The objective of this study was to take a closer look at defense-related expenses for medical malpractice cases over time. We conducted a retrospective review of medical malpractice claims reported to the Physician Insurers Association of America's Data Sharing Project with a closing date between January 1, 1985 and December 31, 2008. On average a medical malpractice claim costs more than $27,000 to defend. Claims that go to trial are much more costly to defend than are those that are dropped, (...) withdrawn, or dismissed. However, since the overwhelming majority of claims are dropped, withdrawn, or dismissed, the total amount spent to defend them surpasses that spent on claims that go to trial. Defense attorney expenses account for the majority of defense-related expenses (74%), while expert witness expenses and other expenses split the remaining 26%. A strong association was also found between the average indemnity payment and the amount it costs to defend individual claims by specialty. Our study found that defense-related expenses for medical malpractice claims are not an insignificant cost. As state and federal governments debate how to repair the malpractice system, addressing the high cost of defending claims should not be ignored. (shrink)

Whenever health care reform is debated, the state of the medical professional liability system in the United States re-emerges as an issue of importance. What exactly is broken with the MPL system and what the implications are is a point of contention among different stakeholder groups. Recent data demonstrate that medical liability premiums have been improving in recent years and the majority of premiums remained flat in 2010. General agreement still exists, however, that medical professional liability insurance premiums have become (...) unaffordable for many physicians, and coverage has become less available, especially for certain medical specialties and in specific areas of the country.Multiple factors go into the determination of medical professional liability insurance premiums including return on investments, reinsurance costs, claims frequency, average amount paid out on malpractice claims, defense expenses, and administrative costs such as underwriting expense. (shrink)

Sustainable behaviour promotes pro-ecological behaviour and is a practice of consuming and utilizing resources responsibly. The ongoing COVID-19-induced pandemic has already put economic, social and psychological distress across the globe. Meanwhile, it has become vital to think of issues related to the sustainable management of resources. Behavioural norms play a prominent role while promoting sustainable living. This research examines how the sustainable dimension in one’s behaviour influences the decision-making in their daily life. Previous studies have shown the importance of sub-factors (...) like happiness, diversity constraint and frugal actions as factors affecting sustainable behaviour. These indicators mainly define the action one will choose to react to while buying and consuming different resources. The study identifies happiness as the mediating variable which influences the relationship between the predictor variables—mindfulness and diversity acceptance and the criterion variable—frugality-linked sustainable behaviour. With a sample of 324 participants, Baron and Kenny’s mediation model was outlined to test the mediation. Results showed a positive relationship between frugality, diversity, mindfulness and happiness. Happiness was found to be mediating between mindfulness, diversity acceptance and frugality-linked sustainable behaviour indicating that mindfulness and diversity acceptance alone have limited potential to impact the frugality-linked sustainable approach that individuals take. Happiness, as explained through a positive frame of mind, plays a very important role in enhancing sustainability behaviour. (shrink)

Abstract“Shut the door,” the chief resident said to me. While I was green enough at the beginning of my clinical clerkships to believe that most of my medical education would happen at the bedside, at that moment, I was learning another important fact: a large part of my ethical education was going to happen behind the closed doors of a call room. The health care team was polluted by a pervasive atmosphere of frustration, as silent but tangible as a thick (...) layer of fog, that obscured the patient's ability to evaluate the consequences of the choice that lay before her. The attending did not permit, let alone create, an environment that provided room for dissent.Institutions should encourage the leaders of clinical education to foster an emotionally safer learning environment in which honest moral dialogue may occur without fear of repercussions. If students cannot learn to apply the principles of ethics actively throughout their clerkships, it will be much harder to do so when they practice independently, and ultimately, patient care will suffer. Conversely, when students and trainees are empowered by their teachers, patient care improves. (shrink)

