The assessment and management of pain is a significant public health problem in the United States. Long-term care facilities face unique barriers and challenges to pain management due to the large population of cognitively impaired residents, little physician contact and poor pain education for nurses and nurse assistants. In addition, common misconceptions about pain and pain treatment in the elderly along with health professional and resident fears of addiction and drug toxicity, add to the problem of pain management. The basic (...) principles of pain treatment in long-term care are identical to all other health care settings – utilizing a combination of drug and non-drug treatments. Recent efforts to institutionalize improved pain management practices, through assessment procedures and defined pain management policies, standards and education programming, is a promising venue for systemically improving pain treatment in long-term care settings. (shrink)
Hegesias (3d c.BC), as hedonist, held that the sage will kill himself. For: One should pursue pleasure and avoid pain. But life is virtually certain to contain more pain than pleasure. Therefore death, which is neither pleasurable nor painful, is better than life. The flaw in the argument lies in the underlying game-theoretical model of life as a game in which play and payoff are distinct. Hegesias's conclusion, that life is not ‘worth living,’ is inescapable by any philosophy so based, (...) including John Rawls's. Why shouldn't his rational persons behind the veil of ignorance opt for prenatal suicide? (shrink)
We are reporting on how involved the mentor was in promoting responsible research in cases of research misconduct. We reviewed the USPHS misconduct files of the Office of Research Integrity. These files are created by Institutions who prosecute a case of possible research misconduct; ORI has oversight review of these investigations. We explored the role of the mentor in the cases of trainee research misconduct on three specific behaviors that we believe mentors should perform with their trainee: (1) review source (...) data, (2) teach specific research standards and (3) minimize stressful work situations. We found that almost three quarters of the mentors had not reviewed the source data and two thirds had not set standards. These two behaviors are positively correlated. We did not see convincing evidence in the records that mentors were causing stress, but it was apparent in the convicted trainees’ confessions that over 50% experienced some kind of stress. Secondary data, while not created for this research purpose, allows us to look at concrete research behaviors that are otherwise not very researchable. We believe it is important for mentors and institutions to devote more attention to teaching mentors about the process of education and their responsibilities in educating the next generation of scientists. This becomes a critical issue for large research groups who need to determine who is in charge educating, supervising and assuring data integrity. (shrink)
Over the past decade, knowledge and learning have emerged as the keys to economic success and as a focus for thinking about organizational effectiveness and innovation. An overwhelming majority of large organizations now engage in a wide range of knowledge and learning activities and nearly all have programs and personnel explicitly dedicated to these tasks. -/- The volume is targeted at those new to knowledge and learning, and is filled with practical examples and focuses on the most critical issues, featuring (...) seminal contributions from leading authorities including: -/- * Thomas Davenport, * Dorothy Leonard, * John Seely Brown, * Sidney Winter, * W. Chan Kim, * Peter Druckard. -/- The book is organized around the three key steps in managing knowledge: development, retention, and transfer. These sections are preceded by a section creating the strategic context for knowledge and followed by a section on the social dimensions that are often overlooked. Finally, the book looks to the future of knowledge and learning. -/- This Reader is an accessible way for executives and students taking advanced Management Studies and executive courses to learn from the latest examples on this topic. (shrink)
In Unsimple truths, Sandra D. Mitchell examines the historical context of current scientific practices and elaborates the challenges complexity has since posed to status quo science and policymaking. Mitchell criticizes models of science inspired by Newtonian physics and argues for a pragmatistic, anti-universalist approach to science. In this review, I focus on what I find to be the most important point of the book, Mitchell’s argument for the conceptual independence of compositional materialism and descriptive fundamentalism. Along the way, I (...) provide a description of Mitchell’s overall project and a road map of the book. (shrink)
The recent Supreme Court decision upholding Roe v. Wade and in particular, the dissent by Justice Sandra Day O'Connor, sheds new light on the issue of abortion. Let us consider any stage of a pregnancy when abortion is medically safe for the mother. If at that stage it is also medically viable to save the fetus, is an abortion performed at that stage of pregnancy morally justifiable? For example, if it is, or becomes, medically safe to perform abortions after (...) first trimester of pregnancy and at the same time saving a fetus is, or becomes, medically viable or not unusual during some stage of the second trimester, can abortions during and after that stage of pregnancy be justified? With a number of qualifications I shall argue the thesis that as a general rule, but not an absolute rule, abortion in these instances is not usually justifiable. For if it is, then one will also have to grant the moral justification for a number of other highly questionable medical practices. This thesis is not to be identified with the stronger claim that abortions of viable fetuses can never be performed. There are surely exceptions such as when the life or health of the mother is in danger. But, I shall argue, the justification for making such exceptions is on different grounds than is sometimes claimed because one must weigh the health of the mother against the life of another human being. (shrink)
I address the problem of how to locate "traitorous" subjects, or those who belong to dominant groups yet resist the usual assumptions and practices of those groups. I argue that Sandra Harding's description of traitors as insiders, who "become marginal" is misleading. Crafting a distinction between "privilege-cognizant" and "privilege-evasive" white scripts, I offer an alternative account of race traitors as privilege-cognizant whites who refuse to animate expected whitely scripts, and who are unfaithful to worldviews whites are expected to hold.
This essay explores how the social location of white traitorous identities might be understood. I begin by examining some of the problematic implications of Sandra Harding's standpoint framework description of race traitors as 'becoming marginal.' I argue that the location of white traitors might be better understood in terms of their 'decentering the center.' I distinguish between 'privilege-cognizant' and 'privilege-evasive' white scripts. Drawing on the work of Marilyn Frye and Anne Braden, I offer an account of the contrasting perceptions (...) and behaviors of white who animate one type of script and those who struggle to forge the other type. I use Maria Lugones account of identity and notions of 'world travel' and 'loving perception' and Aristotle's virtue theory to explicate the ways whites, and white feminists in particular, might cultivate a traitorous character conducive to an antiracist politics. (shrink)
To illustrate the strength of Bartky's clarity of insight I focus on her discussion of shame found in two essays in Femininity and Domination. I argue that these essays as well as the other in the collection identify and offer a clear analysis of many issues central to feminism and call for Bartky to write a sequel which offers constructive suggestions of ways out.