, oncological or congenital effects, generating a set of biopsychosocial implications. Objective: To identify some perceptions and social representations constructed by people with elimination ostomies around their condition. Methodology: This is a descriptive and exploratory study, with a qualitative approach, based on the Theory of Social Representations, carried out through reports from patients with elimination stoma in an outpatient nursing consultation in stoma therapy, processed using the IRaMuTeQ software. Results: A series of interpretations are inferred that reveal the challenges and consequences imposed by these devices, such as social, work and food barriers, which add to the stigmas and negative feelings associated with self-image and self-perception in the consciousness of these individuals, as well as the potentialities observed such as the family, community and spirituality of the participants, requiring understanding from health professionals. Final Considerations: The work expresses representations built around some patients’ perceptions regarding the use of a stoma, which can help in understanding this state, supporting a more empathetic professional practice that is attuned to psychological, social and spiritual aspects

Abstract Background: Healthcare-associated infections are a prevalent issue in health systems that affect everyone. The incidence and prevalence of healthcare-associated infections depend on the context in which they occur. An example of this is ventilator-associated pneumonia in intensive care units. Objective: To analyze the determinants of ventilator-associated pneumonia in an intensive care unit of a central hospital in northern Portugal. Methodology: A retrospective, descriptive-correlational quantitative study was conducted with 705 patients admitted to the ICU of the hospital under investigation. Results: The results show that male gender, previous antibiotic use, endotracheal reintubation, level of consciousness, cuff pressure, ventilation time, injury, poisoning, and certain other consequences of external causes as admitting diagnosis are among the determinants of ventilator-associated pneumonia. Moreover, the incidence of ventilator-associated pneumonia was of 4.5%. Conclusion: The study recommends the judicious use of antibiotics, limiting the duration of invasive ventilation, implementing ventilator weaning protocols, and auditing compliance with the care bundle for ventilator-associated pneumonia. This study sheds light on the prevention of ventilator-associated pneumonia and its recommendations contribute to better care and more effective and safer nursing interventions.

Resumo Enquadramento: As infeções associadas aos cuidados de saúde (IACS) são uma problemática atual dos sistemas de saúde variando a sua incidência, prevalência do contexto de cuidados. A pneumonia associada à ventilação (PAV) é disso um exemplo ocorrendo em unidades de cuidados intensivos (UCI). Objetivo: Analisar determinantes da PAV, em doentes internados numa UCI de um hospital central do norte de Portugal. Metodologia: Estudo descritivo-correlacional e retrospetivo, com base nos registos de 705 doentes internados na UCI. Resultados: Constituíram-se determinantes da PAV o sexo masculino, tratamento prévio com antibiótico, reintubação endotraqueal, nível de consciência, pressão de cuff, tempo de ventilação, diagnóstico de entrada lesões, envenenamento e algumas outras consequências de causas externas. A incidência de PAV foi de 4,5%. Conclusão: O uso criterioso de antibióticos, o menor tempo possível de ventilação invasiva, a implementação de protocolos de desmame ventilatório e auditorias ao cumprimento da bundle da PAV podem contribuir para melhores cuidados e intervenções de enfermagem mais eficazes e seguras.

Resumen Marco contextual: Las infecciones asociadas a los cuidados sanitarios (IACS) son un problema actual en los sistemas sanitarios, y su incidencia y prevalencia varían en función del entorno asistencial. Un ejemplo de ello es la neumonía asociada a la ventilación mecánica (PAV), que se da en las unidades de cuidados intensivos (UCI). Objetivo: Analizar los determinantes de la PAV en pacientes ingresados en la UCI de un hospital central del norte de Portugal. Metodología: Estudio descriptivo-correlacional y retrospectivo, basado en los registros de 705 pacientes ingresados en la UCI. Resultados: Los factores determinantes de la PAV fueron el sexo masculino, el tratamiento antibiótico previo, la reintubación endotraqueal, el nivel de consciencia, la presión del manguito, el tiempo de ventilación, el diagnóstico de entrada de lesiones, la intoxicación y algunas otras consecuencias de causas externas. La incidencia de PAV fue del 4,5%. Conclusión: El uso prudente de antibióticos, el menor tiempo posible de ventilación invasiva, la aplicación de protocolos de destete del ventilador y las auditorías de cumplimiento del paquete de PAV pueden contribuir a mejorar los cuidados y a que las intervenciones de enfermería sean más eficaces y seguras.

