BackgroundDecision-making in initiating life-sustaining health technology is complex and often conducted at time-critical junctures in clinical care. Many of these decisions have profound, often irreversible, consequences for the child and family, as well as potential benefits for functioning, health and quality of life. Yet little is known about what influences these decisions. A systematic review of reasoning identified the range of reasons clinicians give in the literature when initiating technology dependence in a child, and as a result helps determine the (...) range of influences on these decisions.MethodsMedline, EMBASE, CINAHL, PsychINFO, Web of Science, ASSIA and Global Health Library databases were searched to identify all reasons given for the initiation of technology dependence in a child. Each reason was coded as a broad and narrow reason type, and whether it supported or rejected technology dependence.Results53 relevant papers were retained from 1604 publications, containing 116 broad reason types and 383 narrow reason types. These were grouped into broad thematic categories: clinical factors, quality of life factors, moral imperatives and duty and personal values; and whether they supported, rejected or described the initiation of technology dependence. The majority were conceptual or discussion papers, less than a third were empirical studies. Most discussed neonates and focused on end-of-life care.ConclusionsThere is a lack of empirical studies on this topic, scant knowledge about the experience of older children and their families in particular; and little written on choices made outside ‘end-of-life’ care. This review provides a sound basis for empirical research into the important influences on a child’s potential technology dependence. (shrink)

Background There is considerable variation in the functionality of bioethical services in different institutions and countries for children in hospital, despite new challenges due to increasing technology supports for children with serious illness and medical complexity. We aimed to understand how bioethics services address bioethical concerns that are increasingly encountered in paediatric intensive care. Methods A qualitative descriptive design was used to describe clinician’s perspectives on the functionality of clinical bioethics services for paediatric intensive care units. Clinicians who were members (...) of formal or informal clinical bioethics groups, or who were closely involved with the process of working through ethically challenging decisions, were interviewed. Interviews took place online. Resulting transcripts were analysed using thematic analysis. Results From 33 interviews, we identified four themes that described the functionality of bioethics services when a child requires technology to sustain life: striving for consensus; the importance of guidelines; a structure that facilitates a time-sensitive and relevant response; and strong leadership and teamwork. Conclusions Clinical bioethics services have the potential to expand their role due to the challenges brought by advancing medical technology and the increasing options it brings for treatment. Further work is needed to identify where and how bioethics services can evolve and adapt to fully address the needs of the decision-makers in PICU. (shrink)

Following the announcement in 1949 in the USA that cortisone offered rheumatoid arthritis sufferers effective treatment for their crippling disease, the Ministry of Health came under considerable pressure from the medical profession and the public to make cortisone available in Britain. The Ministry, therefore, urged British companies to start manufacturing cortisone. Among the several pharmaceutical firms responding to the Ministry’s request, Glaxo’s expertise in the field of vitamins gave them a head start. This paper describes the varied and flexible strategy (...) that enabled Glaxo to maintain this head start, and the scientific and technical capabilities which the company subsequently built up, enabling them to dominate the market for corticosteroids in Britain.Among the drugs to emerge out of the Glaxo project to manufacture cortisone, which began in 1950 and later became a wider R&D programme on steroids, was the topical steroid Betnovate, launched in 1963, which remains a best-seller today. However, although it led to successful new products, Glaxo’s programme had limitations. The paper identifies a missed opportunity, in the shape of the biosynthetic route to steroid drugs, often considered as a milestone in the development of the new biotechnology. Whether or not this missed opportunity proved costly to the company is uncertain. However, it illustrates the role of technological path-dependence, and the importance of the integration between different scientific disciplines, in this case chemistry and biology, in pharmaceutical innovation. (shrink)

This scarce antiquarian book is a facsimile reprint of the original. Due to its age, it may contain imperfections such as marks, notations, marginalia and flawed pages. Because we believe this work is culturally important, we have made it available as part of our commitment for protecting, preserving, and promoting the world's literature in affordable, high quality, modern editions that are true to the original work.

