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  • Is it morally permissible for general practitioners to disclose their opinion on a woman’s decision on abortion?

    Lynnlette Aung; Selena Knight (BMC, 2020-03-01)
    Abstract Background This paper considers ethical dilemmas arising where a patient asks their General Practitioner for advice and their personal opinion regarding whether or not to have an abortion. Patients often seek their General Practitioner’s advice regarding treatments and procedures, which may occasionally lead to the General Practitioner facing a difficult dilemma of whether to share their personal opinion with their patient. As General Practitioners are more accessible as the first point of contact for patients and often have a closer relationship with them, they may be particularly exposed to such situations. Additionally, the significance of abortion as a sensitive topic and the fact the General Practitioner may have their own personal viewpoint on its morality may make it particularly difficult for them to know how to respond to such a request. Main text This paper explores the difficulties arising in such a situation and considers whether it could ever be ethically justifiable for General Practitioners to express their opinions on such a matter. We consider the duties of a doctor, and highlight the need for clearer guidance for healthcare professionals on managing tensions in their professional boundaries between their personal moral views and their professional responsibilities. A range of ethical viewpoints are considered to explore how a doctor might ap, in particular the principle of autonomy, virtue ethics, and consequentialism. Conclusions This article recognises that a General Practitioner in a situation such as this faces many ethical challenges. We propose that offering their opinion to the patient where specifically requested may be morally justifiable. A virtue ethics approach in particular requires that the General Practitioner applies practical wisdom to make this decision, and where they do disclose their opinion ensure this is done so in such a manner that it does not harm the patient and promotes flourishing. We encourage GPs and other healthcare professionals to consider their own moral perspectives on sensitive issues such as abortion, and reflect on how their moral viewpoints have the potential to influence their practice. In doing so, we hope clinicians can be better should they be faced with a situation such as this.
  • Disease awareness or subtle product placement? Orphan diseases featured in the television series “House, M.D.” - a cross-sectional analysis

    Konstantin Mechler; Juliane Rausch; William K. Mountford; Markus Ries (BMC, 2020-03-01)
    Abstract Background Approximately 7% of the general population is affected by an orphan disease, which, in the United States, is defined as affecting fewer than 1 in 1500 people. Disease awareness is often low and time-to-diagnosis delayed. Different legislations worldwide have created incentives for pharmaceutical companies to develop drugs for orphan diseases. A journalistic article in Bloomberg Businessweek has claimed that pharmaceutical companies have tried marketing orphan drugs by placing a specific disease into the popular television series “House, M.D.” which features diagnostic journeys and was produced between 2004 and 2012. This study aimed to describe the presentation of orphan diseases in the television series “House, M.D.”, to test in an exploratory fashion the hypothesis that treatable orphan conditions are overrepresented in “House, M.D.” and to discuss whether such marketing practices may or may not be ethical. Methods A list of all medical cases depicted in the television series “House, M.D.” was obtained and classified as orphan or non-orphan according to the Orphanet database. The ratios of orphan diseases among all diseases, such with an orphan drug designation and such with an orphan drug approval by the FDA were then compared with conservative approximations of real world conditions (chi-squared tests for equality of proportions). STROBE criteria were respected. Results Out of a total of n = 181 different medical diagnoses, n = 42 (23.2%) were orphan diseases. The difference in percentages in between “House, M.D.” and reality was not statistically significant for orphan diseases overall (p = 0.96), yet was statistically significantly higher for both orphan diseases with one or more orphan drug designations (p = 0.0192) and such with one or more approved orphan drugs (p < 0.0001). Conclusions Orphan diseases with a designated and/or approved orphan drug were overrepresented in the television series “House, M.D.” with statistical significance while orphan diseases overall were not. This may be explained by (so far) undocumented efforts of pharmaceutical companies to place their orphan drugs in the television series, as described in the article in Bloomberg Businessweek. Further research is needed into marketing practices in popular and emerging media formats.
  • Dishonesty and research misconduct within the medical profession