Abstract: One hundred years after the publication of History and Class Consciousness, it is imperative to revisit the classic work of Georg Lukács to discuss the relevance of his ideas in a world where the capitalist mode of production does not cease to show its devastating effects. To do so, we divide the article into two sections. In the first part, we place Lukács’ work in dialogue with that of Hegel and Marx in order to clarify the status of violence as an ontological condition of history, allowing us to determine the theoretical-practical framework from which social revolution can be conceptualized. In the second section, we analyze Lukács’ notion of class consciousness not as a historical fatality but as an act of self-determination of the proletariat. We compare this proposal with the current situation of gentrification of the proletariat which, far from invalidating the Hungarian author’s proposal, constitutes its reversal and the platform for its actualization. Ultimately, it is about the proletarian still today taking control and becoming, through class consciousness, the subject-object of history. We conclude by reinterpreting Lukács’ terms in a practice that counters a reactionary position in order to combat both the reactionary movements and the hedonistic immobilism of the proletariat.

Resumen: A cien años de la publicación de Historia y conciencia de clase, resulta necesario revisitar la clásica obra de Georg Lukács para discutir la actualidad de sus planteamientos en un mundo donde el modo de producción capitalista no deja de mostrar sus efectos devastadores. Para esto, dividimos el artículo en dos apartados. En la primera parte, ponemos en diálogo la obra de Lukács con la de Hegel y Marx para precisar la violencia como condición ontológica de la historia, y establecer cuál es el estatuto teórico-práctico desde el cual se puede pensar la revolución social. En el segundo apartado, analizamos la noción de conciencia de clase de Lukács no como una fatalidad histórica, sino como un acto de autodeterminación del proletariado. Asimismo, cotejamos esta propuesta con la situación actual de aburguesamiento del proletariado que, lejos de invalidar el planteamiento del autor húngaro, constituye su revés y la plataforma de su actualización. Se trata, a fin de cuentas, de que todavía hoy el proletario tome el timón y devenga, por medio de la conciencia de clase, sujeto-objeto de la historia. Concluimos con una reinterpretación de los términos de Lukács en una práctica que deseche una posición reaccionaria para combatir frontalmente tanto los movimientos reaccionarios como el inmovilismo hedonista del proletariado.

Resumo: cem anos após a publicação de História e consciência de classe, é necessário revisitar a obra clássica de Georg Lukács para discutir a atualidade de suas proposições em um mundo onde o modo de produção capitalista continua a mostrar seus efeitos devastadores. Para isso, dividimos o artigo em duas seções. Na primeira parte, colocamos aobra de Lukács em diálogo com a de Hegel e Marx, a fim de definir a violência como condição ontológica da história e estabelecer o status teórico-prático a partir do qual a revolução social pode ser pensada. Na segunda seção, analisamos a noção de Lukács de consciência de classe não como fatalidade histórica, mas como ato de autodeterminação do proletariado. Além disso, comparamos essa proposta com a situação atual de burguesização do proletariado que, longe de invalidar a abordagem do autor húngaro, constitui sua reversão e a plataforma para sua atualização. Em última análise, é uma questão de o proletário ainda hoje assumir o controle e tornar-se, por meio da consciência de classe, o sujeito-objeto da história. Concluímos com uma reinterpretação dos termos de Lukács em uma prática que descarta uma posição reacionária a fim de combater de frente tanto os movimentos reacionários quanto o imobilismo hedonista do proletariado.