Social purpose initiatives rarely take place in one sector or policy domain. They are likely to cross sector, community, local, national and indigenous boundaries and, in so doing, require alternative governance arrangements that are responsive and sustainable. This article focuses on the process of forging cross boundary governance processes drawing on a case study characterised by complex cross sector demands. The subject of the case study is a paradigm-breaking primary health and well-being initiative for a region of New Zealand with (...) longstanding healthcare challenges but contemporary possibilities. We were invited by the owners of this initiative to record and reflect on the challenges and successes, and from this to identify what might be possible for future innovations. In doing so we draw on the adaptive governance literature to frame the governance challenges and offer five paradoxes requiring collective navigation. We recognise the importance of our need to engage with Indigenous scholarship in future analyses and conclude with a series of recommendations on how such paradoxes are navigated for those needing to build governance practice in innovative social purpose initiatives. (shrink)

This article analyses a footnote to the third version of the ‘Work of Art’ essay in which Walter Benjamin presents an account of ‘a certain oscillation’ between ‘cult value’ and ‘exhibition value’ as typical of the reception of all works of art. Benjamin's example in that footnote is the Sistine Madonna, a painting by Raphael in the Dresden Gemäldegalerie that has played an important part in German aesthetics since Winckelmann. Benjamin's footnote on the Sistine Madonna, along with his critique of (...) Hegel's aesthetics in that context, demand to be understood in relation to his remarks on Dada elsewhere in the artwork essay, and to his claim that technological reproducibility leads to the ‘actualization’ of the original reproduced. In that connection, the article concludes with an analysis of Kurt Schwitters's 1921 montage picture Knave Child Madonna with Horse. (shrink)

This study used historical research methodology to assess the work of US nurses caring for patients with cancer from 1920 to 1950. Primary sources, obtained from several US archives, included nursing procedure books, student nurses’ lecture notes, hospital and nursing annual reports, and meeting minutes. Secondary sources included journal articles and textbooks. The aim was to document the clinical work of nurses caring for patients with cancer and assess this work for evidence of emerging specialization in cancer nursing. Following a (...) review of cancer in the 1920s, nursing education specific to cancer, nursing care related to specific cancer therapies, and the practice of concealing a diagnosis of cancer, were examined. Nurses were consistently educated in cancer nursing, but their cancer education became more focused over the decades. Nurses were closely involved with cancer patients as they monitored their patients’ radium or assisted patients following radical surgery. The issue of concealing the diagnosis of cancer was problematic to some nurses. This paper reveals the nature of nurses’ hospital work with cancer patients and demonstrates a core body of cancer nursing knowledge. The emergence of cancer nursing as a specialty is presented. (shrink)

The rapid advancement of new digital technologies, such as smart technology, artificial intelligence (AI) and automation, robotics, cloud computing, and the Internet of Things (IoT), is fundamentally changing the nature of work and increasing concerns about the future of jobs and organizations. To keep pace with rapid disruption, companies need to update and transform business models to remain competitive. Meanwhile, the growth of advanced technologies is changing the types of skills and competencies needed in the workplace and demanded a shift (...) in mindset among individuals, teams and organizations. The recent COVID-19 pandemic has accelerated digitalization trends, while heightening the importance of employee resilience and well-being in adapting to widespread job and technological disruption. Although digital transformation is a new and urgent imperative, there is a long trajectory of rigorous research that can readily be applied to grasp these emerging trends. Recent studies and reviews of digital transformation have primarily focused on the business and strategic levels, with only modest integration of employee-related factors. Our review article seeks to fill these critical gaps by identifying and consolidating key factors important for an organization’s overarching digital transformation. We reviewed studies across multiple disciplines and integrated the findings into a multi-level framework. At the individual level, we propose five overarching factors related to effective digital transformation among employees: technology adoption; perceptions and attitudes toward technological change; skills and training; workplace resilience and adaptability, and work-related wellbeing. At the group-level, we identified three factors necessary for digital transformation: team communication and collaboration; workplace relationships and team identification, and team adaptability and resilience. Finally, at the organizational-level, we proposed three factors for digital transformation: leadership; human resources, and organizational culture/climate. Our review of the literature confirms that multi-level factors are important when planning for and embarking on digital transformation, thereby providing a framework for future research and practice. (shrink)