    Habib Rahman; Stephen Ankier (BMC, 2020-03-01)
    Abstract While there has been much discussion of how the scientific establishment’s culture can engender research misconduct and scientific irreproducibility, this has been discussed much less frequently with respect to the medical profession. Here the authors posit that a lack of self-criticism, an encouragement of novel scientific research generated by the recruitment policies of the UK Royal Training Colleges along with insufficient training in the sciences are core reasons as to why research misconduct and dishonesty prevail within the medical community. Furthermore, the UK General Medical Council’s own data demonstrates a historic inattentiveness to the ease with which doctors can engage in research misconduct. Suggestions are made as to how these issues can be investigated and alternative incentives for career advancement are adumbrated.
  • Clarifying how to deploy the public interest criterion in consent waivers for health data and tissue research

    G. Owen Schaefer; Graeme Laurie; Sumytra Menon; Alastair V. Campbell; Teck Chuan Voo (BMC, 2020-03-01)
    Abstract Background Several jurisdictions, including Singapore, Australia, New Zealand and most recently Ireland, have a public interest or public good criterion for granting waivers of consent in biomedical research using secondary health data or tissue. However, the concept of the public interest is not well defined in this context, which creates difficulties for institutions, institutional review boards (IRBs) and regulators trying to implement the criterion. Main text This paper clarifies how the public interest criterion can be defensibly deployed. We first explain the ethical basis for requiring waivers to only be granted to studies meeting the public interest criterion, then explore how further criteria may be set to determine the extent to which a given study can legitimately claim to be in the public interest. We propose an approach that does not attempt to measure magnitude of benefit directly, but rather takes into account metrics that are more straightforward to apply. To ensure consistent and justifiable interpretation, research institutions and IRBs should also incorporate procedural features such as transparency and public engagement in determining which studies satisfy the public interest requirement. Conclusion The requirement of public interest for consent waivers in secondary biomedical research should be guided by well-defined criteria for systematic evaluation. Such a criteria and its application need to be periodically subject to intra-committee and intra-institution review, reflection, deliberation and amendment.
  • Developing a toolkit for engagement practice: sharing power with communities in priority-setting for global health research projects

    Bridget Pratt (BMC, 2020-03-01)
    Abstract Background Communities’ engagement in priority-setting is a key means for setting research topics and questions of relevance and benefit to them. However, without attention to dynamics of power and diversity, their engagement can be tokenistic. So far, there remains limited ethical guidance on how to share power with communities, particularly those considered disadvantaged and marginalised, in global health research priority-setting. This paper generates a comprehensive, empirically-based “ethical toolkit” to provide such guidance, further strengthening a previously proposed checklist version of the toolkit. The toolkit places community engagement and power-sharing at the heart of priority-setting for global health research projects. Methods A two part method was used to generate a revised toolkit. Part one was conceptual, consisting of novel analysis of empirical data (previously collected as part of the same overall project) to identify additional concepts relevant to power-sharing between researchers and communities in global health research priority-setting. Part two was empirical, seeking feedback on the initial checklist version of the toolkit in interviews with researchers, ethicists, community engagement practitioners, and community organisation staff. Results The conceptual process identified two additional components of engagement and six additional features that affect who defines, who participates, and who is heard in research priority-setting. New ethical considerations related to sharing power in global health research priority-setting are articulated in relation to those components and features. Interviewees provided suggestions for revising the toolkit’s content and language. The implications of these suggestions and the analytic process for the toolkit are described. Conclusions The resultant toolkit is a reflective project planning aid for researchers and their community partners to employ before priority-setting is undertaken for global health research projects. It consists of three worksheets (to be completed collectively) and a companion document detailing how to use them. It is more comprehensive than the initial toolkit, as worksheet questions for discussion cover all phases of priority-setting.
  • Sexual and reproductive health rights knowledge and reproductive health services utilization among rural reproductive age women in Aleta Wondo District, Sidama zone, Ethiopia: community based cross-sectional study