Abstract Hamlet’s character has been the benchmark against which a large part of the European philosophy has had to measure. Various authors, such as Pavel Florenskij, Lev S. Vygotskij, and Carl Schmitt, have seen in Hamlet the contradiction inherent to an unresolved epochal transition, characterized by the endless pain of an interim. My article explores the possibility of interpreting Hamlet’s time in this light, in relation to Walter Benjamin’s ideas on the German Trauerspiel. Unlike Florenskij, who reads Hamlet in a tragic manner, I follow Benjamin’s thesis that places Hamlet as the end of the modern Trauerspiel. Within this framework, the nature of modern consciousness and its relationship with truth is revealed, highlighting how Hamlet embodies the aporetic traits of modern politics, in contrast to Carl Schmitt’s premodern visión.

Resumen El personaje de Hamlet ha sido un punto de referencia para gran parte de la filosofía europea del siglo xx, representando el espíritu y destino de Europa. Diversos autores, como Pavel Florenskij, Lev S. Vygotskij y Carl Schmitt, han visto en Hamlet la contradicción inherente a una transición epocal no resuelta, caracterizada por el dolor interminable de un interim. Mi artículo explora la posibilidad de interpretar el tiempo de Hamlet bajo esta luz, en relación con las ideas de Walter Benjamin sobre el Trauerspiel alemán. A diferencia de Florenskij, que lee a Hamlet de manera trágica, sigo la tesis benjaminiana que sitúa a Hamlet como el fin del Trauerspiel moderno. En este marco, se revela la naturaleza de la conciencia moderna y su relación con la verdad, destacando cómo Hamlet encarna los rasgos aporéticos de la política moderna, en contraste con la visión premoderna de Carl Schmitt.

Abstract: This article analyzes the Yaqui rebellions from 1926 to 1929 in order to understand the factors that led them to come together and unite their forces, making use of Subaltern Studies to observe actions aimed at overthrowing the authorities, dialogue and insurrection. It utilizes journalistic sources that emphasize the interest in the movement in the border region of Sonora and Arizona and the political positions that were constituted around it. It observes that groups of Yaqui rebels turned to dialogue with the authorities and insurrection due to the intervention in their territory and the elimination of policies that benefited their ways of life, as well as that their incorporation was characterized by a reflective consciousness within the group, whose primary objective lay in opposition to the government in power.

Resumen: Este artículo analiza las rebeliones yaquis entre los años de 1926 y 1929, para conocer los factores que los llevaron a integrarse y unificar esfuerzos. Se utilizan los Estudios Subalternos con el objeto de observar las acciones para destituir a las autoridades, el de diálogo e insurrección. Con la finalidad de fundamentar lo anterior, se emplearon fuentes periodísticas donde se destaca el interés del movimiento en la zona fronteriza de Sonora y Arizona, y las posiciones políticas que se conformaron en torno a éste. Como hallazgo se observa que los grupos rebeldes del Yaqui utilizaron el diálogo con las autoridades y la insurrección, por la intervención en su territorio y eliminación de políticas que beneficiaban sus formas de vida. Asimismo, se muestra que su integración se caracterizó por una conciencia reflexiva dentro del grupo, cuyo objetivo principal radicaba en la oposición al gobierno en turno.

