Ethical Concerns in the Business of Recreation and Leisure

Recreation professionals entering the world of business confront value conflicts and ethical dilemmas. Ethical decision-making traditionally has been guided by philosophical principles briefly outlined in this article. Some professionals find the classical approaches too abstract for dealing with the very concrete-situations of the business world. Others accuse classical ethical theory of a utopian, even anticapitalistic, bias. A number of business situations with potential value conflicts are described, including competition, truth in advertising; relations with employees, and relation with clients/customers. An anticipatory ethical approach is recommended, with business administrators providing ethical leadership at the policy level, and the individual recreation entrepreneur recognizing the responsibility to develop a personal framework for resolving ethical dilemmas in a reasoned and consistent way

Federalism and Health Care in Canada: A Troubled Romance?

Canadian federalism fragments health system governance. Although the Constitution has been interpreted as providing shared jurisdiction over health generally, with respect to health care, the courts have interpreted it as giving direct jurisdiction to the provinces. The federal role in health care is therefore indirect, but nevertheless potentially powerful. For example, the federal government has used its spending powers to establish the Canada Health Act (CHA), which commits funding to provinces on condition they provide first-dollar public coverage of hospital and physician services. However, in recent times, as federal contributions have declined, the CHA has been weakly enforced. Further, the failure to broaden the CHA to include prescription drugs, dentistry, and other important aspects of health care have contributed to Canada’s abysmal record on Aboriginal health and its increasingly poor rankings in international comparisons. Progress requires enforcement of an adequately funded CHA, national pharmacare, and concerted action on Aboriginal health

Federalism and Health Care in Canada: A Troubled Romance?

Canadian federalism fragments health system governance Although the Constitution has been interpreted as providing shared jurisdiction over health generally with respect to health care specifically the courts have interpreted the Constitution as giving direct jurisdiction to the provinces The Federal role in health care is therefore indirect but nevertheless potentially powerful For example the Federal government has used its spending powers to establish the Canada Health Act CHA which commits funding to provinces on condition they provide firstdollar public coverage of hospital and physician services However in recent times as federal contributions have declined the CHA has been weakly enforced Further the failure to broaden the CHA to include prescription drugs dentistry and other important aspects of health care have contributed to Canada\u27s abysmal record on aboriginal health and its increasingly poor rankings in international comparisons Progress requires enforcement of an adequately funded CHA national pharmacare and concerted action on aboriginal health It requires bolder federal action and a panCanadian approach to governance in which federalism again becomes a laboratory of experimentation including on health human resource planning drug utilization and safety health emergency readiness health technology assessment electronic health information systems and systemlevel quality assuranc

An Ethical Framework for Global Psychiatry

Existing literature addresses the ethical considerations of global health work and how medical school curricula can help prepare students for them, but little has been written regarding an ethical approach to global psychiatry. In this paper we summarize prominent ethical issues that arise in global health psychiatry in order to provide a foundation for a framework in global health psychiatry. These issues include obtaining informed consent in the face of language barriers, diagnosing and treating for mental illnesses while navigating communities where such conditions are heavily stigmatized, and justifying the cessation of proving care to current patients for the sake of providing care to new patients abroad. To help prepare psychiatrists and students for work that engages these issues, we propose a multi-step process to assist the practicing global psychiatrist in recognizing ethical dilemmas and evaluating potential courses of action based on their respective ethical merits

Evidence for nuclear emissions during acoustic cavitation,”