    Tariku Tadesse; Mesay Hailu Dangisso; Teshome Abuka Abebo (BMC, 2020-03-01)
    Abstract Background Various countries in the world have achieved promising progress in promoting, protecting and guaranteeing sexual and reproductive health rights (SRHRs) since the 1994 International Conference on Population and Development (ICPD) in Cairo. However, SRHRs have not been recognized to their maximum potential in Ethiopia, despite the domestication of the international instruments related to their successful implementation. This study was intended to determine the magnitude of SRHRs knowledge, reproductive health services utilization and their independent predictors among rural reproductive-age women in the Aleta Wondo District, Ethiopia. Methods A community-based cross-sectional study was conducted among 833 rural reproductive-age women from April to May 2019. A systematic random sampling technique was employed to select households, and a structured questionnaire was used to gather the data. EPI INFO version 7 was used to enter the data, and SPSS version 23 was used for data analysis. Logistic regression analysis was employed to assess the association between outcomes and explanatory variables. Odds ratios at 95% CI were also computed and reported. Results Of 833 respondents, 43.9% had good knowledge of SRHR, and 37% had used at least one sexual and reproductive health (SRH) service. Variables that had a statistically significant association with SRHR knowledge in multivariable analysis were: had formal education, household with the highest income, having information sources for SRH services, and knowing about SRH services and providing institutions. SRH services utilization was associated with: having information sources for SRH services, had formal education, household with the highest income, and knowing about SRH services and providing institutions. Conclusion In this study demographic and economic factors, such as education and household monthly income were positively identified as independent predictors for knowledge of SRHR and SRH services utilization. Therefore, responsible government sectors and NGOs should design and implement programs to promote women’s educational status and household economic status to enhance women’s SRHR knowledge and SRH services utilization.
  • Sexual and reproductive health of women living with HIV in Muslim-majority countries: a systematic mixed studies review

    Dyah Juliastuti; Judith Dean; Lisa Fitzgerald (BMC, 2020-03-01)
    Abstract Background The number of women living with the human immunodeficiency virus (WLHIV) in Muslim-majority countries has increased significantly in the last decade. These women are often marginalized and face insecure sexual and reproductive health (SRH) needs and rights. However, little is known about the multi-faceted factors influencing these women’s fertility, contraceptive, and perinatal decisions and sexual life. This systematic mixed studies review aimed to synthesize the empirical evidence on social, cultural, and structural factors influencing the SRH of WLHIV in Muslim-majority countries. Methods This review provides a synthesis of quantitative, qualitative and mixed-method research findings searched from PubMed, EMBASE, Scopus, CINAHL and Cochrane databases. We screened 3452 SRH studies involving WLHIV. The studies, published in English between 2008 and 2017, were from 20 Muslim-majority countries with increased numbers of WLHIV. The quality of eligible studies was appraised using a mixed-methods appraisal tool (MMAT) version 2011. Findings were thematically analysed by a hybrid deductive-inductive approach. Two independent reviewers were involved in the study selection, data extraction, quality appraisal, and data synthesis. Results We included 13 SRH-related studies involving 1748 WLHIV in eight Muslim-majority countries. Most of these studies explored fertility desire and sexual health, while only a small proportion related to contraceptive use and the perinatal-care experience. We identified that WLHIV faced neglect of their SRH rights. These rights were predominantly affected by the socio-cultural, religious and health-services context of the women’s lives, which directed them to unsafe sex practices and stressful perinatal experiences. Conclusions This study points to the need for SRH laws, policies, and interventions which stop WLHIV experiencing SRH discrimination violence and achieving their SRH rights.
  • Asian Journal of Pentecostal Studies 23, no. 1 (February 2020)

    Holy Spirit Research Center ORU Library (Digital Showcase, 2020-02-01)
  • Historias de la televisión: una película al servicio de la televisión

    Andoni Iturbe (Aposta, 2020-04-01)
    Historias de la televisión, dirigida por José Luis Sáenz de Heredia, se realizó en tiempos de desarrollismo franquista, una etapa que ocasionó significativos cambios y transformaciones sociales y económicos en el franquismo. Asimismo, habría que subrayar que es la segunda vez que Sáenz de Heredia presenta un pujante medio de comunicación tras la construcción de la radio en Historias de la radio (1955). Tras valorar los documentos depositados en el Archivo General de Administración y analizar tanto la película como el guion, parte de la hipótesis de que se trata de un filme que se puso al servicio de la televisión y de RTVE con la idea de visualizar y popularizar un aparato que aún no era habitual en los hogares españoles. La metodología confronta tanto el análisis fílmico, la Historia de la Comunicación Social y las aportaciones de la alfabetización mediática y concluye que el film acepta las transformaciones económicas del desarrollismo, moviliza los demás agentes sociales y mediáticos y se posiciona ante el imparable ascenso de la televisión desde la hegemonía del cine.
  • Inferencias sobre jóvenes en procesos de ley a partir de narrativas de funcionarios en México

