Ethical Values and the Integrity of the Climate Change Regime

This book investigates the ethical values that inform the global carbon integrity system, and reflects on alternative norms that could or should do so. The global carbon integrity system comprises the emerging international architecture being built to respond to the climate change. This architecture can be understood as an 'integrity system'- an inter-related set of institutions, governance arrangements, regulations and practices that work to ensure the system performs its role faithfully and effectively. This volume investigates the ways ethical values impact on where and how the integrity system works, where it fails, and how it can be improved. With a wide array of perspectives across many disciplines, including ethicists, philosophers, lawyers, governance experts and political theorists, the chapters seek to explore the positive values driving the global climate change processes, to offer an understanding of the motivations justifying the creation of the regime and the way that social norms impact upon the operation of the integrity system. The collection focuses on the nexus between ideal ethics and real-world implementation through institutions and laws. The book will be of interest to policy makers, climate change experts, carbon taxation regulators, academics, legal practitioners and researchers.

Osteoporosis medication dispensing for older Australian women from 2002 to 2010: Influences of publications, guidelines, marketing activities and policy

Purpose Developments in anti-osteoporosis medications (AOMs) have led to changes in guidelines and policy, which, along with media and marketing strategies, have had an impact upon the prescribing of AOM. The aim was to examine patterns of AOM dispensing in older women (aged 76–81 years at baseline) from 2002 to 2010. Methods Administrative claims data were used to describe AOM dispensing in 4649 participants (born in 1921–1926 and still alive in 2011) in the Australian Longitudinal Study on Women's Health. The patterns were interpreted in the context of changes in guidelines, indications for subsidy, publications (scholarly and general media), and marketing activities. Results Total use of AOM increased from 134 DDD/1000/day in 2002 to 216 DDD/1000/day in 2007 but then decreased to 184 DDD/1000/day in 2010. Alendronate was the most commonly dispensed AOM but decreased from 2007, while use of risedronate (2002 onward), strontium ranelate (2007 onward) and zoledronic acid (2008 onward) increased. Etidronate and hormone replacement therapy (HRT) prescriptions gradually decreased over time. The decline in alendronate dispensing coincided with increases of other bisphosphonates and publicity about potential adverse effects of bisphosphonates, despite relaxing indications for bone density testing and subsidy for AOM. Conclusions Overall dispense of AOM from 2002 reached a peak in 2007 and thereafter declined despite increases in therapeutic options and improved subsidised access. The recent decline in overall AOM dispensing seems to be explained largely by negative publicity rather than specific changes in guidelines and policy.

Canadian Stroke Best Practice Recommendations: Mood, Cognition and Fatigue Following Stroke practice guidelines, update 2015

Every year, approximately 62 000 people with stroke and transient ischemic attack are treated in Canadian hospitals, and the evidence suggests one-third or more will experience vascular-cognitive impairment, and/or intractable fatigue, either alone or in combination. The 2015 update of the Canadian Stroke Best Practice Recommendations: Mood, Cognition and Fatigue Module guideline is a comprehensive summary of current evidence-based recommendations for clinicians in a range of settings, who provide care to patients following stroke. The three consequences of stroke that are the focus of the this guideline (poststroke depression, vascular cognitive impairment, and fatigue) have high incidence rates and significant impact on the lives of people who have had a stroke, impede recovery, and result in worse long-term outcomes. Significant practice variations and gaps in the research evidence have been reported for initial screening and in-depth assessment of stroke patients for these conditions. Also of concern, an increased number of family members and informal caregivers may also experience depressive symptoms in the poststroke recovery phase which further impact patient recovery. These factors emphasize the need for a system of care that ensures screening occurs as a standard and consistent component of clinical practice across settings as stroke patients transition from acute care to active rehabilitation and reintegration into their community. Additionally, building system capacity to ensure access to appropriate specialists for treatment and ongoing management of stroke survivors with these conditions is another great challenge.

Traversing the space between threats and violence: A review of threat assessment guidelines

While the majority of violent threats – defined as an expression of intent to do harm or act out violently against someone or something – do not progress to actual violence, a small proportion of threateners do go on to enact violence. Most researchers argue that violence risk assessments are inadequate for assessing threats of violence, which raises the question: how should a threat assessment (TA) be conducted? To begin to understand available frameworks for assessing threats, a systematic review of TA research literature was conducted. Most TA literature pertains to a specific domain (schools, public figure threats, workplaces) and target audience (clinicians, school personnel, law enforcement). TA guidelines are typically based on literature reviews with some based on empirical measures and others having no strong evidential basis. The most common concepts in TA are exploration of the threatener's mental health, the motivation for the threat and the presence of any plans. Rather than advocating for the development of a protocol for conducting TA, this article outlines the common areas of inquiry in assessing threats and highlights the limitations of current TA guidelines.

