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Requests by patients for providers of specific demographic backgrounds pose an ongoing challenge for hospitals, policymakers, and ethicists. These requests may stem from a wide variety of motivations; some may be consistent with broader societal values, although many others may reflect prejudices inconsistent with justice, equity, and decency. This paper proposes a taxonomy designed to assist healthcare institutions in addressing such cases in a consistent and equitable manner. The paper then reviews a range of ethical and logistical challenges raised by such requests and proposed guidance to consider when reviewing and responding to them.
The conclusion higlights continuing challenges for the EU and the rest of the world and how the future humanity faces is uncertain. Yet an optimistic message is also presented. Noting that shareholder primacy is increasingly coming under question and a growing interest in the concepts of corporate purpose and sustainable value creation, the conclusion draws upon the suggestions made among the chapters throughout the book to highlight the potential for corporations to be a force for good if supported by more effective legal and regulatory reforms and operating with more innovative structures and technologies. More stable, resilient and democratic institutional structures are necessary too as is the inclusion of active political and entrepreneurial women. Also fundamental to change is setting sustainable value creation within planetary boundaries as an overarching purpose for business, with mandatory rules to ensure that sustainability is integrated into the governance of business across global value chains. In a policy coherence for sustainability perspective, the book concludes by positioning the research-based reform proposals for business and finance within broader European Union laws and policies, underlining the necessity of reform also of other related areas, including circular economy policies, competition and state aid law and public procurement.
The Home-grown School Feeding Program (HG-SFP) is a model designed to provide school meals to students using foods sourced from local markets. HG-SFP recently has been incorporated as one of the strategies of educational development in Ethiopia aiming to address hunger and food insecurity problems of school children. Yet, evaluation of the successes and challenges of the program has been limited evaluated. The purpose of the present study was to explore the successes and challenges of the SFP in Sidama Region, Southern Ethiopia. This exploratory qualitative study collected data from eight schools targeted for HG-SFP through key informant interviews and focus group discussions (FGDs). A total of sixteen FGDs and twenty-one in-depth interviews were conducted. Purposive sampling was used to include study participants based on their potential relevance in delivering in-depth information. The findings of the present study showed that HG-SFP was successful in improving class attendance and academic performance of school children. In addition, the program had a contribution in saving the parents’ money and time as a result of the food provided. With regard to SFP challenges, lack of permanent clean water provision, delay in ration delivery, poor-quality food provision, inadequate amount of food allocated for the academic year, lack of necessary infrastructure for the program, and lack of training in sanitation and hygiene for cooks were among the major challenges identified. Therefore, program challenges need high-level attention in order to make the school feeding program more successful in Sidama Region, Ethiopia.
This overview first discusses some traditional thoughts on public finance, particularly the thought of implicit taxation, which have had a profound influence on the behavior of the Chinese government historically and currently. It then describes public finance under the centrally planned economic system, followed by an examination of market-oriented public finance reforms before exploring the challenges to China’s public finance. Finally it explains the contributions of this book. By the end of 1956, China completed the “socialist economic reforms,” turning all large- and medium-sized private enterprises into SOEs and small private enterprises into collectively-owned-enterprises. In 1958, the government took back the land previously allocated to farmers and established the people’s communes. Another economic reform started in 1978, allowing private enterprises to develop and allowing farmers to grow whatever they like on the land allocated to them. A modern tax system and a social insurance system were established and local governments have been given some fiscal freedom. However, there are still problems with public finance.
Chapter 7 discusses China’s infrastructure development. It analyzes the ways in which infrastructure investment has been financed, including revenues from land sales, bank loans, infrastructure development funds, domestic and foreign debt, taxes, fees, and user charges. It shows the composition of funds for financing key infrastructures including transportation, telecommunication, energy, and sanitation. It demonstrates that China's infrastructures have grown rapidly in the past twenty-five years. It examines the reasons for the fast infrastructure development in China and the problems with infrastructure development, including a solid tax system, a pro-infrastructure spending system, expansionary fiscal policies, and large local government revenues from land sales and bank borrowings. It also evaluates China’s belt and road initiative and discusses the L17benefits and potential risks to the countries involved.
A comprehensive, up-to-date, insightful, and innovative masterpiece on the Chinese public finance has finally emerged to fill the gap in the field. Considering China's public finance in its entirety, from tax systems, government spending, infrastructure financing, fiscal policies, local government debt, and central-local fiscal relationships to urban and rural social security and healthcare, it analyses China's public finance reforms and examines the reasons and the consequences of these reforms. It explores the challenges to China's public finance, examines its problems, and suggests potential solutions. While covering a broad range of themes, this book remains judicious with the evidence, providing its readers with innovative yet careful conclusions. Using enormous amount of the latest data and illustrative diagrams, the author explains China's public finance with expertise and clarity. This is an indispensable resource for students and scholars from a range of disciplines with an interest in the Chinese economy.
