scholarly journals Explaining rule of rescue obligations in healthcare allocation: allowing the patient to tell the right kind of story about their life

2021 ◽  
Author(s):  
Sean Sinclair
Keyword(s):  
Life Stories ◽  
Life Story ◽  
Treatment Decision ◽  
Early Death ◽  
Great Cost ◽  
Imminent Death ◽  
The Uk ◽  
The Right ◽  
Fair Innings ◽  
Short Life Expectancy

AbstractI consider various principles which might explain our intuitive obligation to rescue people from imminent death at great cost, even when the same resources could produce more benefit elsewhere. Our obligation to rescue is commonly explained in terms of the identifiability of the rescuee, but I reject this account. Instead, I offer two considerations which may come into play. Firstly, I explain the seeming importance of identifiability in terms of an intuitive obligation to prioritise life-extending interventions for people who face a high risk of an early death, and I explain this in turn with a fair innings-style principle which prioritises life-extending interventions for people expected to die young. However, this account is incomplete. It does not explain why we would devote the same resources to rescuing miners stuck down a mine even if they are elderly. We are averse to letting people die suddenly, or separated from friends and family. And so, secondly, I give a new account that explains this in terms of narrative considerations. We value life stories that follow certain patterns, classic patterns which are reflected in many popular myths and stories. We are particularly averse to depriving people of the opportunity to follow some such pattern as they approach death. This means allowing them to sort out their affairs, say goodbyes to family and friends, review their life, or come to terms with death itself. Such activities carry a lot of meaning as ways of closing our life story in the right way. So, for someone who has not been given much notice of their death, an extra month is worth much more than for other patients. Finally, I review the UK National Health Service's end of life premium, which gives priority to patients with short life expectancy. I suggest it falls short in terms of such considerations. For example, the NHS defines its timings in terms of how long the patient can expect to live as at the time of the treatment decision, whereas the timings should be specified in terms of time from diagnosis.

The changing landscape of OSH regulation in the UK: Achieving the right balance in policy and practice

2013 ◽  
Author(s):  
David Hollis ◽  
Stavroula Leka ◽  
Aditya Jain ◽  
Nicholas Andreou
Keyword(s):  
Policy And Practice ◽  
The Uk ◽  
The Right

Vocational Development in Emerging Adulthood

2018 ◽  
Author(s):  
Michael W. Pratt ◽  
M. Kyle Matsuba
Keyword(s):  
Turning Point ◽  
Life Stories ◽  
Life Story ◽  
Emerging Adult ◽  
Vocational Development ◽  
Data Set ◽  
The World ◽  
Key Concepts

Chapter 6 reviews research on the topic of vocational/occupational development in relation to the McAdams and Pals tripartite personality framework of traits, goals, and life stories. Distinctions between types of motivations for the work role (as a job, career, or calling) are particularly highlighted. The authors then turn to research from the Futures Study on work motivations and their links to personality traits, identity, generativity, and the life story, drawing on analyses and quotes from the data set. To illustrate the key concepts from this vocation chapter, the authors end with a case study on Charles Darwin’s pivotal turning point, his round-the-world voyage as naturalist for the HMS Beagle. Darwin was an emerging adult in his 20s at the time, and we highlight the role of this journey as a turning point in his adult vocational development.

scholarly journals Patients with Metastatic Lung Cancer and Oncologists’ Views on Achievement of Treatment Goals and Making the Right Treatment Decision: A Prospective Multicenter Study

2021 ◽  
pp. 0272989X2199895
Author(s):  
Adinda Mieras ◽  
Annemarie Becker-Commissaris ◽  
Hanna T. Klop ◽  
H. Roeline W. Pasman ◽  
Denise de Jong ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Multicenter Study ◽  
Systemic Treatment ◽  
Treatment Decision ◽  
Treatment Goals ◽  
Metastatic Lung Cancer ◽  
Prospective Multicenter Study ◽  
Cancer Data ◽  
Metastatic Lung ◽  
The Right