In hierdie bydrae sal aangetoon word op welke wyse Hegel in die Phänomenologie des Geistes (1988; hierma FvdG (2013)) betoog dat subjek en objek nie afsonderlik van mekaar bedink kan word nie. Die antwoord op hierdie vraagstuk lê in 'n bepaalde toeëiening van die begrip van die absolute wat as dialektiese bemiddeling tussen subjek en objek dien, waaruit die begrip van selfbewussyn na vore tree. Selfbewussyn is nie alleen 'n hoër vorm van subjektiwiteit nie, maar vorm deel van die groter werklikheid van subjek en objek. Enersyds is die belangrikheid van hierdie vraagstuk van so 'n aard dat dit verdien om geïsoleerd binne Hegel se Phänomenologie bespreek te word, en andersyds moet die vraagstuk gekontekstualiseer word sodat die wyer debatte waarbinne Hegel se antwoord op hierdie aangeleentheid neerslag vind, ook die nodige aandag kry. Ten slotte moet daar ook gewys word op die posisie wat hierdie onderwerp binne Hegel se eie sisteem beklee, naamlik as oorgang tot die begrip van Anerkennung, bloot om die problematiek van denke oor die selfbewussyn as geïsoleerde onderwerp uit te wys. Die debat rondom die verhouding tussen subjek en objek sal vanaf Kant gerekonstrueer word, met die twee sleutelfigure van Fichte en Schelling as verteenwoordigers van uiteenlopende strominge waaruit Hegel geput het. Beide staan egter 'n bemiddelende, spekulatiewe toevoeging tot die subjek-objek-verhouding, die absolute, voor. By Fichte staan die absolute nader aan die subjek en by Schelling die objek, oftewel die natuur. Hegel neem elemente by beide oor maar behou die absolute as bemiddeling. In die eerste drie hoofstukke van Hegel se Fenomenologie van die Gees (FvdG) word die objektiewe aanspraak wat die wetenskap op die waarheid maak ondersoek en word dit as ontoereikend aangebied aan die hand van die inherent weersprekende begrippe (dat 'n ding tegelyk uit 'n eenheid en veelheid van kragte kan bestaan) waarvan dit noodwendig gebruik maak om wetenskap te kan wees. Hiermee wil Hegel nie die wetenskaplike metode as sodanig irrelevant verklaar nie, maar poog om die groter beweging wat die begrip van objektiewe eksterne werklikheid moontlik maak, te identifiseer en uiteindelik te inkorporeer by 'n meer omvangryke begrip van waarheid. Sodanige omvangryke begrip sal noodwendig rekening moet hou met die subjektiewe; die verstandsaktiwiteit waaruit begrippe gevorm word. Anders as by sy voorgangers (Descartes en Kant) beweer Hegel egter nie dat die subjektiwiteit die werklikheid omvat nie, vandaar sy gebruik van die begrip van die fenomenologie, wat op die gebeurtenis van die verskynsels fokus. Die ware is nie 'n afgesonderde noumenale sfeer wat nooit deur die subjek geken kan word nie, maar ontvou as dít wat ten dele deur die subjektiewe, die interpreterende selfbewus-syn, oopgemaak word. Ten slotte dra die besef van die wederkerigheid van subjek en objek by tot die totstandkoming van die selfbewussyn, 'n begrip wat wys op die verweefdheid van bestaan (syn) en self. Drie fases van die objektiewe opvatting van die werklikheid word in die proses van die totstandkoming van selfbewussyn uitgedaag: die aansprake van die sintuiglike sekerheid, die waarneming (gegrond op Hume se sogenaamde "secondary impressions") en ten laaste die begrip van krag as dit wat onderliggend aan alle liggame is. Hegel wys daarop dat die selfbewussyn nie die resultaat, of passiewe waarnemer is van die werklikheid soos dit in die wetenskap voorgestel word nie, maar dat dit 'n noodsaaklike bydrae lewer om die werklikheid van die wetenskap te postuleer sonder om die gewaarwording tot subjektiwiteit te reduseer. Die objektiewe en die subjektiewe is nie twee geskeide domeine van die werklikheid nie, maar gee gelyktydig aan mekaar oorsprong. Laastens sal daarop gewys word dat selfbewussyn nie eenduidig is nie, maar in verhouding staan tot ander selfbewussyne.

