The Problem of Futility: III. The Importance of Physician-Patient Communication and a Suggested Guide through the Minefield

1994 ◽  
Vol 3 (2) ◽  
pp. 257-269
Author(s):  
Dorothy Rasinski Gregory ◽  
Miriam Piven Cotler
Keyword(s):  
Point Of View ◽  
Personal Goals ◽  
Therapeutic Goals ◽  
Critical Elements ◽  
Ideal Situation ◽  
Ongoing Relationship ◽  
System Life ◽  
Definition Of ◽  
Physician Patient

As noted In Part II of this series (CQ 1994;3:133–142), perhaps the most critical elements to define in deciding when treatment Is futile are the goals of therapy from, both the physician's and the patient's point of view. A patient's personal goals are based upon value system., life goals, and personal definition of “quality of life.” These personal goals must then be interpreted and applied in a reasonable and realistic fashion against what the physician has previously described as the legitimate, objective, and attainable therapeutic goals. As far as possible, both, parties must work together to eliminate the uncertainties in their discussion. The ideal situation includes a competent, alert patient and a prudent, caring physician who have had a long-term ongoing relationship. The key to collaboration is communication: a sincere interest in and professional concern for the patient; a willingness to be honest and open; a commitment to talk and to listen; an attempt to make one another feel comfortable in the collaboration; and an effort to recognize and to overcome barriers to communication, whether barriers are personal to either the patient or the physician or are professional, institutional, or societal.

scholarly journals Building a model of strategic financial planning for an organization

2019 ◽  
pp. 174-181
Author(s):  
Olga Rudkovskaya ◽  
Vladimir Gerasenko
Keyword(s):  
Financial Planning ◽  
Life Cycle Stage ◽  
Process Approach ◽  
Point Of View ◽  
Financial Resources ◽  
Financial Strategy ◽  
Key Indicator ◽  
Definition Of ◽  
Goals And Objectives

The article considers approaches to the definition of strategic financial planning, reveals their shortcomings and advantages. Objective: To create a methodological basis for the development of the organization's financial strategy. Methodology: The article is based on the results of research of modern domestic and foreign theories of strategic planning. Application of the results: Increase the validity of the management decisions made based on the results of strategic financial planning. Conclusions: Strategic financial planning is proposed to be considered from the point of view of the system and process approach, which will allow to create an effective functional apparatus, including a system of goals and objectives, principles and tools for the formation and use of financial resources to carry out the activities on developing the directions of organization growth. The formed algorithm of developing a strategic financial planning model allows to take into account the organization’s life cycle stage and its market position in the industry when determining the target parameters of financial development in the long term perspective. An indicator of maximizing the return to capital represented by own and borrowed funds is proposed as a key indicator of the model under consideration. Complying with the set of limitations developed, this indicator provides a more reliable and comprehensive assessment of organization’s development planned directions.

scholarly journals Sustaining Engineering Informatics: Toward Methods and Metrics for Digital Curation

2008 ◽  
Vol 3 (2) ◽  
pp. 59-73 ◽  
Author(s):  
Josh Lubell ◽  
Sudarsan Rachuri ◽  
Mahesh Mani ◽  
Eswaran Subrahmanian
Keyword(s):  
Functional Model ◽  
Point Of View ◽  
Digital Curation ◽  
Open Archival Information System ◽  
User Access ◽  
Digital Objects ◽  
Definition Of ◽  
Design And Manufacture

Ensuring the long-term usability of engineering informatics (EI) artifacts is a challenge, particularly for products with longer lifecycles than the computing hardware and software used for their design and manufacture. Addressing this challenge requires characterizing the nature of EI, defining metrics for EI sustainability, and developing methods for long-term EI curation. In this paper we highlight various issues related to long-term archival of EI and describe the work towards methods and metrics for sustaining EI. We propose an approach to enhance the Open Archival Information System (OAIS) functional model to incorporate EI sustainability criteria, Digital Object Prototypes (DOPs), and end user access requirements. We discuss the end user’s requirements from the point of view of reference, reuse and rationale – the “3Rs” – to better understand the level of granularity and abstractions required in the definition of engineering digital objects. Finally we present a proposed case study and experiment.

scholarly journals Yoga Research and Public Health

2016 ◽  
Vol 8 (1) ◽  
pp. 31-36 ◽  
Author(s):  
Avinash R. Patwardhan
Keyword(s):  
Public Health ◽  
Health Utility ◽  
Medical Application ◽  
Point Of View ◽  
Proof Of Concept ◽  
Social Body ◽  
Key Stakeholders ◽  
Definition Of ◽  
High Level

