Code Fear Kramer, Eric N.
Academic psychiatry,
12/2023, Letnik:
47, Številka:
6
Journal Article
Recenzirano
Odprti dostop
Fast forward 2 years, and I have experienced highs and lows of patient care, from losing a patient to possible suicide to diagnosing psychosis due to a presumed pheochromocytoma, only for the patient ...to discharge against medical advice before confirming the diagnosis on imaging. Losing a patient to suicide can have lasting impacts on mental health professionals, and I cannot imagine navigating such an event without such support 3. The impact on mental health practitioners of the death of a patient by suicide: a systematic review.
Boin (2019) argues that in transboundary crisis management it is almost impossible to achieve centralization and coordination. This article identifies three principles through which actors in a ...transboundary crisis can balance centralization with autonomy while shaping coordination along the way. We reanalysed three transboundary cases: the Dutch military mission in Afghanistan, the downing of MH17 and hurricane Irma striking Sint‐Maarten. The principles we found are as follows: (a) reformulating key strategic priorities, (b) flexible adaptation of crisis management protocols and (c) the emergence of multifunctional units. With these three principles, we reflect on challenges in the Dutch crisis response to the corona outbreak and propose improvements for progressing current crisis management efforts.
...1 h is the cumulative amount of required, dedicated firearm injury prevention education that the first and second authors have received across their combined 6 years of medical school at two ...institutions, which is staggering, considering the 48,830 firearm deaths in the USA in 2021 that have created untold traumas and a pervasive fear of mass shootings, even though mass shootings represent a tiny fraction of all firearm deaths 2. While involuntary psychiatric holds may have differing implications on firearm ownership by state, certain individuals involuntarily admitted to a psychiatric hospital receive a federal lifetime ban from purchasing and owning firearms. Medical educators should form collaborations between schools of public health and public policy and look to the multidisciplinary expert advisory group that created the first national consensus guidelines on firearm injury education for medical professionals, as these guidelines can act as a framework for curriculum development 5.
As an organization operating under extreme conditions, the military is often confronted with destructive behavior from individuals, organizations, and societies. Written by experts from a variety of ...disciplines, this open access book reflects on confrontations with violence under extreme conditions and the various challenges that arise. By examining real first-hand accounts of soldiers’ deployments, the contributions shed new light on the multifaceted and sometimes hidden dynamics of destructive violent behavior and offer an ethical reflection on military practices. In addition, they address topics such as moral decision-making in violent contexts, military trauma, organizational change, and military ethics education. The interdisciplinary exploration of these topics has been the primary focus of Désirée Verweij, who was the Chair of Military Ethics at the Netherlands Defence Academy from 2008 to 2021. The contributions in this book are written in honor of her scholarly achievements and help to ensure that these important issues continue to receive attention. The book will appeal to scholars of military studies, organizational studies and military ethics, and to professionals and decisionmakers in military organizations.
Abstract Objective This study explores the tensions, challenges, and dangers when a utilitarian view of interpreter is constructed, imposed, and/or reinforced in health care settings. Methods We ...conducted in-depth interviews and focus groups with 26 medical interpreters from 17 different languages and cultures and 39 providers of five specialties. Grounded theory was used for data analysis. Results The utilitarian view to interpreters’ roles and functions influences providers in the following areas: (a) hierarchical structure and unidirectional communication, (b) the interpreter seen as information gatekeeper, (c) the interpreter seen as provider proxy, and (d) interpreter's emotional support perceived as tools. Conclusion When interpreters are viewed as passive instruments, a utilitarian approach may compromise the quality of care by silencing patients’ and interpreters’ voice, objectifying interpreters’ emotional work, and exploiting patients’ needs. Practice implications Providers need to recognize that a utilitarian approach to the interpreter's role and functions may create interpersonal and ethical dilemmas that compromise the quality of care. By viewing interpreters as smart technology (rather than passive instruments), both providers and interpreters can learn from and co-evolve with each other, allowing them to maintain control over their expertise and to work as collaborators in providing quality care.
