A statistical technique for determination of withdrawal of northeast monsoon over coastal Tamilnadu

The withdrawal dates of northeast monsoon over coastal Tamil Nadu for the 90-year period (1901-90) have been objectively derived. The methodology of determination was generally based on an index based on the spatial distribution of daily rainfall over stations of coastal Tamil Nadu, over a 5-day pentad for the six month period, September- February. The normal withdrawal date thus obtained was 27 December with a standard deviation of 13.6 days and range 23 November-28 January. The duration of northeast monsoon was distributed with mean 67.5 days, standard deviation 14.9 days and range 26-102 days. During 36.7 % of years the withdrawal spilled over to January of next year. The daily normal rainfall and its difference filter have been discussed with reference to the normal date of withdrawal. The average decrease of rainfall at the time of withdrawal has been derived by application of superposed epoch analysis. It has further been shown that during years when the withdrawal took place in January the intensity of northeast monsoon prior to withdrawal was as intense as in years when withdrawal occurred in December. A few cases of northeast monsoon withdrawal have been illustrated with diagrams. As no definite dynamic or thermodynamic features could be uniquely identified which are associated with the withdrawal, this technique is basically statistical, considering the behaviour of the daily normal rainfall as the sole criterion. Unique thermodynamic and dynamic features are not identifiable which are associated with the withdrawal of northeast monsoon over coastal Tamilnadu.

Camera Obscura or the Way Things Appear: Some Remarks About Marx’s Economic Writings

I analyse the foundations of Marx’s analysis to examine the applicability of Marx’s theory of the capitalist economy to the study of current economic events. In this paper, I do not present critique the interpretations of Marx’s works made by contemporary economists; however, much of modern Marxian economics is invalid in terms of Marx’s own method and inappropriate for understanding modern capitalism. The paper is concerned with topics that have been the subject of contemporary debate and are central to Marx’s own economic writings. Here I present only textual evidence of the main tendencies in the development of capitalism discovered by Marx. There are limits to value (= time) as the sole criterion of economic expediency; the constant reproduction of a scarcity of jobs amid an abundance of goods; enlargement of material commercial relations on the other spheres of social life; development of monetary relations – the emergence of derivatives of money, i. e., ersatz money, digital money. The main conclusion that I came to is that some societies are gradually losing value and moral guidelines, threatening the very development and even the existence of other communities or peoples.

Bioethical Concerns During the COVID-19 Pandemic: What Did Healthcare Ethics Committees and Institutions State in Spain?

Objectives: Each new wave of the COVID-19 pandemic invites the possible obligation to prioritize individuals' access to vital resources, and thereby leads to unresolved and important bioethical concerns. Governments have to make decisions to protect access to the health system with equity. The prioritization criteria during a pandemic are both a clinical and legal-administrative decision with ethical repercussion. We aim to analyse the prioritization protocols used in Spain during the pandemic which, in many cases, have not been updated.Method: We carried out a narrative review of 27 protocols of prioritization proposed by healthcare ethics committees, scientific societies and institutions in Spain for this study. The review evaluated shared aspects and unique differences and proffered a bioethical reflection.Results: The research questions explored patient prioritization, the criteria applied and the relative weight assigned to each criterion. There was a need to use several indicators, being morbidity and mortality scales the most commonly used, followed by facets pertaining to disease severity and functional status. Although age was initially considered in some protocols, it cannot be the sole criterion used when assigning care resources.Conclusions: In COVID-19 pandemic there is a need for a unified set of criteria that guarantees equity and transparency in decision-making processes. Establishing treatment indications is not the aim of such criteria, but instead prioritizing access to care resources. In protocols of prioritization, the principle of efficiency must vary according to the principle of equity and the criteria used to guarantee such equity.

Is the Consumer Welfare Obsolete? A European Union Competition Law and Competition Perspective

In 2005, the European Commission advocated for a more economic approach to enforcing competition laws. The sole criterion for assessing the lawfulness of a market practice should be the appraisal of its net effect on consumer welfare. The Court of Justice was reluctant to adopt such an approach until its 2017 Intel Judgment. Its endorsement—which is debatable insofar as the judgment may give rise to different interpretations—may appear paradoxical in that it is concomitant with a sharp challenge to the consumer welfare criterion in the United States. The purpose of this article is to retrace the history of this criterion, particularly its adoption in the context of EU competition law. We aim to show that the criticisms of the effects-based approach can be addressed not by moving away from the consumer welfare criterion but by integrating it into a broader perspective that also takes into account the protection of the competition process itself.

Towards the Development of Sustainable Tourism in Pakistan: A Study of the Role of Tour Operators

The literature on sustainable tourism is scant, particularly in the least developed countries. Very few studies touch upon the concept and no holistic theoretical or conceptual frameworks around the idea of sustainable tourism have been formulated. This study aims at exploring the role of tour operators in developing sustainable tourism in Pakistan and how the tour operators (TOs) conceive their role in this regard. TOs were reached through phone calls, emails, and virtual sources as face-to-face interviews were not possible due to COVID-19 pandemic and restrictions on travel by the government. In-depth interviews were conducted to gather data. Results suggest that the TOs although realize the importance of social, environmental, and economic dimensions of tourism on the communities but have no management systems in place to cater accordingly. There are no incentives in place by the government facilitate TOs to design and implement such systems. The TOs do not select a destination based on Global Sustainable Tourism Council criterion, but rather the selection of destination is mostly demand-based and profit-oriented. The study suggests that corporate profit motive is the sole criterion for decision making and is one of the major causes impeding sustainable tourism in Pakistan. The role of TOs in developing sustainable tourism is vague as the TOs do not have any systems in place to implement sustainable models. The study recommends that efforts need to be put in place to incentivize sustainable tourism in Pakistan and proper laws should be set forth by the authorities to comply by the TOs. The role of TOs is important and understood, however, there is a need to put proper systems in place.

