THE PATIENT’S WILL TO MEDICAL INTERVENTION – PRO FUTURO STATEMENT

2018 ◽  
Vol 1 (XVIII) ◽  
pp. 291-299
Author(s):  
Edyta Przybyłek ◽  
Anna Rej-Kietla ◽  
Sandra Kryska ◽  
Dariusz Zawadzki
Keyword(s):  
Medical Intervention ◽  
Special Importance ◽  
Medical Interventions ◽  
The Future ◽  
The Subject ◽  
Patient’S Will

A patient’s will statement is a document of special importance. In accordance with the provision included in the pro futuro statement, the patient declares that in certain situations in the future he does not want any or specific medical interventions to be taken against him.The purpose of this article is to present the subject of the pro futuro statement with the indication of the problems related to the use of this statement. The issue of a patient’s will statement regarding medical intervention will be analyzed based on available Polish and international legislation related to this issue and the analysis of specialized literature in this area.

scholarly journals The patient's order as a separate manifestation of his will

2021 ◽  
Vol 2 (20) ◽  
pp. 4
Author(s):  
Nataliia Korobtsova
Keyword(s):  
Care Patient ◽  
Medical Intervention ◽  
Point Of View ◽  
Legal Institution ◽  
Power Of Attorney ◽  
Patient’S Rights ◽  
The Future ◽  
The Will ◽  
Will Power ◽  
Patient’S Will

The article analyzes the issues of the patient's will in medical relations, it is proved that it is due to the expression of will to the proposed treatment (consent or refusal) that the patient is a full active participant in this relationship. However, his inability to express his will, temporary or irreversible, caused by the development of the disease, the peculiarity of its course may be an obstacle to determining his real desire for future treatment, medical intervention and jeopardize the violation or inability to exercise the patient's right to consent or refuse medical intervention. To avoid this, there is a certain legal institution in the legislation of a number of countries around the world, through which it is possible to plan your treatment in advance, to refuse it, in case of inability to do so in the future. In some legal systems, this institution has different names - "wishes made earlier", "medical will", "patient's will", "power of attorney to make decisions on health care", "patient orders" and so on. The paper analyzes the content of this institute, considers the views of scholars on it, made a comparative analysis with the legal construction of the "testament" and concluded that there are significant differences between these constructions, which makes it impossible, from the author's point of view, to call this will "testament". . It is proposed to consider such a will as one of the patient's rights - "patient order", which is made in writing by an adult - the patient, regardless of the type and stage of the disease in case of possible future inability to consent to medical examination, intervention or treatment. The patient has at his disposal not only his will for the future (list of medical procedures that are allowed to be performed in relation to his health, which are not), but also the case when it can be used (for example, coma, autonomic state). It is impossible to conclude it through a representative, because in this case the will of the patient is unknown. This order is executed by proxies (relatives, close persons, representatives, doctors, etc.). Despite the fact that in Ukraine today this legal institution is absent, the main directions of recoding of civil legislation indicate the possibility of its appearance in the updated legislation  

The future role of the psychiatrist in Europe – a UEMS perspective

2014 ◽  
Vol 11 (01) ◽  
pp. 35-42
Author(s):  
M. Hermans
Keyword(s):  
Mental Health ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
General Interest ◽  
Future Role ◽  
Personal Opinion ◽  
The Future ◽  
The Subject ◽  
The Many

SummaryThe author presents his personal opinion inviting to discussion on the possible future role of psychiatrists. His view is based upon the many contacts with psychiatrists all over Europe, academicians and everyday professionals, as well as the familiarity with the literature. The list of papers referred to is based upon (1) the general interest concerning the subject when representing ideas also worded elsewhere, (2) the accessibility to psychiatrists and mental health professionals in Germany, (3) being costless downloadable for non-subscribers and (4) for some geographic aspects (e.g. Belgium, Spain, Sweden) and the latest scientific issues, addressing some authors directly.

INVESTIGATION OF CHARACTERISTICS OF THE GRAIN RECEIVING FROM RAILWAY TO THE GRAIN TRANSSHIPMENT TERMINAL

2020 ◽  
Vol 20 (2) ◽  
pp. 7-13
Author(s):  
G. Stankevych ◽  
L. Dmytrenko ◽  
A. Kats ◽  
V. Shpak
Keyword(s):  
Quality Indicators ◽  
Grain Quality ◽  
Total Duration ◽  
Railway Transport ◽  
Oil Crops ◽  
The Future ◽  
Leading Position ◽  
Standard Values ◽  
The Subject ◽  
Sown Area

