The risk of tort liability for health maintenance organizations and other managed care plans has dramatically increased in recent years. This is due in part to the growing percentage of health care rendered through managed care plans. The cost-containment mechanisms commonly used by managed care plans, such as limiting access to services and/or choice of providers, creates a climate ripe for disputes that may end up in court. As dissatisfied patients and providers seek recourse in the courts, tort doctrines are (...) extended and new legal theories emerge as needed. For example, the concepts of direct and vicarious tort liability developed in the hospital context have been extended by courts to encompass HMOs. vicarious liability claims, based on ostensible agency or respondeat superior doctrines, have been brought against HMOs and managed care plans for negligent treatment by physicians selected to provide care to members. (shrink)

The risk of tort liability for health maintenance organizations and other managed care plans has dramatically increased in recent years. This is due in part to the growing percentage of health care rendered through managed care plans. The cost-containment mechanisms commonly used by managed care plans, such as limiting access to services and/or choice of providers, creates a climate ripe for disputes that may end up in court. As dissatisfied patients and providers seek recourse in the courts, tort doctrines are (...) extended and new legal theories emerge as needed. For example, the concepts of direct and vicarious tort liability developed in the hospital context have been extended by courts to encompass HMOs. vicarious liability claims, based on ostensible agency or respondeat superior doctrines, have been brought against HMOs and managed care plans for negligent treatment by physicians selected to provide care to members. (shrink)

Having a serious illness like breast cancer is a calamity for individuals and families. Along with the pain, discomfort, and dislocation comes the issue of how to pay the medical expenses for the care and treatment of the disease. If the seriously ill person has inadequate or no insurance, these problems are aggravated.Stories abound about seriously ill people losing private health insurance following diagnosis with a catastrophic disease, remaining in jobs just to maintain health insurance, or facing financial hardship because (...) of gaps in coverage. Yet surprisingly little research has focused on the problems that people with serious illness face with health coverage and, in particular, how concerns about access to health insurance coverage shape their lives.Further, despite profoundly moving anecdotes of cancer victims and other seriously ill people about their problems with health insurance and despite recent federal and state efforts to reform the private health insurance market in ways discussed below, neither the federal government, states, nor the private sector has crafted comprehensive strategies to enhance health coverage for the seriously ill. (shrink)

Having a serious illness like breast cancer is a calamity for individuals and families. Along with the pain, discomfort, and dislocation comes the issue of how to pay the medical expenses for the care and treatment of the disease. If the seriously ill person has inadequate or no insurance, these problems are aggravated.Stories abound about seriously ill people losing private health insurance following diagnosis with a catastrophic disease, remaining in jobs just to maintain health insurance, or facing financial hardship because (...) of gaps in coverage. Yet surprisingly little research has focused on the problems that people with serious illness face with health coverage and, in particular, how concerns about access to health insurance coverage shape their lives.Further, despite profoundly moving anecdotes of cancer victims and other seriously ill people about their problems with health insurance and despite recent federal and state efforts to reform the private health insurance market in ways discussed below, neither the federal government, states, nor the private sector has crafted comprehensive strategies to enhance health coverage for the seriously ill. (shrink)