Although current literature about the “cure versus care” issue tends to promote a patient-centered approach, the disease-centered approach remains the prevailing model in practice. The perceived dichotomy between the two approaches has created a barrier that could make it difficult for medical students and physicians to integrate psychosocial aspects of patient care into the prevailing disease-based model. This article examines the influence of the formal and hidden curricula on the perception of these two approaches and finds that the hidden curriculum (...) perpetuates the notion that “cure” and “care” based approaches are dichotomous despite significant changes in formal curricula that promote a more integrated approach. The authors argue that it is detrimental for clinicians to view the two approaches as oppositional rather than complementary and attempt to give recommendations on how the influence of the hidden curriculum can be reduced to get a both-cure-and-care-approach, rather than an either-cure-or-care-approach. (shrink)

The Public Sphere from Outside the West brings together established and emerging new voices from philosophy, literature, anthropology, history, migration studies and information technology to address the present reality of the public sphere. In the age where everyone is in the public and everything is visible, this volume creates a delay in which the internet of things, mass surveillance and social media are asked "What is/not the Public?†? The essays bring to attention the formation of geo-politically and historically distinct public (...) spheres from South Africa, India, America and Europe. Such formations are found not only in the postcolonial histories of print, photography, cinema and caricature but also those underway in the digital era, such as the Arab Spring, Occupy movements and Anonymous. Through critical engagement with philosophers such as Kant, Heidegger, Benjamin, Habermas and Arendt, the determining concepts of the Public Sphere-privacy, secrecy, reason, the people-are shown to be undergoing epistemological and practical ruptures. Demonstrating the necessity of these considerations to understand the world public that is rapidly transforming this concept in radical ways through technologies today, this is the first collection on the subject to feature an impressive range of international thinkers. Global and timely in outlook, it breaks new ground and changes our way of looking at politics in the 21st century. (shrink)

This paper is an attempt to examine critical ways of displacing the meaning of journey – as minor rhythms and motions of everyday life. The everyday and its cyclical nature embedded in a productive life within the capitalist social regime is seen as an unexotic site of quotidian struggle. It warrants our attention only when the body asserts its presence at the site of rebellion or resistance. This is frequently reported as an exception to the given norm. The concrete reality (...) of our given material conditions is always fermenting and churning towards the “not yet”. Patterns of the everyday are seen as an extraordinary event or rupture only when the body rebels. My contention is that this journey of the body-politic is not embedded in a certain moment of its arrival or departure, from point A to B, but marked by dynamic, shifting vectors that are capable of a “leap”. In, against and beyond the spectre of capital, this paper will try to outline and discuss these minor perforations in time through the Shaheen Bagh protests and the migrant exodus during the pandemic in India. (shrink)

This paper argues that in social circumstances deformed by persistent anti-black racisms, invisibility does not necessarily constitute a failure of recognition or acknowledgment by others. Rather, it comes forth as a protective shield, to resist reductive and objectifying forms of seeing that often result in violence. But such invisibility has its limits. In this paper, I read Incendiary Art (2017) by Patricia Smith, a collection of poems set in the context of the Black Lives Matter movement in the US, to (...) interrogate both the limits of such protective invisibility, and the responsibility of the reader to acknowledge the potential violence of their own gaze. I examine the emancipatory political value of the poetic as showing a way towards a transformative engagement with others as ‘who’ they are, and subsequently towards a mutual co-constitution that is at the very heart of actualising a democratic political plurality. (shrink)

We propose a new relevance sensitive model for representing and revising belief structures, which relies on a notion of partial language splitting and tolerates some amount of inconsistency while retaining classical logic. The model preserves an agent's ability to answer queries in a coherent way using Belnap's four-valued logic. Axioms analogous to the AGM axioms hold for this new model. The distinction between implicit and explicit beliefs is represented and psychologically plausible, computationally tractable procedures for query answering and belief..

