Neutrality in public service interpreting

Most of the interpreting in the world today is done by public service interpreters. However, there has been a great deal of confusion regarding public service interpreting (PSI), specifically the role of the interpreter and neutrality in PSI. While codes of ethics assert that public service interpreters must act neutrally and impartially, users of PSI tend to view the interpreter as their advocate, making it difficult for the interpreter to maintain neutrality. In fact, as previous studies have shown, maintaining neutrality is one of the biggest challenges public service interpreters face. This article provides a review of the existing literature on the role of public service interpreters, ranging from early studies (e.g., Roberts, 1997; Wadensjö, 1998; Pöchhacker, 2000) via more recent work (e.g., Hale, 2008; Kalina, 2015; Valero Garcés, 2015) to the latest studies on the issue (e.g., Balogh & Salaets, 2019; Şener & Kincal, 2019; Runcieman, 2020). Using practical examples, the article analyses some of the existing codes of ethics and professional guidelines, which, as several authors suggest, are insufficient and should be reassessed. Throughout the paper, differences in different PSI settings (e.g., healthcare centres, schools, social services offices) are addressed.

Euthanasia in advanced dementia; the view of the general practitioners in the Netherlands on a vignette case along the juridical and ethical dispute

Background In the Netherlands, euthanasia has been regulated by law since 2002. In the past decade, a growing number of persons with dementia requested for euthanasia, and more requests were granted. A euthanasia request from a patient with advanced dementia (PWAD) can have a major impact on a general practitioner (GP). We aimed to get insights in the views of Dutch GPs on euthanasia concerning this patient group. Methods A postal survey was sent to 894 Dutch GPs. Questions were asked about a case vignette about a PWAD who was not able to confirm previous wishes anymore. Quantitative data were analyzed with descriptive statistics. Results Of the 894 GPs approached, 422 (47.3%) completed the survey. One hundred seventy-eight GPs (42.2%) did not agree with the statement that an Advance Euthanasia Directive (AED) can replace an oral request if communication with the patient concerned has become impossible. About half of the respondents (209; 49.5%) did not agree that the family can initiate a euthanasia trajectory, 95 GPs (22.5%) would accept such a family initiative and 110 GPs (26.1%) would under certain conditions. Discussion In case of a PWAD, when confirming previous wishes is not possible anymore, about half of the Dutch GPs would not accept an AED to replace verbal or non-verbal conformation nor consider performing euthanasia; a minority would. Our study shows that, probably due to the public debate and changed professional guidelines, conflicting views have arisen among Dutch GPs about interpretation of moral, ethical values considering AED and PWADs.

Features of business administration in the context of global chaordic business environment (part two)

The purpose of the article is to create professional guidelines for politicians, managers of organizations of various profiles and levels (national, regional and municipal), who have to take into account in their business practice the presence of uncertainty, turbulence and chaos in their business environment, including its international segment. It is known that administration as a bureaucratic method of management has long been widely used in routine, repetitive processes of business practice. But when the business process becomes more complicated, communications grow, the manager drowns in the flow of information, does not have time to make decisions, when the situation is unexpectedly and constantly changing, the efficiency of administration falls catastrophically and creates new more complex problems. Moreover, the higher the level of a manager, the more time they spend on the administration process, and the more in such cases it becomes a hindrance to development processes, causes them significant harm and becomes a catalyst for the strengthening or formation of new chaotic zones in the business environment. Numerous practical problems associated with attempts of managers to work constructively in chaos zones and effective management in conditions of increased uncertainty and turbulence in the business environment gradually began to form and make it possible to generalize significant experience in this area, called chaos management. The article systematizes the author’s many years of experience as an independent consultant on organizational and strategic development in Russian and foreign companies, which was associated with the search for effective solutions to improve the manageability of a business (company) in the face of constant turbulent changes in the market. The object of systematization is the administration processes for solving problems that arise in the business environment of modern companies, which the business community did not have to deal with so often and regularly early. The essence is that there is a tendency of the need for a significant rethinking of the approach to the work of modern managers-administrators, a revision of their work technologies and the structure of management functionality in a chaordic business environment. New skills of business thinking are required that are adequate to the principles of the theory of social chaos, which describes the features of the behavior of modern nonlinear systems (events), which at first glance seem random, unpredictable and disordered. Otherwise, the administrator will be «pulled» into the chaos zones and by his unprofessional actions will only expand and deepen them, stimulating the diffusion of the zones of instability and instability, i.e. the penetration of chaos into other areas (systems), where it can be claimed or borrowed, but for other purposes.