Busy auditors, ethical behavior, and discretionary accruals quality in Malaysia

The required professional and ethical pronouncements of accountants mean that auditors need to be competent and exercise due care and skill in the performance of their audits. In this study, we examine what happens when auditors take on more clients than they should, thus raising doubts about their ability to maintain competence and audit quality. Using 2803 observations of Malaysian companies from 2010 to 2013, we find that auditors with multiple clients are associated with lower earnings quality, proxied by total accruals and discretionary accruals. Our results demonstrate that associating client firms’ reported discretionary accruals with individual auditors, rather than their firms or offices, is important in determining audit quality. Moreover, we demonstrate that the disclosure of auditors’ signatures on their reports is useful for assessing auditor quality at the individual level, thus contributing to the debate on the usefulness of having auditor identities on reports.

Current Care Guidelines for Cardiopulmonary Resuscitation : Implementation, skills and attitudes

Background: The national resuscitation guidelines were published in Finland in 2002 and are based on international guidelines published in 2000. The main goal of the national guidelines, available on the Internet free of charge, is early defibrillation by nurses in an institutional setting. Aim: To study possible changes in cardiopulmonary resuscitation (CPR) practices, especially concerning early defibrillation, nurses and students attitudes of guideline implementation and nurses and students ability to implement the guideline recommendations in clinical practices after publication of the Current Care (CC) guidelines for CPR 2002. Material and methods: CPR practices in Finnish health centres; especially concerning rapid defibrillation programmes, as well as the implementation of CC guidelines for CPR was studied in a mail survey to chief physicians of every health centre in Finland (Study I). The CPR skills using an automated external defibrillator (AED) were compared in a study including Objective stuctured clinical examination (OSCE) of resuscitation skills of nurses and nursing students in Finnish and Swedish hospital and institution (Studies II, III). Attitudes towards CPR-D and CPR guidelines among medical and nursing students and secondary hospital nurses were studied in surveys (Studies IV, V). The nurses receiving different CPR training were compared in a randomized trial including OSCE of CPR skills of nurses in Finnish Hospital (Study VI). Results: Two years after the publication, 40.7% of Finnish health centres used national resuscitation guidelines. The proportion of health centres having at least one AED (66%) and principle of nurse-performed defibrillation without the presence of a physician (42%) had increased. The CPR-D training was estimated to be insufficient regarding basic life support and advanced life support in the majority of health centres (Study I). CPR-D skills of nurses and nursing students in two specific Swedish and Finnish hospitals and institutions (Study II and III) were generally inadequate. The nurses performed better than the students and the Swedish nurses surpassed the Finnish ones. Geriatric nurses receiving traditional CPR-D training performed better than those receiving an Internet-based course but both groups failed to defibrillate within 60 s. Thus, the performance was not satisfactory even two weeks after traditional training (Study VI). Unlike the medical students, the nursing students did not feel competent to perform procedures recommended in the cardiopulmonary resuscitation guidelines including the defibrillation. However, the majority of nursing students felt confident about their ability to perform basic life support. The perceived ability to defibrillate correlated significantly with a positive attitude towards nurse-performed defibrillation and negatively with fear of damaging the patient s heart by defibrillation (Study IV). After the educational intervention, the nurses found their level of CPR-D capability more sufficient than before and felt more confident about their ability to perform defibrillation themselves. A negative attitude toward defibrillation correlated with perceived negative organisational attitudes toward cardiopulmonary resuscitation guidelines. After CPR-D education in the hospital, the majority (64%) of nurses hesitated to perform defibrillation because of anxiety and 27 % hesitated because of fear of injuring the patient. Also a negative personal attitude towards guidelines increased markedly after education (Study V). Conclusions: Although a significant change had occurred in resuscitation practices in primary health care after publication of national cardiopulmonary resuscitation guidelines the participants CPR-D skills were not adequate according to the CPR guidelines. The current way of teaching is unlikely to result in participants being able to perform adequate and rapid CPR-D. More information and more frequent training are needed to diminish anxiety concerning defibrillation. Negative beliefs and attitudes toward defibrillation affect the nursing students and nurses attitudes toward cardiopulmonary resuscitation guidelines. CPR-D education increased the participants self-confidence concerning CPR-D skills but it did not reduce their anxiety. AEDs have replaced the manual defibrillators in most institutions, but in spite of the modern devices the anxiety still exists. Basic education does not provide nursing students with adequate CPR-D skills. Thus, frequent training in the workplace has vital importance. This multi-professional program supported by the administration might provide better CPR-D skills. Distance learning alone cannot substitute for traditional small-group learning, tutored hands-on training is needed to learn practical CPR-D skills. Standardized testing would probably help controlling the quality of learning. Training of group-working skills might improve CPR performance.