Mental health clinicians treating youth in foster care face several ethical challenges, such as competence for treating youth in foster care, understanding who can provide informed consent, and confidentiality. However, few articles have addressed these ethical concerns or provided recommendations for clinicians on how to navigate these issues. This article presents a brief summary of the foster care system, an overview of the major ethical challenges clinicians may encounter when treating youth in foster care, areas of the American Psychological Association’s (...) Ethics Code, Code of Ethics of the National Association of Social Workers, and American Counseling Association Code of Ethics most germane to the treatment of youth in foster care, and general recommendations for clinicians treating this population. (shrink)

"Charming, interesting, thought-provoking and a great read." Rosalind Hursthouse The daughter of a pacifist rector who answered "No!" when his congregation asked him "Is everything in the bible true?", perhaps Mary Midgley was destined to become a philosopher. Yet few would have thought this inquisitive, untidy, nature-loving child would become "one of the sharpest critical pens in the west." This is her remarkable story. Probably the only philosopher to have been in Vienna on the eve of its invasion by (...) Nazi Germany in 1938 and dance in Trafalgar Square on VE day seven year later, she studied philosophy at Oxford in the same year as Iris Murdoch, Elizabeth Anscombe and Philippa Foot, all of whom became close friends. Midgley tells us in vivid and humorous fashion how they cut a swathe through the arid landscape of 1950s British philosophy, writing and arguing - often with each other - about the grand themes of character, beauty and the meaning of rudeness while the spectral figure of Ludwig Wittgenstein hovered in the background. She also charts the highs and lows of philosophy and academia in Britain. On joining the Reading philosophy department on £400 a year in 1949, she doubled its staff complement. But her many years at Newcastle University - where Mike Brearley, who later captained England at cricket, also used to teach - were rewarded with the closure of the philosophy department in the 1980s. The mother of three children, her journey is also one of a woman who in the 1950s and 1960s was fighting to combine a professional career with raising a family. In startling contrast to many of the academic stars of her generation, we learn that Midgley nearly became a novelist and started writing philosophy only when in her fifties, suggesting that Minerva's owl really does fly at dusk. Plainly told like her philosophy, this is an elegiac and moving account of friendships found and lost, bitter philosophical battles and of a profound love of teaching all too rarely acknowledged today. (shrink)

Cywydd Ffarwelio Rhys MERERID HOPWOOD Mae awr i fwynhau miri, y mae awr mi wn am hwyl cwmni, ond nawr, yn ein dathliad ni, mae un na fynnaf mo'ni. ...

Aristotle believed that there were actually only three colours present in the rainbow, : of these, the first is produced by the dulling of white light when it is reflected in or obscured by a dark medium such as smoke, cloud, or water, and exemplified in the redness of the sun as seen through haze around the horizon. Successive failures of sight weaken the colour further, first to πράσινov and then to άλoυργóν. Between the first two colours a fourth, ξανθóν, (...) is often apparent, being the result of the juxtaposition of the two colours. This last statement, where it has not been ignored as one of the inexplicable or misguided things Aristotle says from time to time, has met with considerable criticism. (shrink)

Aristotle believed that there were actually only three colours present in the rainbow, : of these, the first is produced by the dulling of white light when it is reflected in or obscured by a dark medium such as smoke, cloud, or water, and exemplified in the redness of the sun as seen through haze around the horizon. Successive failures of sight weaken the colour further, first to πράσινov and then to άλoυργóν. Between the first two colours a fourth, ξανθóν, (...) is often apparent, being the result of the juxtaposition of the two colours. This last statement, where it has not been ignored as one of the inexplicable or misguided things Aristotle says from time to time, has met with considerable criticism. (shrink)

Emerging research has examined individual differences in affective forecasting; however, we are aware of no published study to date linking psychopathology symptoms to affective forecasting problem...