A safe procedure? The unusual case of a fatal airway obstruction by silicone during the production process of a tracheostomal epithesis in a 13-year-old boy

A tracheostomal epithesis is a plastic prosthesis that serves for sealing a tracheostoma and ensuring the position of the tracheostomy tube. The production of a tracheostomal epithesis requires an impression of the tracheostoma. To this end, silicone impression material is applied by an anaplastologist in and around the tracheostomal region, including the trachea. The blocked cuff of the tracheostomy tube serves to prevent aspiration of the material. We report on a 13-year-old boy who died during this procedure because the lower airways were obstructed with cured silicone. Forensic autopsy confirmed asphyctic suffocation as cause of death. Forensic physical investigation of the tracheostomy tube and its cuff revealed no structural or functional defects. Yet, the investigation results prove that the viscous silicone must have passed the cuff. To conclude, this case report demonstrates that the production of an impression of a tracheostoma is a procedure with a potentially lethal outcome. Hence, professional guidelines, including clear safety precautions, are urgently needed.

The Privilege of Information—An Examination of the Defence of Therapeutic Privilege and its Implications for Pregnant Women

Though apparently in existence across common law countries, the defence of ‘therapeutic privilege’ receives scant judicial analysis in case law. The extent of its reach is unclear and its underpinning justification is shaky. Often it forms a throwaway remark or poorly explored caveat when the duty of a physician to disclose information is being examined, rather than receiving any detailed judicial scrutiny in its own right. Furthermore, despite references to it in case law, it is questionable if it has ever successfully been invoked as a defence in either England and Wales or Ireland. This piece examines this lack of clarity and the often-vague references to the existence of therapeutic privilege in both case law and professional guidelines, followed by a consideration of why the defence may be particularly problematic and unjustified in the context of childbirth and the immediate postpartum period. Considering the dangers of therapeutic privilege in pregnancy presents a timely opportunity to examine the issues with the use of the defence in all other healthcare contexts, focusing particularly on its impact on individual patient autonomy. Finally, this piece concludes by contending that therapeutic privilege ought to be abolished, if it truly exists at all.

Features of business administration in the context of global chaordic business environment

The purpose of the article is to create professional guidelines for politicians, managers of organizations of various profiles and levels (national, regional and municipal), who have to take into account in their business practice the presence of uncertainty, turbulence and chaos in their business environment, including its international segment. It is known that administration as a bureaucratic method of management has long been widely used in routine, repetitive processes of business practice. But when the business process becomes more complicated, communications grow, the manager drowns in the flow of information, does not have time to make decisions, when the situation is unexpectedly and constantly changing, the efficiency of administration falls catastrophically and creates new more complex problems. Moreover, the higher the level of a manager, the more time they spend on the administration process, and the more in such cases it becomes a hindrance to development processes, causes them significant harm and becomes a catalyst for the strengthening or formation of new chaotic zones in the business environment. Numerous practical problems associated with attempts of managers to work constructively in chaos zones and effective management in conditions of increased uncertainty and turbulence in the business environment gradually began to form and make it possible to generalize significant experience in this area, called chaos management. The article systematizes the author’s many years of experience as an independent consultant on organizational and strategic development in Russian and foreign companies, which was associated with the search for effective solutions to improve the manageability of a business (company) in the face of constant turbulent changes in the market. The object of systematization is the administration processes for solving problems that arise in the business environment of modern companies, which the business community did not have to deal with so often and regularly early. The essence is that there is a tendency of the need for a significant rethinking of the approach to the work of modern managers-administrators, a revision of their work technologies and the structure of management functionality in a chaordic business environment. New skills of business thinking are required that are adequate to the principles of the theory of social chaos, which describes the features of the behavior of modern nonlinear systems (events), which at first glance seem random, unpredictable and disordered. Otherwise, the administrator will be "pulled" into the chaos zones and by his unprofessional actions will only expand and deepen them, stimulating the diffusion of the zones of instability and instability, i. e. the penetration of chaos into other areas (systems), where it can be claimed or borrowed, but for other purposes.