In the future, in Ukraine it is planned to increase the sown area for cereals, legumes and oilseeds, to increase the gross grain harvest to 80 million tons, and its export abroad was increased twice. Intensive construction in the southern ports of Ukraine of grain transshipment terminals with large metal silos will solve the problem of increasing grain export in the future. At these powerful terminals, the bulk of the grain comes mainly by rail, and is shipped to water. The aim of the work was to study the characteristics of the grain receiving from railway transport to the grain transshipment terminal of LLC “Ukrelevatorprom” in order to improve its works efficiency. The object of the study was the development of technology of grain receiving at the grain transshipment terminal; the subject of research is cereals, legume sand oil crops, as well as data from daily volumes of receiving and dispensing operations at the grain transshipment terminal of LLC “Ukrelevatorprom” for 2015-2016. The studies were carried out on the basis of processing data from the consignment notes for 2015-2016, according to which there was a summed amount of grain (net) daily transported by the railway. Further processing of the obtained data was carried out by a combined graphoanalytical method, for which, on the basis of tabular values for each studied year, the corresponding histograms and graphs were built and the necessary indicators were determined. Analysis of the structure of grain crops supplied by railway to LLC “Ukrelevatorprom” in 2015 and 2016 and their ratio showed that the main share was occupied by cereal crops (78.0 % and 73.1 % respectively), which were mainly represented by corn, share which was significantly dominated by other crops (wheat of various classes and barley) and amounted to 45.8 % and 44.5 %, respectively, which can be explained by its high demand in the international grain market, in which Ukraine occupies a leading position. Oilseeds (rapeseed) were taken in accordance with 19.1 % and 14.9 %, and legumes (soybeans) — 2.9 % and 12.0 %. An analysis of the timing of the unloading of grain wagons (hopper cars) showed that the total duration of this process, depending on the crops, averages 37...59 minutes. The longest steps for unloading wagons are to determine the grain quality indicators, especially rapeseed, and to spill grain from the wagons, therefore, to reduce their duration, it is necessary to form feeds of wagons with grain batches of the same quality and use more modern express analyzers to determine grain quality indicators, which will increase the productivity of the grain receiving line from the railway. According to the research results, the enterprise has the potential to increase by about 30 % the volume of grain intake. It was established that the periods of the grain receipt at the enterprise in 2015-2016 amounted to 349 and 353 days, respectively, the actual coefficients of the daily irregularity Kdaily for the grain receipt from the railway in these years are equal to 1.47 and 1.52, and the monthly irregularity Kmonth, respectively 1.33 and 1.21, does not exceed the standard values Kdaily = 2.5 and Kmonth= 2.0. This made it possible to clarify the database from the actual characteristics of the process of grain receiving by railway and can be used in design and verification calculations of equipment in technological lines for receiving grain from railway transport, and will contribute to increasing the efficiency of grain transshipment terminals. 

Features of optative modality in Macedonian language (with emphasis on the functionalities of independent da-construction)

2020 ◽  
pp. 301-323
Author(s):  
Natalya I. Kikilo ◽  
Keyword(s):  
Detailed Analysis ◽  
Present Article ◽  
Literary Language ◽  
Natural Context ◽  
Wide Range ◽  
Verb Forms ◽  
Text Types ◽  
The Future ◽  
The Subject ◽  
Ritual Context

In the Macedonian literary language the analytic da-construction used in an independent clause has a wide range of possible modal meanings, the most common of which are imperative and optative. The present article offers a detailed analysis of the semantics and functions of the Macedonian optative da-construction based on fiction and journalistic texts. The first part of the article deals with the specificities of the optative as a category which primarily considers the subject of a wish. In accordance with the semantic characteristics of this category, optative constructions are used in those discourse text types where the speakers are explicitly designated (the most natural context for the optative is the dialogue). The analysis of the Macedonian material includes instances of atypical usage of the optative da-construction, in which the wish of the subject is not apparent and thereby produces new emotional tonalities perceptible to the reader of a fiction/journalistic text. The study describes Macedonian constructions involving two different verb forms: 1) present tense form (da + praes) and 2) imperfective form (da + impf). These constructions formally designate the hypothetical and counterfactual status of the optative situation, respectively. Thus, the examples in the analysis are ordered according to two types of constructions, which reflect the speaker’s view on the probability of the realisation of his/her wish. Unrealistic wishes can be communicated through the present da-construction, while the imperfective construction denotes situations in which the wish can be realised in the future. The second part of the article is devoted to performative optative da-constructions, which express formulas of speech etiquette, wishes and curses. The analysis demonstrates that these constructions lose their magical functions, when used outside of the ritual context, and begin to function as interjections.