ABSTRACT An adequate response to the environmental and sustainability issues we now face cannot be limited to single perspectives, disciplines, or ways of knowing, and instead requires an interdisciplinary approach. Despite the connections between the fields of citizenship-, character- and sustainability education, they have thus far run parallel to each other, without any substantial convergence. This paper focuses on the conceptual and historical reasons for this lack of integration, exploring the tensions among them perceived by many scholars and practitioners, such (...) as an individual vs. a social vs. a global focus, a deliberative vs. fact based pedagogic approach, and an individual vs. socio-political educational context. The paper ends by exploring different ways in which these three fields of education might be integrated. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Feminism and World ReligionsJordan PaperFeminism and World Religions. Edited by Arvind Sharma and Katherine K. Young. Albany: State University of New York Press, 1999. Pp. x + 333.The editors of Feminism and World Religions, Arvind Sharma and Katherine K. Young, both at McGill University, have been editing anthologies, as well as an [End Page 118] annual journal, on the subject of "women and religion" in its various modes (...) and variations, for a number of years. This new iteration is particularly specific to its avowed topic and a valuable addition to the genre. In-depth contributions were solicited for the "Religions of the Book" and for South and East Asian religions. As with any anthology, no matter how well planned, individual treatments will invariably reflect the differences in the interests and methodologies of the various authors. All of the treatments here, however, do focus on history and ideology. All were ostensibly written by insiders, although what this actually means varies from tradition to tradition.Katherine Young has contributed an excellent, analytical introduction to both the topics of the book and the individual chapters. She has also authored an in-depth "Postscript" (thirty-four pages) concerning a number of contemporary issues relevant to the volume's theme and the issue of "insiders." She addresses such problems as "the politics of identity," "the proper sphere for feminism," "the tension between revolution and reform," and the "polarization between men and women."I will begin with the chapters on the Religions of the Book, although this does not accord with the order in the anthology. "Feminism in Judaism," by Ellen M. Umansky, is possibly the most succinct introduction available from the last two decades to the extraordinary number of changes, as well as the lack of change, in some varieties of this religion. The contribution by the well-known Rosemary Radford Ruether, "Feminism in World Christianity," briefly traces the roots of Christian feminism from the time of the New Testament and then surveys developments in the United States and feminist theology in Europe, moving on to what many such surveys ignore: the Middle East, Africa, Asia, and Latin America. "Feminism in Islam" by Riffat Hassan focuses on the nature of androcentrism in Islam. She juxtaposes the Hadith literature against the Qur'ān, and finds that the negative attitudes toward women are not in the Qur'ān but are based on a questionable interpretation of a few Hadith statements. She analyzes three basic theological assumptions and finds all wanting: the issue of woman's creation, the issue of woman's "guilt" in the "Fall" episode, and the issue of the purpose of woman's existence. She concludes with a fascinating comparison of the issue of women's sexuality as found in the Qur'ān and in the history of Islam.South Asia is dealt with in two very different approaches. Vasudha Narayanan's "Brimming with Bhakti, Embodiments of Shakti: Devotees, Deities, Performers, Reformers, and Other Women of Power in the Hindu Tradition," is a full (fifty-three pages) and engaging exposition of the subject from a variety of perspectives as delineated in the chapter's title. It is a lucid and comprehensive analysis of a most complex issue; indeed, she begins with a survey of the problem of identifying "Hinduism" in and of itself. Rita M. Gross, in her "Strategies for a Feminist Revalorization of Buddhism," quite properly, given her own cultural milieu, speaks not of Buddhism in Asia, but of how Buddhism can be in the West. She argues here, as she has in a relatively recent book, Buddhism after Patriarchy, that the androcentrism, even aspects of misogyny, that is found in the development of Buddhism, does not follow from essential Buddhist ideology, and it need not be continued in the present. [End Page 119]The remaining two chapters, on China, are more problematic than the preceding ones. The two authors of "Feminism and/in Taoism," Karen Laughlin and Eva Wong, are both connected with the International Taoist Tai Chi Society, which can be perceived as far removed from the continuing aspects of Daoist religion on both the Chinese mainland and Taiwan. Their focus is on the classical texts of Daoist... (shrink)

Experimental radiobiology represented a long-standing priority for the U.S. Atomic Energy Commission, but organizational issues initially impeded the laboratory progress of this government-funded work: who would direct such interdisciplinary investigations and how? And should the AEC support basic research or only mission-oriented projects? Alexander Hollaender's vision for biology in the post-war world guided AEC initiatives at Oak Ridge, where he created and presided over the Division of Biology for nearly two decades. Hollaender's scheme, at once entrepreneurial and system-oriented, made good (...) use of the unique resources provided by the AEC and by Oak Ridge's national laboratory setting, while at the same time it restructured wartime research practices to better reflect biologists' own priorities. Because Hollaender offered many academic experimental biologists a way of envisioning military-related patronage as integral - rather than antithetical - to their professional identities, his work provides an important lens through which to examine the early post-war intellectual and institutional development of radiobiology. (shrink)