Research on yoga is witnessing an unprecedented proliferation currently, partly because of great interest in yoga’s health utility. However, yoga research does not seem to be sufficiently public health oriented, or its quality corresponding to its quantity. Yoga research is falling short to enable key stakeholders like end users, prescribers, and payers to meaningfully, confidently, and fruitfully answer the questions like: Is it generalizable? Is it standardizable? Which yoga style should be used/recommended/paid for? Or will it be worth the money? Therefore, it is important to examine the alignment to purpose or value of yoga research from a public health point of view so as to make it more practical. The issues such as lack of clear definition of yoga, wide variation in its dosage, cacophony of lineage-based styles, no data about comparative effectiveness between the yoga components, confounders and biases clouding the evidence regarding its benefits, too little data on long-term adherence, equivocal results about its cost effectiveness, discussions lacking embrace of better methods in research, and absence of a theory of yoga are examined. This is not a detailed discussion of every issue yoga research faces, but a high-level overview of those that have direct practical bearing. In the end, a few pragmatic approaches are offered. The article suggests that yoga-component analysis, development of a theory of yoga, adoption of a health-aligned functional typology of yoga, development and testing of a simple universal basic prototype of yoga intervention, emphasis on research about long-term adherence, and discouragement for mere proof of concept research might make yoga research serve the stakeholders better. It urges the research community to practice “context cognizant scholarship” to disentangle health compatible yoga from its historical-cultural-social body before examining it for health or medical application.

scholarly journals Innovation and sustainability: the Italian scenario

2021 ◽  
pp. 71-76
Author(s):  
Rosanna Cataldo ◽  
Maria Gabriella Grassia ◽  
Paolo Mazzocchi ◽  
Claudio Quintano ◽  
Antonella Rocca
Keyword(s):  
Research Question ◽  
Point Of View ◽  
Policy Makers ◽  
Sustainable Innovation ◽  
Relevant Topic ◽  
Short And Long Term ◽  
Definition Of ◽  
Process Solutions ◽  
The Impact

Society and policy makers demand innovation systems oriented towards several goals of sustainable development. Therefore, recent literature has dedicated a growing interest to both innovation and sustainability in the pursuit of environmental, economic and social development; in addition, the emerging topic of ‘sustainable innovation’ (and ‘eco-innovation’) seems to combine the main features of them. The definition of these concepts has been significantly changed during the last decades, and a broad discussion continues today about which indicators should be used to measure innovation, sustainability and their combination. The current paper investigates this relationship, and - in the authors’ opinion - the research question connected to the impact of the innovative product (and service and process) solutions on sustainability can be addressed by means of a stable theoretical framework. To study the interaction between innovation and sustainability, the usage of specific territorial features might represent a useful perspective to manage short-and long-term environmental and economic issues. As for the theoretical model, the present article considers a specific technique suitable for investigating the entire set of characteristics involved in the model. From a public makers and managerial point of view, the possibility of improving the firm’ efficiencies in terms of several dimensions of sustainable innovation represents a relevant topic that must be encouraged.

scholarly journals Coconut Carbon Sequestration Part 2 / Strategies for the Carbon Market & Simulating Potential Incomes for Coconut CDM Projects

CORD ◽  
2008 ◽  
Vol 24 (1) ◽  
pp. 20
Author(s):  
O. Roupsard
Keyword(s):  
Scientific Information ◽  
Coconut Oil ◽  
Value Added ◽  
Carbon Market ◽  
Point Of View ◽  
Short Term ◽  
C Cycle ◽  
R Project ◽  
Definition Of

The following article is a review of possible strategies of the coconut sector facing the carbon market, through the Clean Development Mechanism (CDM) of the Protocol of Kyoto, but also through Non-Kyoto (voluntary) initiatives. It sums up the conditions for certifying plantations, together with recent statistics of similar projects accepted by UNFCCC, which are currently displaying a rapid growth rate. It stresses the complexity of the CDM, but also the accessibility for coconut energy & afforestation + reforestation (A/R) projects, considering that coconut plantations do actually correspond to the definition of “forest”. Using recent scientific information on C cycle of coconut plantations and coconut oil, it proposes also a simulation of the expected potential profitability of coconut energetic and A/R projects. From the point of view of the farmer and of the oil mill, in absence of any CDM project (the reference here), the value-added comes mainly from local processing of the copra into coconut oil. When implementing a short-term A/R project (t-CER), the value-added by C fixation in the ecosystem would be ca. +15 to +19%, as compared to the copra and oil references. When implementing a long-term project (l-CER), the value-added would reach +40 to +52%. When implementing an energy-oil project solely, the value-added by C fixation in the coconut oil would be only +5% (this not including other benefits at national scale, however). When implementing a dual A/R + energy-oil project, the value-added by C fixation would be +19% for t-CER, and +45% for l-CER with respect to the copra and oil references. These results are just potential values given for example, suspected to vary much according to the actual conditions of coconut plantation productivity, management and also C market conditions. However, the simulation clearly supports every APCC initiative in this direction.

