This paper describes a practice innovation: the addition of formal weekly discussions of patients with prolonged PICU stay to reduce healthcare providers’ moral distress and decrease length of stay for patients with life-threatening illnesses. We evaluated the innovation using a pre/post intervention design measuring provider moral distress and comparing patient outcomes using retrospective historical controls. Physicians and nurses on staff in our pediatric intensive care unit in a quaternary care children's hospital participated in the evaluation. There were 60 patients in (...) the interventional group and 66 patients in the historical control group. We evaluated the impact of weekly meetings to establish goals of care for patients with longer than 10 days length of stay in the ICU for a year. Moral distress was measured intermittently and reported moral distress thermometer scores fluctuated. "Clinical situations" represented the most frequent contributing factor to moral distress. Post intervention, overall moral distress scores, measured on the moral distress scale revised, were lower for respondents in all categories, and on three specific items. Patient outcomes before and after PEACE intervention showed a statistically significant decrease in PRISM indexed LOS, a statistically significant increase in both code status changes DNR, and in-hospital death, with no change in patient 30 or 365 day mortality. The addition of a clinical ethicist and senior intensivist to weekly inter-professional team meetings facilitated difficult conversations regarding realistic goals of care. The study demonstrated that the PEACE intervention had a positive impact on some factors that contribute to moral distress and can shorten PICU length of stay for some patients. (shrink)

Exhaustive study of concept of liberation of soul (Mokṣa) in six systems of Hindu philosophy and other schools.

Reserach work on Hindu doctrines and philosophy.

Television advertisements depicting the use of electronic cigarettes have recently exposed minors to images of smoking behaviors. While these advertisements are currently legal, existing laws should be interpreted or expanded to ban the commercial depiction of smoking behaviors with any product that resembles a cigarette to shield minors from potentially influential advertising.

Amid the action of the 2013 Super Bowl aired the usual array of high-priced advertisements. Most ads were original. Some were unusual. One regional ad, however, seemed distantly familiar. The 30-second commercial promoted the NJOY King electronic cigarette1 to at least 10 million viewers in several major markets. It featured an attractive male model taking a drag from what looks like a cigarette. He then slowly blows smoke to the tune of Foreigner’s “Feels Like the First Time.” Of course, the (...) “smoke” does not come from burning tobacco. Rather, it is the water vapor produced by an e-cigarette as part of its nicotine delivery process. This, however, was not evident from the imagery. For those watching the broadcast, including thousands of minors, NJOY’s advertisement depicted what tobacco companies have not portrayed on television for decades: a person engaged in smoking behavior. (shrink)

Since its inception in September 2010, the Network for Public Health Law has responded to hundreds of public health legal technical assistance claims from around the country. Based on a review of these data, a series of major trends in public health practice and the law are analyzed, including issues concerning: the Affordable Care Act, tobacco control, emergency legal preparedness, health information privacy, food policy, vaccination, drug overdose prevention, sports injury law, public health accreditation, and maternal breastfeeding. These and other (...) emerging themes in public health law demonstrate the essential role of law and practice in advancing the public's health. (shrink)

Public health law research reveals significant complexities underlying the use of law as an effective tool to improve health outcomes across populations. The challenges of applying public health law in practice are no easier. Attorneys, public health officials, and diverse partners in the public and private sectors collaborate on the front lines to forge pathways to advance population health through law. Meeting this objective amidst competing interests requires strong practice skills to shift through sensitive and sometimes urgent calls for action (...) to address known threats to the health of individuals and the community. It also necessitates objective, timely information and national and regional legal support. (shrink)