In this research, we examine the effects that customer perceptions of employee deception have on the customers’ attitudes toward an organization. Based on interview, archival, and observational data within the international airline industry, we develop a model to explain the complex effects of perceived dishonesty on observer’s attitudes and intentions toward the airline. The data revealed three types of perceived deceit (about beliefs, intentions, and emotions) and three additional factors that influence customer intentions and attitudes: the players involved, the beneficiaries (...) of the deceit, and the harm done by the perceived lie. We develop a model with specific propositions to guide organizations with respect to apparently deceitful behavior of their employees. Implications and directions for future research are provided, focusing on the question of whether organizations should consistently encourage honesty or train their employees to be effective liars. (shrink)

Emergency care in large urban hospitals across the country is in the midst of major redesign intended to deliver quality care through improved access, decreased wait times, and maximum efficiency. The central argument in this paper is that the conceptualization of quality including the documentary facts and figures produced to substantiate quality emergency care is socially organized within a powerful ruling discourse that inserts the interests of politics and economics into nurses' work. The Canadian Triage and Acuity Scale figures prominently (...) in the analysis as a high‐level organizer of triage work and knowledge production that underpins the way those who administer the system define, measure and evaluate emergency care processes, and then use this information for restructuring. Managerial targets and thinking not only dominate the way emergency work is understood, determined, and controlled but also subsume the actual work of health‐care providers in spaces called ‘wait times’, where it is systematically rendered ‘unknowable’. The analysis is supported with evidence from an extensive institutional ethnography that shows what nurses actually do to manage the safe passage of patients through their emergency care process starting with the work of triage nurses. (shrink)

This is an exploratory study of perceptions of human dignity in childhood as recalled by young adults. Our goal is to discover the range of dimensions, sources and experiences, both those that supported and violated, of the concept of human dignity. This research, drawing on responses from over two hundred university students, may help to develop a language with which to explore the concept of human dignity in a broader, more systematic way. The approach taken here permits us to move (...) beyond the ‘legal’ frame that often confines us to discussions of the extremes of child abuse and neglect, to a frame that frees us to explore the meaning and real life experiences with human dignity in childhood and the impacts on later life. Violating and not supporting human dignity in childhood helps produce a world populated by adults who, having been harmed as children, go on to harm and violate others as adults. If our goal is to have a world populated by children who were nurtured to flourish into child-centered adults who are empathic, intelligent and responsive and who have no need to hurt others, then our understanding of human dignity in childhood must be increased. This paper and the materials on which it is based seek to provide preliminary insights into the language of human dignity. (shrink)