Background Previous studies have investigated patients’ treatment goals before starting a treatment for metastatic lung cancer. Data on the evaluation of treatment goals are lacking. Aim To determine if patients with metastatic lung cancer and their oncologists perceive the treatment goals they defined at the start of systemic treatment as achieved after treatment and if in hindsight they believe it was the right decision to start systemic therapy. Design and Participants A prospective multicenter study in 6 hospitals across the Netherlands between 2016 and 2018. Following systemic treatment, 146 patients with metastatic lung cancer and 23 oncologists completed a questionnaire on the achievement of their treatment goals and whether they made the right treatment decision. Additional interviews with 15 patients and 5 oncologists were conducted. Results According to patients and oncologists, treatment goals were achieved in 30% and 37% for ‘quality of life,’ 49% and 41% for ‘life prolongation,’ 26% and 44% for ‘decrease in tumor size,’ and 44% for ‘cure’, respectively. Most patients and oncologists, in hindsight, felt they had made the right decision to start treatment and also if they had not achieved their goals (72% and 93%). This was related to the feeling that they had to do ‘something.’ Conclusions Before deciding on treatment, the treatment options, including their benefits and side effects, and the goals patients have should be discussed. It is key that these discussions include not only systemic treatment but also palliative care as effective options for doing ‘something.’

scholarly journals What do users think of the UK’s three COVID-19 contact-tracing apps? A comparative analysis

2021 ◽  
Vol 28 (1) ◽  
pp. e100320
Author(s):  
Vahid Garousi ◽  
David Cutting
Keyword(s):  
Mobile Apps ◽  
Analysis Data ◽  
End Users ◽  
Contact Tracing ◽  
User Reviews ◽  
The Public ◽  
Engineering Teams ◽  
Technical Issues ◽  
The Uk ◽  
The Right

ObjectivesOur goal was to gain insights into the user reviews of the three COVID-19 contact-tracing mobile apps, developed for the different regions of the UK: ‘NHS COVID-19’ for England and Wales, ‘StopCOVID NI’ for Northern Ireland and ‘Protect Scotland’ for Scotland. Our two research questions are (1) what are the users’ experience and satisfaction levels with the three apps? and (2) what are the main issues (problems) that users have reported about the apps?MethodsWe assess the popularity of the apps and end users’ perceptions based on user reviews in app stores. We conduct three types of analysis (data mining, sentiment analysis and topic modelling) to derive insights from the combined set of 25 583 user reviews of the aforementioned three apps (submitted by users until the end of 2020).ResultsResults show that end users have been generally dissatisfied with the apps under study, except the Scottish app. Some of the major issues that users have reported are high battery drainage and doubts on whether apps are really working.DiscussionTowards the end of 2020, the much-awaited COVID-19 vaccines started to be available, but still, analysing the users’ feedback and technical issues of these apps, in retrospective, is valuable to learn the right lessons to be ready for similar circumstances in future.ConclusionOur results show that more work is needed by the stakeholders behind the apps (eg, apps’ software engineering teams, public-health experts and decision makers) to improve the software quality and, as a result, the public adoption of these apps. For example, they should be designed to be as simple as possible to operate (need for usability).

Religious freedom and the ‘right to discriminate’ in the school admissions context: a neo-republican critique

Legal Studies ◽  
2011 ◽  
Vol 31 (4) ◽  
pp. 615-643 ◽  
Author(s):  
Eoin Daly ◽  
Tom Hickey
Keyword(s):  
Public Education ◽  
Religious Freedom ◽  
Religious Discrimination ◽  
Religious Schools ◽  
The Public ◽  
Definition Of ◽  
The Uk ◽  
The Right ◽  
Republican Theory ◽  
Faith Schools