BackgroundA requisite for ethical human subjects research is that participation should be informed and voluntary. Participation during the informed consent process by way of asking questions is an indicator of the extent to which consent is informed.AimsThe aims of this study were to assess the extent to which parents providing consent for children's participation in an observational tuberculosis (TB) research study in India actively participated during the informed consent discussion, and to identify correlates of that participation.MethodsIn an observational cohort study (...) of tuberculosis in infants in South India, field supervisors who were responsible for obtaining informed consent noted down questions asked during the informed consent discussions for 4,382 infants who were enrolled in the study. These questions were post-coded by topic. Bivariate and multivariate analysis was conducted to examine factors associated with asking at least one question during the informed consent process.ResultsIn total, 590 out of 4,382 (13.4%) parents/guardians asked any question during the informed consent process. We found that the likelihood of parents asking questions during the informed consent process was significantly associated with education level of either parent both parents being present, and location.ConclusionsThe findings have implications for planning the informed consent process in a largely rural setting with low levels of literacy. Greater effort needs to be directed towards developing simple participatory communication materials for the informed consent process. Furthermore, including both parents in a discussion about a child's participation in a research study may increase the extent to which consent is truly informed. Finally, continuing efforts need to be made to improve the communication skills of research workers with regard to explaining research processes and putting potential research participants at ease. (shrink)

This paper uses Castoriadis’s idea of the imaginary and Agnes Heller’s conceptualization of modernity as an interplay of the historical and technological imaginations, to examine how modernity engages with the idea of development to foster a particular vision of the future as always in progression. It uses the examples of Tasmania and Kerala, in Australia and India, respectively, as case studies which challenge the dominant perception of development as a linear and progressive ideology of growth that translates into ‘the development (...) of productive forces and the rational mastery of nature’. The case studies also show how, despite the radically different paths through modernity, it is the same logics of modernity that are at work in both locations. (shrink)

Our moral compass is not the only thing that compels us to provide compassionate health care, which also improves patient outcomes and patient and provider satisfaction. In the current era of increasing medical complexity, provider burnout, and value-based reimbursement, health care systems struggle to durably improve their providers’ compassion in the provision of care. A religious retreat curriculum for leaders at OSF HealthCare, in Illinois and Michigan, has led to a significant, long-term increase among employees in their compassion toward patients, (...) colleagues, and self. (shrink)

Demanding work-life and excessive workload, the conflict between professional and personal lives, problems with patients and those related to the occurrence of death and high risk for their own life are a few factors causing burnout, disengagement, and dissatisfaction in the professional lives of healthcare professionals. The situation worsened during the COVID-19 pandemic. It is of utmost importance to find effective solutions to mitigate the stress and anxiety adversely affecting the mental well-being and professional lives of HCPs. This study was (...) designed to examine the efficacy of Sudarshan Kriya Yoga for alleviating work exhaustion, improving Professional Fulfillment, and influencing positivity among HCPs during COVID-19. In a comparative observation before the intervention, after the intervention, and 30 days after the intervention in the Experimental Group and Control Group, it was found that immediately after SKY, HCPs experienced a significant improvement in Professional Fulfillment, work exhaustion, positive affect, and negative affect compared to the Control Group. The effect of SKY continued until Day 30 for Professional Fulfillment and had positive and negative effects. Findings suggest that SKY elevated Professional Fulfillment among HCPs during the COVID-19 pandemic and reduced their work exhaustion and the negative effect on their mental health. SKY can aid HCPs in maintaining their well-being when faced with unprecedented challenges. (shrink)

In the fight against racism, philosophy has to interrogate caste in its own histories and current decolonial consensus. Caste has been evading its interrogation as the oldest race theory and racist practice, which continue to oppress the lower-caste peoples who constitute the majority population of the Indian subcontinent. Caste and race are species of the hypophysics of man, which consecrates scaled intrinsic value in human nature through the notion of “being born as” by “being born to.” They are analogues in (...) having the same denigrate-dominate function of exploiting by including as born inferior. However, caste and race are also homologues since the hypophysics of caste has been at the origins of the hypophysics of race from at least the eighteenth century, culminating in the “Aryan doctrine” of the Nazis, now being revived. Caste was the empirical, conceptual, and textual resource for Europeans as it showed that large groups could be dominated as well as excluded through the self-designated superiority, supplied by the Brahminical texts, of the oppressing group. Rather than a colonial construct, caste is the oldest racism, which in colonial times devised new calypsologies—ways to mask itself against rising anticaste thought and politics. Postcolonial and subaltern theories disguise caste’s racism as “religion,” “culture,” and subaltern subjectivity, while some sociologists have denigrated Dalit scholarship as unacademic and emotional. The homologies of caste are still dangerously regnant today. (shrink)