Sample quotes from emails sent by visitors to Mary Klages's successful literary theory web pages on which this book is based: 'Finding your course was a godsend ...

ABSTRACTHélène Landemore's Democratic Reason offers a new justification for democracy and for broad-based citizen participation, appealing to the “emergent” intelligence of large, diverse groups. She argues that ordinary citizens should rule as directly as possible because they will make better informed, more intelligent decisions than, for example, appointed officials, councils of experts, or even elected representatives. The foundation of this conclusion is the premise that “diversity trumps ability” in a wide range of contexts. But the main support for that claim (...) is merely a series of computer experiments that are strongly biased toward that result and tell us essentially nothing about decision making in real-world political settings. Moreover, Landemore's analyses of alternative forms of rule deal only in abstract comparisons between sharply distinguished ideal types. Among other difficulties, they entirely overlook the central consideration in such comparisons: the relative ability of any decision-making process to go beyond stereotyped, intrinsic strategies and integrate multiple sources and varieties of information. In the end, Landemore's claims for the superior intelligence of broadly participatory forms are thus not supported by credible evidence. (shrink)

Suffering can make sacred, so it may partly be nature, and not culture alone, that leads us to apprehend a sacred aspect in victims of oppression. Those who recognize this sacredness show piety—a special form of respect—toward members of oppressed groups. The result is a system of social constructions often dismissed as “identity politics.” This essay starts with an analysis of the intentionality of piety and sacredness and how they relate to suffering, sacrifice, sanctions, pollution, and purification. It then argues (...) that the sacralization of oppressed groups is an expression of the perennial human disposition to acknowledge sacredness and to respond piously. The essay then analyzes this sacred status as socially constructed. Based on the sacred-making power of suffering, the sacred status elicits piety, gives its bearers special authority, surrounds them with sanctions, and calls for symbolic sacrificial punishments of the impious. By dissecting sacrificial politics as a system of social constructions, we see that, although the oppressed groups are made sacred, certain people in the oppressor groups—“the Pious”—continue to exercise fundamental power. This essay, by displaying the inner logic of this cultural phenomenon, helps us both to sympathize with and to critique the system and then to pose questions about what good or bad the system might be doing. (shrink)

This paper begins with a sketch of a few themes in the philosophy of property insofar as they relate to the concept of cultural appropriation. It then offers a survey of Edmund Husserl’s account of culture. These reflections put us in a better position to ask whether property ownership provides a suitable interpretative framework for acts of intercultural copying and influence. On the contrary, Husserl’s account of culture leads us away from the claim that members of a cultural group should (...) be understood to have property in cultural formations arising within their group. By putting meaning, rather than ownership, at the center of our understanding of culture, the paper offers an alternative account of what might be wrong, when there is something wrong, with events typically labeled culturally appropriative. The paper concludes by connecting concerns for cultural appropriation with conceptions of cultural authenticity, distinguishing between an autochthonal sense of authenticity, focused on internal origins and protection from outside forces, and a Husserlian sense of authenticity, connected to reason, responsibility, and truth. (shrink)

In the Philippines, all transplant centers are mandated by the Department of Health (DOH) to have a Hospital Transplant Ethics Committee (HTEC) to ensure that donations are altruistic, voluntary and free of coercion/commercial transactions. This study was undertaken primarily to describe the organizational and functional profile of existing HTECs and identify areas for improvement. This is a descriptive cross‐sectional study. There was variation in their logistical arrangements (support from hospital, filing systems, office spaces), operations (length and frequency of meetings, number (...) of referrals) and membership (composition, qualifications, occupation, training). The approval rate for donor‐recipient pairs is high with the majority of cases made by living non‐related donors. Appropriate reasons were cited for rejection. The perception of HTECs is that they are competent and confident in their decision‐making. However, there is a need to standardize HTEC composition, provide operating procedures and additional training which can be done by the DOH. (shrink)