In law and discourse, it has typically been assumed that the religious freedom of state-funded religious schools must trump any competing right to non-discrimination on grounds of belief. For example, the Irish Constitution has been interpreted as requiring the broad exemption of denominational schools from the statutory prohibition on religious discrimination in school admissions. This stance is mirrored in the UK Equality Act 2010. Thus, religious discrimination in the public education context has been rationalised with reference to a ‘liberty-equality dichotomy’, which prioritises the integrity of faith schools' ‘ethos’, as an imperative of religious freedom. We argue that this familiar conceptual dichotomy generates a novel set of absurdities in this peculiar context. We suggest that the construction of religious freedom and non-discrimination as separate and antagonistic values rests on a conceptually flawed definition of religious freedom itself, which overlooks the necessary dependence of religious freedom on non-discrimination. Furthermore, it overstates the necessity, to religious freedom, of religious schools' ‘right to discriminate’. We argue for an alternative ordering of the values of religious freedom and non-discrimination – which we locate within the neo-republican theory of freedom as non-domination.

scholarly journals Enabling Technologies for Improved Data Management: Hardware

2001 ◽  
Vol 9 (1) ◽  
pp. 11-25
Author(s):  
Kerstin van Dam-Kleese ◽  
Michael Hopewell
Keyword(s):  
Data Management ◽  
Scientific Community ◽  
Wide Spectrum ◽  
Work Force ◽  
Working Environment ◽  
Computational Techniques ◽  
Enabling Technologies ◽  
New Challenges ◽  
The Uk ◽  
The Right

The most valuable assets in every scientific community are the expert work force and the research results/data produced. The last decade has seen new experimental and computational techniques developing at an ever-faster pace, encouraging the production of ever-larger quantities of data in ever-shorter time spans. Concurrently the traditional scientific working environment has changed beyond recognition. Today scientists can use a wide spectrum of experimental, computational and analytical facilities, often widely distributed over the UK and Europe. In this environment new challenges are posed for the Management of Data every day, but are we ready to tackle them? Do we know exactly what the challenges are? Is the right technology available and is it applied where necessary? This part of enabling technologies investigates current hardware techniques and their functionalities and provides a comparison between various products.

scholarly journals Elders’ Life Stories: Impact on the Next Generation of Health Professionals

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Tracy Chippendale
Keyword(s):  
Health Professionals ◽  
Life Stories ◽  
Life Story ◽  
Descriptive Analysis ◽  
Life Review ◽  
Mixed Methods Design ◽  
Intergenerational Exchange ◽  
Negative Images ◽  
Images Of Aging ◽  
Quantitative Results

The purpose of this study was to pilot an enhanced version of the “Share your Life Story” life review writing workshop. The enhanced version included the addition of an intergenerational exchange, based on the content of seniors’ writings, with students planning careers in the health sciences. The researcher employed a mixed methods design. Preliminary results using descriptive analysis revealed an increase in positive images of aging and a decrease in negative images of aging among the five student participants. Qualitative results revealed six themes that illuminate the hows and whys of the quantitative results as well as additional program benefits. Feedback from students and seniors helped to refine the intergenerational protocol for a larger scale study.

Mieleltään haavoittuneet

Kuntoutus ◽  
2021 ◽  
Vol 44 (3) ◽  
pp. 36-48
Author(s):  
Johanna Vilppola ◽  
Markku Vanttaja
Keyword(s):  
Mental Health ◽  
Life Stories ◽  
Life Story ◽  
Rehabilitation Process ◽  
Societal Factors ◽  
Health Related ◽  
Health Rehabilitation ◽  
Mental Health Rehabilitation ◽  
Intentions To Participate ◽  
Education Work