This article will explore in what sense subject and object are considered reciprocally in Hegel's first three chapters in the Phenomenology of Spirit. The third chapter, although notoriously difficult to read, is one of the most important epistemological documents in modern philosophy. Hegel's approach will be traced within the debate stemming from Kant's transcendental philosophy mainly through Fichte and Schelling. It will be shown that Hegel incorporated elements from all these figures to arrive at his unique position. Kant's transcendental philosophy established the idea that the thinking consciousness contributes fundamentally to knowledge to the extent that knowledge is fully produced by the subject, and the true nature of the object is unattainable to consciousness. The widely held conclusion was that Kant S thought amounted to a too strong divide between subject and object. Fichte and Schelling managed, thanks to the notion of the absolute, to mediate between subject and object, thereby opening the door to Hegel's dialectics as a philosophy of mediation. Both Fichte and Schelling, as was the case, broadly speaking, with German Idealism taken as a whole, still considered thinking as an activity of being that contributes to the fulfilment of being, linking objects to consciousness. Fichte's "absolute I", a consciousness that precedes the consciousness of the self, standing over the self and the object, was deemed to resemble the Kantian subject too closely. Schelling's natural philosophy, on the other hand, situates the absolute within nature and consciousness as developing from within nature towards the deployment of the self. This approach was considered potentially falling back into a dogmatic mode of thinking. Even if these positions remain caught in problems they seek to overcome, they did make notable progress in addressing the question of the relation of the subject to the object in a modern context. Hegel develops his initial answer to this question in the Phenomenology of Spirit first as an inheritor of the Enlightenment, notably empiricism, but stands critical of its basic suppositions. He does not accept that complete knowledge is immediately accessible, and resorts to the notion of the Absolute to indicate that mediated knowledge leads to truth. Unlike Fichte, Reinhold and Schelling, he does not immediately introduce the absolute as a mediator of knowledge but arrives at it through counterarguments for the positions put forward by the assumption of immediate objective knowledge. This dialectic approach leads to the unfolding of consciousness, self-consciousness and Spirit. Our subjective contribution to knowledge production is also not assumed beforehand, like in Kant, but is the result of the confrontation with the assumptions made by experiential knowledge. Without subjectivity, knowledge of the unity of reality is impossible, as is knowledge of the difference between objects. Knowing objects according to their nature requires subjectivity from which order is established, but the subject experiences itself as standing in relation to objects. Consciousness is confronted by an outside world that must be made sense of. Not only is the establishment of the relation between subject and object important but according to Hegel, the subject's relation to the object is reflected in his self-understanding and self-consciousness. The notion of self-consciousness is revealed precisely by the relation between subject and object, but not before this relation. Hegel therefore starts his journey to the absolute through natural consciousness, a consciousness that takes immediate knowledge of objects around us as authoritative. One can call this immediate knowledge objective in the sense that it takes no queues from subjectivity. Hegel proceeds to critique objective knowledge, claiming that immediate knowledge doesn't reckon with the factor of time, and therefore cannot be the ultimate source of truth. This critique is ambivalent, as it does recognise the world of objects as a source for knowledge, however, this must be supplemented by our own consciousness in order to arrive at a deeper understanding of this knowledge. Consciousness becomes an essential ingredient necessary for understanding. The second chapter introduces perception as the measure of reality. Perception brings a multitude of things under a general principle, thereby creating an understanding between things and their general substance. This second approach to truth cannot explain how generality and particularity exist in the first place. Hegel moves to the notoriously difficult third chapter in which he describes the dynamic relation between force and understanding. Force is identified as the underlying dimension of external reality, but it has in turn to be postulated, making necessary the involvement of the understanding as hypothesising activity. At first, force is merely described in terms of its expressions, but acknowledgement of its fundamental trait as underlying the whole of physical reality without being a tangible thing, leads to the realisation of the role of the understanding. This realisation is self-consciousness. Self-consciousness becomes aware of its participative role in its determination of the underlying structures of reality, structures that are postulated, and not apparent. In the last section, it is pointed out that self-consciousness is not to be understood as standing alone concerning objects - self-consciousness also stands in relation to other-selves. Self-consciousness is not an object and cannot be fully determined as is the case with things. This does not form the primary concern of the article and will merely be described to point to the position of self-consciousness within the larger scheme of Hegel's thinking. This does not take away the importance that the topic under discussion here has for the development of Hegel's system, which is the reason for the focus given here.

Resumen La crisis tirotóxica es una patología poco frecuente, que se presenta en pacientes con hipertiroidismo; se presenta un caso clínico de una paciente de 38 años, con hipertiroidismo quien acude por alteración de estado de conciencia, fiebre y taquicardia, la causa de esta emergencia médica estuvo filiada a un cuadro de crisis tirotóxica, gracias al conocimiento de la clínica médica, esta patología puede afectar a varios órganos por los efectos tóxicos del exceso de hormonas tiroideas. Su diagnóstico y tratamiento se basa en la sospecha clínica, utilizando escalas como la de Burch y Wartofsky, además de niveles de hormonas tiroideas, marcadores de función hepática, cardiaca, renal, electrocardiograma, ecografía tiroidea, como complemento del mismo. La tormenta tiroidea tiene una alta tasa de mortalidad y los pacientes deben recibir un tratamiento inmediato, para manejar las complicaciones y restaurar la función tiroidea normal.