Making a case for the inclusion of refractory and severe mental illness as a sole criterion for Canadians requesting medical assistance in dying (MAiD): a review

BackgroundFollowing several landmark rulings and increasing public support for physician-assisted death, in 2016, Canada became one of a handful of countries legalising medical assistance in dying (MAiD) with Bill C-14. However, the revised Bill C-7 proposes the specific exclusion of MAiD where a mental disorder is the sole underlying medical condition (MAiD MD-SUMC).AimThis review explores how some persons with serious and persistent mental illness (SPMI) could meet sensible and just criteria for MAiD under the Canadian legislative framework.MethodsWe review the proposed Bill C-7 criteria (capacity, voluntariness, irremediability and suffering) as well as the nuances involved in separating a well-reasoned request for assisted suicide from what might be solely a manifestation of a SPMI.FindingsIn this paper, we argue against the absolute exclusion of patients with SPMIs from accessing MAiD. Instead, we propose that in some circumstances, MAiD MD-SUMC may be justifiable while remaining the last resort. Conducting MAiD eligibility assessments removes the need to introduce diagnosis-specific language into MAiD legislation. Competent psychiatric patients who request MAiD should not be treated any differently from other eligible candidates. Many individuals with psychiatric disorders will be incapable of consenting to MAiD. The only ethical option is to assess eligibility for MAiD on an individual basis and include as legitimate candidates those who suffer solely from psychiatric illness who have the decisional capacity to consent to MAiD.

Turgot, the Fondations and the questionv of social needs

This paper focuses on the entry Fondation, compiled by Anne-Robert-Jacques Turgot and published in 1757 in the Encyclopédie. Turgot analyzes the phenome-non of fondations from the socio-economic point of view. In order to assess whether these ancient institutions were suitable for a society moving towards modernity, he uses public utility as the sole criterion of assessment. According to Turgot, the fondations were an obstacle to free enterprise and free market, as on the one hand they accumulated and immobilized capital by subtracting it from productive and profitable investments and, on the other hand, they provided assis-tance and charity without adequate labour promotion by encouraging idleness. Also for these reasons Turgot is in favour of the suppression of these ancient institutions and he prefers the figure of the individual, active and responsible, or free associations of individuals. However, Turgot's attack on fondations seems only one aspect of his broader criticism of all the institutions that were supporting the ancient social order.

An Exploratory Qualitative Study of Computer Screening to Support Decision-Making about Use of Palliative Care Registers in Primary Care: GP Think Aloud and Patient and Carer Interviews

Objectives: This study aimed to understand factors that influence general practitioner (GP) use of automated computer screening to identify patients for the palliative care register (PCR) and the experiences of palliative care and this emerging technology from patients’ and carers’ perspectives. Methods: A computer screening program electronically searches primary care records in routine clinical practice to identify patients with advanced illness who are not already on a PCR. Five GPs were asked to “think aloud” about adding patients identified by computer screening to the PCR. Key informant interviews with 6 patients on the PCR and 4 carers about their experiences of palliative care while on the PCR and their views of this technology. Data were analyzed thematically. Results and Conclusions: Using computer screening, 29% additional patients were added by GPs to the PCR. GP decision-making for the PCR was informed by clinical factors such as: if being treated with curative intent; having stable or unstable disease; end-stage disease, frailty; the likelihood of dying within the next 12 months; and psychosocial factors such as, age, personality, patient preference and social support. Six (60%) patients/carers did not know that they/their relative was on the PCR. From a patient/carer perspective, having a non-curative illness was not in and of itself sufficient reason for being on the PCR; other factors such as, unstable disease and avoiding pain and suffering were equally if not more, important. Patients and carers considered that computer screening should support but not replace, GP decision-making about the PCR. Computer screening merits ongoing development as a tool to aid clinical decision-making around entry to a PCR, but should not be used as a sole criterion. Care need, irrespective of diagnosis, disease trajectory or prognosis, should determine care.

‘You should see a doctor’, said the robot: Reflections on a digital diagnostic device in a pandemic age

Aims: In three days at the beginning of the COVID-19 pandemic, the Copenhagen Emergency Medical Services developed a digital diagnostic device. The purpose was to assess and triage potential COVID-19 symptoms and to reduce the number of calls to public health-care helplines. The device was used almost 150,000 times in a few weeks and was described by politicians and administrators as a solution and success. However, high usage cannot serve as the sole criterion of success. What might be adequate criteria? And should digital triage for citizens by default be considered low risk? Methods: This paper reflects on the uncertain aspects of the performance, risks and issues of accountability pertaining to the digital diagnostic device in order to draw lessons for future improvements. The analysis is based on the principles of evidence-based medicine (EBM), the EU and US regulations of medical devices and the taxonomy of uncertainty in health care by Han et al. Results: Lessons for future digital devices are (a) the need for clear criteria of success, (b) the importance of awareness of other severe diseases when triaging, (c) the priority of designing the device to collect data for evaluation and (d) clear allocation of responsibilities. Conclusions: A device meant to substitute triage for citizens according to its own criteria of success should not by default be considered as low risk. In a pandemic age dependent on digitalisation, it is therefore important not to abandon the ethos of EBM, but instead to prepare the ground for new ways of building evidence of effect.