This chapter discusses intergenerational class mobility, which is the extent to which sons — and even daughters — follow in their father's footsteps. It asks how ‘open’ India is, and whether it is becoming more ‘open’ with greater equality of opportunity as it slowly modernises. The discussion is limited to the patterns of intergenerational mobility of men and women who are actually in paid employment.

The practice of paying prisoners to for their participation in research has long been debated, and the controversy is reflected in the differing policies in the U.S. prison systems. Empirical study of financial payments to inmates who enroll in research has focused on whether this practice is coercive. In this study, we examined whether monetary incentives have the potential to be unduly influential among fifty HIV‐positive prisoners. The majority of prisoners surveyed believed that inmates should receive some compensation for their (...) involvement in research and disagreed with statements suggesting that the offer of payment constitutes undue influence. However, a sense of potentially being susceptible to undue influence was significantly higher among participants who had spent a longer time in prison and had less education. Overall, our findings suggest that most prisoners feel that they would be able to make a decision about research enrollment that is not solely based on an offer of monetary payment. (shrink)

Is there a philosophical nationalism? Reading Fichte’s Addresses to the German Nation and its use by the Nazis, Derrida concluded that all nationalisms are philosophical and onto-theological as they are posited beyond race, biology, and nature. However, Fichte’s text reveals a specific form of racism that insists on biology and nature. Fichte’s racism is a species of “hypophysics,” a consecration of nature as value. His theory of language is simultaneously biological and spiritual, these two aspects flowing from a single geistige (...) Naturgesetz (spiritual-natural-law) and determining the hypophysical unity of language, community and “philosophy” (as he defined it). The logic of such a hypophysics is misrecognized and left unaddressed in the conventional categories of “naturalism” and “biologism.” Further, hypophysical-logic is not onto-theo-logic (in Heidegger’s definition). This imposes new questions for the history and future of philosophy: how does hypophysics enter philosophy; can there be philosophy without hypophysics and its attendant racisms? (shrink)

Freud’s late works established the schema of a more or less inexorable civilizational course built around one drive—the death drive—despite his emphatic insistence on a dual structure of two drives. This schema became influential for Critical Theory and in a more subterranean way, also for decolonial thought, and has been widely invoked during the pandemic. It indicates the extent to which drive, destruction, and mastery have consolidated into a, which not only fails to be dislodged by but even informs Derrida’s (...) readings of Freud. Instead, we have to be attentive to the play of homology in Freud as of life, psyche, and civilization, as archaic inheritance. Freudian homology distinguishes itself from what Derrida called “genealogical drive.” The Freudian assumptions in this regard need to be addressed in a step beyond which works with a concept of origin—as its own interruption—that can neither comprehend nor deconstruct the concept of origin as a single and perpetually active homological power as is to be found in Freud. (shrink)

The authors of this insightful and urgent collection both use the metaphor of evil as a virus or contagion and conceptualize the COVID-19 virus as a manifestation of evil to reconsider the purpose of philosophy in and for a pandemic.