scholarly journals Innovation and Industry 4.0 as a part of small state diplomacy

2020 ◽  
Vol 74 ◽  
pp. 02013
Author(s):  
Jana Peterkova
Keyword(s):  
Industry 4.0 ◽  
National Level ◽  
Point Of View ◽  
Small States ◽  
Economic Diplomacy ◽  
Critical Elements ◽  
Strategic Plans ◽  
Innovation Diplomacy ◽  
Definition Of

Innovation and Industry 4.0 are topical issues in the era of globalization in many countries around the world. The article focuses on the international practice of small states and the role of innovation as a topic of their foreign policy and diplomacy. The article aims to evaluate the position of the innovation theme in the portfolio of typical issues of diplomatic practice. The aim is to find out to what extent the attention is paid to innovation concerning the country’s economic diplomacy and what the prospects for further development are. In the first part, the text will focus on the theoretical definition of the theme of innovation and its anchoring in the diplomacy of small states. The second part introduces the situation from the practice of small states in a broader perspective and brings examples of successful integration of the innovation theme into the strategic plans of small states. The third part maps the contemporary trends and the presence of innovation diplomacy in Czech practice. Attention will be paid mainly to the national level, both from a strategic and instrumental point of view. Using a comparison of successful examples from abroad with the current situation in Czechia, it is possible to identify critical elements that can contribute to a better understanding of the topic by contemporary Czech practice.

On the Conception of the Modern Political Labels Dictionary

2021 ◽  
pp. 105-118
Author(s):  
Alexander P. Skovorodnikov ◽  
◽  
Galina A. Kopnina ◽  
Keyword(s):  
Verbal Label ◽  
Word Formation ◽  
Russian Language ◽  
Point Of View ◽  
Public Speech ◽  
Political Events ◽  
Political Linguistics ◽  
Definition Of ◽  
Different Sources

The article aims to describe the conception of the Modern Political Labels Dictionary being developed at the Siberian Federal University. The creation of such a dictionary is relevant owing to the development of political lexicography which allows revealing the state and features of modern political language development. It is also noted that political labels remain largely unstudied despite their wide and quite long-term use in media. The authors of both the dictionary and the article believe that it can be useful not only for specialists focused on conducting linguistic examinations of conflictogenic texts, but also for those who are interested in politics. The Modern Political Labels Dictionary makers see the main purpose of its creation in characterizing modern political discourse verbal labels used as a tool of information-psychological confrontation as completely as possible. The concept of the dictionary is based on the following definition of the term “political verbal label”: it is a nominative ideologeme (word and phrase) tending to stereotypization. It is a linear negative myth used to discredit socially and politically significant objects. A political verbal label is characterized by exaggerated pejorative connotations and weakened denotative components. The dictionary being developed is explanatory and illustrative. It also includes derivations and (optional) philological commentaries. The selection of speech samples for the dictionary was mainly based on a linguo-ideological analysis following the methodology proposed by N.A. Kupina that assumes the identification of key ideologeme labels in a text and analysis of their com-patibility to reveal semantic, axiological, and aesthetic additives that reflect an author’s point of view on certain political events. The article also characterizes the dictionary structure including a theoretical introduction, dictionary entries, a glossary, and a list of abbreviations; examples of dictionary entries are provided. The words and phrases se-lected for the glossary passed verification procedure acting as Yandex, Google and Russian Language National Corpus search query to confirm their non-unity (usability): the existence of at least 3 to 5 contexts from different sources in which the selected unit is used with the same meaning was considered sufficient. It is noted in the description of a dictionary entry that it contains both mandatory (head unit; interpretation of its semantics in compliance with the principle of unification of interpretation models; speech samples from texts of various styles and genres created in post-Soviet and modern periods) and optional (commentaries on the functioning specifics of a political label: its origin, use periods, productivity and role in text; variations; synonyms and derivatives) components. It is concluded that the work on the dictionary made it possible to clarify the definition of the political labels phenomenon; identify the most common political labels, and expand the notion of their paradigmatic (synonymous, opposing) connec-tions, word-formation capabilities, functioning specifics in modern public speech; and present the meta-reactions of society to their use. The above-mentioned makes it possible to fill the current gap in the theory of political linguistics.

scholarly journals Formation And Development Of Constitutional And Legal Responsibility In Ukraine During The Cossack Republic And The Hetman State

2021 ◽  
pp. 158-166
Author(s):  
V.V. Knysh
Keyword(s):  
State Building ◽  
Point Of View ◽  
Legal Responsibility ◽  
The Political ◽  
Scientific Article ◽  
Special Role ◽  
Definition Of ◽  
Law Making ◽  
Broad Understanding