En quoi consiste, ou devrait consister, l'éthique professionnelle en enseignement? Comment se manifeste-t- elle dans les gestes pédagogiques? Selon quels critères peut-on la juger? Comment développer l'éthique professionnelle dans le cadre des formations initiale et continue en enseignement? En tenant compte du contexte social et culturel du Québec, des principes éthiques déjà énoncés par le ministère de l'Education ainsi que des lois, codes et conventions ayant des incidences sur la pratique enseignante, les auteures présentent des éléments à considérer pour la (...) réflexion éthique sur l'agir professionnel. Elles proposent des clarifications conceptuelles et un certain nombre de repères et de balises afin de guider les enseignants et de stimuler la discussion sur l'éthique professionnelle, non seulement dans la classe, mais aussi dans l'école et dans la société. (shrink)

As an incapacitated patient is unable to make decisions regarding their care, physicians turn to next-of-kin when appointing a surrogate decision-maker in the absence of an advanced directive. With the increasing complexity of modern families, physicians are facing new ethical dilemmas when choosing the individual to make end-of-life decisions for their patients. Legal definitions and hierarchies are no longer adhering to the purpose of a surrogate-decision maker, which is to maintain a patient’s autonomy. Moral criteria for surrogates, which emphasize the (...) importance of making decisions that align with the patient’s desires and wishes and negate biological relationships over emotional connections, are becoming much more important. This paper explores a case study in which physicians must appoint a surrogate decision-maker for an incapacitated patient, forced to choose between a biological relationship and a strong emotional connection. (shrink)

In his justly celebrated Expert Political Judgment, Philip E. Tetlock evaluates the judgment of economic and political experts by rigorously testing their ability to make accurate predictions. He finds that ability profoundly limited, implying that expert judgment is virtually useless, if not worse. He concludes by proposing a project that would seek to improve experts' performance by holding them publicly accountable for their claims. But Tetlock's methods severely underestimate the value of expert opinion. Despite their notorious disagreements, experts have highly (...) pertinent information and advice in many areas of public policy. The main problem with experts is that political actors seize on their most extreme views in one direction or the other, and overlook their areas of general agreement and the core of relatively reliable information that they provide. (shrink)

In his justly celebrated Expert Political Judgment, Philip E. Tetlock evaluates the judgment of economic and political experts by rigorously testing their ability to make accurate predictions. He finds that ability profoundly limited, implying that expert judgment is virtually useless, if not worse. He concludes by proposing a project that would seek to improve experts' performance by holding them publicly accountable for their claims. But Tetlock's methods severely underestimate the value of expert opinion. Despite their notorious disagreements, experts have highly (...) pertinent information and advice in many areas of public policy. The main problem with experts is that political actors seize on their most extreme views in one direction or the other, and overlook their areas of general agreement and the core of relatively reliable information that they provide. (shrink)

In June 2002, Arthur Andersen LLP became the first accounting firm in history to be criminally convicted. The repercussions were immense. From a position as one of the leading professional services firms in the world, with 85,000 staff in 84 countries and revenues in excess of $9 billion, Andersen effectively ceased to exist within a matter of months. Although Andersen’s conviction related specifically to a charge of obstructing justice, public attention focused on the audit relationship between Andersen and its major (...) client, Enron Corporation, particularly the actions (and inactions) that had allowed Enron to post spectacular year-on-year earnings and profit growth. As well as examining events leading up to the demise of Andersen, the case provides an opportunity to consider the broader controversy over accounting and corporate governance practices and, more generally, the pressures found within organisations that can foster unethical conduct. The case was prepared from public sources. (shrink)

Bryan Caplan’s The Myth of the Rational Voter turns, in two contrasting ways, on the role of experts. On the one hand, Caplan uses the opinions of economists as a benchmark for identifying error in public opinion, finding such error systematic and pervasive. On the other hand, in considering remedies, he largely discounts the ability of policymakers to use expert advice and their own expertise to resist misguided public pressure. Although Caplan’s use of expert opinion as a benchmark, in principle, (...) is acceptable, he overstates what we can conclude from that exercise with his data. There are, however, alternative grounds for a more tentative, yet broadly similar, assessment of the prevalence of error in mass opinion. (shrink)