Abstract Thyrotoxic crisis is a rare pathology, which occurs in patients with hyperthyroidism; we present a clinical case of a 38-year-old patient with hyperthyroidism who comes for altered consciousness, fever and tachycardia, the cause of this medical emergency was related to a picture of thyrotoxic crisis, thanks to the knowledge of the medical clinic, this pathology can affect various organs by the toxic effects of excess thyroid hormones. Its diagnosis and treatment is based on clinical suspicion, using scales such as Burch and Wartofsky, in addition to thyroid hormone levels, liver function markers, cardiac, renal, electrocardiogram, thyroid ultrasound, as a complement to it. Thyroid storm has a high mortality rate and patients should receive immediate treatment to manage complications and restore normal thyroid function.

Resumen Se presenta el caso de un varón de 64 años que fue internado por delirium asociado a ictericia con patrón de colestasis en el hepatograma, y una masa en el pulmón derecho en el contexto de pérdida de peso y síndro me constitucional de 8 meses de evolución. Se realizó punción de la masa pulmonar cuyo cultivo desarrolló colonias blanquecinas identificadas como Nocardia cyria cigeorgica por espectrometría de masas (MALDI-TOF MS). Se llegó al diagnóstico de lupus eritematosos sistémico (LES) por presentar 8 de los criterios de acuerdo con el grupo SLICC 2012 y 24 puntos de acuerdo a los criterios EULAR/ACR 2019. La biopsia hepática mostró leve y variable infiltrado inflamatorio mixto en espacios porta, con ausencia de hepatitis de interfase y presencia de reacción ductular periférica. Se interpretaron estos hallazgos como vincu lados a hepatopatía por LES. El delirium fue interpretado como afectación neuroló gica por LES en base al descarte de otras enfermedades. Recibió tratamiento antibiótico y tras constatarse reducción del tamaño de la masa pulmonar se adminis traron pulsos de ciclofosfamida intravenosa. Evolucionó favorablemente, con normalización del hepatograma y el estado de conciencia, y recuperación del peso en forma progresiva. Al año se lo encontró en buen estado de salud. Justifica el reporte del caso la rara forma de presenta ción del LES de comienzo tardío, así como la nocardiosis pulmonar concomitante sin tratamiento inmunosupre sor previo.

Abstract A case is presented of a 64-year-old male patient who was admitted because of delirium, jaundice, a pattern of cholestasis in the liver profile and a right lung mass in the context of a constitutional syndrome and weight loss in the last eight months. The lung mass was punctured and the culture of the obtained material developed white colonies, identified by mass spectrometry (MALDI-TOF) as Nocardia cyriacigeorgica. Regarding the clinical diagnosis, it was considered as systemic lupus erythematosus (SLE), on the basis of fulfilling 8 criteria according to SLICC 2012 group, and 24 points according to EULAR/ACR 2019. The liver biopsy showed a mixt cellular infiltrate in portal spaces, with absence of interphase hepatitis and presence of peripheral ductular reaction. These findings were interpreted as liver compromise relate to SLE. Delirium was also considered as a neurological mani festation related to SLE on the basis of ruling out other causes. After being treated with antibiotics and documenting a reduction in the size of the lung mass he received cy clophosphamide in intravenous pulses, achieving normal ization of his liver profile and his state of consciousness, and a progressively weight recovering. A year after he was in good health. The report of this case is justified because of the rare presenting form of late onset SLE, as well as the concomi tant pulmonary nocardiosis in the absence of previous immunosuppressant treatment.

