Although current literature about the “cure versus care” issue tends to promote a patient-centered approach, the disease-centered approach remains the prevailing model in practice. The perceived dichotomy between the two approaches has created a barrier that could make it difficult for medical students and physicians to integrate psychosocial aspects of patient care into the prevailing disease-based model. This article examines the influence of the formal and hidden curricula on the perception of these two approaches and finds that the hidden curriculum (...) perpetuates the notion that “cure” and “care” based approaches are dichotomous despite significant changes in formal curricula that promote a more integrated approach. The authors argue that it is detrimental for clinicians to view the two approaches as oppositional rather than complementary and attempt to give recommendations on how the influence of the hidden curriculum can be reduced to get a both-cure-and-care-approach, rather than an either-cure-or-care-approach. (shrink)
BackgroundA requisite for ethical human subjects research is that participation should be informed and voluntary. Participation during the informed consent process by way of asking questions is an indicator of the extent to which consent is informed.AimsThe aims of this study were to assess the extent to which parents providing consent for children's participation in an observational tuberculosis research study in India actively participated during the informed consent discussion, and to identify correlates of that participation.MethodsIn an observational cohort study of (...) tuberculosis in infants in South India, field supervisors who were responsible for obtaining informed consent noted down questions asked during the informed consent discussions for 4,382 infants who were enrolled in the study. These questions were post-coded by topic. Bivariate and multivariate analysis was conducted to examine factors associated with asking at least one question during the informed consent process.ResultsIn total, 590 out of 4,382 parents/guardians asked any question during the informed consent process. We found that the likelihood of parents asking questions during the informed consent process was significantly associated with education level of either parent both parents being present, and location.ConclusionsThe findings have implications for planning the informed consent process in a largely rural setting with low levels of literacy. Greater effort needs to be directed towards developing simple participatory communication materials for the informed consent process. Furthermore, including both parents in a discussion about a child's participation in a research study may increase the extent to which consent is truly informed. Finally, continuing efforts need to be made to improve the communication skills of research workers with regard to explaining research processes and putting potential research participants at ease. (shrink)
This paper contains two traditions of diagrammatic studies namely one, the Euler–Venn–Peirce diagram and the other, following tradition of Aristotle, the square of oppositions. We put together both the traditions to study representations of singular propositions, their negations and the inter relationship between the two. Along with classical negation we have incorporated negation of another kind viz. absence. We have also considered the changes that take place in the context of open universe.
We investigate the evolution of linear density contrasts obtained with respect to a homogeneous spatially flat Friedman-Lemaître–Robertson–Walker background by solving the density contrast equations governed by Newtonian and MONDian force laws using symmetry-based approach. We find eight-parameter Lie group symmetries for the linear order density perturbation equation for the Newtonian case whereas the density contrast equation follows only one parameter Lie group symmetry in MONDian case. We use Lie symmetries to find the group invariant solutions from invariant curve condition. The (...) physical features of the evolution for various mode of density contrast with respect to the global cosmic background density in homogeneous isotropic cosmological models have been investigated using analytical group invariant solutions along with their numerical solutions. An account for cosmological density contrast and mass fluctuation also have been provided. We also have shown that the MONDian force law generates higher amplitudes in the density fluctuation, results in a more rapid structure formation that cannot be possible under the Newtonian force law. (shrink)
True Hinduism has a power and beauty that no one acquainted with it can regard with anything but the deepest respect. This book contains a range of scriptures, an array of ritualistic procedures and traditions of brahminical orthodoxy, varied interpretations coupled with multiple views. True Hinduism has a power and beauty that no one acquainted with it can regard with anything but the deepest respect. You have to approach it as you approach poetry, with a willing suspension of disbelief. Above (...) all the peripheral myths, customs, beliefs and rites, rises the great. (shrink)
