Nursing Care of Low-Risk Newborns in Low Resource Setting: Nurses' Aides May Bridge the Gap at Community Hospitals

Objective: To study the role of a nurses' aide in the care for newborns weighing between 1500 and 2000 g at birth in a low resource setting. Study Design: Observational. Setting: The General hospital in 1994-95, in a public sector, located in a remote area in India Intervention: A female ward assistant with seven years of schooling trained, on-the-job, to keep babies warm, initiate maternal breastfeeding, and to detect rapid breathing. The nursing staff from the pediatric ward supervised her performance. A separate "warm room" appropriately heated for preterm and sick babies became a makeshift nursery. The nursing staff administered enteral feeding, oxygen, and antibiotics. Services of the resident doctors or general duty medical officers were not available. Results: The survival rate was nearly 100% for babies with birthweights between 1,500 and 2,000 g (none referred out). Conclusions: A nurses' aide may facilitate the delivery of special care for newborns where nursing personnel are grossly inadequate and saving babies weighing between 1,500 and 2,000 g may need minimal inputs. It may be worthwhile to target 1,500 and 2,000 g birthweight categories even when resources are meager. What is already known about this subject? Low resource settings face staff shortages, especially nursing staff. Health workers with midwifery skills can deliver nearly 90% of essential care services for maternal and neonatal health. A substantial proportion of neonatal deaths occur among moderately low birth weight babies. What does this study add? It is possible to train a semi-literate person to facilitate early breastfeeding and to keep a baby warm. A large proportion of deaths among babies with birthweight ranging from 1500 to 2000 g are preventable with meager resources. How might this impact on clinical practice or future developments? The facilities facing shortage of nursing staff in low resource settings, may employ nurses’ aide to deliver basic newborn care.

Advancement of the Duty to Cooperate in Marine Environmental Protection in the Jurisprudence of ITLOS

The UN Convention on the Law of the Sea sets forth an unprecedented regime for marine environmental protection that compels parties to cooperate and includes mandatory dispute settlement procedures with binding decisions. Although the Convention does not contain a specific article stipulating a general duty to cooperate, cooperation permeates the logic of the document. The International Tribunal for the Law of the Sea (ITLOS) has recognised the importance of cooperation to marine protection and preservation in several cases. It could be suggested that the States Parties have a positive obligation to cooperate and a need to implement a range of actions to this end. ITLOS has consistently interpreted the duty to cooperate as comprising specific obligations: to consult, to exchange information, to monitor and assess relevant activities, to develop measures to prevent pollution or other environmental harm; which offers both the basis for the implementation of the duty to cooperate and the criteria for determining compliance.

Duties and Choices in Philanthropic Giving

Kant held that everyone has a general duty to promote the happiness of others as well as a more stringent duty to help those in distress when one easily can. These are duties of “practical love”: duties to act, not to feel. The general duty does not specify whose happiness to promote or the means and extent of obligatory helping. Several objections from contemporary philosophers are addressed: (1) that Kant’s principle of beneficence as Hill presents it is too “anemic” (David Cummiskey) (2) that Kant requires us to devalue our own happiness (Michael Slote), and (3) that Kant fails to acknowledge that some acts are morally good to do but not required (J. O. Urmson). Then this essay discusses briefly how other moral considerations may affect the application of Kant’s principles to particular cases of philanthropic giving: justice, respect, the kind of help needed, and the motives of the giver.

German Transplants in Estonian Tort Law: General Duties to Maintain Safety

The jurisprudence and case-law approach of German tort law – and, more broadly, German-school legal thinking in general – has found its way into Estonian case law on torts and into Estonia’s scholarly texts on jurisprudence. From among the catalogue of transplants from German tort law that have reached Estonian law or legal practice, the paper focuses on one whose importance cannot be overestimated: the concept of tort liability based on breach of the general duty to maintain safety. This domain has witnessed remarkable change since the beginning of the 2000s, when an analogous concept of liability was still unfamiliar to many Estonian lawyers. The article examines whether and to what extent the concept of liability based on the general duty to maintain safety has become recognised in Estonian legal practice in the years since. Also assessed is the relevant case law to date, for ascertainment of whether any adoption of an equivalent concept of liability has been successful and, in either event, what problems remain to be resolved. The importance of this issue extends far beyond that of individual questions: the recognition of general duties to maintain safety affects our understanding of the very structure of tort law, of that of the general composition of tort, and of the connections that link the individual prerequisites for tort liability. Furthermore, this constellation influences our thought in the field of tort law more generally and our approach to the cases emerging in real-world legal practice.