Resumen El virus dengue es un virus endémico en Argentina que, si bien inicialmente se consideró que no era neu rotrópico, actualmente se reconoce que tiene neuroinva sión, condicionando así una prevalencia de manifesta ciones neurológicas de hasta el 15% entre los enfermos. Aun siendo considerados síntomas de gravedad, existe subdiagnóstico de encefalitis por dengue debido a su variada forma de presentación clínica. Las manifesta ciones neurológicas de la encefalitis por dengue pueden abarcar desde fiebre y cefalea hasta alteraciones del nivel de conciencia y convulsiones. Si bien el líquido cefalorraquídeo (LCR) puede hallarse normal en hasta un tercio de los casos, lo habitual es que presente aumento de concentración de proteínas y pleocitosis. En cuanto a los métodos de neuroimagen, los hallazgos suelen ser variados e inespecíficos, e incluso pueden ser normales hasta en 40-50% de los casos. Se presentan 3 casos de encefalitis por dengue diag nosticados en un hospital universitario de Buenos Ai res, Argentina, en donde la presentación clínica varió desde desorientación témporo-espacial hasta estatus convulsivo refractario con diferentes presentaciones en el LCR pero todos con PCR positivo para dengue y con neuroimágenes sin alteraciones.

Abstract Dengue virus is an endemic virus in Argentina that, although it was initially considered to be non-neuro tropic, it is currently recognized to be neuroinvasive; thus conditioning a prevalence of neurological mani festations of up to 15% among patients. Even being considered severe symptoms, there is underdiagnoses of dengue encephalitis due to its varied clinical presenta tion. Neurological manifestations of dengue encephalitis can range from fever and headache to altered levels of consciousness and seizures. Although the cerebrospinal fluid may be normal in up to a third of cases, it usually presents increased protein concentration and pleocyto sis. Regarding neuroimaging methods, the findings are usually varied and nonspecific, and can even be normal in up to 40-50% of cases. We present three cases of dengue encephalitis di agnosed in a university hospital in Buenos Aires, Ar gentina, where the clinical presentation varied from temporal-spatial disorientation to refractory convulsive status with different presentations in the cerebrospinal fluid but all with positive PCR for dengue in it and with normal neuroimaging.

Human praxis denotes practical wisdom, which through deliberate human action aims at personal and collective transformation, including people's ideas, commitments and consciousness. The occupational therapy profession has a long history of both enacting human praxis for the evolvement of the profession, and also facilitating it among the people it serves. Occupational therapy can draw on its innate wisdom and ability to accurately read contexts to consciously harness human praxis to render the profession as indispensable as a healthcare profession as well as a profession that can contribute significantly to social development. Consciously harnessing human praxis for change can be done by applying reflective and reflexive critical reasoning; epistemic fluency within multidisciplinary spaces (that could promote better transdisciplinary practices); as well as deconstructing the constituents of human praxis to apply it as a treatment mode. Furthermore, consciously using human praxis can contribute to the fields of education, research and leadership that promote and cultivate human dignity.

The continuing educational crises and the recurrent discourse on educational reform in South Africa foreground critical questions on what constitutes a viable philosophical and pedagogical strategy for the country. This article examines the transformative praxis of a dissident teachers' organisation, the Teachers' League of South Africa (TLSA or the League), and how the development of its distinctive non-racist and non-collaborationist worldview provide meaningful possibilities for present-day educationists seeking a progressive educational alternative. The article draws on decolonial and critical education theories to engage the views of TLSA teachers and non-League education activists. Documentary material on the TLSA and its umbrella body, the Unity Movement, provide key primary sources for the article. In addition, secondary information linked to the broader liberation movement offers valuable insights and perspectives on what could be defined as an alternative educational praxis. Overall, the article examines whether the coexistence of the TLSA's holistic educational outlook and 'egalitarian oriented' counter-consciousness, offers tangible possibilities for exploring an emancipatory decolonial education.