Studies of auxin metabolism rarely express their results as a metabolic rate, although the data obtained would often permit such a calculation to be made. We analyze data from 31 previously published ...papers to quantify the rates of auxin biosynthesis, conjugation, conjugate hydrolysis, and catabolism in seed plants. Most metabolic pathways have rates in the range 10 nM/h-1 μM/h, with the exception of auxin conjugation, which has rates as high as ~100 μM/h. The high rates of conjugation suggest that auxin metabolic sinks may be very small, perhaps as small as a single cell. By contrast, the relatively low rate of auxin biosynthesis requires plants to conserve and recycle auxin during long-distance transport. The consequences for plant development are discussed.
As minimally invasive surgical techniques progress, the demand for efficient, reliable methods for vascular ligation and tissue closure becomes pronounced. The surgical advantages of energy-based ...vessel sealing exceed those of traditional, compression-based ligatures in procedures sensitive to duration, foreign bodies, and recovery time alike. Although the use of energy-based devices to seal or transect vasculature and connective tissue bundles is widespread, the breadth of heating strategies and energy dosimetry used across devices underscores an uncertainty as to the molecular nature of the sealing mechanism and induced tissue effect. Furthermore, energy-based techniques exhibit promise for the closure and functional repair of soft and connective tissues in the nervous, enteral, and dermal tissue domains. A constitutive theory of molecular bonding forces that arise in response to supraphysiological temperatures is required in order to optimize and progress the use of energy-based tissue fusion. While rapid tissue bonding has been suggested to arise from dehydration, dipole interactions, molecular cross-links, or the coagulation of cellular proteins, long-term functional tissue repair across fusion boundaries requires that the reaction to thermal damage be tailored to catalyze the onset of biological healing and remodeling. In this review, we compile and contrast findings from published thermal fusion research in an effort to encourage a molecular approach to characterization of the prevalent and promising energy-based tissue bond.
Plasmodesmata permit solutes to move between cells nonspecifically and without having to cross a membrane. This symplastic connectivity, while straightforward to observe using fluorescent tracers, ...has proven difficult to quantify. We use fluorescence recovery after photobleaching, combined with a mathematical model of symplastic diffusion, to assay plasmodesmata-mediated permeability in the Arabidopsis (Arabidopsis thaliana) root meristem in wild-type and transgenic lines, and under selected chemical treatments. The permeability measured for the wild type is nearly 10-times greater than previously reported. Plamodesmal permeability remains constant in seedlings treated with auxin (30 nM indoleacetic acid for 2 and 24 h; 100 nM indoleacetic acid for 2 h); however, permeability is diminished in two lines previously reported ro have impaired plasmodesmal function as well as in wild-type seedlings treated for 24 h with 0.6 mM tryptophan. Moreover, plasmodesmal permeability is strongly altered by applied hydrogen peroxide within 2 h of treatment, being approximately doubled at a low concentration (0.6 mM) and nearly eliminated at a higher one (6 mM). These results reveal that the plasmodesmata in the root meristem carry a substantial flux of small molecules and that this flux is subject to rapid regulation.
Many militaries envision a technologically advanced future with a strong innovative capability and therefore invest in so-called innovation hubs focused on experimenting with new modes of operation ...with drones and (semi-)autonomous vehicles. However, there appears to be a discrepancy between these military visions and soldiers’ lived experiences on the ground. This article presents an ethnographic study of one innovation hub: the Robots and Autonomous Systems unit of the Dutch Army. Examining this unit through an analytical framework of sociotechnical imaginaries and expectations, we first outline how “innovation” and “military” imaginaries are integrated so that technological innovation is presented as necessary, desirable, and inevitable for military futures. Second, we explore soldiers’ experiences of military innovation, identifying friction between the strategic and operational levels. At the strategic level, soldiers experience meaning and purpose in their work whereas, at the operational level, soldiers’ expectations, practices, and experiences do not align with the “innovative military future” imaginary, resulting in disillusionment. With this empirical study, we contribute to a better understanding of how large-scale visions of technological “progress” play out in military practice.
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