Misophonia has been characterized as intense negative reactions to specific trigger sounds. However, recent research suggests high-level, contextual, and multisensory factors are also involved. We recently demonstrated that neurotypicals’ negative reactions to aversive sounds are attenuated when the sounds are synced with positive attributable video sources. To assess whether this effect generalizes to misophonic triggers, we developed a Sound-Swapped Video database for use in misophonia research. In Study 1, we created a set of 39 video clips depicting common trigger sounds (...) and a corresponding set of 39 PAVS temporally synchronized with the OVS videos. In Study 2, participants rated the 39 PAVS videos for their audiovisual match and pleasantness. We selected the 20 PAVS videos with best match scores for use in Study 3. In Study 3, a new group of participants observed the 20 selected PAVS and 20 corresponding OVS and judged the pleasantness or unpleasantness of each sound in the two contexts accompanying each video. Afterward, participants completed the Misophonia Questionnaire. The results of Study 3 show a robust attenuating effect of PAVS videos on the reported unpleasantness of trigger sounds: trigger sounds were rated as significantly less unpleasant when paired with PAVS with than OVS. Moreover, this attenuating effect was present in nearly every participant regardless of their score on the MQ. In fact, we found a moderate positive correlation between the PAVS-OVS difference and misophonia severity scores. Overall our results provide validation that the SSV database is a useful stimulus database to study how misophonic responses can be modulated by visual contexts. Here, we release the SSV database with the best 18 PAVS and 18 OVS videos used in Study 3 along with aggregate ratings of audio-video match and pleasantness. We also provide detailed instructions on how to produce these videos, with the hope that this database grows and improves through collaborations with the community of misophonia researchers. (shrink)

Treatise on Vedanta philosophy; includes interpretation in Hindi and Sanskrit.

Annotation. "This trim publication satisfies a much-felt need among teachers of Indian philosophy, who badly want introductions to the several systems of classical Indian thought such as Professor Deutsch provides."--Journal of Asian Studies.

Study of Vedāntakaustubha of Śrīnivāsācārya, commentary on Brahmasūtra of Bādarāyaṇa, work on Vedanta philosophy.

Larry Laudan v článku z roku 1983 označil problém demarkace, tj. rozlišení „vědy" a „pseudovědy", za filosofický pseudoproblém, kterým není třeba se zabývat, a slova „vědecké" a „pseudovědecké" za prázdné pojmy, které můžeme z našeho slovníku zcela vyškrtnout. V předkládané studii zpochybňuji toto Laudanovo stanovisko a předkládám argumenty ve prospěch tvrzení, že 1) rozlišení vědy a pseudovědy představuje důležitý a aktuální problém, kterým je třeba se zabývat, a že 2) možný způsob řešení tohoto problému nabízejí současná sociální studia vědy. Jejich (...) východiskem je pojetí vědy jako „formy života" a pojetí demarkačního kritéria jako proměnlivého souboru charakteristik, který sice nelze jednoznačně definovat, ale přesto jej lze zkoumat, a to prostřednictvím sociologické analýzy vědecké praxe. Mým záměrem je na příkladu několika vzorových studií představit specifika sociologického přístupu z hlediska jeho metodologie i povahy nabízených řešení a zhodnotit jeho možnosti i omezení pro filosofii vědy. (shrink)

Description: The Vedantasutra of Badarayana is one of the great philosophical works of India. It deals with those fundamental questions concerning man's existence, that still remain an enigma despite all attempts of eminent philosophers and religious leaders both past and present, of this world at unravelling its mysteries. The teachings of the Vedas, the doctrines of contemporary philosophers and the purport of important passages from Upanisads are its subject-matter. It is at once a repository of all earlier knowledge, a genesis (...) for further philosophical speculation and an evaluating scale for new metaphysical ideas. Its scope being universal and timeless, Badarayana resorted to a terse and aphoristic style for compressing a vast body of knowledge into such brief statements that could easily be memorized. The sutras are something more than an aphorism; for each, though brief to the point of being obscure, is so pregnant with meaning that interpretation has become difficult and resulted in the growth of an unending line of commentators, both Indian and foreign, spanning centuries from Sankara the earliest, passing through Bhaskara, Ramanuja, Madhva, Srikantha, Nimbarka, Sripati, Vallabha, Suka, Baladeva to Radhakrishnan the latest. This book, known as the Govinda Bhasya, is the commentary of Baladeva, who was a disciple of Sri Caitanya the famous Vaisnavite saint of Bengal. Its approach is theistic and based on the teachings of Madhva and Caitanya. The English translation is faithful to the original. (shrink)