RESUMEN La clase alguna vez fue importante en la educación de adultos, y todavía lo es en un mundo neoliberal. Pero puede ser difícil definirlo en la fragmentación de la clase trabajadora organizada y la precarización/manualización de muchas ocupaciones de la clase media. Históricamente, en las sociedades industriales se podía considerar que la clase estaba determinada por las relaciones productivas, mientras que la conciencia de clase era un fenómeno cultural, forjado en parte por los propios trabajadores en luchas educativas y políticas. Pero esas sociedades industriales más antiguas se han fragmentado y una cultura más individualizada y políticas de diversidad han pasado a ocupar un lugar central. La clase como fenómeno vivo puede descuidarse y se pone en primer plano el género, la raza y la sexualidad. No obstante, la clase sigue moldeando las experiencias entre las personas y las percepciones sobre la educación, los niveles de salud física, mental y la esperanza de vida. Y el descuido de la dinámica de clases y la desigualdad social ha sido cuestionado en formas de investigación autobiográfica y autobiográfica de la clase trabajadora. Esto se inspira en el movimiento de mujeres, el giro biográfico/narrativo y los desafíos al abandono del sujeto humano experimentado en los estudios sociales y culturales. La investigación y los escritos abarcan especialmente a mujeres de clase trabajadora en diversos entornos y diálogos intergeneracionales. La clase se cruza aquí con otras opresiones. El trabajo ilumina cómo la educación de adultos requiere una reconceptualización holística como un proceso relacional, encarnado, emocional, narrativo, psicosocial, intelectual e incluso espiritual, en el que la dinámica del reconocimiento de uno mismo/otro, el amor y la noción feminista entregarse a otro son centrales.

RESUMO A classe foi importante para a educação de adultos no passado, mas ainda é relevante no mundo neoliberal. Todavia, pode ser difícil defini-la no contexto fragmentado da organização da classe social e do caráter causal e manual de muitas ocupações da classe média. Historicamente, nas sociedades industriais, a classe era moldada pelas relações de produção, enquanto que a consciência de classe se constituía num fenómeno cultural, definido também pelos próprios trabalhadores nas lutas educativas e políticas. Mas as sociedades industriais do presente possuem uma cultura fragmentada e individualizada, assim como políticas diversificadas que assumem hoje uma dimensão central. A classe como um fenómeno social pode hoje ser negligenciada se se atribuir centralidade ao género, à raça ou à sexualidade. Apesar desta circunstância, a classe continuar a moldar as experiências entre as pessoas, as perceções acerca da educação, o nível de saúde física e mental e a esperança de vida. A negação das dinâmicas de classe e da desigualdade social foi desafiada pela investigação autobiográfica da classe trabalhadora. Esta investigação inspirou-se no movimento feminista, nos estudos biográficos e narrativos e nos desafios causados pela negação que os estudos social e culturais têm atribuído à experiência humana. A investigação e os trabalhos académicos destacam as mulheres da classe trabalhadora em contextos diversos e os diálogos intergeracionais. A classe cruza aqui com outras formas de opressão. O trabalho enfatiza como a educação de adultos exige uma reconceptualização holística, enquanto processo relacional, corporizado, emocional, narrativa, psicossocial, intelectual e até espiritual, na qual as dinâmicas de reconhecimento de si e do outro, do amor e da noção feminista de dar-se ao outro são centrais.

ABSTRACT Class once mattered in adult education, and still does in a neo-liberal world. But it can be difficult to define in the fragmentation of the organised working-class and the casualisation/manualisation of many middle-class occupations. Historically, in industrial societies class could be seen as shaped by productive relations, while class consciousness was a cultural phenomenon, partly forged by workers themselves in educational and political struggles. But those older industrial societies have fragmented and a more individualised culture and diversity politics have taken centre stage. Class as a living phenomenon can be neglected as gender, race and sexuality are foregrounded. Notwithstanding, class continues to shape experiences between people, and perceptions of education, levels of physical, mental health and life expectancy. And the neglect of class dynamics and social inequality has been challenged in forms of working-class auto/biographical research. This is inspired by the women’s movement, the biographical/narrative turn and challenges to the neglect of the experiencing human subject in social and cultural studies. The research and writing especially encompass working-class women in diverse settings, and intergenerational dialogues. Class intersects here with other oppressions. The work illuminates how adult education requires holistic reconceptualisation as a relational, embodied, emotional, narrative, psychosocial, intellectual and even spiritual process, in which the dynamics of self/other recognition, love and the feminist notion of the gift are central.