scholarly journals Choosing Wisely, the reasons for its success

2019 ◽  
Vol 89 (2) ◽  
Author(s):  
Marco Bobbio ◽  
Sandra Vernero
Keyword(s):  
Healthcare Providers ◽  
Choosing Wisely ◽  
Medical Community ◽  
Ethical Implications ◽  
Risks And Benefits ◽  
Slow Medicine ◽  
History Of ◽  
Adequate Evaluation ◽  
Clinical Risks ◽  
The U.S

The philosophy and the history of the International Choosing Wisely movement, launched in the U.S. in 2012, are described. It grew and spread beyond what it was anticipated at the beginning because there is a rising concern of the medical community regarding the appropriate use of procedures and treatments placed into the market before an adequate evaluation of risks and benefits. Not only healthcare providers, but also patients, citizens and politicians, are becoming aware of the consequences of inappropriate decisions and behaviors since inappropriateness has economic (waste of resources), clinical (risks), but also ethical implications. In Italy the movement was launched and still is coordinated by the Slow Medicine organization, that created the campaign Doing more does not mean doing better – Choosing Wisely Italy, which aimed to improve clinical appropriateness through the reduction of unnecessary tests and treatments and the dialogue between physicians and patients. Currently, 44 societies of physicians, nurses, pharmacists and physiotherapists identified 230 recommendations about tests, treatments and procedures commonly used in Italy’s clinical practice that do not provide any benefit to most patients but may cause harm.

scholarly journals Unwitting Accomplices: Endocrine Disruptors Confounding Clinical Care

2020 ◽  
Vol 105 (10) ◽  
pp. e3822-e3827 ◽  
Author(s):  
Matthew Genco ◽  
Lisa Anderson-Shaw ◽  
Robert M Sargis
Keyword(s):  
Metabolic Diseases ◽  
Clinical Care ◽  
Endocrine Disrupting Chemicals ◽  
Healthcare Providers ◽  
Medical Community ◽  
Medical Decision ◽  
Ethical Challenge ◽  
Hormone Synthesis ◽  
Ethical Implications ◽  
Endocrine Disrupting

Abstract Burgeoning evidence over the last 25 years has identified myriad synthetic chemicals with the capacity to alter various aspects of hormone synthesis and action. These endocrine-disrupting chemicals (EDCs) have been linked to various diseases, including reproductive disorders, metabolic diseases, and developmental abnormalities, among others. Exposure to EDCs arises from industrial activity, use of personal and home care products, and consumption of contaminated food and water; however, the role of healthcare in exposing individuals to EDCs is grossly underappreciated. Indeed, through the use of medications as well as medical equipment and devices, healthcare providers are unknowing mediators of exposure to EDCs, chemicals that might not only promote disease but that may also antagonize the efficacy of treatments. The ethical implications of provider-dependent exposure are profound. A failure to disclose the endocrine-disrupting properties of medical interventions violates core principles of nonmaleficence, patient autonomy, and justice as well as the practice of informed consent. Furthermore, physicians’ lack of knowledge regarding EDCs in medical practice artificially skews risk–benefit calculations that are fundamental to informed medical decision-making. To combat this underappreciated ethical challenge, urgent action is required. Healthcare providers must be educated about endocrine disruption. Known EDCs, defined by endocrinologists, should be clearly labeled on all medical products, and all medication components and devices should be screened for endocrine-disrupting properties. Finally, communication strategies must be devised to empower patients with knowledge about these risks. Providing ethically competent care requires an open acknowledgment of endocrine risks imposed by the medical community that have heretofore been ignored.

An American Language

2018 ◽  
Author(s):  
Rosina Lozano
Keyword(s):  
United States ◽  
National Policy ◽  
The United States ◽  
Spanish Language ◽  
Spanish Speakers ◽  
Language Recognition ◽  
Political Language ◽  
Political Issue ◽  
History Of ◽  
The U.S

An American Language is a political history of the Spanish language in the United States. The nation has always been multilingual and the Spanish language in particular has remained as an important political issue into the present. After the U.S.-Mexican War, the Spanish language became a language of politics as Spanish speakers in the U.S. Southwest used it to build territorial and state governments. In the twentieth century, Spanish became a political language where speakers and those opposed to its use clashed over what Spanish's presence in the United States meant. This book recovers this story by using evidence that includes Spanish language newspapers, letters, state and territorial session laws, and federal archives to profile the struggle and resilience of Spanish speakers who advocated for their language rights as U.S. citizens. Comparing Spanish as a language of politics and as a political language across the Southwest and noncontiguous territories provides an opportunity to measure shifts in allegiance to the nation and exposes differing forms of nationalism. Language concessions and continued use of Spanish is a measure of power. Official language recognition by federal or state officials validates Spanish speakers' claims to US citizenship. The long history of policies relating to language in the United States provides a way to measure how U.S. visions of itself have shifted due to continuous migration from Latin America. Spanish-speaking U.S. citizens are crucial arbiters of Spanish language politics and their successes have broader implications on national policy and our understanding of Americans.