    Felipe González Ortiz; Abraham Osorio Ballesteros; José Javier Niño Martínez (Aposta, 2020-04-01)
    Este trabajo analiza de las formas cognitivas de aprehender a la sociedad por parte de los jóvenes en proceso de ley. Para ello se hizo una elipsis en la que las fuentes de información fueron las narrativas de los funcionarios que atienden a estos jóvenes. A partir de ellas configuramos un ethos general que nos permitió descubrir síntomas colectivos que explicarían la existencia de un contrato moral débil en los jóvenes que no asumen responsabilidad frente a los actos de violencia cometidos. Los resultados encontrados indican que la falta de afecto en la esfera de socialización primaria es una causa de la producción de jóvenes melancólicos y excéntricos, actores susceptibles de una vida en frustración que potencia la violencia y la construcción de una sociedad anómala, en la que los sujetos son víctimas sin posibilidad de restauración institucional.
  • Las expectativas sobre el alumnado extranjero en un barrio periférico de Granada (España): trayectorias educativas bajo el filtro del culturalismo

    Alberto Capote Lama; Jose Antonio Nieto Calmaestra; Nuria Martín Ruiz (Aposta, 2020-04-01)
    Ha pasado más de una década desde el boom migratorio en España, donde la llegada de alumnado de origen extranjero ha dejado de ser una novedad en las aulas. Este artículo se interesa sobre la percepción que la trayectoria educativa del alumnado extranjero en la educación obligatoria tienen tanto el personal docente como los progenitores. El estudio se centra en si dicha percepción es positiva u optimista, y en examinar qué tipo de variables se sopesan en los discursos. Especialmente el recurso a una supuesta especificidad cultural, como eje principal en las percepciones, o la introducción de otras variables sociales. Se trata de un estudio cualitativo de carácter local realizado en un barrio de la ciudad de Granada con una notable presencia de inmigrantes, aunque sin llegar a cuotas altas de segregación.
  • La publicidad televisiva sobre el juego online: narrativas y estrategias

    Coral Morera Hernández (Aposta, 2020-04-01)
    La inversión en publicidad sobre el juego online ha presentado un incremento importante en los últimos años mientras que el número de jugadores y usuarios registrados no deja de crecer. Proponemos una línea de investigación académica que analice este hecho en aras de conocer la publicidad que se está difundiendo, y abrir una línea de trabajo sobre la evolución de la misma en este sector. Para ello proponemos un análisis de contenido de la publicidad de juego online sobre una muestra de anuncios que se han emitido, o se están emitiendo en la actualidad por televisión en España, y que incluye un corpus amplio que abarca los segmentos más implicados: bingo, casas de apuestas y casinos online. El estudio confirma que nos hallamos ante una serie de campañas muy elaboradas, en las que se están empleando recursos y estrategias bien definidos y ejecutados. El fomento del juego online a través de la publicidad que se emite por televisión plantea, cuanto menos, valoraciones éticas contradictorias y discutibles, en la que menores y adolescentes se convierten en los públicos más vulnerables.
  • Las políticas sociales desde una sociología de las emociones: un estudio de las prácticas de consumo de sus destinatarias

    Andrea Dettano (Aposta, 2020-04-01)
    La proliferación y masividad que han asumido en las últimas décadas los Programas de Transferencias Condicionadas de Ingresos ha suscitado numerosos análisis. De los diferentes aspectos que podrían observarse sobre este tipo de atención a la población en situación de pobreza, aquí abordamos su relación con el consumo, al haber ganado, dicha práctica, diversas menciones en torno a la aplicación de estos programas. Así, el presente escrito –desde los estudios de las PS y las emociones– tiene por objetivo describir las emociones de las mujeres madres titulares de los PTCI de la Ciudad de Buenos Aires en relación a sus prácticas de consumo. Para lograr dicho objetivo se trabaja con una estrategia cualitativa de indagación a partir del análisis de 43 entrevistas en profundidad a destinatarias de los PTCI de la Ciudad: Ciudadanía Porteña y Asignación Universal por Hijo. Se concluye que el consumo de estas mujeres madres se ciñe a aquello que consideran como correcto, útil y necesario para el desarrollo de los niños/as a cargo y está signado por unas emociones asociadas a los cuidados maternales.
  • Motivaciones y efectos percibidos en el consumo de cerveza entre millennials: El caso de Monterrey y su área metropolitana