This scientific article is devoted to the problems of formation and development of the institute of constitutional and legal responsibility in the period of the Cossack republic and the Hetman state. A special role here belongs to the legal enshrinement of this institution in the provisions of the Constitution of Philip Orlyk. In general, in legal science there are various scientific directions in the definition of constitutional liability. Such scientific approaches can be combined into four groups, in particular: 1)    scientific direction, which is based on the substantiation of a narrow understanding of constitutional and legal responsibility, which is based on the recognition of only retrospective (negative) constitutional and legal responsibility; 2)    scientific direction, which substantiates a broad understanding of constitutional and legal responsibility, which involves a combination of retrospective (negative) and long-term (positive) responsibility; 3)    scientific direction, which distinguishes between retrospective (negative) and long-term (positive) responsibility; 4) scientific direction, which substantiates both the combination of retrospective (negative) and perspective (positive) responsibility, and the existence of only retrospective (negative) responsibility. At the same time, in the context of the latest trends in Ukrainian state-building and law-making, as well as taking into account the need for historical and legal (rather than purely theoretical, sectoral or institutional) study of the needs of transformation of legal responsibility in Ukraine and its individual types, constitutional and legal responsibility needs separate scientific research from a historical and legal point of view, including the formation and development during the Cossack republic and the Hetman state. According to the author, the acts of the Cossack republic and the Hetman state, and especially the Constitution of Pylyp Orlyk of 1710 not only determined the foundations of the political and socio-economic system of Ukraine, the apparatus of state power on the basis of division of power into legislative, executive and judicial, but also provided constitutional legal responsibility as a means of ensuring interaction between branches of government and a means of their effective functioning. This constitutional and legal responsibility existed both in the form of positive responsibility, which manifested itself in a clear definition of the powers of authorities and the establishment of ways and forms of interaction between them, and in the form of negative responsibility, which provided for sanctions against officials at all levels.

Diabetic Retinopathy and Metabolic Control

1993 ◽  
Vol 3 (4) ◽  
pp. 207-215 ◽  
Author(s):  
M. Porta
Keyword(s):  
Metabolic Control ◽  
Good Control ◽  
Polyol Pathway ◽  
Point Of View ◽  
Protein Glycosylation ◽  
Diabetic Microangiopathy ◽  
Clinical Point ◽  
History Of ◽  
Definition Of

Retinopathy is probably the first long-term complication of diabetes mellitus to become clinically evident, possibly because the retina is the only microvascular bed that can be observed directly and repeatedly. This makes it a good model for studying the pathogenesis and natural history of diabetic microangiopathy. Most of the proposals to account for its pathogenesis invoke mechanisms that depend directly on the circulating and tissue levels of glucose: protein glycosylation, activation of the “polyol pathway”, abnormalities of vascular endothelium, altered capillary blood flow. Several population studies and clinical trials suggest that the degree of metabolic control maintained over the years influences the rates of appearance and progression of retinopathy. However, on an individual basis, factors independent of control may intervene, making some patients more or less prone to this complication. Animal models also suggest that the progression of retinopathy may become irreversible from its very early stages. From a clinical point of view, it is difficult to establish a satisfactory definition of “good” control and approaching it may increase the risk of dangerous hypoglycemia and weight gain. Diabetes and eye specialists are thus left to strive for the best possible, sensible, metabolic control but must also rely on early diagnosis and treatment for the sight-threatening complications of diabetes.

Understanding functional illiteracy from a policy, adult education, and cognition point of view: Towards a joint referent framework

2019 ◽  
Vol 30 (2) ◽  
pp. 109-122
Author(s):  
Aleksandar Bulajić ◽  
Miomir Despotović ◽  
Thomas Lachmann
Keyword(s):  
Adult Education ◽  
Operational Definition ◽  
Literacy Skills ◽  
Point Of View ◽  
Industrialized Countries ◽  
Functional Illiteracy ◽  
Scale Levels ◽  
Components Of Reading ◽  
The One ◽  
Definition Of

Abstract. The article discusses the emergence of a functional literacy construct and the rediscovery of illiteracy in industrialized countries during the second half of the 20th century. It offers a short explanation of how the construct evolved over time. In addition, it explores how functional (il)literacy is conceived differently by research discourses of cognitive and neural studies, on the one hand, and by prescriptive and normative international policy documents and adult education, on the other hand. Furthermore, it analyses how literacy skills surveys such as the Level One Study (leo.) or the PIAAC may help to bridge the gap between cognitive and more practical and educational approaches to literacy, the goal being to place the functional illiteracy (FI) construct within its existing scale levels. It also sheds more light on the way in which FI can be perceived in terms of different cognitive processes and underlying components of reading. By building on the previous work of other authors and previous definitions, the article brings together different views of FI and offers a perspective for a needed operational definition of the concept, which would be an appropriate reference point for future educational, political, and scientific utilization.

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