Using exploratory factor analysis on a unique dataset of global executives, we find that their perceptions of their national government’s risk management effectiveness are largely driven by two latent factors: leadership virtue, and governance. We show that the leadership virtue signal is potentially a stronger signal. We hypothesize that this may be because making decisions and taking actions to manage risk is a continuous process requiring inter alia foresight and moral discipline in looking to the interests of others and acting (...) in service to those interests above self-interest. This suggests at least two propositions for further testing, for which, we offer rhetorical argument and anecdotal evidence at the end of this paper and suggest methodologies for further testing. To our knowledge, this is the first paper to uncover this connection empirically between national risk management and leadership virtue. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:“Normalizing” Intersex Didn’t Feel Normal or Honest to Me.Karen A. WalshI am an intersex woman with Complete Androgen Insensitivity Syndrome (CAIS). My 57–year history with this has its own trajectory—mostly driven by medical events, and how I and my parents reacted. Most of my treatment by physicians has not been positive. It didn’t make me “normal” at all. I was born normal and didn’t require medical interventions. And (...) by the way, I’ve never been confused about who or what I am.Truthful disclosure didn’t come to me about my biology and what was done to me as an infant until I was 33, when I forced the issue by removing my medical records from my endocrinologist’s office. I learned that there was never full disclosure to my [End Page 119] parents either, and therefore there was no informed consent for the “corrective” surgeries performed on me as an infant. My parents were only told that their little girl would get cancer and would not have a normal development as a girl unless her “deformed ovaries” were removed, and that they should never discuss these problems with me. Thus, after having presented with an inguinal hernia and having exploratory surgery at age 16 months, my intra–abdominal testes were removed in a second surgery two months later. I was pronounced a “male pseudohermaphrodite,” a diagnosis that was shared neither with my parents nor with me.Years later, I discovered an article my surgeon published in 1960 in the Delaware Medical Journal about me and another intersex person he operated on (whom he labeled a “true hermaphrodite”). The article gives a very detailed pathology report of my gonads, but only two sentences regarding my welfare and the rationale for performing those surgeries. Dr. J. F. Kustrup wrote in this article, “These [two cases] emphasize the need for early diagnosis and treatment in order to avoid the possibility of malignant change and to permit these individuals to follow a normal psychosexual pattern.” And: “Hermaphroditism and pseudohermaphroditism are conditions in which early diagnosis and treatment are essential to avoid malignant degeneration and to allow the child some chance toward normal pyschic [sic] development.” I was grateful to find this article because it revealed the unfounded assumptions underpinning the recommendations for treatment, much of which continues today. Worse even than the sort of social prejudice that shapes treatment is the absence of evidence for what doctors treat as “necessary” interventions. For my syndrome, CAIS, there never was—and still is not—data to support the cancer scare, or the opinion that I’d be confused and not have a normal life.From about the age of four, I can remember being different and being stonewalled by my doctor and prevented by my parents from talking about it. The feelings and fears I tried to express were shushed away, and I could tell that my questions were upsetting everyone. Even if I had wanted to be complicit with their lame diversions and nonsensical explanations, the massive abdominal scars were there as a daily reminder and hinted at a very different story.The Road to Hell is Paved with Good IntentionsGrowing up, I was treated like a fascinoma and a lab rat at a major teaching hospital on the East Coast. All I learned from those doctors as a young kid was what it feels like to be ogled, photographed and probed by a roomful of white–coated male doctors. Dissociation made itself my friend, and helped me to cope through the annual genital and anal exams and probing. I thought I was a freak and I felt completely powerless to protect myself from them and their “care”.At my annual appointment at age 12, with my mom present, three doctors told me I was infertile. Learning that I couldn’t have kids really saddened and shocked me, but there was no opportunity to talk about my feelings—either that day, or any time afterward. I was told to stop crying. I remember them telling me that there was no one else like me and that this was a random genetic anomaly, thereby reinforcing the freakishness... (shrink)

Conventional wisdom suggests that dishonesty on the part of an organization's employees has a negative effect on the organization's reputation. However, many organizations condone (or even require) dishonesty under certain circumstances. In this research of 128 airline passengers, we examine situations in which employees are perceived to be dishonest within one such industry, the international airlines, and examine the impact of this dishonesty on organizational reputation and customer satisfaction. We found that the reputation of the firm was most damaged when (...) the lie benefited the company or the employee, rather than the passenger. In addition, the view of the airline significantly decreased when the lie caused a high amount of harm (compared with a low amount) to the passenger. (shrink)

A natural experiment was conducted studying the relations among student cheating, motivation, religiosity, and attitudes toward cheating. Students enrolled in a dual religious/college curriculum were surveyed regarding their cheating behavior, attitudes toward cheating, religiosity, and learning/grade motivations toward classes. Business and liberal arts college students were represented. Results strongly support the following conclusions. First, grade orientation is associated with increases in self-reported cheating. Second, among these religious students, more religiosity correlates with reduced reports of cheating in all courses. This result (...) appears to be due to the unique effect of religion on self-reported cheating rates and, depending on course content, on a reduction of grade orientation in religious students. Third, business students report more cheating than their liberal arts counterparts, even when taking the same courses. They have less critical attitudes toward cheating and greater grade orientation, both of which statistically contribute to this difference, but other factors are involved as well. Keywords: academic integrity, motivation, religiosity, cheating. (shrink)