Looking-Glass Reflections : Norms in translating Lewis Carroll

This thesis in the field of translation studies focusses on the role of norms in the work of a literary translator. Norms are seen as guidelines for the translator; they also reflect the way the target audience either accepts or rejects the translation. Thus they are of an intersubjective nature. The theoretical background of the study is based on the views on norms of Andrew Chesterman and Gideon Toury. The writer makes use of her own editing and publishing experience, as well as her experience in translating Lewis Carroll, considering these in respect to theoretical views of norms and vice versa. The aim is also to bring to light some of the tacit knowledge related to translating, editing and publishing in Finland. The study has three angles. First, the writer introduces the norms of Finnish literary translation as gathered from her own working experience. The sources from which these norms arise and which affect them are briefly described. Six central translation norms emerge; they are described and exemplified through cases of Carroll translation. Secondly, a small-scale questionnaire study is presented. This was carried out in order to sound the normative views of other translators and to limit the role of subjectivity. The views of the informants largely support the set of norms presented by the writer, although the norms of quotability and harmony between translation and illustration do not arise. Instead, the answers give rise to a seventh, ethical norm, which is labelled the norm of integrity. Thirdly, there is a brief presentation of Lewis Carroll, his Alice books and their translation history in Finland. The retranslation hypothesis and the motives of retranslation are considered in the light of the work of Outi Paloposki and Kaisa Koskinen. The final part of the thesis plunges into actual translation work. It includes one and a half chapters of Through the Looking-Glass (Alicen seikkailut peilintakamaassa) as translated into Finnish by the writer. The translation commentary first discusses a number of recurring and general translation points; the running commentary then analyses 77 individual translation solutions and their justifications. The writer uses introspection as a way of reflecting on her own translation process, its decisive points and the role of norms therein. Keywords: Translation studies, Carroll, norms

Arvoja näkyvissä : Kaunokirjallisuuden etiikka Ludwig Wittgensteinin filosofian valossa

The goal of this dissertation was to study whether it is possible and meaningful to apply Ludwig Wittgenstein s distinction between saying (Sagen) and showing (Zeigen) to ethically oriented literary criticism. The following questions were used as the primary guidelines: 1. Is it possible, in the context of literary criticism, to put in practice Wittgenstein s ethical conceptions, which are quite theoretical and metaphysical by nature? 2. If so, what practical literary devices do authors use if they want to demonstrate their ethical values within the frame of a fictional work? 3. Does philosophy offer useful ethical consepts that open us new and interesting readings in fiction? The philosophical background of Wittgenstein s distinction is clarified in chapter I. This clarification is based on his main works, Tractatus logico-philosophicus and Philosophishe Untersuchungen, the published correspondence between Wittgenstein and Paul Engelmann, and selected Wittgenstein research and papers. Analyzing ethics and it s expression in Georg Trakl s poetry further elucidates Wittgenstein s concept of showing. The concept that a literary work is an act of an author was used as a starting point. The presumption was that analyzing this act of an author will reveal how ethical values can be demonstrated in literature. Categorizing an author s act at different levels of literary expression provides the structure of this study. In chapters IV - XIII literary devices useful for demonstrating ethics are examined and explained using examples from the works of Joseph Conrad, Charles Dickens, Nikolay Leskov, Ludwig Uhland, Eino Leino, Pentti Haanpää and Maria Jotuni. The concepts and views of researchers and writers such as Mihail Bahtin, Peter Juhl, E. D. Hirsch, Peter Lamarque and Stein Haugom Olsen are used. The concepts outlined in previous chapters are then applied in three case studies: Aeschylus s Oresteia trilogy, J-L. Runeberg s poem Sven Dufva and Sofi Oksanen s novel Puhdistus (Purge). On the whole, Wittgenstein s idea that ethical values can be demonstrated (shown) by means of literature is revealed as a fruitful point of departure for a more exact ethical reading, offering a new perspective on literary works.