Our moral compass is not the only thing that compels us to provide compassionate health care, which also improves patient outcomes and patient and provider satisfaction. In the current era of increasing medical complexity, provider burnout, and value-based reimbursement, health care systems struggle to durably improve their providers’ compassion in the provision of care. A religious retreat curriculum for leaders at OSF HealthCare, in Illinois and Michigan, has led to a significant, long-term increase among employees in their compassion toward patients, (...) colleagues, and self. (shrink)
The National Blood Policy in India relies heavily on voluntary blood donors, as they are usually assumed to be associated with low levels of transfusion-transmitted infections . In India, it is mandatory to test every unit of blood collected for hepatitis B, hepatitis C, HIV/AIDS, syphilis and malaria. Donors come to the blood bank with altruistic intentions. If donors test positive to any of the five infections, their blood is discarded. Although the blood policy advocates disclosure of TTI status, donors (...) are not, in practice, informed about their results. The onus is on the donor to contact the blood bank. Out of approximately 16 000 donations in the past 2 years, 438 tested positive for TTI, including 107 for HIV. Only 20% of the donors contacted the blood bank; none of them were HIV positive. Disclosure by blood banks of TTI status by telephone or mail has resulted in serious consequences for some donors. Health providers face an ethical dilemma, in the absence of proper mechanisms in place for disclosure of test results, regarding notification to donors who may test positive but remain ignorant of their TTI status. Given the high cost of neglecting to notify infected donors, the authors strongly recommend the use of rapid tests before collecting blood, instead of the current practice, which takes 3 h to obtain results, and disclosure of results directly to the donor by a counsellor, to avoid dropouts and to ensure confidentiality. (shrink)
The development of action representation during adolescence was investigated using a visually guided pointing motor task to test motor imagery. Forty adolescents and 33 adults were instructed to both execute and imagine hand movements from a starting point to a target of varying size. Reaction time was measured for both Execution and Imagery conditions. There is typically a close association between time taken to execute and image actions in adults because action execution and action simulation rely on overlapping neural circuitry. (...) Further, representations of actions are governed by the same speed-accuracy trade-off as real actions, as expressed by Fitts’ Law. In the current study, performance on the VGPT in both adolescents and adults conformed to Fitts’ Law in E and I conditions. However, the strength of association between E and I significantly increased with age, reflecting a refinement in action representation between adolescence and adulthood. (shrink)
Purpose Google commands approximately 70 per cent of search market share worldwide, resulting in businesses investing heavily in search engine advertising on Google to target potential customers. Recently, Google changed the way in which content and ads were displayed on the search engine results page. This reshuffling of content and ads is expected to affect the advertisers who advertise on Google and/or use it to drive traffic to their websites. The purpose of this study is to analyze the impact of (...) these changes on various stakeholders. Design/methodology/approach Data have been collected from various sources on the internet including blogs and discussion forums. Netnography has been used as it allows a detailed evaluation of the consumers’ needs, wants and choices in a virtual space. Findings The average cost-per-click for ads on the top positions is expected to increase. Advertisers whose ads usually occupy the lower positions would be adversely affected. To counter this, more emphasis should be placed on ad extensions and on product listing ads. In addition, organizations would benefit from increased efforts on search engine optimization. Practical implications A variety of coping strategies have been developed that can help marketers to successfully navigate through the change, including the use of ad extensions and the use of product listing ads. Originality/value This practice-focused paper offers guidelines for digital marketers to use sponsored search more effectively as part of their arsenal in light of some important changes recently made by Google. The potential of netnography as a research methodology has also been expanded by using it in a novel setting and in drawing up actionable insights. (shrink)
v. 1. Methodological issues and themes in the Koran -- v. 2. The nature of monotheism in Koranic thought -- v. 3. Circular causation model in the Koran -- v. 4. Monotheism applied to social issues in the Koran -- v. 5. The Koranic principle of complementarities applied to social and scientific themes.