This small-scale mixed methods study sought to explore the nature of the musical learning in the Reception year. Research data from the questionnaires (n = 39) provide some evidence that little has changed over the last two decades in some aspects of the music provision for children aged 4 and 5 years. However, interviews with eight Reception teachers revealed some unexpected findings on account of some contemporary barriers. Qualitative data suggest that children’s entitlement to develop their innate musicality within the Foundation stage curriculum may be at risk, as some teachers find the challenges of ‘fitting it all’ is difficult to accomplish.
This chapter provides an opportunity to engage in analysis of contemporary Australian politics and question some of the challenges chosen for further discussion in this chapter. It also aims to bring together much of the discussion through the previous 12 chapters. By highlighting some of the problems Australia faces, including climate change, a global refugee crisis, and a global pandemic, our goal is not to suggest that Australian democracy is broken beyond repair. All nations face similar issues, and so Australia is not unique in that sense. Indeed, we might still argue Australia is Donald Horne’s The Lucky Country – in both the sense of being ‘lucky’, and in the sense Horne intended it (Horne, 2008). But it is only by analysing the challenges we as a nation face, that students of Australian politics can truly evaluate the future of Australian democracy.
Determining the health-care experiences, problems, and difficulties of nurses during a pandemic is important to shape the measures of nursing care management. This study aimed to better understand clinical nurses’ challenges and expectations surrounding coronavirus disease 2019 (COVID-19) pandemic.
Methods:
A qualitative study with semi-structured interviews was conducted. The study sampling comprised of 48 clinical nurses who have worked in pandemic hospitals. Interviews were recorded, transcribed, and evaluated based on the content analysis method.
Results:
In this study, 6 main themes were determined as intrapersonal, interpersonal, institutional/organizational, community, policies and system challenges, and expectations. Based on the results, nurses’ perceived challenges were psychological distress, dilemma, safety and security issues, workload increased, disruption in family and social relationships, stigmatization encountered, and not making their voices heard enough due to the lack of nurses in the scientific advisory board. Nurses’ expectations were determined as improvement of their personal rights and institutional psychosocial support.
Discussion:
The results of this study can be used as a guide for action plans to support nurses, develop health-care protocols for safe patient care, and create family and pandemic support systems.
Emergencies and disasters occur in any society, and it is the hospitals and their emergency department staff who must be prepared in such cases. Therefore, 1 of the effective methods of training medical care staff is the use of simulators. However, when introducing new simulation approaches, we face many challenges. The aim of this study was to identify challenges of the simulation of the hospital emergency department during disasters and provide effective solutions.
Methods:
This conventional content, thematic, analysis study was conducted in 2021. Participants were selected from Iranian experts using purposeful and snowball sampling methods. Data were collected using semi-structured interviews and were analyzed by the content analysis.
Results:
After analyzing the data, the challenges of simulating the hospital emergency department during disasters were identified in 2 main components and 6 perspectives, which included organizational components (inappropriate and aimless training methods, lack of interaction and cooperation, lack of funding, and inadequate physical space) and technological components (weak information management and lack of interdisciplinary cooperation). Solutions included management (resource support) and data sharing and exchange (infrastructures, cooperation and coordination).
Conclusion:
The simulation technology can be used as a method for training and improving the quality of health care services in emergencies. Considering that most of these challenges can be solved and need the full support of managers and policy makers, by examining these issues, supporting staff of health care centers are advised to make a significant contribution to the advancement of education and problem reduction in the event of disasters.
Most seniors in Canada live at home and consistently indicate that they prefer to stay there for as long as possible. Consequently, this desire places increasing pressure on supports such as informal caregivers and community services. The current rapid review set out to examine the psychosocial aspects of aging and dying in place that point to gaps in programs and services to support this preference. We searched PubMed, PsycInfo, and Google Scholar for peer-reviewed entries, and identified 42 articles for analysis, which we charted on a form we created and tested. Lack of attention to the whole person, lack of preparation for the journey ahead, and difficulties establishing collaborative and trusting relationships were, broadly, the challenges identified. A blend of initiatives in the community combined with an integrated palliative approach to care may mitigate some of the challenges that limit options for aging and dying in place.
Different abilities enlarge the terrain of the creative trance. By demonstrating the extended capacities of human beings, challenges widen the possibilities for everyone. Not all conditions can be “cured,” but healing is always available through self-transformation. Differently abled people experience altered states in sports competitions, the Paralympics, dance, wheelchair dance, music, science, and visual art, sometimes without limbs, vision, or hearing. They share a triumph of achievement gained through accomplishing something that was at one time thought to be impossible – perhaps even by them. There are physically integrated dance and theater companies for people of all abilities and a long lineage of blind African American music professionals. The effort to confront impediments alters the neural landscapes of their brains and empowers their creative trance. As the world champion wheelchair dancer, Piotr Iwanicki says, “When I’m on the dance floor, nothing matters at all. Dancing is all my life. It’s my passion.”