The emphasis in human pluripotent stem cell (hPSC) technologies has shifted from cell therapy to in vitro disease modelling and drug screening. This review examines why this shift has occurred, and how current technological limitations might be overcome to fully realise the potential of hPSCs. Details are provided for all disease‐specific human induced pluripotent stem cell lines spanning a dozen dysfunctional organ systems. Phenotype and pharmacology have been examined in only 17 of 63 lines, primarily those that model neurological and (...) cardiac conditions. Drug screening is most advanced in hPSC‐cardiomyocytes. Responses for almost 60 agents include examples of how careful tests in hPSC‐cardiomyocytes have improved on existing in vitro assays, and how these cells have been integrated into high throughput imaging and electrophysiology industrial platforms. Such successes will provide an incentive to overcome bottlenecks in hPSC technology such as improving cell maturity and industrial scalability whilst reducing cost. (shrink)

One interpretation of the conditional If P then Q is as saying that the probability of Q given P is high. This is an interpretation suggested by Adams (1966) and pursued more recently by Edgington (1995). Of course, this probabilistic conditional is nonmonotonic, that is, if the probability of Q given P is high, and R implies P, it need not follow that the probability of Q given R is high. If we were confident of concluding Q from the fact (...) that we knew P, and we have stronger information R, we can no longer be confident of Q. We show nonetheless that usually we would still be justified in concluding Q from R. In other words, probabilistic conditionals are mostly monotonic. (shrink)

Journal of Philosophical Logic 34, 97-119, 2005.

Purpose The purpose of this paper is to understand the dark side of blockchain technology (BCT) adoption in small and mid-size enterprises. The focus of the authors is to decode the intricate relationship among the selected variables missing in the existing literature. Design/methodology/approach A focused group approach is initiated by the authors to identify the barriers. Total interpretive structural modeling, Matrice d'impacts croisés multiplication appliquée á un classment, that is, matrix multiplication applied to classification and decision-making trial and evaluation laboratory (...) are used to analyze the complex relationships among identified barriers. Findings This study finds that implementation of BCT reduces maintenance cost by withdrawing manual effort, as BCT has better capability to quantify the internal status of the system (observability characteristic). The observability characteristic of BCT provides high compatibility to the system. This study also finds that the compatibility of BCT with the organization reduces implementation cost and facilitates project management. The findings of this study recommend analyzing maintenance cost and compatibility of BCT before implementing it. Small and mid-size enterprises can select complex BCT depending on the sophistication level of IT usage and IT project management capabilities. Research limitations/implications This study comes with various limitations, where the model developed by the authors may not be conclusive, as it is based exclusively on expert opinion. The samples collected may not help in validating the model statistically. Though the model has its limitations, it can still be considered as a nascent initiative for further investigation using structural equation modeling. Originality/value The outcomes of the theoretical and managerial contributions of the study can be categorized into three levels. This study can be used both by the industrialists and researchers to understand the barriers and the recovery methods thereafter. Suggestions that serve as future directives are also discussed by the authors. (shrink)

In her article, around the vision of Obiora Ike, the author presents how multicultural education is made possible, in a world where, as university education functions as a fantastic bridge builder, it is a good catalyst for social reforms and equality. University is a place for dynamical leadership at all levels and for a peaceful engagement along the advancement of the digital revolution and reliance on information technology.

Purpose Google commands approximately 70 per cent of search market share worldwide, resulting in businesses investing heavily in search engine advertising on Google to target potential customers. Recently, Google changed the way in which content and ads were displayed on the search engine results page. This reshuffling of content and ads is expected to affect the advertisers who advertise on Google and/or use it to drive traffic to their websites. The purpose of this study is to analyze the impact of (...) these changes on various stakeholders. Design/methodology/approach Data have been collected from various sources on the internet including blogs and discussion forums. Netnography has been used as it allows a detailed evaluation of the consumers’ needs, wants and choices in a virtual space. Findings The average cost-per-click for ads on the top positions is expected to increase. Advertisers whose ads usually occupy the lower positions would be adversely affected. To counter this, more emphasis should be placed on ad extensions and on product listing ads. In addition, organizations would benefit from increased efforts on search engine optimization. Practical implications A variety of coping strategies have been developed that can help marketers to successfully navigate through the change, including the use of ad extensions and the use of product listing ads. Originality/value This practice-focused paper offers guidelines for digital marketers to use sponsored search more effectively as part of their arsenal in light of some important changes recently made by Google. The potential of netnography as a research methodology has also been expanded by using it in a novel setting and in drawing up actionable insights. (shrink)

“Humble” and “business school” are not two words you might associate together, but we can address grand challenges only if business school education instills epistemic humility through reflexivity. We hope that this call-to-action challenges educators to consider how we develop future business leaders who are sensitized to the communities around them, open to tackling the range of challenges that the Sustainable Development Goals (SDGs) present to all of society.