The Phantom Defense: America's Pursuit of the Star Wars Illusion. By Craig Eisendrath, Melvin A. Goodman, and Gerald E. Marsh. Westport, CT: Praeger, 2001. 216p. $24.95. Ballistic Missile Defense and the Future of American Security: Agendas, Perceptions, Technology, and Policy. By Roger Handberg. Praeger, 2001. 264p. $62.00. Rockets' Red Glare: Missile Defenses and the Future of World Politics. Edited by James J. Wirtz and Jeffrey A. Larsen. Boulder, CO: Westview, 2001. 368p. $28.50.

2002 ◽  
Vol 96 (4) ◽  
pp. 879-880
Author(s):  
David Goldfischer
Keyword(s):  
World Politics ◽  
Ballistic Missile ◽  
Missile Defense ◽  
Star Wars ◽  
Technological Context ◽  
The Future ◽  
Ballistic Missile Defense ◽  
Long Time ◽  
Strategic Defense ◽  
The Subject

As Michael O'Hanlon concludes in his excellent contribution to Rockets' Red Glare: “We should…get used to the debate over ballistic missile defenses. It has been around a long time, and no final resolution is imminent” (p. 132). In one sense, a review of these three recent books makes clear that many analysts had grown a bit too used to positioning themselves in terms of the 1972 ABM Treaty. Preoccupied with arguments over whether the treaty should be preserved, modified, or rewritten in light of a changing strategic and technological context, no one seemed to have anticipated that President George W. Bush would simply withdraw from it, invoking Article XV's provision that either party could withdraw if “extraordinary events related to the subject matter of this Treaty have jeopardized its supreme interests.” Even many strategic defense supporters who deemed the treaty obsolete (as Robert Joseph persuasively maintains in his contribution to Rockets' Red Glare) generally believed that it should only—and would only—be scrapped if negotiations over U.S.-proposed changes broke down. (“The Bush Administration,” surmises O'Hanlon, “will surely try very hard to amend it before going to such an extreme”) (p. 112). In the event, the president's team disavowed even the word “negotiation,” saying they were willing only to “consult” the Russians regarding the treaty's impending demise.

scholarly journals Building an ‘Industrial Engineering Mindset’ among Indian Healthcare Executives: Toward Management of Healthcare Facilities at an Industrial Scale post the COVID-19 Pandemic

2021 ◽  
pp. 2516600X2110059
Author(s):  
Som Sekhar Bhattacharyya ◽  
Rajesh Chandwani
Keyword(s):  
Literature Review ◽  
Industrial Engineering ◽  
Industrial Scale ◽  
Subject Domain ◽  
Healthcare Facilities ◽  
Healthcare Executives ◽  
The Future ◽  
Adequate Quantity ◽  
The Subject

The COVID-19 pandemic highlighted the necessity of good quality and adequate quantity of healthcare infrastructure facilities. Healthcare facilities were provided for COVID-19 facilities with improvisation and supplementary lateral infrastructure from other sectors. However, the main point of contemplation going into the future was regarding how to quickly develop healthcare facilities. The subject domain of ‘industrial engineering’ (IE) and its associated perspectives could provide some key insights regarding this. The authors undertook a conceptual literature review and provided theoretical argumentation toward this. The findings provided insights regarding the application of industrial engineering concepts in healthcare facilities and services.

scholarly journals Nursing Teleconsultation for the Outpatient Management of Patients with Cardiovascular Disease during COVID-19 Pandemic

2021 ◽  
Vol 18 (4) ◽  
pp. 2087
Author(s):  
Vincenzo Russo ◽  
Roberta Cassini ◽  
Valentina Caso ◽  
Chiara Donno ◽  
Annunziata Laezza ◽  
...  
Keyword(s):  
Cardiovascular Diseases ◽  
Continuity Of Care ◽  
Medical Intervention ◽  
Lipid Lowering ◽  
Outpatient Management ◽  
Medical Interventions ◽  
Artery Disease ◽  
Clinical Conditions ◽  
Mean Time