Reverse Engineering Application Instruments and Code Reliability: A Comparative Study of Tools

Based on different scenarios (professional guidelines) practice of Software Reverse Engineering (SRE) is used to analyse the combined instructions system to extract information regarding design and implementation of either part of, or the whole software application. These business rules are implemented in the form of a line code whereas actual source code is hidden and only gets the binary form of the code. Technologies that used for reverse engineering are CVF, V7, CFC, 14D, RTR, B#. These instruments are used for a better understanding of the program algorithm, logic, and program specifics in windows API functions, programming assembler language, network interaction principle. The tools that are discussed will not disturb the code consistency and basic structure of software. Present research shows a comparative analysis of various tools to establish which reverse engineering tool is better based on what characteristics.

The use of molecular biomarker tests: an interview study with healthcare providers about a molecular biomarker test for prostate cancer

Aim: Investigate why healthcare providers are not always willing to use molecular biomarker tests, even though they promise to personalize disease diagnosis and treatment. Materials & methods: We interviewed 20 Dutch urological healthcare providers to ascertain why they used or did not use SelectMDx, a biomarker test for prostate cancer. Results: Whether and how it was used differed from the developers’ expectations, because users and nonusers disagreed about its perceived advantages; the scientific and clinical evidence; the advantages of MRI; and the value of PCA3 testing. Financial issues and the absence of SelectMDx in professional guidelines and hospital care pathways also hampered its use. Conclusion: Eliciting users’ and nonusers’ views is important to better understand how biomarker tests can be embedded in clinical practice.

Referral to and enrolment in cardiac rehabilitation after open-heart surgery in the Netherlands

Aim Although referral to phase 2 cardiac rehabilitation (CR) following open-heart surgery is recommended in professional guidelines, according to the literature, participation rates are suboptimal. This study investigates the referral and enrolment rates, as well as determinants for these rates, for phase 2 CR following open-heart surgery via sternotomy. Methods A cross-sectional survey study was conducted among patients who underwent open-heart surgery via sternotomy in a university hospital. Data on referral and enrolment rates and possible factors associated with these rates (age, sex, type of surgery, educational level, living status, employment, income, ethnicity) were collected by a questionnaire or from the patient’s medical file. Univariate logistic regression analysis (odds ratio) was used to study associations of patient characteristics with referral and enrolment rates. Results Of the 717 eligible patients, 364 (51%) completed the questionnaire. Their median age was 68 years (interquartile range 61–74) and 82 (23%) were female. Rates for referral to and enrolment in phase 2 CR were 307 (84%) and 315 (87%), respectively. Female sex and older age were independently associated with both non-referral and non-enrolment. Additional factors for non-enrolment were surgery type (coronary artery bypass grafting with valve surgery and miscellaneous types of relatively rare surgery), living alone and below-average income. Conclusion Phase 2 CR referral and enrolment rates for patients following open-heart surgery were well over 80%, suggesting adequate adherence to professional guidelines. During consultation, physicians and specialised nurses should pay more attention to certain patient groups (at risk of non-enrolment females and elderly). In addition, in-depth qualitative research to identify reasons for non-referral and/or non-enrolment is needed.

Women's perception of choice and support in making decisions regarding management of breech presentation

Background Professional guidelines recommend midwives and obstetricians actively involve women in making decisions about their care. To date, breech research has focused mainly on assessing the effectiveness of different management options. Aim This research explores women's experience of breech presentation and their perception of choice and support in making decisions with regards to breech management. Methods This study uses a phenomenological research design. Semi-structured interviews took place in hospital or women's homes. A total of six postnatal women who were diagnosed with breech presentation after 36 weeks' gestation took part in the study. Data was analysed using Colaizzi's method. Findings A total of 84 significant statements were clustered into four main emerging themes. These include women's feelings, their healthcare expectations, their preferences and their values. Results Breech discussions mostly occurred between obstetricians and women. These primarily focused on external cephalic version, Elective Lower Segment Caesarean Section and Breech Vaginal Birth. These options did not always become choices available to women.