Mielenterveyssyistä johtuvat sairauspoissaolot ja työkyvyttömyyseläkkeet ovat lisääntyneet Suomessa viime vuosikymmeninä. Sen vuoksi on tarpeen tutkia mielenterveyskuntoutujien yksilöllisiä elämäntilanteita sekä heidän kuntoutumistaan ja kiinnittymistään yhteiskuntaan. Tässä artikkelissa tarkastellaan mielenterveyskuntoutujien kuntoutusprosessia erityisesti koulutus- ja työtoimijuuden näkökulmasta. Tutkimusaineistona käytetään aikuisten mielenterveyskuntoutujien kirjoittamia elämänkerrontoja (n = 42). Elämänkerrontojen teema-analyysin ja tyypittelyn perusteella kirjoittajat jaettiin kolmeen erilaiseen ryhmään, jotka nimettiin toimijoiksi (9), taistelijoiksi (18) ja tipahtaneiksi (15). Toimijat olivat aktiivisia oman kuntoutumisensa, koulutuksensa, työnsä sekä kokonaiselämänsä suhteen. Heillä oli vahva pyrkimys hakeutua koulutukseen, palata takaisin työelämään tai ylläpitää nykyinen koulutus- ja työtilanteensa. Taistelijat olivat puolestaan omassa kuntoutusprosessissaan matkalaisia, jotka halusivat olla yhteiskunnan tarpeellisia jäseniä. Myös heillä oli koulutukseen ja työhön liittyviä haaveita, mutta keinot oman elämän hallitsemiseksi olivat toisten ihmisten tuen varassa. Tipahtaneet olivat luovuttaneet sekä oman kuntoutumisensa että koulutus- ja työtoimijuutensa suhteen. Heillä ei ollut enää koulutukseen tai työhön liittyviä tavoitteita. Abstract Mentally wounded. Research of Education and Work Agency of Mental Health Rehabilitees Mental health related sick leaves and early pensions have increased enormously in our society in the last decades. That is why it is important to study the life narratives of mental health rehabilitees, especially focusing on individual and societal factors connected to rehabilitation, education and work agency. The data of this research consisted of 42 self-written life stories of adult mental health rehabilitees. Based on theme analysis and typification, life stories were divided into three groups: agentic actors (9), warriors (18) and dropouts (15). Agentic actors were described as active agents of their own rehabilitation, education, work and life. They had strong intentions to participate in education and work. Warriors seemed to be more like passengers in their own rehabilitation process, yet they had intentions to be a necessary part of society. They had hopes and dreams towards education and work, but they seemed to be lacking concrete means to lead their independent lives.  The dropouts had given up on their agency in rehabilitation, education and work. They had no more goals or intentions concerning education and work. Keywords: mental health rehabilitation, life story, education, work, agency

scholarly journals Differential Effect of the Deletion of African Swine Fever Virus Virulence-Associated Genes in the Induction of Attenuation of the Highly Virulent Georgia Strain

Viruses ◽  
2019 ◽  
Vol 11 (7) ◽  
pp. 599 ◽  
Author(s):  
Elizabeth Ramirez-Medina ◽  
Elizabeth Vuono ◽  
Vivian O’Donnell ◽  
Lauren G. Holinka ◽  
Ediane Silva ◽  
...  
Keyword(s):  
Protective Immunity ◽  
Gene Deletion ◽  
African Swine Fever Virus ◽  
African Swine Fever ◽  
Early Death ◽  
Fever Virus ◽  
Differential Behavior ◽  
Viral Genes ◽  
The Uk ◽  
Highly Virulent

African swine fever virus (ASFV) is the etiological agent of an often lethal disease of domestic pigs, African swine fever (ASF). The ASFV Georgia 2007 isolate (ASFV-G) is responsible for the current epidemic situation in Europe and Asia. Genetically modified ASFVs containing deletions of virulence-associated genes have produced attenuated phenotypes and induced protective immunity in swine. Here we describe the differential behavior of two viral genes, NL (DP71L) and UK (DP96R), both originally described as being involved in virus virulence. Deletion of either of these genes efficiently attenuated ASFV strain E70. We demonstrated that deletion of the UK gene from the ASFV-G genome did not decrease virulence when compared to the parental virus. Conversely, deletion of the NL gene produced a heterogeneous response, with early death in one of the animals and transient fever in the other animals. With this knowledge, we attempted to increase the safety profile of the previously reported experimental vaccine ASFV-GΔ9GL/ΔUK by deleting the NL gene. A triple gene-deletion virus was produced, ASFV-GΔ9GL/ΔNL/ΔUK. Although ASFV-GΔ9GL/ΔNL/ΔUK replicated in primary cell cultures of swine macrophages, it demonstrated a severe replication deficiency in pigs, failing to induce protection against challenge with parental ASFV-G.

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