Abstract: This paper extends the experimental and numerical results presented previously and addresses the major criticisms raised. In addition, the most recent results are discussed. In acoustic cavitation experiments with chilled (0 8C) deuterated acetone (C 3 D 6 O), the production of tritium and 2.45 MeV neutrons [which are characteristic of deuterium-deuterium (D -D) fusion] was observed during vapour bubble implosions in an acoustic pressure field. Similar experiments with deuterated acetone at room temperature (20 8C) and control experiments with normal acetone (C 3 H 6 O), at both 0 and 20 8C, showed no statistically significant increases in either tritium level or neutron emissions. Numerical simulations of the processes that account for the shock waves generated in the liquid and within the collapsing bubbles supported these experimental observations and showed that high densities and temperatures (510 8 K) may be achieved during bubble cloud implosions, yielding the conditions required for D -D nuclear fusion reactions. The present paper treats the bubble fusion experiments and theoretical results in greater detail than was possible in the previous publications, contains some refinements, addresses some important questions raised by reviewers and critics and discusses possible applications of this interesting phenomenon

Test Characteristics of Urinary Lipoarabinomannan and Predictors of Mortality among Hospitalized HIV-Infected Tuberculosis Suspects in Tanzania.

Tuberculosis is the most common cause of death among patients with HIV infection living in tuberculosis endemic countries, but many cases are not diagnosed pre-mortem. We assessed the test characteristics of urinary lipoarabinomannan (LAM) and predictors of mortality among HIV-associated tuberculosis suspects in Tanzania. We prospectively enrolled hospitalized HIV-infected patients in Dar es Salaam, with ≥2 weeks of cough or fever, or weight loss. Subjects gave 2 mLs of urine to test for LAM using a commercially available ELISA, ≥2 sputum specimens for concentrated AFB smear and solid media culture, and 40 mLs of blood for culture. Among 212 evaluable subjects, 143 (68%) were female; mean age was 36 years; and the median CD4 count 86 cells/mm(3). 69 subjects (33%) had culture confirmation of tuberculosis and 65 (31%) were LAM positive. For 69 cases of sputum or blood culture-confirmed tuberculosis, LAM sensitivity was 65% and specificity 86% compared to 36% and 98% for sputum smear. LAM test characteristics were not different in patients with bacteremia but showed higher sensitivity and lower specificity with decreasing CD4 cell count. Two month mortality was 64 (53%) of 121 with outcomes available. In multivariate analysis there was significant association of mortality with absence of anti-retroviral therapy (p = 0.004) and a trend toward association with a positive urine LAM (p = 0.16). Among culture-negative patients mortality was 9 (75%) of 12 in LAM positive patients and 27 (38%) of 71 in LAM negative patients (p = 0.02). Urine LAM is more sensitive than sputum smear and has utility for the rapid diagnosis of culture-confirmed tuberculosis in this high-risk population. Mortality data raise the possibility that urine LAM may also be a marker for culture-negative tuberculosis

Children's Medicines in Tanzania: A National Survey of Administration Practices and Preferences.

The dearth of age-appropriate formulations of many medicines for children poses a major challenge to pediatric therapeutic practice, adherence, and health care delivery worldwide. We provide information on current administration practices of pediatric medicines and describe key stakeholder preferences for new formulation characteristics. We surveyed children aged 6-12 years, parents/caregivers over age 18 with children under age 12, and healthcare workers in 10 regions of Tanzania to determine current pediatric medicine prescription and administration practices as well as preferences for new formulations. Analyses were stratified by setting, pediatric age group, parent/caregiver education, and healthcare worker cadre. Complete data were available for 206 children, 202 parents/caregivers, and 202 healthcare workers. Swallowing oral solid dosage forms whole or crushing/dissolving them and mixing with water were the two most frequently reported methods of administration. Children frequently reported disliking medication taste, and many had vomited doses. Healthcare workers reported medicine availability most significantly influences prescribing practices. Most parents/caregivers and children prefer sweet-tasting medicine. Parents/caregivers and healthcare workers prefer oral liquid dosage forms for young children, and had similar thresholds for the maximum number of oral solid dosage forms children at different ages can take. There are many impediments to acceptable and accurate administration of medicines to children. Current practices are associated with poor tolerability and the potential for under- or over-dosing. Children, parents/caregivers, and healthcare workers in Tanzania have clear preferences for tastes and formulations, which should inform the development, manufacturing, and marketing of pediatric medications for resource-limited settings