    Blanca A. Camargo; Luis Portales (Aposta, 2020-04-01)
    La producción y comercialización de cerveza en México se presenta como una de las actividades económicas más relevantes del país, posicionándose como una de las principales bebidas entre la generación millenial. El incremento en su consumo entre jóvenes presenta una paradoja interesante. Por un lado, su consumo en exceso representa una preocupación asociada a los efectos que genera en términos de actos violentos, accidentes y muertes. Por otro lado, su consumo está asociado a factores socioculturales, especialmente en regiones caracterizadas por la producción de esta bebida y las altas temperaturas, tal como es el caso del Área Metropolitana de Monterrey. Ante este contexto, la presente investigación tuvo como objeto el identificar los inicios y motivaciones en el consumo de cerveza de los millennials de esta área, así como los efectos percibidos en su bienestar y su socialización. Para cumplir con este objetivo se realizaron entrevistas a profundidad a 111 jóvenes de diferentes segmentos socioeconómicos, de las cuales se identificó la relevancia que tiene el contexto, tanto cultural como familiar, en los inicios del consumo de la cerveza. Resultado de este análisis fue la identificación de cuatro categorías asociadas a las motivaciones que incitan al consumo de cerveza, y los efectos positivos y negativos de su consumo para los participantes. El presente trabajo demuestra que la cerveza es considerada como un elemento cultural y social, en donde su consumo ha sido impulsado por la sociedad mediante su normalización y aceptación, teniendo como variantes importantes el género y los niveles socioeconómicos de los jóvenes que la consumen.
  • Enfoques consensuales y conflictuales del capital: un intento de síntesis

    Mikel Barba del Horno (Aposta, 2020-04-01)
    En este artículo se hace una revisión de la literatura en torno al concepto de capital y sus diferentes formas: económico, cultural, humano y social. Se propone agrupar las aportaciones de la literatura en base a dos corrientes enfrentadas: la visión consensual que interpreta que el capital es un recurso de la sociedad que permite aumentar los niveles de bienestar general y la visión conflictual, que presenta el capital como un recurso diferencial que poseen sólo algunos individuos o grupos y que sirve para obtener una ventaja respecto a otros grupos. Finalmente se expone un esquema, de corte conflictual, basado en la teoría de campos de Pierre Bourdieu que trata de integrar las principales aportaciones en torno al capital social y al capital cultural.
  • Del pluralismo médico al nomadismo terapéutico: una propuesta crítica desde los procesos de estratificación social y las estrategias de vida

    Rubén Muñoz Martínez (Aposta, 2020-04-01)
    El pluralismo médico ha sido un concepto ampliamente utilizado en las ciencias sociales y, en los últimos años, en las ciencias aplicadas en salud. Se han señalado en diversos trabajos sus principales limitaciones, por ejemplo no considerar los procesos estructurales en el análisis de la diversidad de recursos de asistencia en salud, pero son muy escasas las aportaciones conceptuales y epistémicas desde su problematización. Se propone el concepto nomadismo terapéutico para generar ejes de indagación epistémica sobre la atención médica y la cronicidad desde el análisis de los procesos de estratificación social y las estrategias de vida de los actores y grupos sociales. Para ello, se presentan dos estudios de caso en la atención en salud mental dirigida a personas migrantes en Bruselas (Bélgica) y en el apego al tratamiento antirretroviral de personas mayas con VIH en Chiapas (México).
  • Integrated Detection of a Complex Underground Water Supply Pipeline System in an Old Urban Community in China

    Shifan Deng; Siyu Ma; Xiaowen Zhang; Shiqiang Zhang (MDPI AG, 2020-02-01)
    An underground water supply pipeline system is an integral part of urban infrastructure. The safety, stability, reliability, and efficiency of this water system are critical for the daily work and livelihood of the people dependent on it. However, with the development of cities in China, the water supply systems in urban communities require constant re-building and improvement, which complicates the system. Considering the defects of obsolete design, lack of information, and irregularity of the constructions over the years, the maintenance of underground pipelines in older communities is onerous and arduous. In this work, the older pipeline system at the Taibai campus of Northwest University, Shaanxi Province, was taken as one typical old urban community and investigated by different measures. Detection was performed from the available concentrated water supply wells to surrounding areas combining electromagnetic induction, geophysical method by ground-penetrating radar (GPR), and acoustic detection methods. Applying the integrated detection method and considering known pipeline network designs, the properties and complex relationships of different pipeline materials (cast iron, polyethylene (PE), and polyvinyl chloride (PVC)) were determined. In addition, a spatial distribution map of the pipes from wells and the main input water supply pipelines was achieved. The results suggest that the integrated detection scheme combining these three methods provides an effective approach to analyze complex water supply pipelines in older communities, in which each single detection method has more uncertainties. The study provides valuable references for similar communities in many developing countries.
  • Modeling Green Energy Development Based on Sustainable Economic Growth in China