Digital Twins and Product-Service Systems are just two of the recent trends in product development. While many presented approaches seem promising, their implementation often face challenges. This is especially true if existing approaches are transferred onto new applications. Diving into these topics this paper presents the basics but also challenges as well as synergies emerging between them. The objective is set, to move from specialised applications to broader approaches that can provide benefit to a range of applications and ease the entrance, particularly, for smaller enterprises.
In a smart product-service system (smart PSS), non-tangible services are bundled with tangible products as well as options for information and communication technologies. Enterprises offer smart PSS in order to provide added value for customers and deal with increasing competitive pressure. However, the development of these complex systems also presents enterprises, especially SMEs, with challenges. In order to identify the challenges in the development of smart PSS and requests for corresponding support, a multi-method study was conducted with eighteen participants from German SMEs.
Access to care services in remote areas is challenging. The use of telemedicine technology in these areas facilitates access to health care. This study aimed to summarize the current research on telemedicine in remote areas such as mountains and forests. A systematic search was conducted in databases including Medline (through PubMed), Scopus, IEEE Xplore Digital Library, and ISI Web of Science to identify relevant studies published until May 12, 2021. Screening of retrieved articles for selection and inclusion in the study was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes extension for Scoping Reviews (PRISMA-ScR) checklist. A total of 807 articles were identified after removing duplicates, from which 20 studies meeting our inclusion criteria were selected. Challenges, opportunities, and equipment required to use telemedicine in remote areas were extracted from the selected studies. The results revealed that telemedicine implementation in remote areas had many challenges, including harsh weather conditions, Internet connectivity problems, difficult equipment transportation, and ethical issues. Telemedicine also has many benefits, such as cost and time savings for patients, improving patients’ quality of life, and improving patient satisfaction. Telemedicine for inhabitants of forested and mountainous areas facilitates rapid access to health care and enhances patient satisfaction. Distinguishing advantages and barriers as well as reducing restrictions will have an essential role in accelerating the use of this technology.
This chapter assessed sustainability and resilience of eleven farming systems in their current situation, as well as in hypothetical future systems, using qualitative and quantitative methods. The assessment shows that current farming systems address sustainability dimensions in an unbalanced way and are characterized by poor resilience. Future resilient systems are imagined to promote environmental and social functions in the long term.
The Swedish egg and broiler sector faces strict regulation, changes in consumer’ preferences for high-quality food, and a need for constant technological adaptation. The aim of this chapter is to map key characteristics and to assess the resilience of the sector.
This chapter explores the current and future resilience of the small, mixed farming systems in the Nord-Est region of Romania. The chapter shows how the agricultural system, which has already undergone a major transformation after the collapse of communism in the 1990s, continues to reorganize and to adapt to the new conditions of the market economy and to respond to the new challenges induced by it.
The huge explosion that occurred at Beirut Port led to a high number of casualties. Consequently, 7 field hospitals (FHs) were deployed in Lebanon. The purpose of this study is to explore the challenges that emergency medical teams (EMTs) faced and explain the gaps at the national level related to deploying a FH.
Methods:
A qualitative study was conducted. To collect the data, semi-structured interviews were done with 8 key informants (5 from the FHs, 2 from Lebanese Army Forces, and 1 from Ministry of Public Health). In this study, purposive sampling was used and data were analyzed using Braun and Clarke (2006) thematic analysis and MAXQDA software.
Results:
Three major themes (logistical challenges, staff challenges, and coronavirus disease [COVID-19] pandemic) and 10 subthemes emerged for the challenges that EMTs faced. The gaps at the national level were categorized into 2 themes (absence of needs-based response and limited effective coordination between the host country and donor countries) and 5 sub-themes.
Conclusion:
Lebanon focuses on response rather than preparedness for disasters. EMTs that arrived didn’t meet the medical needs. Hence, there is a need to strengthen the national capacities and to ensure better communication and coordination between the disaster-affected country and the EMTs.
The law of neutrality is not obsolete. Its validity subsists despite the prohibition of the use of force,the advent of collective security and the violations of the rights of neutrals during the two world wars. The sources of the law are customary laws and treaties. Customary law of neutrality is based on State practice mainly in the form of national military manuals. It is applicable in the event of an international armed conflict irrespective of the existence of a formal state of war and irrespective of the scale and extent of th conflict. Neutrality has withstood the challenge of collective security and the prohibition of the use of force both in the interwar years and after World War II. The gross violations of the rights of neutrals during World Wars I and II have been justified as reprisals or countermeasures; this is a further confirmation that beligerent practice at the time constituted a deviation from the law rather than a change or demise of the law of neutrality.