Red Blood Cell Distribution Width in Holistic Nursing Mode for Patients with Acute Left Heart Failure

Acute left heart failure is a very common acute heart failure in clinic, which must be treated immediately. If the treatment time is delayed, the mortality will be greatly increased. At present, there is not a good index to judge the severity of acute left heart failure. Therefore, it is necessary to analyze the relevant data and find a suitable measurement index. The purpose of this paper is to study the application effect of red blood cell (RBC) distribution width in holistic nursing mode for patients with acute left heart failure, taking patients with acute left heart failure in our hospital as the research object. The RBC distribution width of patients was detected, and the mortality and symptom relief time of patients were counted. The results showed that there was no significant difference in mortality when RBC distribution width was young. When the RBC distribution width is greater than 14.6%, the mortality rate increases rapidly. The symptom relief time of holistic nursing group was much shorter than that of general duty nursing group, and the difference was the biggest when it was over 14.6% in RBC distribution width, reaching 8.5 minutes. In the holistic nursing group, there was no significant difference in symptom relief time. In the group of general duty nursing, when the RBC distribution width is more than 14.6%, the time of symptom relief increases sharply. RBC distribution width can be considered to predict the severity of a patient’s lines.

Influence of competence and job satisfaction on the performance of the state civil apparatus (ASN) in Tonra district of bone regency

One of the main functions of the government is to organize public services as a form of the general duty of government for the welfare of the community, including the government of Tonra District of Bone Regency. Bureaucracy or government services are government instruments to realize efficient, effective, equitable, transparent and accountable public services. The research was conducted at tonra district office of Bone District of South Sulawersi Province. The population in this study is all employees in the tonra district government area numbering 60 people. The type of data in this study is primary data obtained from respondents' answers to a number of questions and statements in questionnaires related to research variable indicators. Research variables consist of independent variables (X1) namely competence, and job satisfaction (X2), as well as dependent variables namely ASN performance (Y). The results of the study obtained that the variables of competence and job satisfaction both partially and simultaneously (together) have a real (significant) effect on the performance of ASN in the scope of the government office of Tonra District of Bone Regency. Thus it can be concluded that the factors of compote and job satisfaction are very important to note in human resource management and institutional/ organizational management, especially in the government office of Tonra District of Bone Regency.

Case Management

This chapter details the provisions on case management under the European Rules of Civil Procedure. Rule 47 provides that ‘parties must present their claims, defences, factual allegations and offers of evidence as early and completely as possible and as appropriate to the careful conduct of litigation in order to secure procedural expedition’. In general, responsibility for the efficient and speedy resolution of disputes is shared between the court and parties. Rule 48 concerns the court control of proceedings. Meanwhile, Rule 49 sets out the court's general duty of active case management, which is part of the principle of co-operation. All European jurisdictions' procedural codes employ court orders or court directions as a means of communication between the court and parties in order to facilitate effective case management as provided in Rules 48 and 49. The process of rendering court orders under Rule 50 is intended to ensure that management under these Rules is carried out effectively and with sufficient respect for the parties' right to be heard.

Political correctness and the right to free speech: the case of preferred pronouns

In this paper I argue for the general duty to refer to transgender people by their preferred pronouns when they are conventional. In the case of non-conventional, tailor-made pronouns, there is no such duty because those so-called “designated pronouns” are not actually functional pronouns. Last, but not least, even though there is a duty of civility to use the designated name and conventional pronoun of trans-people, individuals retain the right to speak out their belief in that sex and gender are biological facts, and thus, the right to state in reference to a transwoman: “She is not a woman”.

Psychological Symptoms in Italian, Spanish and Portuguese Youth During the COVID-19 Health Crisis: A Longitudinal Study

Aiming to slow down the spread of the COVID-19, a lockdown was declared in the first term of 2020 in many European countries, applying different restrictions measures. Although the psychological effects of home confinement in children have been described, there is a lack of longitudinal research examining the impact of the confinement over time. The present study analyzes the evolution of the psychological wellbeing of children and adolescents from three European countries with different restrictions. Parents of 624 Italian, Spanish, and Portuguese children and adolescents aged 3 to 18 years old completed the “Impact Scale of COVID-19 and Home Confinement on Children and Adolescents” two, five, and eight weeks after the lockdown. Results show a different pattern for each country. Children from Italy, the first European country that applied a lockdown, were better adapted than Spanish and Portuguese children the first two weeks after confinement but they were more psychologically impacted by home confinement at the eight-week assessment. Portuguese children, who followed a general duty of home confinement, were the best adapted to the situation, with no significant differences over time. A significant change was found in anxiety symptoms in Spanish children, with a decrease at the last assessment. Findings suggest that long confinements and hard restrictions affect children, so prevention measures should be applied during confinements to prevent psychological problems in children.

11. Judicial Powers II

This chapter discusses the ‘decentralized’ powers of the European Court of Justice. It looks at two specific constitutional principles that the Court has derived from the general duty of sincere cooperation: the principle of equivalence and the principle of effectiveness. Both principles have led to a significant judicial harmonization of national procedural laws. The chapter then turns to a third incursion into the procedural autonomy of national courts: the liability principle. While the previous two principles relied on the existence of national remedies for the enforcement of European law, this principle establishes a European remedy for proceedings in national courts. An individual can here, under certain conditions, claim compensatory damages resulting from a breach of European law. Importantly, the remedial competence of national courts is confined to national wrongs. They cannot give judgments on ‘European’ wrongs, as jurisdiction over the latter is—like the power to annul Union law—an exclusive power of the Court of Justice of the European Union. Finally, the chapter explores what happens in areas in which the Union has harmonized the remedial or jurisdictional competences of national courts.