    Zhijuan Zhang; Marcin Lis (MDPI AG, 2020-02-01)
    Industrial development of the economic system of any state is directly related to the use of energy potential. China’s industrial breakthrough is no exception. Today, China is one of the largest importers−consumers of oil, whose economy is extremely dependent on the energy market. The growing production and population, as well as climatic changes that directly determine the well-being of society, have become the causal basis for the development of alternative ways of generating energy. The aim of the study is to model the implementation of the sustainable development strategy in China through the production and use of biofuels. The simulation is made taking into account the following. The production capacities of Chinese licensed producers of fuel ethanol are calculated. The efficiency of bioethanol production from various types of biological raw materials is evaluated. An economic and mathematical model of bioethanol production is built. The article forecasts the profitability of bioethanol sales from various types of biological raw materials (sugar sorghum, corn) in Chinese and European markets. The study comprehensively reveals the features of the use of biofuels in an industrial country, taking into account geopolitical factors, social and market contexts, as well as technical analysis of the raw materials and production potential of Chinese companies. The article also interprets the economic processes associated with the introduction of biofuels in the ecological and economic systems of China. The article demonstrates other concepts regarding the consequences of the energy sector’s transition to the principles of energy production from biomass. The article shows the contradictory nature of the impact of biofuel production on the food market and the agricultural sector. The article analyzes possible social, resource and macroeconomic risks, and also indicates possible vectors for further research that might be aimed at diversifying the associated negative processes.
  • Technological Ecosystems in Citizen Science: A Framework to Involve Children and Young People

    Alicia García-Holgado; Francisco José García-Peñalvo; Paul Butler (MDPI AG, 2020-03-01)
    Young people are distinguished as a social group with the capacity to drive new behaviours and understandings in today’s society. However, most young people consider that people in charge of decision-making processes are not addressing their concerns. The WYRED project proposes a framework for citizen science based on a technological ecosystem to promote the transfer of perspectives, ideas, and knowledge among young people and decision-makers on issues related to the digital society. The work goal is to analyse the model proposed through a citizen science case study centred in identifying the ideas and opinions of children and young people between 7 and 30 years old, concerning gender stereotypes on the Internet. A total of 69 children and young people from Belgium, Italy, Spain, Turkey, Ukraine, and the United Kingdom have interacted for two weeks in a private space guaranteed by the defined ecosystem. The results of the analysis of the interaction between young people and facilitators (with different profiles: educators, researchers and decision-makers) demonstrate that the use of technological ecosystems to sustain the development of citizen science projects allows for the improvement of knowledge transfer processes between children and young people with stakeholders, as well as the analysis of these processes.
  • Adaptive Sustainable Reuse for Cultural Heritage: A Multiple Criteria Decision Aiding Approach Supporting Urban Development Processes

    Lucia Della Spina (MDPI AG, 2020-02-01)
    The European Union identifies the cultural heritage of cities as the main driver of development strategies. From this perspective, adaptive reuse can play a decisive role not only in terms of increasing the life cycle of the heritage but also as an urban strategy capable of generating new economic, cultural, and social values, thus supporting innovative dynamics of local development. The aim is to propose an integrated evaluation model based on the combined use of multi-criteria techniques, which helps to classify adaptive reuse strategies of unused cultural heritage assets and supports decision-makers in the implementation of development strategies in vulnerable contexts. The case study focuses on the potential reuse of some historical fortifications located along the coasts of the Strait of Messina in Southern Italy. The results obtained show that the proposed model can be a useful decision support tool, in contexts characterized by high complexity, able to guarantee the transparency of the decision-making process, and in which it is necessary to highlight the elements that influence the dynamics of the choice for the construction of shared development strategies.

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