Should measures promoting women to corporate boards be solely justified in terms of economic arguments? Traditionally, such measures have tended to rely on utilitarian arguments, despite the fact that the most prominent of these arguments—the relationship between women’s presence on boards and firm financial performance—is equivocal. Conversely, this article argues that rationales for increasing women on boards should be based on both equality and economics grounds. An equality rationale is necessary as it clarifies the underlying issues which have given rise (...) to the lack of women on boards as well as enables female representation to be valued in its own right, instead of in terms of business reform. At the same time, an economic rationale remains necessary in order to convince ardent sceptics. Yet because the most prominent rationale is ambivalent, a new economic rationale is needed. This article proposes that the new rationale be drawn from strategic management theory to focus on the contributions women can make to the board decision-making process. (shrink)
Three distinct models of political economy are articulated in this article to chart out the possible politico-economic futures of the Arab World. Of these, the present predicaments of the revolutionizing Arab populace are argued to have been caused by the continuance of the wrong social choices. It depended for a long time now on the alienating model of differentiation and alienation of the Arab nations by their rulers, and by their uncritical immersing in the equally debilitating globalization agenda. Two models (...) of the alienating and unfeasible types are formulated as the prevailing ones today. The arguments and empirical study of limited socioeconomic data with the examples of Egypt, Tunisia and Yemen, which are considered as exemplary of the revolutionary Arab World, point out that social factors based on the demand for participation and representation, self-reliant social change, and opportunities are the overwhelming factors of politico-economic change. These factors, as opposed to the purely economic factors, must be embedded in a synergistic way with the rest in a distinctive future model of Arab political economy. Three formal models of possible political economy of the future Arab World with their evolutionary futures are formalized. Necessary social and policy implications are drawn in reference to these three evolutionary Arab futures in political economy. (shrink)
This paper uses Castoriadis’s idea of the imaginary and Agnes Heller’s conceptualization of modernity as an interplay of the historical and technological imaginations, to examine how modernity engages with the idea of development to foster a particular vision of the future as always in progression. It uses the examples of Tasmania and Kerala, in Australia and India, respectively, as case studies which challenge the dominant perception of development as a linear and progressive ideology of growth that translates into ‘the development (...) of productive forces and the rational mastery of nature’. The case studies also show how, despite the radically different paths through modernity, it is the same logics of modernity that are at work in both locations. (shrink)
This chapter discusses intergenerational class mobility, which is the extent to which sons — and even daughters — follow in their father's footsteps. It asks how ‘open’ India is, and whether it is becoming more ‘open’ with greater equality of opportunity as it slowly modernises. The discussion is limited to the patterns of intergenerational mobility of men and women who are actually in paid employment.
Venn diagram system has been extended by introducing names of individuals and their absence. Absence gives a kind of negation of singular propositions. We have offered here a non-classical interpretation of this negation. Soundness and completeness of the present diagram system have been established with respect to this interpretation.
Adolescent brain development has become an important target for governments to act upon, in the name of healthy individuals and economic prosperity. In the Foresight Project on Mental Capital and Wellbeing , initiated by the Government Office for Science, adolescent behaviour was identified as one of the key challenges for UK policy. The report draws on 'state of the art′ evidence from scientific experts, to recommend ways in which to 'capitalize′ on mental faculties to improve, boost, and make maximum use (...) of the cognitive resources and mental health of individuals during the entire lifespan. Specifically, through a close analysis of the category of adolescence in cognitive neuroscience, we examine the perspective of personhood espoused by MCW. We show how the notion of 'plasticity′, which underpins the recommendations about how to make the most of adolescents′ developing brains and cognitive resources, creates vital linkages between neuroscience and neosocial policy. (shrink)
PurposeThis paper presumes that a public policy document must aim at protecting human rights. The question being raised is- what kind of moral reasoning or grounding can we afford to the idea that human rights are important for the whole framework of public policy. The paper aims at looking at the moral and political philosophy of Immanuel Kant as we find it in his Groundwork of the Metaphysics of Morals and the Metaphysics of Morals for providing this background.MethodThe paper provides (...) an exegetical account of some of the key concepts in Kant’s moral philosophy and the application of these in socio-political contexts.Result and DiscussionThe processes involved in the framing of the document, the document itself, as well as the persons framing the document must aspire to respect and protect human rights. The implication itself rests on the principle that a moral end cannot be achieved by immoral means and protecting human rights is a moral end that all societies must seek to achieve. Hence not only the end, which in this case is the policy document itself, but the means, i.e., the processes of framing the documents and intentions of those responsible and accountable for it, must also be moral. (shrink)