Subset Spaces were introduced by L. Moss and R. Parikh in [8]. These spaces model the reasoning about knowledge of changing states.In [2] a kind of subset space called intersection space was considered and the question about the existence of a set of axioms that is complete for the logic of intersection spaces was addressed. In [9] the first author introduced the class of directed spaces and proved that any set of axioms for directed frames also characterizes intersection spaces.We (...) give here a complete axiomatization for directed spaces. We also show that it is not possible to reduce this set of axioms to a finite set. (shrink)

We investigate the semantics of messages, and argue that the meaning ofa message is naturally and usefully given in terms of how it affects theknowledge of the agents involved in the communication. We note thatthis semantics depends on the protocol used by the agents, and thus not only the message itself, but also the protocol appears as a parameter in the meaning. Understanding this dependence allows us to give formal explanations of a wide variety of notions including language dependence, implicature, (...) and the amount of information in a message. (shrink)

The standard theory for belief revision provides an elegant and powerful framework for reasoning about how a rational agent should change its beliefs when confronted with new information. However, the agents considered are extremely idealized. Some recent models attempt to tackle the problem of plausible belief revision by adding structure to the belief bases and using nonstandard inference operations. One of the key ideas is that not all of an agent's beliefs are relevant for an operation of belief change.In this (...) paper we incorporate the insights pertaining to local change and relevance sensitivity with the use of approximate inference relations. These approximate inference relations offer us partial solutions at any stage of the revision process. The quality of the approximations improves as we allow for more and more resources to be used. We are provided with upper and lower bounds to what would be obtained with the use of classical inference. (shrink)

In Language and Equilibrium, Prashant Parikh offers a new account of meaning for natural language. He argues that equilibrium, or balance among multiple interacting forces, is a key attribute of language and meaning and shows how to derive the meaning of an utterance from first principles by modeling it as a system of interdependent games.His account results in a novel view of semantics and pragmatics and describes how both may be integrated with syntax. It considers many aspects of meaning--including (...) literal meaning and implicature--and advances a detailed theory of definite descriptions as an application of the framework.Language and Equilibrium is intended for a wide readership in the cognitive sciences, including philosophers, linguists, and artificial intelligence researchers as well as neuroscientists, psychologists, and economists interested in language and communication. (shrink)

Trisomy 13 and 18 are rare chromosomal abnormalities associated with high morbidity and mortality. Improved survival rates and increased prevalence of aggressive medical intervention have resulted in families and physicians holding different perspectives regarding the appropriate management of children with T 13/18. Families were invited for open-ended interviews regarding their experiences with the medical care of a child with T 13/18 over the past 5 years. Seven of 33 invited families were surveyed; those who had spent more than 40 days (...) in the hospital were most likely to accept the invitation. Grounded theory technique was used to analyze the interviews. This method elicited four key themes regarding family perspectives on children with T 13/18: they are unique and significant, they transform the lives of others, their families can feel overwhelmed and powerless in the medical setting, their families are motivated to “carry the torch” and tell their story. Families also emphasized ways in which Internet support groups can provide both positive and negative perspectives. The ensuing discussion explores the difficulties of parents and physicians in forecasting the impact that T 13/18 will have on families and emphasizes a narrative approach to elicit a map of the things that matter to them. The paper concludes that while over-reliance on dire prognostic data can alienate families, examining the voice, character and plot of patient stories can be a powerful way for physicians to foster shared decision-making with families. (shrink)