A natural experiment was conducted studying the relations among student cheating, motivation, religiosity, and attitudes toward cheating. Students enrolled in a dual religious/college curriculum were surveyed regarding their cheating behavior, attitudes toward cheating, religiosity, and learning/grade motivations toward classes. Business and liberal arts college students were represented. Results strongly support the following conclusions. First, grade orientation is associated with increases in self-reported cheating. Second, among these religious students, more religiosity correlates with reduced reports of cheating in all courses. This result (...) appears to be due to the unique effect of religion on self-reported cheating rates and, depending on course content, on a reduction of grade orientation in religious students. Third, business students report more cheating than their liberal arts counterparts, even when taking the same courses. They have less critical attitudes toward cheating and greater grade orientation, both of which statistically contribute to this difference, but other factors are involved as well. Keywords: academic integrity, motivation, religiosity, cheating. (shrink)

Name der Zeitschrift: Semiotica Jahrgang: 2016 Heft: 213 Seiten: 177-196.

This article examines the human placenta not only as a scientific, medical and biological entity but as a consumer bio-product. In the emergent placenta economy, the human placenta is exchanged and gains potentiality as food, medicine and cosmetics. Drawing on empirical research from the United States, the United Kingdom, Denmark and Japan, the authors use feminist cultural analysis and consumer theories to discuss how the placenta is exchanged and gains commodity status as a medical supplement, smoothie, pill and anti-ageing lotion. (...) Placenta preparers and new mothers cite medical properties and spirituality as reasons for eating or encapsulating the placenta, reinstating ideas of the liberated good mother. Meanwhile, the cosmetics industry situates the placenta as an extract and hence a commodity, re-naturalizing it as an anti-ageing, rejuvenating and whitening bio-product. The authors conclude that, in the emergent bio-economy, the dichotomy between the inner and the outer body is deconstructed, while the placenta gains clinical and industrial as well as affective value. (shrink)

Much of the built world is designed around food; for storing, producing, transporting, selling, serving and eating. We recognise the regeneration of a neighbourhood through its new cafes, restaurants and grocery shops. This title features new restaurants in London, New York, Sydney and Tokyo; the design of markets; provocative essays by architects, historians, and social scientists; and interviews with designers and entrepreneurs.

The budding yeast Cdc6 protein is important for regulating DNA replication intiation. Cdc6p acts at replication origins, and cdc6‐1 mutants arrest with unreplicated DNA and show elevated minichromosome loss rates. Overexpression of the related Cdc 18 protein in fission yeast results in DNA rereplication; however, Cdc6p overexpression does not cause this result. A recent paper(1) further defines the role of Cdc6p in DNA replication. Cdc6p only promotes DNA replication between the end of mitosis and late G1, and although the Cdc6 (...) protein is highly unstable, neither degradation nor nuclear localization is critical for limiting DNA replication to this interval. (shrink)

Experimental radiobiology represented a long-standing priority for the U.S. Atomic Energy Commission (AEC), but organizational issues initially impeded the laboratory progress of this government-funded work: who would direct such interdisciplinary investigations and how? And should the AEC support basic research or only mission-oriented projects? Alexander Hollaender's vision for biology in the post-war world guided AEC initiatives at Oak Ridge, where he created and presided over the Division of Biology for nearly two decades (1947-1966). Hollaender's scheme, at once entrepreneurial and system-oriented, (...) made good use of the unique resources provided by the AEC and by Oak Ridge's national laboratory setting, while at the same time it restructured wartime research practices to better reflect biologists' own priorities. Because Hollaender offered many academic experimental biologists a way of envisioning military-related patronage as integral - rather than antithetical - to their professional identities, his work provides an important lens through which to examine the early post-war intellectual and institutional development of radiobiology. (shrink)