Introduction: During the COVID-19 outbreak, non-urgent clinic visits or cardiac interventional procedures were postponed to a later date, and the implementation of telemedicine has guaranteed continuity of care for patients with chronic diseases. The aim of our study was to describe the medical interventions following nursing teleconsultation for the outpatient management of patients with cardiovascular diseases during the COVID-19 pandemic. Materials and Methods: All patients who did not attend the follow-up visit from 4 to 15 April 2020 at our institution and who were re-scheduled due to the COVID-19 lockdown were selected to be enrolled in the study. Each patient was followed by a semi-structured telephonic interview performed by a nurse. The outcomes of our study were to assess the patients’ adherence to nursing teleconsultation and the usefulness of nursing teleconsultation to detect clinical conditions in need of medical intervention. Results: In total, 203 patients (81%) underwent nursing teleconsultation in a mean time of 7 ± 3 days from the outpatient visit lost due to the COVID-19 lockdown. Furthermore, 53 patients (26%) showed poor adherence to nursing teleconsultation. Among the 150 patients (mean age 67 ± 10 years; 68% male) who completed the telephonic interview, the nursing teleconsultation revealed the need of medical intervention in 69 patients (46%), who were more likely at very high cardiovascular risk (77% vs. 48%; p < 0.0003) and who showed a higher prevalence of dyslipidemia (97% vs. 64%; p < 0.0001) and coronary artery disease (75% vs. 48%, p < 0.0008) compared to those not in need of any intervention. The up-titration of the lipid-lowering drugs (n: 32, 74%) was the most frequent medical intervention following the nursing teleconsultation. The mean time between the nursing teleconsultation and the date of the rescheduled in-person follow-up visit was 164 ± 36 days. Conclusions: Nursing teleconsultation is a simple and well-tolerated strategy that ensures the continuity of care and outpatient management for patients with cardiovascular diseases during the COVID-19 pandemic.

scholarly journals Effects of an individualized analgesia protocol on the need for medical interventions after adenotonsillectomy in children: a randomized controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jian Guo ◽  
Peijun Zhuang ◽  
Kun Liu ◽  
Yuanyuan Wan ◽  
Xuan Wang
Keyword(s):  
Median Duration ◽  
Controlled Trial ◽  
Pain Scale ◽  
Medical Intervention ◽  
Secondary Outcome ◽  
Sleep Study ◽  
Medical Interventions ◽  
Randomized Controlled ◽  
Obstructive Sleep ◽  
Blinded Trial

Abstract Background It has been proposed that the dose of rescue opioids should be individually titrated to the severity of obstructive sleep apnea after adenotonsillectomy. However, a sleep study is not always available before adenotonsillectomy. This randomized, controlled and blinded trial evaluated a strategy of pain control individualized to the results of a fentanyl test, rather than the results of polysomnography, in children after adenotonsillectomy. Methods A total of 280 children (3–10 years old) undergoing elective adenotonsillectomy were randomized into an individualized protocol (IP) group or a conservative protocol (CP) group. All patients received a fentanyl test before extubation. Pain was assessed every 10 min in the recovery room, and rescue morphine was given when the Children’s Hospital of Eastern Ontario Pain Scale (CHEOPS) score was > 6. In the IP group, the dose of rescue morphine was individualized to the results of the fentanyl test (10 μg/kg in the case of a positive result and 50 μg/kg in the case of a negative result). In the CP group, the dose was fixed (25 μg/kg). The primary outcome was the percentage of patients requiring at least one medical intervention. The secondary outcome was the median duration of CHEOPS scores > 6. Results Fewer patients in the IP group than in the CP group required medical interventions [11.9% (16/134) vs 22.3% (29/130), P = 0.025]. The median duration of CHEOPS scores > 6 was shorter in the IP group than in the CP group [20 (95% CI: 17 to 23) min vs 30 (95% CI: 28 to 32) min, P <  0.001]. Conclusions Compared with a conservative dosing approach, this individualized protocol may improve analgesia without a significant increase in respiratory adverse events. Trial registration ClinicalTrials.gov NCT02990910, registered on 13/12/2016.

A corpus-based investigation of techno-optimism and propositional certainty in the National Intelligence Council’s ‘Future Global Trends Reports’ (2010–2035)

2017 ◽  
Vol 12 (1) ◽  
pp. 39-57
Author(s):  
Jamie McKeown
Keyword(s):  
Global Trends ◽  
Future Role ◽  
Ideological Bias ◽  
The Past ◽  
The Us ◽  
The Future ◽  
The Subject ◽  
Global Peace ◽  
Discursive Representations

This article reports the findings from a study of discursive representations of the future role of technology in the work of the US National Intelligence Council (NIC). Specifically, it investigates the interplay of ‘techno-optimism’ (a form of ideological bias) and propositional certainty in the NIC’s ‘Future Global Trends Reports’. In doing so, it answers the following questions: To what extent was techno-optimism present in the discourse? What level of propositional certainty was expressed in the discourse? How did the discourse deal with the inherent uncertainty of the future? Overall, the discourse was pronouncedly techno-optimist in its stance towards the future role of technology: high-technological solutions were portrayed as solving a host of problems, despite the readily available presence of low-technology or no-technology solutions. In all, 75.1% of the representations were presented as future categorical certainties, meaning the future was predominantly presented as a known and closed inevitability. The discourse dealt with the inherent uncertainty of the subject matter, that is, the future, by projecting the past and present into the future. This was particularly the case in relation to the idea of technological military dominance as a guarantee of global peace, and the role of technology as an inevitable force free from societal censorship.

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