A survey-based research study was conducted to analyze sustainability practices of large U.S. corporations in their domestic and international operations. Large U.S. corporations were slow to address global environmental challenges, but a majority of them now demonstrate a clear understanding of their responsibilities. Most large U.S. corporations are proactively involved in sustainability and environmentally friendly measures, and their involvement at home is more intense than abroad. Analyses revealed that U.S. corporations engage in eight activities related to sustainability: investing in energy-efficient (...) methods, generating electricity from solar power, generating electricity from wind power, using biofuels, trading carbon credits, supporting environmental organizations, generating electricity from biomass, and generating electricity from hydropower. Of these, only generating electricity from biomass and hydropower were not significantly different with respect to U.S. corporations’ foreign and domestic implementation. This paper represents the first attempt to determine whether and how U.S. corporations’ efforts to promote sustainability differ with respect to their operational locus. (shrink)
Objectives To conduct an independent evaluation of the first phase of the Health Foundation’s Safer Patients Initiative (SPI), and to identify the net additional effect of SPI and any differences in changes in participating and non-participating NHS hospitals. Design Mixed method evaluation involving five substudies, before and after design. Setting NHS hospitals in the United Kingdom. Participants Four hospitals (one in each country in the UK) participating in the first phase of the SPI (SPI1); 18 control hospitals. Intervention The SPI1 (...) was a compound (multi-component) organisational intervention delivered over 18 months that focused on improving the reliability of specific frontline care processes in designated clinical specialties and promoting organisational and cultural change. Results Senior staff members were knowledgeable and enthusiastic about SPI1. There was a small (0.08 points on a 5 point scale) but significant (P<0.01) effect in favour of the SPI1 hospitals in one of 11 dimensions of the staff questionnaire (organisational climate). Qualitative evidence showed only modest penetration of SPI1 at medical ward level. Although SPI1 was designed to engage staff from the bottom up, it did not usually feel like this to those working on the wards, and questions about legitimacy of some aspects of SPI1 were raised. Of the five components to identify patients at risk of deterioration—monitoring of vital signs (14 items); routine tests (three items); evidence based standards specific to certain diseases (three items); prescribing errors (multiple items from the British National Formulary); and medical history taking (11 items)—there was little net difference between control and SPI1 hospitals, except in relation to quality of monitoring of acute medical patients, which improved on average over time across all hospitals. Recording of respiratory rate increased to a greater degree in SPI1 than in control hospitals; in the second six hours after admission recording increased from 40% (93) to 69% (165) in control hospitals and from 37% (141) to 78% (296) in SPI1 hospitals (odds ratio for “difference in difference” 2.1, 99% confidence interval 1.0 to 4.3; P=0.008). Use of a formal scoring system for patients with pneumonia also increased over time (from 2% (102) to 23% (111) in control hospitals and from 2% (170) to 9% (189) in SPI1 hospitals), which favoured controls and was not significant (0.3, 0.02 to 3.4; P=0.173). There were no improvements in the proportion of prescription errors and no effects that could be attributed to SPI1 in non-targeted generic areas (such as enhanced safety culture). On some measures, the lack of effect could be because compliance was already high at baseline (such as use of steroids in over 85% of cases where indicated), but even when there was more room for improvement (such as in quality of medical history taking), there was no significant additional net effect of SPI1. There were no changes over time or between control and SPI1 hospitals in errors or rates of adverse events in patients in medical wards. Mortality increased from 11% (27) to 16% (39) among controls and decreased from 17% (63) to 13% (49) among SPI1 hospitals, but the risk adjusted difference was not significant (0.5, 0.2 to 1.4; P=0.085). Poor care was a contributing factor in four of the 178 deaths identified by review of case notes. The survey of patients showed no significant differences apart from an increase in perception of cleanliness in favour of SPI1 hospitals. Conclusions The introduction of SPI1 was associated with improvements in one of the types of clinical process studied (monitoring of vital signs) and one measure of staff perceptions of organisational climate. There was no additional effect of SPI1 on other targeted issues nor on other measures of generic organisational strengthening. (shrink)