La ética del Otro: una introducción al pensamiento de Emmanuel Lévinas

2019 ◽  
Vol 1 (1) ◽  
pp. 5-14
Author(s):  
Carlos Alvaréz Teijeiro
Keyword(s):  
Interpersonal Relationships ◽  
Emmanuel Levinas ◽  
Radical Change ◽  
The Other ◽  
Western Philosophy ◽  
Ethical Implications ◽  
Essential Question ◽  
History Of ◽  
The Relationship ◽  
First Philosophy

Emmanuel Lévinas, the philosopher of ethics par excellence in the twentieth century, and by own merit one of the most important ethical philosophers in the history of western philosophy, is also the philosopher of the Other. Thereby, it can be said that no thought has deepened like his in the ups and downs of the ethical relationship between subject and otherness. The general objective of this work is to expose in a simple and understandable way some ideas that tend to be quite dark in the philosophical work of the author, since his profuse religious production will not be analyzed here. It is expected to show that his ideas about the being and the Other are relevant to better understand interpersonal relationships in times of 4.0 (re)evolution. As specific objectives, this work aims to expose in chronological order the main works of the thinker, with special emphasis on his ethical implications: Of the evasion (1935), The time and the Other (1947), From the existence to the existent (1947), Totality and infinity: An essay on exteriority (1961) and, last, Otherwise than being, or beyond essence (1974). In the judgment of Lévinas, history of western philosophy starting with Greece, has shown an unusual concern for the Being, this is, it has basically been an ontology and, accordingly, it has relegated ethics to a second or third plane. On the other hand and in a clear going against the tide movement, our author supports that ethics should be considered the first philosophy and more, even previous to the proper philosophize. This novel approach implies, as it is supposed, that the essential question of the philosophy slows down its origin around the Being in order to inquire about the Other: it is a philosophy in first person. Such a radical change of perspective generates an underlying change in how we conceive interpersonal relationships, the complex framework of meanings around the relationship Me and You, which also philosopher Martin Buber had already spoken of. As Lévinas postulates that ethics is the first philosophy, this involves that the Other claims all our attention, intellectual and emotional, to the point of considering that the relationship with the Other is one of the measures of our identity. Thus, “natural” attitude –husserlian word not used by Lévinas- would be to be in permanent disposition regarding to the meeting with the Other, to be in permanent opening state to let ourselves be questioned by him. Ontology, as the author says, being worried about the Being, has been likewise concerned about the Existence, when the matter is to concern about the particular Existent that every otherness supposes for us. In conclusion it can be affirmed that levinasian ethics of the meeting with the Other, particular Face, irreducible to the assumption, can contribute with an innovative looking to (re)evolving the interpersonal relationships in a 4.0 context.

Asian Americans and Pacific Islanders Excel in Business but Not without Risks

2016 ◽  
Vol 14 (2) ◽  
pp. 77-90
Author(s):  
Bill Imada
Keyword(s):  
Asian Americans ◽  
Asian American ◽  
Immigration Policy ◽  
Pacific Islanders ◽  
Significant Growth ◽  
Current Trends ◽  
History Of ◽  
Mainstream Society ◽  
American Society ◽  
The U.S

In recent years, data has shown that there has been significant growth in Asian American Pacific Islander-owned (AAPI) enterprises. Driven by demographic changes, related in large part to the history of immigration policy, the AAPI population has been growing, and this has been accompanied by AAPI innovators and entrepreneurs leaving greater marks on American society and the U.S. economy. This growth, however, is not without risks and threats. The legacy of being “othered” by mainstream society means that AAPI success in business and in the corporate landscape can be met with resentment and criticism. This article explores the history of AAPI entrepreneurship and current trends. It also examines the challenges that the community may continue to face and offers recommendations on how to ensure continued growth and expanded opportunities for AAPIs in business.

A Concise History of the U.S. Army Signal Corps

1988 ◽  
Author(s):  
Kathy Roe Coker ◽  
Carol E. Rios
Keyword(s):  
Signal Corps ◽  
History Of ◽  
The U.S

History of Respiratory Illness at the U.S. Naval Academy

2001 ◽  
Author(s):  
Tammy L. Blankenship ◽  
Gary Gackstetter ◽  
Gregory C. Gray
Keyword(s):  
Respiratory Illness ◽  
Naval Academy ◽  
History Of ◽  
The U.S

Transocean and the History of Tax Inversions

2018 ◽  
Vol 34 (1) ◽  
pp. 1-12
Author(s):  
Susan M. Albring ◽  
Randal J. Elder ◽  
Mitchell A. Franklin
Keyword(s):  
Multinational Corporations ◽  
Economic Impacts ◽  
Income Taxes ◽  
Tax Rates ◽  
Corporate Tax ◽  
Corporate Income Taxes ◽  
History Of ◽  
Jobs Act ◽  
The U.S ◽  
Over Time

ABSTRACT The first tax inversion in 1983 was followed by small waves of subsequent inversion activity, including two inversions completed by Transocean. Significant media and political attention focused on transactions made by U.S. multinational corporations that were primarily designed to reduce U.S. corporate income taxes. As a result, the U.S. government took several actions to limit inversion activity. The Tax Cuts and Jobs Act of 2017 (TCJA) significantly lowered U.S. corporate tax rates and one expected impact of TCJA is a reduction of inversion activity. Students use the Transocean inversions to understand the reasons why companies complete a tax inversion and how the U.S. tax code affects inversion activity. Students also learn about the structure of inversion transactions and how they have changed over time as the U.S. government attempted to limit them. Students also assess the tax and economic impacts of inversion transactions to evaluate tax policy.

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