Trisomy 13 and 18 are rare chromosomal abnormalities associated with high morbidity and mortality. Improved survival rates and increased prevalence of aggressive medical intervention have resulted in families and physicians holding different perspectives regarding the appropriate management of children with T 13/18. Families were invited for open-ended interviews regarding their experiences with the medical care of a child with T 13/18 over the past 5 years. Seven of 33 invited families were surveyed; those who had spent more than 40 days (...) in the hospital were most likely to accept the invitation. Grounded theory technique was used to analyze the interviews. This method elicited four key themes regarding family perspectives on children with T 13/18: they are unique and significant, they transform the lives of others, their families can feel overwhelmed and powerless in the medical setting, their families are motivated to “carry the torch” and tell their story. Families also emphasized ways in which Internet support groups can provide both positive and negative perspectives. The ensuing discussion explores the difficulties of parents and physicians in forecasting the impact that T 13/18 will have on families and emphasizes a narrative approach to elicit a map of the things that matter to them. The paper concludes that while over-reliance on dire prognostic data can alienate families, examining the voice, character and plot of patient stories can be a powerful way for physicians to foster shared decision-making with families. (shrink)
Purpose This research aims to study the coping experience of visually impaired bankers in India after they have received reasonable accommodation from their employers, that is, the work process or environment has been suitably modified to ensure a barrier-free environment for them. Design/methodology/approach Data were collected through semi-structured interviews with 12 VI bankers working with public sector banks in India. A phenomenological approach was adopted during data analysis. Findings Despite the provision of reasonable accommodations, VI employees often find it difficult (...) to fulfill their job responsibilities. This is on account of extensive paperwork required for completion of their jobs and the partially accessible information systems available to them. As a result, these VI employees are found resorting to workarounds to carry out their jobs, with the nature of workarounds adopted varying with the type and extent of visual impairment. Furthermore, it is observed that VI employees require social support not only from their superiors and peers but also from their subordinates and customers to carry out their tasks. Research limitations/implications Data collection was done through snowball sampling which could have resulted in sampling bias. Due to confidentiality issues, observation of workarounds in practice by VI employees could not be carried out as part of the study. Originality/value The study contributes to the literature on integration of persons with disabilities by examining their coping experience after provision of reasonable accommodations. It emphasizes the role of workarounds, an under-studied area in PwD integration, as well as support of other stakeholders in the experience. (shrink)
This essay introduces the second installment of a symposium in Common Knowledge called “Apology for Quietism.” This introductory piece concerns the sociology of quietism and why, given the supposed quietude of quietists, there is such a thing at all. Dealing first with the “activist” Susan Sontag's attraction to the “quietist” Simone Weil, it then concentrates on the “activist” William Empson's attraction to the Buddha and to Buddhist quietism, with special reference to Empson's lost manuscript Asymmetry in Buddha Faces (and to (...) Sharon Cameron's work on the topic in her book Impersonality). The author, who is also editor of the journal, argues against the effort of some contributors to substitute new terms for quietism and emphasizes instead what he calls (quoting Sontag) “the need for repose.”. (shrink)
Gandhi’s notion of passive-resistance is critical in two ways and defines swaraj and swadeshi, leading to his assertion that India alone is the land of redemption for the world afflicted with modern civilization, “the sheet-anchor of our hope”. “Sound at the foundation”, “India remains as it was before”, while the world speeds on, “usurp[ing] the function of Godhead” and indulg[ing] in novel experiments”. This paper aims at elaborating Gandhi’s definition of nature in terms of the scalar, speed, as found in (...) Hind Swaraj and other writings in order to demonstrate that India as hind swaraj is critical nation. (shrink)
Respecting patients’ rights is a fundamental aspect of providing quality healthcare. The present investigation attempts to explore the awareness among patients about their rights in a coastal township in India. A questionnaire-based cross-sectional study was carried out among 215 patients admitted to the wards of a tertiary care teaching hospital in Mangalore. Awareness among patients regarding their rights varied for various issues and ranged between 48.4 and 87.4 %. Awareness about patients’ rights was independent of gender, socio-economic and educational status. (...) Doctors were found to be the most common source of information for patient’s about their rights in the study. Doctors must conform to the relevant legislations and involve patients in all aspects of healthcare. There is a need to increase awareness among patients about their rights to ensure informed decisions and better health care services. (shrink)
Page generated Fri Jul 30 10:55:22 2021 on philpapers-web-65948fd446-659hb
cache stats: hit=10696, miss=11674, save= autohandler : 1123 ms called component : 1110 ms search.pl : 989 ms render loop : 954 ms next : 476 ms addfields : 418 ms publicCats : 370 ms save cache object : 95 ms menu : 70 ms retrieve cache object : 41 ms autosense : 36 ms match_cats : 32 ms initIterator : 32 ms quotes : 31 ms prepCit : 28 ms search_quotes : 16 ms applytpl : 6 ms match_authors : 1 ms match_other : 1 ms intermediate : 1 ms init renderer : 0 ms setup : 0 ms auth : 0 ms writelog : 0 ms